Sarah Waters is an adult psychotherapist who also specialises in Dyadic Developmental Practice (DDP) 1 which is attachment focused family therapy. She is a member of HART Group 2 (Health Advisory Recovery Team) and is on the steering group of Therapists for Medical Freedom3. Both include psychological experts that share concerns about policy and guidance relating to the COVID-19 pandemic.
The following is a story presented in a particular form of narrative research, where findings from the therapy room are presented in a fictional format to explore clinical processes and ethical dilemmas– all of the characters and the situation itself is entirely fictitious – no client confidentiality has been compromised.
Within the piece, Sarah has explored what it might have been like to encounter the behaviours and rituals required by COVID-19 health advice & mandates in a world before COVID-19. What would we have made of them in 2019 as counsellors and therapists? If you were to strip away the fear of a virus and the media-led normalisation of the bizarre rituals that have now become part of our everyday landscape – what might our reaction have been to encounter a fixation with mask-wearing, germs, constant handwashing, testing, surveillance and enforced social distancing?
Without the endless media messaging which links the behaviours to virtue and safety, might we have been able to see more clearly the profound harms being caused by the measures, and been more honest with ourselves as a profession about the way they can be detrimental to both client and therapist in the relational work we do?
These are important questions to sit with as you read the following piece:
A therapist’s duty of care……
It is January 2019, and I am waiting in my therapy room for a new client, Daisy, who is 12 years old and being brought in by her mother. I am an experienced therapist, working for a charity supporting children and adults who are affected by Domestic Abuse:
When they arrive, I am startled and alarmed to see them both wearing masks, plus mum has brought her 6-month-old baby with her. Daisy looks pale, thin and her eyes are full of fear. They both seem terrified to take their masks off when I gently ask if they would like to. They sit down on the small sofa opposite me and huddle together.
The masks create a barrier and I find it very difficult to hear what Mum is saying, let alone start to forge a therapeutic relationship, as face coverings are so alien to human interaction and psychological safety4.
Daisy sits quietly and holds the baby whilst mum explains why she feels her daughter needs support. Daisy was once lively and vibrant, Mum says, but has lost her joyful zest for life. She spends most of her days in her room either behind a screen, or listlessly, lying on her bed. Even when she is ‘allowed’ out Daisy feels fearful being around other people, in case she infects them.
“Infects them with what?” I gently ask her. Daisy looks down, lacking the confidence to speak. Mum explains that her partner, J, has increasingly become obsessed with illness and dying, demanding that they all wear masks and stay away from people. J says they must sanitise everything they touch and test ourselves repeatedly with some plastic, test kits that had been ordered from China.
J expects all in the family to stick these tests up their noses and down the back of their throats, sometimes every day. Mum is worried that Daisy is now starting to show signs of OCD and health anxiety. Mum also explains that she’s concerned about what is in the test kits5, and whether they even worked? Some days they tested positive but had no symptoms at all and on other days if one of the family had a cold or felt a bit unwell, the tests would show a negative result. Mum sounded so very confused by it all….
As the story unfolds, I become more concerned by the minute. I’ve done a lot of Domestic Abuse, Attachment and Trauma training over my 20 plus years of working as a therapist and all my alarm bells were ringing, very loudly. The description of their daily lives just gets worse:
..J, who before this had been outwardly trustworthy and caring, insists it is for their own good and that if they don’t follow the rules they might die or kill others. J told them that the illness didn’t really affect young people6, but that Daisy could pass it on easily, particularly to the elderly, even if she didn’t have symptoms herself. Mum explained how bewildering it all was, as she had never known of an illness before that could be passed on if you didn’t have any symptoms. However, Mum and Daisy have always trusted J, so they go along with what they are told to do, even though it was damaging Daisy’s mental health and was making Daisy’s asthma much worse.
The fear messaging never stops, Mum continues, it is repeated, every day, all day. Life is dangerous, they must follow the rules or very punitive measures would be put in place. Posters have been put up in the house telling them what to do, they couldn’t get away from it. The messaging has been going on and on for months and months without break. Neither Mum nor Daisy are allowed to speak to any friends or family who don’t believe in the illness. J even tracks their phones to make sure they don’t go anywhere or speak to anyone who doesn’t think like they do – it is a living nightmare.
