Inside the long COVID maze
Thresholds, January 2021

In March 2020, ordinary life stopped as COVID-19 cases soared, and regardless of whether we had direct experience of the virus, we all found ourselves plunged into a daunting present and an unknown future.

‘Midway along the journey of our life I awoke to find myself in a dark forest, for the straightforward path had been lost’¹

As therapists, we know the most desperate times can become a catalyst for spiritual awakening and personal transformation. We also know the right kind of support can make all the difference to the often-treacherous journey towards a person’s essential self.

Could an experience of COVID-19 be an accelerator of spiritual awakening, at a scale yet to be seen? And, if so, how can therapists respond to the need for holding when we also have a ‘present-time’ knowledge of this reality at a deeply personal level?

COVID: a personal experience

For me, COVID-19 was personal from the start, having been infected with the virus in early March. As a result of my own suffering, and a need to connect, I founded the first Facebook support group specifically for those in the UK and Ireland with COVID-19, or with an experience of the virus through someone they care about.

The journey of healing is often equated to a road or even a marathon. Yet healing from coronavirus is neither. Instead of being a straight path, it is like waking up and finding oneself lost and alone, in the middle of a maze.

Unlike a road, or even Dante’s forest, a maze has sharp corners and dead ends. There are times when all seems to be going well until the realisation hits that the path has doubled back on itself. While friends and family can stand on the outside, shouting directions or throwing in supplies, this journey is as individual as the person making it. And it can have very real psychological ramifications.

The initial COVID-19 virus and subsequent post-viral relapses can disrupt living with shocking intensity, effectively rendering the individual incapacitated, sometimes for weeks. The physical symptoms are compounded by the emotional impact of having an illness so new that it can neither be charted or accurately understood. The result is that sufferers might be left blaming or second-guessing themselves and enduring misunderstanding and dismissal from others. Not to mention an ever-present dread of reinfection. Is it any wonder then that this experience might prompt profound crises of meaning, as everything that once felt safe and reliable suddenly disappears?

Parallel process

Grief resides at every step. Every time a corner is turned, or the way suddenly appears to be going backwards, a new form of despair emerges, forcing a new reality and leaving a painful reminder of how much has been lost. However, grieving in all its guises is an essential part of the healing process, and each step, corner or turn provides an opportunity to integrate the experience of COVID-19. If acceptance can be found within these new limitations, so too can follow elements of purpose and meaning in this new reality. Even if just for a little while.

Spiritual awakening demands deep personal exploration. The courage and conviction required to transcend from the ‘known’, into the ‘unknown’ and forward towards the ‘not yet known’, makes the journey intrepid.

Irrespective of one’s personal experience of COVID, I believe that we are all now moving through a ‘global trauma’ where parallel process is not only inevitable, but inescapable. We are all having to face a loss of the known; where we must be willing to die to one story, to be ‘…reborn into a new larger story’.²

Roberto Assagioli developed psychosynthesis psychology and identified a common process of spiritual awakening, a painful phase of adjustment, then the lifelong process of character transformation in the light of the revelation of our deeper Self and the essential unity of the world we know (see table).³

Assagioli’s four-stage model of spiritual awakening

‘Symptoms of Psychological Disturbance’, adapted from ‘Self-Realization and Psychological Disturbances’ by Roberto Assagioli, Synthesis 3-4, 1977, based on the chapter of that name in Psychosynthesis: A Manual of Principles and Techniques, by Roberto Assagioli. Table reproduced with kind permission by the Institute of Psychosynthesis. © Institute of Psychosynthesis Manual.

The stages of awakening

During each stage of awakening, psychological disturbances may become so extreme that the individual could consciously or unconsciously attempt to step back into reenchantment, abandoning the journey altogether. And yet, with COVID-19, the journey is unavoidable and not simply confined to those infected. We are all in our own personal maze. Unless we willingly commit to doing more than attempting to survive COVID-19 – by working with it and developing our own higher potential – we may struggle to mirror our clients’ search for growth.

So, what happens when the therapist’s present reality is mirrored by the client who has come to see them? And how might this interpersonal and intrapsychic interplay become a tool towards an evolution of consciousness rather than a hindrance or something to fear?

First, we must continue to develop our conscious relationship with ourselves by welcoming every emotion, hook, projection, resistance and prejudice and giving them voice internally. In short, doing for ourselves what we attempt to facilitate in our clients.

Living through ‘global trauma’ could trigger a resurgence of memories of personal suffering, which may have long been forgotten. You may have already witnessed this phenomenon within the therapy room as much as in life in general. We need to remain alert to how parallel process might bring forth emotional flashbacks and how these could shift the balance and connection away from our essential self, reverting back to a sense of ‘defendedness’ and survival. How might we need to actively contain and soothe our own wounds in these darkest of times? And can we risk being visible with our vulnerability or struggle if required?

