I really thought that we could not do adolescent psychiatry in any meaningful way wearing face masks. In psychiatry we have a long tradition of attempting to make meetings with our patients unofficial and relaxed, wearing no uniforms, personalizing our meeting rooms, attempting to make inpatient wards homely. Now, with the covid-19 pandemic, we had given up shaking hands, we looked like surgery staff in our blue outfits, we were organizing meetings where people sat as far as possible from each other, face to face human contacts were changed to crackling remote connections… but could we create a trustful contact with an anxious, fearful, depressed or angry young person hiding behind a face mask? Could we reliably assess the nonverbal communication of a person wearing a face mask? Wouldn’t the fragile psychiatric patients be confused and horrified due to our hiding behind the face masks and retreat, symbolically or even literally? Could the inpatient ward staff model constructive communication from behind of face masks?
I felt awful when I first encountered someone revealing their anxiety and pain from behind a face mask, to me hiding behind my face mask. As if the paper mask ridiculed the emotion and the words of the distressed, and I, half of the face invisible, was being a clean white wall.
Finnish audiences usually do not disturb lecturers with questions and comments. Guest speakers from other countries often tend to conclude their success from how well they manage to invite the audience to interact. It is necessary to prepare them by telling that in Finland we show respect by being silent and not intervening. Lecturer speaking though remote connection definitely does not increase interaction! Attending the first remote lecture with all audience in our meeting room wearing face masks was nevertheless a strange experience. As if the face masks also necessitated avoiding eye contact and making small comments to your neighbour. And if somebody dared whisper something, you could not hear…
Astonishingly, however, face masks soon became a routine. All the work can be done. I initially had to fight the temptation to bend my head low and look down and reconsider twice before saying anything when wearing a mask. Recently I have noticed that wearing a mask has even improved my taking a focused eye-contact. Being aware that the other person can only see the eyes, I make an extra effort to express interest, encouragement, understanding and connection with eyes. Thus, less becomes more.
However I hope that when the pandemic is over we shall return to normal, and will not have learned for ever to consider being close to another person primarily a danger, human touch primarily a potential source of contagion.