Episode Summary: Keeping Yourself (and Your Practice) Strong Amidst the COVID-19 Global Panic

Podcast: Private Practice Startup
Episode: 181
Hosts: Dr. Kate Campbell
Guest: Dr. Camilla Gamba (Milan, Italy)
Date: April 11, 2020

Overview

This episode centers on the profound challenges and adaptations faced by private practice therapists during the COVID-19 pandemic. Host Dr. Kate Campbell speaks with Dr. Camilla Gamba, an expat therapist based in Milan—one of the initial epicenters of the crisis in Europe. Drawing on her frontline experiences living under extended lockdown, Dr. Gamba candidly explores the emotional rollercoaster, professional adjustments, and the ways she has stayed resilient, both personally and in practice. The conversation is supportive, honest, and filled with usable insights for therapists navigating uncertainty, massive changes, and the anxiety of the global pandemic.

Key Discussion Points & Insights

1. Life and Practice Update from Milan

[03:06, Dr. Camilla Gamba]

• Living and working in Milan, Dr. Gamba describes a sense of a "weird time warp," losing track of days and feeling both compressed and stretched by time.
• After the initial chaos, mood is rising as Italy seems to be reaching the pandemic’s peak.

“It’s been three weeks, but it feels like this weird time warp where it feels like forever, but also really short. So I actually made myself a little calendar where every day I keep track because I lose track of what day it is." – Dr. Camilla Gamba [03:06]

• Initial transition to teletherapy saw a significant drop in caseload (down by 10 clients), but remaining clients have adjusted.
• The therapist’s work shifted: “All of a sudden, every single one of these persons’ lives got upturned.”

2. The Emotional Rollercoaster and Personal Adjustments

[04:59, Dr. Kate / 06:54, Dr. Camilla]

• Both therapist and clients are simultaneously living through the pandemic—creating unique emotional dynamics.
• Dr. Gamba describes fluctuating between gratitude (for a reduced caseload and needed rest) and concern (for clients who dropped off).
• She plans personal check-ins instead of waiting for clients to reconnect.

“I was initially just sad and scared at this drop in the caseload. And then a couple of weeks in, I was thinking, okay, this is actually, I really need this break.” – Dr. Camilla Gamba [06:54]

3. Therapist Vulnerability and the Temptation to Fix

[09:10, Dr. Camilla]

• Dr. Gamba candidly admits feeling she wasn't the "best therapist" at the outset—her urge to fix things or give advice increased as a coping mechanism for her own lack of control.
• She emphasizes the value of authenticity and grace toward oneself as a therapist.

“Part of me wants to make a few confessions about not having been the best therapist ... The first thing that kicked in for me was just a very personal, like, let me give people advice ... a control thing that maybe we've all felt.” – Dr. Camilla Gamba [09:10]

• Retreating, resting, and reducing exposure to news was key for self-regulation and being present for clients.

4. Mutual Empathy and Boundaries in Therapeutic Relationships

[12:30, Dr. Camilla]

• For the first time, clients expressed concern for Dr. Gamba’s wellbeing, shifting typical boundaries.

“They were concerned about me as their therapist, which was a new thing in the therapeutic relationship ... I did share a few things, just because I think they expressed their need to know that I was okay.” – Dr. Camilla Gamba [12:30]

• The pandemic blurred lines of self-disclosure, with the goal to remain professionally supportive.

5. Family, Friends, and Community Connections

[14:09, Dr. Camilla]

• Dr. Gamba moved in with her father for quarantine—strengthening their bond.
• Video calls with family and friends evolved from fun to “sad news” shares as the pandemic's toll intensified.
• Social support structures changed as the crisis deepened.

6. Peer Support and Colleague Check-Ins

[16:34, Dr. Camilla]

• Collegial relationships provided essential support, reassurance, and normalization—peers were struggling similarly.
• Seeing “everyone seems to be doing so well” on social media was intimidating, but peer conversations revealed most therapists were simply coping.

“It was just really nice to check in with my colleagues to see that they were pretty much all going through the same thing.” – Dr. Camilla Gamba [16:34]

7. The Importance of Self-Compassion and Acceptance

[18:22, Dr. Camilla / 18:51, Dr. Kate]

• Both guest and host stress the need to accept reduced capacity and emotional bandwidth.

