Working through multiple crises: the experience of psychotherapists and psychoanalysts in Lebanon

Abstract Background This research explores the impact of the COVID-19 pandemic on psychotherapists' practices and their ability to maintain a framework despite a shared reality with their patients. The specific focus in this article is on the Lebanese context, which is characterized by a series of crises including economic collapse, the COVID-19 pandemic, and the Beirut blast. The objective of this study was to examine how the destabilization of the meta-frame due to crises necessitates adaptations in theoretical knowledge, practice, and setting. Methods We conducted a qualitative study among a population consisting of mental health professionals, which were recruited in multiple countries through associations and societies of psychologists, psychotherapists, and psychoanalysts. Data was collected using semi-structured individual interviews. The interviews were analyzed using interpretative phenomenological analysis (IPA), which allowed for a dynamic exploration of the participants' experiences. A total of 44 participants were interviewed, with 15 interviews specifically focusing on Lebanese psychoanalysts and psychotherapists. Results Our study revealed four superordinate themes: (1) the strained frontiers; (2) the cumulative traumatic reality and its impact; (3) A challenged professional identity; (4) The creativity stemming from collective trauma. Conclusions Our results highlight the insecurity caused by external reality infiltrating the therapeutic setting. Online therapy allowed for continued work, but uncertainty about the online environment's impact on therapeutic relationships was observed. The study underscores the importance of adaptability, containment, and support for therapists navigating crises, particularly in the online setting.