Several things are running through my mind at this point as I try to understand the story that comes tumbling out, muffled behind the white paper mask. Is this a case of Factitious Disorder Imposed on Another7 (Which used to be known as Munchausen’s by Proxy) in which a parent fakes or induces illness in their child? Or is this a form of narcissistic abuse8, in which reality distorting, isolation and learned helplessness are well-known hallmarks and something I hear about on a day-to-day basis? My heart goes out to Daisy and the baby, who should surely be protected from this abuse, and to her mother, who seems completely hypnotised9 by her partner. A web has been spun around them all, justified to keep them and others safe:
…Mum goes on to explain that J is a good person, has provided for them financially and has always seemed to have their best interests at heart. Plus, J speaks with such urgency and conviction. Mum had trusted this person for so long and yet now many things just do not make sense. Why would J want to harm her and her two daughters after looking after them so well for so many years?
I wonder how Daisy’s mum can allow this to happen and not see the terrible damage that it is doing to her daughters. Her fear levels are so high she doesn’t seem to be able to rationalise what’s going on. I remember a video I watched the week before about the reptilian brain10 and how being in fear limits being curious, open, and engaged. It keeps us stuck in survival mode. I also know how difficult it is for those subjected to narcissistic abuse to have a real grasp on reality.
Even if there is an illness out there that affects mainly the elderly, treating a young person like this must surely be a form of child abuse? What I am witnessing feels so manipulative that Daisy and her mum are oblivious to the fact they are experiencing abuse at all. The more I think about it and the more Daisy’s mum speaks – I know that this is a very clever form of narcissistic abuse. However, the physical masking and constant testing is something I have never heard of before. It does chillingly remind me of Baderman’s Chart of Coercion11. This describes communist methods for eliciting individual compliance used by the Chinese and Koreans against the American soldiers in the 1950’s. It is so cruel and potentially damaging on every level of development – both physical and emotional. Treating a young person like this is just not acceptable in the year 2021, surely?
My trauma training (and intuition) emphasises the necessity for safety, love, acceptance, connection, close relationships, play, empathy and most importantly, the absence of fear. All these are necessary for healthy emotional development. What I am witnessing here is the total opposite of that. Bowlby, plus all child development experts that have followed him, have emphasised time and time again that children are extremely vulnerable, but they must be resilient to survive. I can’t help thinking that he would be turning in his grave! Poor Daisy and her baby sister are clearly adapting in various ways to the hostile environment they are in, to ensure their own survival. They may be permanently damaged by this. I feel sick to my stomach.
Looking at the confused face of the baby as it searches its sister’s and mother’s masked faces for comfort, my mind flits to the attachment workshop that I attended a few years before and I remember watching the video of the Still Face Experiment12. It showed the devastating effects, in a very short time, on a baby whose mother stops smiling at it for only a few minutes. This poor baby would have great difficulty in determining what facial expressions J, Daisy and Mum would be exhibiting behind their masks which surely will present severe challenges for it as it grows up. Babies particularly depend on their parent’s facial expressions, coupled with tone and/or voice to regulate their reactions toward others.
I wonder if J understands the potential effects of prolonged mask-wearing? Or has thought about the potential long-term impact on the baby’s development? Maybe the threat of getting ill overrode all these concerns, but in my book, this is just not good enough. Surely baby’s emotional development must come first. The room soon fills with crying as the baby becomes completely dysregulated and inconsolable, unable to feel safe in the room, as it cannot read the cues of its mother’s blank and expressionless face. A baby’s worst nightmare has, it seems, come true.
I switch my concern from the baby to Daisy, common sense telling me that wearing a mask all day, or even for a few hours, could surely not be good for her13, emotionally or physically. It must be restricting her breathing and reducing her oxygen intake plus possibly infecting her with expelled germs. Goodness knows how it will be affecting her immune system. On top of this, not being allowed out much to breathe fresh air and being separated from her friends and family, is a complete and utter recipe for disaster. With the persistent use of toxic sanitiser and being full of fear, I can’t think of a worse breeding ground for sickness.
