Interviews with working professionals most affected by the world’s current state.
“My name is Monika Sharma, I am 48 years old.”
Q. What do you do professionally, Monika?
I am a licensed clinical psychologist in downtown Chicago and the owner of NVision You Holistic Psychotherapy Services. I have a team of 7 full-time therapists, 3 graduate student interns, and an office manager.
Our clients come to us to help cope with difficult life situations involving home, work, relationships and dating, motivation, anxiety, depression, grief, body image, and performance. We offer counseling to individuals, couples, and teens, as well as hypnosis to help our clients address their concerns and achieve their goals.
Q. How has your work been affected by the COVID-19 most recently?
Around March 5, Chicago and Illinois began making rapid decisions to shut down schools and businesses. Colleagues and I spent a week in a highly anxious state, listening to the news, trying to determine whether to continue working with clients at the office or start offering teletherapy (therapy through a live video connection).
I wanted to make sure we continued to get paid in order to mitigate our own financial hit. Insurance wasn’t openly covering teletherapy at that time, so that was a concern.
My biggest priority was how to take care of my staff and our clients’ physical health, while continuing to care for their emotional health.
Right after St. Patrick’s Day, Gov. Pritzker gave the order that all bars and restaurants will no longer be open for dine-in service. Schools were already closed. I knew that we had to move the whole practice officially to teletherapy beginning 3/15/20 and take the risk we won’t get paid by insurance. But I made the decision on faith that Illinois mental health professionals would fight and win to get coverage during the Covid-19 crisis.
Thankfully, my practice already had a HIPAA-compliant platform in place to do video and phone sessions, so we didn’t have to scramble to find this like many other therapists had to do.
We experienced a slight dip in our client numbers from clients who preferred to wait until they could return to the office, but most of our clients chose to work with us through the Covid-19 crisis via teletherapy.
One surprise is that some of our clients feel more free to open up and dive deeper in their own emotions since they are speaking with us from the comforts of their own home.
However, as therapists, we are feeling some screen fatigue and are working to manage our own questions, life upheaval, and emotions alongside our clients. Most of us are looking forward to being back in the office with our clients and each other, but can see ourselves offering teletherapy regularly moving forward for clients who find it difficult to come in. There are certainly some perks in that our clients are able to commit to seeing us when coming to the office has been difficult due to kids, travel, traffic, and work.
Q. How have these changes affected you personally?
Like many people I know, I have been on an emotional roller coaster since Covid-19 became a real threat to us locally. I’ve felt anxiety and sadness realizing the seriousness and scope of this virus on our loved ones, community, and economy. I feel grief that things won’t look the same, even when we begin to rebuild from this. I also feel a surge of clarity on what I want my life to be about.
In 2014, I decided to become a Single-Mothers-By-Choice (SMC), and now have a 5 ½ year old curious, high energy, mama-adoring, lovely little girl.
Prior to the Covid-19 crisis, like so many people, I was caught in the frenzy of “Go! Go! Go!,” always racing against the clock to get to the next activity on time (and we still always ran late). And because I bought into the lie of “not enough time,” my daughter and I were always rushing through our morning routine, our dinner routine, our cleanup routine, and our bedtime routine. I was doing it all solo, sequentially vs simultaneously like some 2-parent households, and so time was legitimately a commodity. One of her biggest complaints was that I never play with her. She was right!
This imposed pause has allowed me time to spend quality time with [my daughter]; playing, talking, and inviting her into daily activities like cooking and laundry with me.
Q. When did the gravity of this situation hit you?
On March 11, I had a conversation with a local friend of mine who is a doctor in infectious diseases. She explained what Covid-19 is and its trajectory in a very straightforward way.
My parents are in their late 70’s and live in the Chicago suburbs. I realized that they are highly vulnerable to complications and fatality with Covid-19, and that’s when it hit me. I decided I would not visit them anymore. I usually see them once per week, and I haven’t seen them since March 1.
But they have been staying home, and I feel reassured that they are safe which makes missing them worthwhile. My parents have friends whose son (who I’d known as a kid) suddenly collapsed dead at home two weekends ago from Covid-19. He was living in Florida, and they had not taken the same precautions we’ve taken in Illinois. That was a second wave hitting me of how serious Covid-19 is.
