Teenage regression in confinement
There’s a haunting familiarity to this confinement. I began to recognise it about two weeks in. I was acting out in ways I haven’t done for years. I felt endlessly hungry, though I was stuck at home barely doing any exercise, whereas usually I would walk miles to and from work. It was not a physical hunger I was experiencing – it was an emotional one. Triggered by the impotence I felt when reading the news; my fear for the future; my sense of suffocation at being locked inside. I was craving sugar, cream, melted cheese – the very foods I used to binge on as a teenager. It was as if I had gone back in psychological time.
Now, of course, it is obvious to me what was happening. At the time, I just felt extremely stressed and out of control. My nervous system was on overdrive. Every time I looked at the news, my deepest fears were being played out. I could not protect myself or anyone I loved from this terrifying, inexplicable threat; the world was imploding and would continue to implode in multiple, unimaginable ways. While my world was collapsing around me, I felt properly trapped: in Spain we are allowed out only to buy crucial items; we cannot do outdoors exercise and all the parks are closed. It is hardly surprising that I had begun to comfort myself with food the way I comforted myself as a teenager. I remember how impotent and boxed in I used to feel when I was fourteen, fifteen. I could not predict when my mother would lose her temper; nor could I help her out of one of her slumps. I could not take away our financial problems. Crucially, I could not move out to live on my own. I had to survive within the family I had been born into. Therein began a highly unhealthy relationship with food.
As the weeks have progressed, I have observed this same tendency in my clients: a regression to adolescent behaviours, triggered by the COVID-19 threat. Like powerless teenagers, we can neither fight nor take flight; in fact, we have no choice but to obey and stand still. The result on an emotional level is a rollercoaster of emotions. One of my clients had a vivid nightmare only a few days ago: a flashback to a very real scene from her childhood. A childhood in which the parent-child role was reversed early on. In the dream, she was fourteen or fifteen, sat beside her dad in the car. ‘He was smoking,’ she says. ‘I felt sick. I asked him not to smoke. I told him it was making me ill. He said I could move to sit in the back if I didn’t like it. When I woke up I had this burning anger in my stomach. I was tossing and turning for hours.’
She tells me then about the binge-eating she’s been fighting on and off for years; that it’s flared up during the confinement. It began in her teens. Her parents were broke and food was short; she used to eat for comfort. Now, whole days in a row she can’t control it. She’s been hiding it from her husband, the way she used to hide it from her parents.
This commonality in our emotional reactions to COVID-19 has made me reflect on how the therapeutic process is changing the more the confinement persists. We, as professionals, are living through a collective trauma with those we are supporting. There is a kind of levelling in our relationship as a result. Part of each session is spent sharing what we have heard; exploring what ‘normal’ might now look like; pondering how much longer they will keep us locked up. My clients ask me how I’m feeling in a way they've never asked me before. I’ve had to get used to this: as professionals, we are trained to give very little away. But when the threat is so universal, the connection has to change in its quality. We cannot fake it. More than ever, I have to take care of myself if I’m to take care of others. I cannot let my teenaged defences run riot if I am to help others keep theirs at bay.
There was a stark observation early on in the media coverage of COVID-19: that it acts indiscriminately. It kills the poor; it kills the rich; there is no one who might be spared. But we must not forget that there are sharp differences in how we might come out of this. There are those who don’t need to work and have savings that will last for years; there are those who are being forced to work in close proximity with others, even without protective clothing. There are those, who, like myself, are able to work from home. COVID-19 and the crisis it will leave in its wake is not indiscriminate. Having said this, we are all human. We could all die. We could all lose close relatives and friends. When we emerge from this crisis, we could all find that no one can afford to pay for the services we have to offer. This is where the crisis is levelling.
All my clients are expatriates. During COVID-19, many of them have found themselves longing to go back to where they came from; or, at least, to be more in touch with their families, even if those families are problematic. Whatever has compelled them to live abroad, often moving from country to country over the years, there is a common thread in their stories of adolescent restlessness or discontent. Of course, the difficulties may have begun earlier – in the quality of their early childhood attachments; but in the current situation it is the memories of the teenaged years that keep coming up.