Risking rupture

Spiritual awakening often happens when every other path has been exhausted and when resistance is low. Both in clinical practice and in our own lives, it is the willingness to risk rupture in order to facilitate repair that nurtures trust, resilience, humility and compassion. These are essential qualities for spiritual awakening and for transformation to be integrated within the personality. It is through the conscious awareness of our own wounding, and the holding of those wounds with tenderness, that we energetically model this for our clients. As Spinoza wrote, ‘…suffering, ceases to be suffering the moment we form a clear and precise picture of it’.⁴

Next is the skill required to hold the limitations of clients with reverence and respect, while actively inviting these into the therapy room. This can be a client’s first experience of the honouring of their inner values and boundaries. The invitation for one’s resistance to have an active place in the room can galvanise the client/therapist alliance. It also recognises that self is present within the resistance.

As COVID-19 is a mutual happening, there can be benefits to being candid about our own limitations when and if appropriate. It is essential to exercise the utmost discernment with this intervention, and it should be used only after earnest reflection on the potentialities for harm and the eternal question ‘for what?’. Yet, such a risk can provide ground for tender exploration in service of the client’s journey of awakening.

In my case, I decided I needed to reveal this personal vulnerability to my clients. I was very ill. The options were ending the therapy completely or inviting my quandary into the room. Although not hospitalised, I stayed at home struggling to breathe and function. I was working on a thesis but as COVID-19 consumed my body, my feelings and thoughts faded away, as though someone had suddenly turned the sound down on them.

I had wondered what would happen when I faced this situation in the therapy room. What terrible consequences might arise if I suddenly needed to cancel a session? I was faced with proof that the ideal of being the blank slate, or the perfect external unifying centre, was not going to work.

Instead of causing irreparable damage to the therapeutic alliance, my willingness to risk showing the destructive and frightening impact of COVID-19 on me had surprising consequences. Witnessing my fallibility invited my clients to see and honour their own; and to ‘rise to the occasion’ and find resources within themselves. Inviting my clients to wonder with me what we would make of the impacts of this situation together, allowed them to voice their anger, to find repair in new and unexpected ways; and to evoke will and make choices. And what of those times in their history when clients ignored their needs in favour of survival? Suddenly, with me not doing this, clients were called to take their own needs more seriously too, again with choice, connecting to something more than survival.

Deepening the therapeutic bond

The acceptance of loose ends and imperfect relationship not only deepened the therapeutic bond, but further illustrated how the perfect known is neither real nor sustainable. I needed to be willing to face the stark reality of my own suffering for clients to see that annihilation might not happen if they faced their own.

Months have passed, but there are periods when I am pulled back into illness. Perhaps in years to come, we will understand why and how the relapse happens; however, for now, there are times when I simply must choose to stop. To attempt to see clients would be a disservice to the client, at the sacrifice of myself.

When Dante meets the spirit of Virgil in the forest, he hears the immortal and eternally soothing phrase, ‘I will not leave you to wander this underworld alone’.⁵ In some ways, we are all in the underworld together, and all simultaneously alone.

The support group I created has become a lifeline for more than 3,000 members who have found a space for solidarity. In this community, they can begin to hold and value their authenticity, voice their truth in all its ugliness, and be honest about the darkness they find themselves in. And rather than berating the body for its failings, many are becoming skilled at listening to the sound of their body’s ‘no’ and treating their felt experience as a trusted and valued friend, who is most definitely human and doing the best it can.

To connect with inner values and be open to something that is yet unknown is to surrender to the deeper Self – the ‘more than we rationally know’ within us. It carries us through life’s trials. Members illustrate through their own journeys that such a connection brings a discovery of the capacity to hold oneself with tenderness in suffering. It also starts a burgeoning dialogue with the calm and grounding voice of the wisdom within.

These elements can also support our clients in therapy as they find their own definition of self-care and move into relationship with themselves.

We may not be in the maze with our client in the physical sense, nor can we aspire to ‘fix’ the more drastic physical impacts that science is still to catch up with. But we can cultivate compassion in the face of physical or emotional relapse and demonstrate a willingness to ask, ‘What do I need in this moment?’ This clears a path to spiritual awakening and new perspectives via the shifting relationship to Self. And suffering, while perhaps not welcomed, can be better tolerated as part of their process. But first, it is essential for us, as their therapist, to do the same. In this way, the parallel process can facilitate authentic mirroring, holding and guiding an awakening within the client in a parallel journey.

Supporting the disidentification process

For where there is space for humanness, so too will we find honesty, a joyful spirit, humour and curiosity. These qualities further help the disidentification process, which involves not being so consumed by the ‘fight, flight, flee or faint’ survival responses, but instead being alongside our own suffering, resting within the window of tolerance⁶ where we can remember who we are. As space is created for vulnerability, we shift to a place where wounding can be seen differently. Houston writes: ‘The wounding becomes sacred when we are willing to release our old stories and to become vehicles through which the new story may emerge.’²

We don’t know how this COVID-19 story is going to end. However, what remains clear is that, not only can the psychotherapeutic process be invaluable to support spiritual awakening through a global pandemic, it is essential to find ways to creatively attune to our clients, wherever they are in their maze.

Moreover, if we can bring the willing intent to remain conscious of our place within our own maze, we can then meet the client as never before; trusting that, in both cases, the spiritual essence of Self will lead the way.