Death and COVID-19

What I've noticed during the pandemic are regression, difficulty maintaining differentiation, and a return to unhelpful and undermining defenses. I've been exploring existentialism, object relations, and assumptive world theory in my clinical practice and here is what I've found.

Many of the family systems I work with have never explored their mortality. Death is also symbolic of socioeconomic ruin for many. The fear and grief of these potential realities is rarely shared with one's partner(s).

The most stressed family systems I work with are reporting intrusive memories about families of origin in which emotional, sexual, and physical violence undermined trust and shaped a world of object relations and attachment styles re-colonized by avoidance, dissociation, fear, and disorganization. Even after years of therapy, these wounds are being reactivated and expressed in the systemic present, leaving all parties confused and uncertain about what is happening to them.

Finally, there is the loss of the assumptive world. These are beliefs that position the world as benevolent, meaningful, and associate the worth of self with moral attributions of goodness. In short, bad things happen to bad people and good things happen to good people. These cognitions keep out of consciousness the randomness and "unfairness" of life.

Exploring these themes with couples brings to the surface unacknowledged angst that is easier to act out than it is to share in vulnerability. Raising and normalizing these experiences have provided comfort and re-centering for those I work with. It also reminds me of my own humanity.

Joe Winn, LICSW, CST, works with couples, individuals, and families in Concord, and teaches at South Shore Sexual Health Center in Quincy.

Image by Allessandro Vallainc via Unsplash.

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