My mind is racing about all the physical consequences that it hardly has space to think about the emotional. What must this poor child be going though? Surely her emotional development will also be affected, especially as her mother and partner are also wearing the masks. My mind flits to Steven Porges Polyvagal Theory14 – a subconscious system for detecting threats and safety and what he terms ‘neuroception’. Poor Daisy’s sympathetic nervous system must be being constantly activated by the fear messaging she is subjected to, day in day out. The potential long-term consequences of this make me shudder.
Surely this is not all being done on purpose I think to myself – no one could be so cruel, surely?
I now recall my knowledge around narcissistic abuse and emotional blackmail. It is another tell-tale sign that I know from experience is intended to elicit feelings of fear, guilt, and compliance. This is precisely how Daisy, and her mum are feeling. They are being gaslighted, which leaves them second-guessing, doubting reality, and their own judgements or perceptions. It sounds highly psychologically abusive, and dangerous to me. J is trying to isolate the family by keeping them away from others and demanding they stay 2 meters apart if they do meet anyone.
I know from my experience that this gives abusers a sense of control and power. It describes the split and alienation the narcissist will create to set their victims apart from others. This is often done through division and bullying. This serves to weaken and isolate leaving it easier for the narcissist to maintain control in the dynamic of the relationship. Abusive partners (or governments), aim to achieve this in a variety of ways. These include: trying to be seen to have another person’s best interests at heart, but through negative judgements and manipulation, slowly aiming to keep them away from loved ones. This creates an unhealthy over-reliance/dependence on the perpetrator. This behaviour instils a form of trauma bonding15that is very difficult to break. The conditions for this to take place are to be threatened with, and to believe, that there is a real danger. This is coupled with harsh treatment interspersed with very small kindnesses, isolation from other people’s perspectives and a belief that there is no escape.
Everything Daisy’s mum is pouring out to me in our session suggests to me that this is what is going on.
Judging others is another defence mechanism commonly seen in narcissistic abusers: they will comment, both negatively and harshly, on other people’s actions, choices, speech, and beliefs. Passing judgement on others serves to make them feel better about themselves and helps them to maintain a position of superiority. I am thinking about this at the same time Mum is telling me that J had more recently started criticising everyone outside the family that doesn’t believe in what J is saying and about the illness. Apparently, J is making out that everyone that doesn’t follow the same safety practices as them are are unclean, spreading germs and should be locked up! The list of narcissist characteristics goes on and on. Finger-pointing, lying, projecting, not taking any responsibility, slander and withholding. This is really one of the worst cases of psychological abuse I had ever heard about.
As we come to the end of our session, I gently ask Daisy’s Mum if she has thought about leaving J and taking her daughters with her. From her passive response, it is obvious that she is in a state of learned helplessness16. This occurs when an individual continuously faces a negative, uncontrollable situation and stops trying to change their circumstances, even when they could do so. I gently explain to her that I will have to report what she has told me to the local safeguarding team as a matter of urgency. This is my duty as a therapist when told about any form of abuse towards a child or young person. She was informed of our safeguarding policy prior to our appointment so is aware that confidentiality is waived in such circumstances. She looks at me with her large, fearful eyes and I can see that deep down she knows that what is happening is very, very wrong. I can sense she feels grateful and relieved, as finally a trained professional is now going to take charge and call out the abuse.
Mum, Daisy and the baby leave the session and I immediately pick up the phone, my inner supervisor telling me this must be done straight away, no questions asked. I make the call and it is recorded. I am assured that it will be dealt with as a matter of priority. The trained social worker at the other end of the phone is as shocked as I am. At last, I reassure myself, this young family will now get the help and support they deserve in the face of such shocking violations of everything it is to be human.
Covid Rules are blamed for 23% dive in young children’s development – with face mask rules among possible culprits17
Only six healthy children died of Covid in a year, but lockdowns fuel a youth health timebomb.6
The damage of masking children could be irreparable.13