One long-term client took drugs this week after months of not taking any. She was triggered primarily by a huge sense of worry that her dad back home could get the virus. The comedown made the worry worse and the subsequent anxiety has been overwhelming. She has struggled to sleep. In our latest session, we did some breathing and I asked her to tell me where she was feeling the anxiety in her body. She said she felt it in her stomach. I asked her whether there was a colour, a texture, a sense of place she associated it with. She said, ‘It’s a smell. That’s what it is. It smells like a hot water bottle. The hot water bottle I used to have at my dad’s house. I was fourteen.' She opened her eyes then, clearly distressed: the association was too much for her. As an aside, I've been reminded several times recently that when trauma is current, we must be careful how deep we dig as therapists. But the point here is that those years – thirteen, fourteen, fifteen – are what keep on resurfacing time and time again.
A client only yesterday told me that she has been having the strangest sensation of embarrassment that reminds her of something she has not felt since she was an adolescent. She might be sitting at the kitchen table writing, and suddenly this physical feeling comes over her. She does not know what she has to be embarrassed about. She is eight months pregnant and handling the confinement remarkably well. She lives alone with a loving partner. I ask her what it was in her teenaged years that made her embarrassed. 'There were times when people – always men – made inappropriate comments about my body. It was always that. I wasn't ready to hear it. But why has it come back? Obviously no one is saying anything inappropriate. It feels so teenaged!'
I have several clients who travelled home to their parents the moment they knew the lockdown was coming. Already adults and used to being autonomous, they have quite literally regressed in their return. It might be said that, as a result, they are living two crises simultaneously: fighting to keep their hard-won independence within their families, where they are still seen as children; and facing all the restrictions and uncertainties that COVID-19 brings with it. This double claustrophobia is having quite interesting effects. One client who suffered from extreme anxiety before the lockdown speaks of feeling trapped and stuck. Of being unable to breathe, because she cannot escape her family. Yet, she has also begun to see more clearly who she is. For the first time, she has talked about being on the wrong career path and wanting to make a big change. After our last session, she intended to tell her parents about this wish, something she had previously been terrified to do.
Another client asked to bring his mother into his next session. When he was a teenager, they had a difficult relationship. Back home now, he has been finding her passive aggression and the tensions within his family maddening. He has had moments of regretting going home at all. Yet he decided to use this time to work on their relationship. The session with her went well. There was an honest communication that concluded with a commitment to see each other as adults; to support each other more within the family; to go on their daily walk together and use that time to talk.
This week I was reminded of just how traumatic what we are living through is; how extreme the conditions are. I was reading The Body Keeps the Score by Bessen Van der Kolk. There were two paragraphs that stood out for me:
‘Where traumatised children are concerned, the last things we should be cutting from school schedules are the activities that can help them move out of fight-or-flight states: chorus, physical education, recess, and anything else that involves movement, play, and other forms of joyful engagement.’ (p.349)
‘People who feel safe and meaningfully connected with others have little reason to squander their lives doing drugs or staring numbly at television; they don’t feel compelled to stuff themselves with carbohydrates.’ (p.351)
During this period of lockdown and isolation, faced with a terrifying invisible enemy, we are deprived of many of the best means we have to cope. We are unable to go outside and get exercise; to feel free even in the simplest ways, ways we used to take for granted. We are unable to engage in spontaneous human connections beyond those within our own flats, or those we find via zoom. This is why it is a collective trauma of a dimension we have never known in our generation; this is why it is being compared to a war.
What we can do is focus on what is within our control: eating healthy food; not snacking between meals; having regular zoom calls with family and friends who nurture us; avoiding or at least minimising alcohol and caffeine; finding an indoor exercise we enjoy and can do regularly. Lastly, and perhaps most importantly, we must prioritise sleep. In all of this, we become the parents to ourselves that we did or did not have when we were teenagers. And, of course, all of this is easier said than done. If we struggle, we should strive to be compassionate towards ourselves, too; to understand that what we are living through is extraordinary. That our reactions, no matter how extreme they seem at times, are normal. We are experiencing an overwhelming response in our nervous system. If we were not experiencing this, we would not be human. We would be numb.