My parents’ friends are in shock and grieving their son’s death alone, and none of their friends can be with them through their grief.
When I think about how many people are isolated through their sickness and grief, it breaks my heart. Losing someone you love is tragic enough. To not be able to mourn with the support of family and friends, to not participate in the rituals that help say goodbye, bring closure, and begin healing…that is an added layer of trauma to the reality of this crisis. It hits deep and tears at the heart.
Q. What resources are in place to help you and your staff do your jobs?
We are fortunate that we are able to continue providing therapy from home with some minor adjustments on everyone’s end. We had the HIPAA-compliant telehealth system already in place. I’d already gone through a training and was able to quickly guide my staff through telehealth best practices. And we all have a place from home that provides privacy, which some families don’t have. With insurance covering teletherapy through April 30, it buys some time to provide near-seamless care to our clients during these stressful times. We will have to fight to get insurance to continue coverage beyond that date.
Personally, I’m in a rare and fortunate position because I hired an executive assistant/office manager in December 2019. She lives within walking distance from my home and has prior nanny experience. When we decided to close our office doors during this pandemic, I asked her to come to my home and work from here. She has been a godsend! I’m so grateful to have her do administrative work from my home while helping care for my daughter so I can see my clients uninterrupted and have the mental space to continue making decisions regarding the business.
Q. What are your predictions for your small business in the next 4-6 weeks?
For April 2020, we should have teletherapy services covered by most of our clients’ insurance policies. However, moving into May, many of our clients may not be earning money or may no longer have insurance coverage. During these times of global uncertainty, isolation and loss, we would like to be able to continue providing low-fee and pro-bono therapy to our clients who could otherwise not afford to keep coming. I’m hoping our revenue remains relatively stable or we get some small business loans in order to provide this while paying for our payroll and operating expenses.
Based on recent statements by Governer Pritzker and our mayor, Lori Lightfoot, I don’t anticipate that businesses will be opening on May 1, 2020; at least, not business as usual. I’ve been thinking about what to do should they start slowly opening operations.
I don’t see us returning to the office to see clients right away because our offices are small (9’x12’), and there is no way to maintain social distance.
Many of my therapists have expressed the desire to return to the office and provide teletherapy from there because at least we can safely be with each other.
We all miss each other.
Q. How are you helping clients manage their anxiety and uncertainty? How about for yourself?
Some of our clients are really struggling through the quarantine for so many varying reasons… from isolation if they are living alone to the need for space if they are living with others; anxiety over the health of themselves and loved ones to anxiety over the health of the world; fears of their personal and global economic situations; how to manage home-schooling and caring for their kids while still working full-time; feeling pressure to “do more” with the time that has opened up in their schedule when, in fact, it’s perfectly ok to “do less”; concerns about gaining weight and becoming less physically fit than typical; and an overwhelming sense of grief over losing the way things were and may never be again.
We learned for ourselves and have been advising our clients to limit our exposure to the news. Consuming news throughout the day increases feelings of anxiety, uncertainty, and fear. We get all the information we need in about 10 minutes per day, and we encourage our clients to limit their news to that length of time.
We are also encouraging clients to find activities that bring us joy, creativity, vitality, nourishment, connection, and restoration. Our body truly responds to what our brain feeds it, and we can choose where to place our mind’s gaze. There is so much we can’t do regarding the state of our world right now. And yet there is also so much we CAN do regarding our day-to-day physical, emotional, and relational care.
We still have a lot of power right now. Can we recognize it and use it?
My team and I are planning to create a free live stream series called The Pandemic Cause, starting on Thursday, April 27 via Zoom. We plan to cover topics that we are hearing from our clients and experiencing for ourselves, and will invite experts in various fields to add their perspectives. It will give an opportunity for attendees to ask their questions, and we will make recordings available to those who can not attend.
Q. What tips do you have for those working in the mental health field during this time?
It is important to recognize our own needs for self-care. Everything our clients are coping with, we’re coping with those things too. It’s okay to not have answers. We are all in new territory, and we are figuring this out together. Be compassionate toward yourself, and bring that compassion and empathy in working with your clients. We are all humans, and we are all experiencing human vulnerability and frailty. It’s our humanity that can be most powerfully healing right now.
Feel free to leave Monika a comment below!