COVID-19 Systems and Families: Acknowledging Loss, Transcending Hope.

Abstract

It is a pleasure to present this special COVID-19 edition of the Australian & New Zealand Journal of Family Therapy (ANZJFT). Much like the metaphor of a puzzle when describing the work systemic therapists engage in with families, little by little, with a bit of thought, reflection, and patience, as the pieces come together to form the complete picture, this edition fell into a unified whole. The concept of this COVID-19 special edition had its genesis between March and April 2020 during the tumultuous initial phase of the pandemic. The idea coalesced in my mind as I initiated discussions with family and systemic practitioners and colleagues around the globe as it quickly became apparent that the effects of the pandemic would leave no part of the world untouched. After all, we may have been in different boats, but we have been battered by the same storm. This resulted in a collaborative reflective paper in ANZJFT (Amorin-Woods et al., 2020) involving systemic therapists from various international contexts and cultures in order to share and gather initial ‘lived experiences’ of the early stages of the pandemic. Subsequently, I was invited by the ANZJFT editor, Glenn Larner, to be a guest editor for this special edition, the collation of which has spanned the intervening 9 months. As the pandemic evolved, I found myself once again reaching out and inviting fellow family systemic therapists globally to share their experiences: their learnings and adaptations in their personal lives and in their clinical practice, teaching, and supervision. In recognising the profound multilayered impact on communities and societies, including the unique and devastating family disruption and mental health consequences, this issue focuses on the regenerative phase of the pandemic. Systemic practical responses to the pandemic were sought through experiential approaches, innovative interventions and practice, and relevant case studies aimed at supporting our work with families and individuals. My intention was to connect with diverse and unique perspectives validating of culture, context, and ecology. This process has further consolidated the reality that, as practitioners, none have been untouched. Alas, while there was great interest in contributing to this special edition, as highlighted in my initial reflections paper, the ubiquitous effects of loss, stress, and isolation had also become evident in the personal and professional experiences of practitioners, thus preventing them from participating. Some had been made redundant as funding for services were cut and university programs closed; others in private practice felt forced to close their practices. Some contracted the virus and were too unwell to put ‘pen on paper’; others who used specific tools such as ‘humour’ in their work could not see the ‘funny’ or light side of this situation. Clearly the presenting consequences were equally relevant for all while travelling this collective journey of ‘the unexpected.’ It would have been dismissive of me to have produced this editorial without acknowledging our fellow family and systemic therapists’ struggles. Since the advent of the pandemic, family and systemic therapists have had to adapt to many changes both personally and professionally. Themes common to most papers in this edition are centred around challenges as well as possible opportunities arising from the pandemic in the areas of practice, teaching, and supervision. Approaches, tools, and skills explored in these contributions have been inventive, resourceful, and unique. Most include case studies to assist practitioners in navigating the dynamic of clinical practice during this novel and ever-changing environment. The personal and professional impact through individual narratives is illustrated in the article, ‘Systemic conversations in the time of COVID: Conversations among culturally diverse therapists' by Amorin-Woods, Andolfi, and Aponte. This piece is based on my two separate Zoom conversations with two highly respected masters of our field, Harry Aponte and Maurizio Andolfi. Points of exploration include the personal and professional ‘lived experiences’ of the pandemic, acknowledging our individual cultures and contexts, the rise of alternative platforms of service delivery and teaching, human social connection, and the relevance of the person and self of the therapist in promoting change. We reflect on the losses: the face-to-face human interactions while sharing the same ‘in vivo’ environment and the nuances linked to such interactions. One of these is ‘touch,’ an important tool in facilitating and increasing connection; another is financial disadvantage impacting on clients and students constituting a barrier to accessing services. We also identify opportunities which include the opportunity to observe families in situ, facilitating the access of enviro-organic resources normally unavailable within the therapeutic space. The use of ‘self’ as an instrument of positive change is also discussed. The organic use of ‘self’ in practice is further explored in my own article, ‘The COVID-19 pandemic: An evolving story. Professional and personal insights using self and culture as agents of calm and healing after a year of co-habitation with imminent threat.' This paper explores the unrelenting fear, chronic stress, and psychological trauma present in communities, families, and individuals generated by the COVID-19 pandemic. It postulates that living under constant threat and unpredictability results in people being abruptly