The Precedent of Good Enough Therapy During Unprecedented Times

Abstract

The unprecedented nature of the coronavirus pandemic and clinicians’ own concerns for safety and stability amidst collective uncertainty have threatened to undermine our ability to trust what we already know about our clients and how to help them. Rather than search for a novel solution, I suggest that what we need during a shared crisis is to renew our trust in the existing ethos of good enough therapy, a metaphoric corollary to Winnicott’s concept of good enough mothering, which presupposes the realities of imperfection and uncertainty along the continuum of growth. Using personal reflections, clinical vignettes from my psychotherapy practice, and drawing from modern attachment theory, contemporary relational psychoanalysis, and object relations theory, I posit in this article that clinical social workers already possess the framework, skills, and knowledge needed to deeply understand and meaningfully work with clients as they, and we, endure shared trauma. Through the clinical material, I examine opportunities to make use of clients’ reactions, as well as my own, in order to deepen the therapeutic process. I discuss the necessity of holding the therapeutic frame with increased flexibility in light of my use of self-disclosure surrounding my COVID-19 diagnosis and recovery, and I assess the impact of this disclosure.