“It's important just to share that with each other, that it's okay—we're just not at our full capacity of mental space and we're all just managing it. And that's okay.” – Dr. Camilla Gamba [18:22]

• For some, a drop in caseload is necessary self-care, and can eventually be reframed as beneficial or even a blessing.

8. Looking Ahead: Reconstruction and Hope

[19:48, Dr. Camilla / 23:20, Dr. Camilla]

• As Italy considers the “reconstruction phase,” Dr. Gamba chooses to focus on optimism over catastrophic projections.
• Adapting to a new normal can bring surprising comfort and resilience.

“It’s amazing how adaptable we are. And I’m just really conscious that we can make it work and, soon enough, we’ll be everybody back on our feet better than ever.” – Dr. Camilla Gamba [24:53]

• For those early in lockdown, she advises taking things slowly, reducing news intake, and allowing time to adjust—eventually, routines form, and things feel more manageable.

9. Using the Time Wisely—Or Simply Resting

[30:34, Dr. Camilla / 32:15, Dr. Camilla]

• Therapists should honor their energy and bandwidth; for some, this is a time of rest, not productivity.
• “If you’re hearing this and you think I’m just tired and I don’t have the energy, then that’s okay. The time that you have now is time that you take to rest. That’s great, because you’ll need that energy.” [31:59]

10. The Collective Learning Curve and the Power of Community

[32:44, Dr. Camilla]

• Encourages the use of peer supervision groups and professional community, locally and internationally.
• “We’re all figuring this out in real time ... the more we can share in your own community, but if you want to reach out internationally, there’s a lot of international groups … let’s all share together because we’re all figuring this out and becoming masters at this.”

Notable Quotes & Moments

• On embracing imperfection and authenticity:
  "We’re all in this together ... we're all experiencing it for the first time together. Because we’ve never had a pandemic before. So there’s not like a textbook of how to cope ..."
  – Dr. Kate Campbell [11:02]

• On hope through adaptation:
  "If it’s another month, another two months of this, I can take it. And most of the people around me who are in my kind of situation ... we’re all thinking, yeah, one month, two months, whatever it takes, we can do it."
  – Dr. Camilla Gamba [22:35]

• On reframing adversity:
  "Hopefully this will mean that when it’s time to reboot and restart, I’ll have that renewed energy for whatever comes next for my community and my clients."
  – Dr. Camilla Gamba [19:48]

• On learning from adversity:
  "If we can take this as an opportunity to learn something about ourselves ... about what we can do, about what our limits are ... it might be good things, it might be bad things, but it's all going to be useful information to grow."
  – Dr. Camilla Gamba [27:31]

• On humility:
  “I've learned to cope with feeling very, very small and insignificant in the world and it's very humbling … It's also made me appreciate the little things that I can do that are still helpful.”
  – Dr. Camilla Gamba [28:41]

Timestamps for Key Segments

• 03:06 – 04:59: Dr. Gamba updates on her practice and the transition to telehealth
• 06:54 – 09:10: Emotional impact of reduced caseload, reaching out to clients who dropped off
• 09:10 – 11:02: The urge to “fix,” therapy style changes, managing therapist control issues
• 12:30 – 13:54: Navigating boundaries and therapist self-disclosure
• 14:09 – 16:03: Family, friends, community support during lockdown
• 16:34 – 18:22: Peer support and validation from colleagues
• 18:51 – 19:48: Self-compassion and reframing caseload decline
• 19:48 – 24:53: Looking ahead to recovery, hope vs. catastrophic thinking
• 27:31 – 28:41: Personal and professional lessons from the crisis
• 30:34 – 32:44: Encouragement for rest and the value of community support

Final Takeaways

• The pandemic is a collective trauma that therapists are both experiencing and helping others navigate.
• It's vital to normalize imperfection, honor your own needs, and remember it’s okay to rest.
• Sharing experiences with peers offers critical support and perspective.
• Eventually, adaptation occurs, and hope for reconstruction—both personally and professionally—emerges.
• Embrace the learning, connect with others, and trust that, in time, practices and practitioners can emerge stronger and more resilient.