Anonymous: The Deaf Community and the rise of online therapy; 2D versus 3D therapeutic encounters

For many years much of my clinical practice has been dedicated to supporting a national charity in providing accessible face-to-face therapeutic services to members of the Deaf Community across a large region in the UK.

This work provides me with half the income I ordinarily secure privately. I do not engage in this work to line my pockets, as the lining is not lucrative nor consistent.

No matter how low the income has been I have dedicated much of my clinical practice to this work. I have spent hundreds of hours in the company of Deaf Community members providing both therapy and supervision.

This learning and the work undertaken has been powerful as a therapist and feedback from clients suggest they have been thrilled to be seen and connected with in British Sign Language (BSL), Signed Supported English (SSE) or other forms of signed languages.

Deaf community members always state how satisfying it is to receive services without a third party being present. A third party (an interpreter) is present in many other areas of Deaf people lives (for example, GP, Dental, Hospital appointments and even having a baby) and to know that Deaf people have a ‘sacred space’ to explore the depths of their feelings without an interpreter has been fought for and success with BSL Psychotherapists and Counsellors has been established across the UK. 

As a linguist, sign language interpreter and now a signing psychotherapist, the somatic narrative and the sensorimotor story provide valuable information in all clinical work, whether with the Deaf Community or not. 

The body narrative offers a window into the world of each and every person engaging in psychotherapy. It allows recognition of any incongruence between what is signed (or spoken) and what the body is actually saying.

These valuable ‘bodymind’ statements aid the work significantly and provide a platform for exploration. They illuminate the ‘unsigned’ and sharing this with a client can be useful and enlightening.

Meeting clients face-to-face engages people in a 3D therapeutic experience and a rapport building that I believe cannot be replicated in a 2D, screen-to-screen encounter. I know from my involvement a need to attend appointments face-to-face supports people to experience what can only be described as private, sacrosanct, empathic therapeutic encounters. In the many years of clinical practice the work has been fruitful and in many cases life-changing. 

In recent years the world of therapy has become engaged in online services. This is wonderful for members of the Deaf community who are living remotely and have internet access.

It means these community members can be reached and their mental health needs can be supported from the comfort of their home. However, if for any reason the home environment is not a place for comfort or relaxation then online therapy could prove to be exceptionally difficult and in some cases impossible.

Imagine a client has been courageous enough to self-refer or indeed attend a GP appointment and they have in the first case said very little to their GP or in their referral. They have chosen to keep private about the real truth of their need to attend.

Imagine this person is a victim of emotional or domestic abuse and they thought engaging in counselling or psychotherapy could help them understand their position and potentially move forward.

Now imagine this…their abuser is sitting in the room whilst they ‘attend’ online therapy! Imagine how entirely awful this experience would be!!

What about a client who has been having an affair and their family members are wondering around the house as the client attempts to move through some sort of healing process whilst being in the company of their loved ones.

What about a client discussing their feelings in relation to sexuality and parents popping in and out of their bedroom whilst they struggle to uncover their feelings. These examples happen in psychotherapy, online or not. 

I am not against moving forward but I am against money-making or profit increases at the expense of Deaf Community members.

Online therapy will be provided regardless of my article but once again it is going to be down to members of the Deaf Community to ‘stand up and fight for their right’ to access a service that has previously been available to them.

It will mean Deaf people will need to fight for their right to meet a therapist in a face-to-face setting. It will mean that those who don’t know that this is an option to them may decide that due to their circumstances they ‘cannot’ pursue therapy. 

My sadness has driven me to write this article and my passion for face-to-face accessible services for ALL is a matter very close to my heart. I am saddened that once again a community who suffer usually at the hands of hearing oppressors and hearing leaders are being impacted once again.

My advice would be to promote choice and allow Deaf people to choose what they want whether that is face-to-face or online. If I knew this was going to happen I would be a keen supporter of online service provision but I already know that the online option is the first line treatment offered.

Furthermore, even if a refusal for online provision is made and face-to-face is requested there are no guarantees. My plea is simple, please allow Deaf people to choose what they want and please stop hearing oppressors deciding what is best for Deaf Community members. 

 Sad, Signing, Psychotherapist UK