A psychotherapist who walks and talks with clients reflects on strength 

Tracy Nathanson, a licensed psychotherapist in the Hamptons, specializes in the treatment of anxiety, depression, relationship issues, life transitions, stress management and career challenges. But the founder of Pace of Mind Therapy twists tradition, taking patients off the couch or out of the office and into the fresh air, for walk/talk therapy in parks or along the beach.

The pandemic curtailed her approach to psychotherapy. Not only would there be much less walking, but in-person therapy in the office stopped. She and her patients primarily rely on sessions via FaceTime. The change came in March 2020 as the need for services started growing.

Nathanson pivoted to continue caring for patients. They adjusted, as did she, making the most of the situation until things return to "normal."

How did your patients respond to the change?

Honestly, they were relieved that there was another way to receive therapy. Everyone made the switch, although some cut back their frequency.

What's been most challenging?

I miss seeing my patients in person. Nothing can replace face-to-face interaction and the nonverbal cues that are exchanged. There are times during in-person sessions when there is silence, when the patient is sitting with thoughts. This is an important part of the therapeutic process. I find it challenging to do this via teletherapy.

How have patients adapted?

I see patients in the privacy of their homes or other locations. Some are more comfortable than others with this window into their lives. It can be difficult for them to find a safe space to talk — particularly if they have roommates working from home. Telehealth, though, gives patients flexibility, and there’s no commute.

What are some of your favorite spots to do walk/talk?

I like the eastern end of Long Island, especially the Hamptons. I love beach walks, and my patients do, too. There is something very calming about looking at the ocean and hearing the sound of the waves.

Has social distancing hampered those sessions; did you stop doing them entirely?

Not completely, I do some individual walks, but to be safe I put the group walk/talk sessions on hold. The pandemic makes them more challenging, we social distance and wear masks.

What makes walk/talk therapy effective, particularly now?

There are many emotional, social, psychological and physical benefits. We are in the fresh air. Exposure to the sun boosts vitamin D and your immunity, which is important during COVID. Walking is good cardio activity. With therapy people feel supported and less alone at a time when many feel isolated.

Is your business up, down, about the same?

I have gotten a few new clients, although we have not met in person. I look forward to that. At the same time, there have been some terminations, so I am basically the same.

Are there changes you've implemented that you will continue post-pandemic?

I think we will have to see how it goes and see what feels right with each patient.

What have you learned about your patients?

There has been this collective trauma and loss — loss of freedom, loss of control, loss of predictability, loss and change in employment. Some of my patients lost family members and friends. They are resilient, courageous.

Is there an upside in all the change?

With people working all day from home, there is more interest in the walk/talk model. People are walking more. As the weather changes and people get vaccinated, I think the demand will grow. I discovered how much I need my patients. They’ve helped me during this time. I feel less alone. We are going through this experience together.

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