5 Local and Global Things To Remember Now

Last Wednesday, working at my computer, I happened to catch Aiysha Malik, a Mental Health Officer at WHO in Geneva on Twitter doing a live Q & A about mental health and #Covid19. I know Aiysha from other projects at the UN level; I recognized the hallways and workspaces where she was filming, because I had worked in them, too. In the clip, which I encourage you to
watch, Aiysha talks about all the things systemic folks know and all the things systemic folks do, including the use of language to de-stigmatize, how to talk to children during the outbreak, and how to be reflexive in your self-care. Systemic family therapists often don’t realize all the ways we are recognizable at the global level. If you listen to Aiysha, you’ll see us, too. Indeed, Ms. Malik is one of many people I’ve met at the UN level who is intimately aware of the implications of applied systems thinking, and how families and family therapy are such a key part of any one person’s mental health.

As I watched and listened to Aiysha, I thought: I would love to see my fellow family therapists looking and listening and thinking about this kind of outreach, perhaps using it to augment their work during #Covid19, and then perhaps creating moments of their own, to be shared and exchanged for our learning. There are many things we cannot control at the moment, but also, many things that we can. We benefit in times like these to see and share important outreach and leadership between us, in AAMFT, from local and regional bodies, and within our own individual communities. No matter if our primary world is digital or analog, or our geolocation is here or there, or quarantine or isolation or six feet of separation, indeed we are all in this together, as the Director General of WHO put it in today’s situation report.

My clients, my students, my family and loved ones are all trying to sort through how #Covid19 is going to affect their lives and their everyday world. I am wondering a few things, myself. Amidst the uncertainty, it helps to take a breath and remember: I’ve learned a few things over my career as a family therapist. If you are a systemic clinician in the world today, you have learned a few things, too—even if this is your first pandemic. In fact, absolutely everything you do locally as a systemic family therapist also has its concomitant international parallel, on the global level.

Here are five things that matter right now, in the work of systemic family therapy at the local level, and also, our shared global one:
(1) Inherently, systemic family therapists profoundly understand the mutual interdependency of our lives and behaviors, and the relational spaces between them. This idea feels like an especially vivid truth right now, as we face #Covid19. Our health is relational; our well-being depends also on the well-being of others. This is as meaningful in a family session as it is during a global pandemic.

(2) In systemic work, our outreach is through our engagement with others. Our work happens inside relational spaces, and these days, these ‘flatten the curve’ days, those connections can be enriched through dedicated, purposeful, virtual outreach. This virtual connecting is especially profound during a crisis. I learned this very sharply a few years ago in my work with Syrians during the Syrian war; the powerful virtual worlds we created together—our relational space as a team—were essential  to support the work we were doing with families living in extreme adversity.

(3) All of us, as systemic family therapists, are accustomed to working with clients and families within some degree of extreme adversity. You cannot be a family therapist and not know deeply some degree of the pain and suffering that can happen in families. Pandemics are, by definition,  extreme in their adversity. The magnitude of it may be unfamiliar, but its nature is not. That is important to recognize.

(4) We all live in virtual communities to one degree or another. In an emergency, adversities are heightened, and responses to them must be combined with other efforts that can match the dynamic nature of the disruptive events. In this pandemic, that means virtual work—be it online teaching, telemental health, WhatsApp peer groups, or any infinite number of ways we use our digital communities to thrive and survive.

(5) Digital communities and creating and maintaining meaningful relational process inside them is critical in emergencies. You may not be used to using them the way we now must rely on them, but you can bet that your peers who have lived or worked inside epidemics and pandemics, war and conflict, or other humanitarian disasters on one side of the globe or the other, do. Let’s learn from them. How can we scale up our everyday skills to work within that world? For instance, I started seeing clients virtually on several telemental health platforms last Fall; however, my online presence as a therapist has already taken on a new meaning in the pandemic. Responding to the outbreak, my home state of Massachusetts is now expanding Telehealth services to the 1.8 million people covered by the state’s public health insurance. I expect this to increase in demand and response during this outbreak, and also, to see its eventual inclusivity of mental health, for there is no health without mental health.

Last Monday, I called my colleague Saliha Bava, to talk about an upcoming presentation we will do at AAMFT 2020 in Orlando in November. We hadn’t talked in a while, so we chatted socially for a bit; I was on my way to Asia for a project, and Saliha, busily on sabbatical, was working on her fascinating research. Today, both of us have had our plans upended, just like the rest of the world, and things do not look the same as they did last week. As we revise what the next six months will look like, we need not stop our work; we adapt it. For instance, Saliha started putting out brief, useful, clips on her Youtube channel, focusing on guidance for professionals and nonprofessionals about how to manage the uncertainty and relational complexities during the outbreak. (I’ve already forwarded one of her videos to my students). I’m writing this, and by doing so, hopefully inviting all the very interesting systemic clinicians I know to also contribute their leadership and ideas about how they are doing their outreach, inventiveness, and relational spaces during this remarkable moment we are living in.

Everything that we know and do as a systemic family therapist in our own local community has its parallel at the global, international level. We may not have quite seen it as clearly as we do today. I hope we do not forget it.

Written by Laurie L Charlés, PhD, LMFT.

Laurie L Charlés worked as a consultant for the World Health Organization Mental Health Response team in Conakry, Guinea, during the Ebola Virus Disease outbreak in 2015. She is currently writing a book for family therapists interested in working in global mental health, to be published by Routledge later this year. She is an AAMFT Clinical Fellow and Approved Supervisor.