forced into a persistent survival mode marked by hypervigilance and erratic coping styles. This consequently leads to activation of their sympathetic nervous system, just like a switch which has been flicked on and stays permanently on. I suggest that systemic practitioners require openness, flexibility, authentic presence, and the ability to access uniquely organic and creative means in supporting families and individuals under these conditions. Two case studies are presented on the use of ‘self,’ which draw on my own cultural background and cross-cultural therapy approach, as instruments of change to induce calm, comfort, hope, and healing. The challenges and opportunities of technology are carefully examined in the paper by Trotta and Mosconi, ‘The paradoxical effects of COVID-19 in Italian systemic practice: Clinical and teaching “insights”.’ This contribution discusses the impact of the pandemic in Italy as it relates to training and practice. The unpredictability of the emergence of COVID requires greater flexibility where there is a need for new interventions. Through interesting clinical examples, this paper looks at the merits of the online setting, not as a substitute, but rather as an opportunity to learn a new set of skills where ‘the screen’ becomes a useful integrative and supportive tool in the process of training and therapy. Opportunity for creativity comes alive with ‘COVID: Using the DAN model with couples to increase family resilience’ by Mariotti, Muratori, Langella, and Scaltriti. The DAN (digital, analogic, and narrative) model, drawn from a manualised intervention, was developed by the renowned Iscra Institute in Modena, Italy, with the aim of promoting resilience in couples. Given the uncertain and unpredictable territory of the pandemic, the model has relevant current applications offering a map to prompt processes of reflection with couples and family systems struggling during these difficult times. Relevant tools are described and application to practice is illustrated through a case study. The collaborative and reflective paper titled ‘The COVID-19 pandemic and families in Japan,’ from Shibusawa, Ishii, Nakamura, Tamura, and Watanabe, focuses on Japanese families and explores the impact of the pandemic in Japan from a family systems perspective. It describes the course of the pandemic and how government policies to mitigate the effects of the pandemic have had a profound impact on families. This includes participation in family and social rituals, more prescribed gender roles, prejudice against those at risk of spreading the infection, as well as a high incidence of suicide. The article by Selekman, ‘COVID-19 as a transformative opportunity for families and therapists: Harnessing the possibilities that constraints offer us,’ discusses how the constraints of COVID-19 afford family therapists with opportunities to refine their therapeutic alliance-building skills, while gaining an intimate insider’s view of their clients’ daily lives, often inaccessible in the therapeutic space. The paper highlights the inherent ability of families to access their own internal resources to increase resilience and strengthen family relationships. Clients’ resourcefulness and creativity are acknowledged, as are their own novel self-generated problem-solving and health-enhancing strategies. Singh and Sim's paper, ‘Families in the time of the pandemic: Breakdown or breakthrough?’ explores the challenges and opportunities for families and systemic therapists as they venture into unfamiliar territory. Using a case example, the authors illustrate the application of three key and interconnected systemic themes, namely, unsafe uncertainty, family life cycle, and social diversity. The authors concede that despite formidable challenges, opportunities exist within families and communities that cut through different social contexts related to family, culture, economics, and politics. Another paper that focuses on online digital mediums is ‘Lockdown learnings: No longer the mirrored room’ by Burgess-Manning. The paper examines a discussion panel convened during the COVID-19 lockdown in Aotearoa/New Zealand, comprised of family therapists and family therapy students to investigate the effects of using online digital mediums for family therapy. Learnings include how the use of a screen can change the power dynamic between therapist and client with implications for the therapeutic relationship. The last article by Cook, Bragg, and Reay is ‘Pivot to telehealth: Circle of security parenting groups during COVID-19.’ The paper examines the Circle of Security (CoS) parenting program, reporting the perspectives and experiences of the group facilitator and the parents who participated in the CoS intervention online during the COVID-19 pandemic. The advantages, challenges, and positive impacts of the program are investigated with participants’ narrative reflections demonstrating satisfaction with the online delivery and reporting enhanced awareness of strengths and struggles. It has been a privilege to collaborate and partner with this international group of family and systemic practitioners, who have presented a remarkable and culturally diverse collection of papers. This demonstrates ‘thinking on their feet’ and creative, innovative, and resourceful ideas and approaches. I am confident that in reading these articles, practitioners will find a sense of solidarity and shared experience living and working in the time of COVID while also finding valuable ideas for application in clinical practice, teaching, and supervision regardless of culture and context.