A Theory of Everything # 6 'the Mask'

The continued formulation of my 'theory of everything' in an effort to understand what happened to me while under the therapeutic supervision of CAMHS art therapist, Sally Mungall between September and December, 2021.

Here I will begin to explain the extraordinary effect that Sally Mungall’s use of Covid 19 face masks had on the therapeutic relationship and the adverse influence those masks had on my own psychological transference.

In response to the Covid-19 pandemic, the Government issued guidance on measures needed to protect staff and patients, specifically universal use of face masks for staff and face masks/coverings for all patients/visitors in health and care settings. Guidance was first issued by the UK Health Security Agency on the 3^rd March, 2020. While COVID restrictions ended in many settings in England from Monday by the middle of July, 2021, NHS visitor guidance remained in place across all health services including hospitals, GP practices, dental practices, optometrists and pharmacies to ensure patients and staff were protected. This guidance was reaffirmed by NHS England and NHS Improvement on the 21^st November, 2021.

Yet, a relaxing of attitudes surrounding the use of face masks, especially after July, 2021, influenced decisions made by some NHS staff to ignore guidance. Meg’s own CAMHS psychotherapist, Mark Birbeck, carried out much of his work, if not all, without a face covering. Meg never wore a face mask at any time during psychotherapy, between February 2021 and January, 2022.

When I first met Sally Mungall on the 2^nd September, 2021, she was wearing a face covering.

When I met her two weeks later, Sally Mungall was still wearing a face covering.

I challenged her on her use of the mask during psychotherapy. I was about to commit myself to a regime of psychotherapy likely to explore deeply disturbing intergenerational trauma and expose awful secrets that had remained hidden in deep subterranean vaults for more than fifty years. Old fears turned over in their sleep as monsters lifted their hideous heads above the lips of slimy, noisome wells while a small, frightened boy looked for a mother.

I needed to relate to my therapist. Therapists of all types rely on a depth of relating with their clients.

I needed to know my therapist, needed to be sure that they were somebody who could listen to the very worst parts of my story and hold onto those parts and not judge, not shame, not ridicule. Was Sally Mungall somebody who might recoil in horror, react with disgust or reprimand with disapproval? Could I trust her to safeguard my awful secrets?

Masks worn during the COVID-19 pandemic shielded the mouth and nose, covering around 60%–70% of the essential face region needed for a visual eye and mouth connection, which aids decision-making and behaviour (Carbon, 2020 )

I have trained myself, since I was a young adolescent, to read people. I have becomes adept at interpreting body language and quite skilled in spotting deception. If I suspect dishonesty in a person I will usually shut them down and or walk away. When the stakes are higher and those same people cannot be avoided, I enlist my internal security guards who remain vigilant and ready to intervene.

On the 16^th September, 2021 I was sat opposite Sally Mungall, negotiating the terms of ‘art therapy’. While one part of my mind engaged in conversation, another part, an investigating detective persona, scrutinised her, intently. I recorded everything about her, her physicality, her mannerisms, her clothes and so much more. I noticed everything, her short stature, her tall boots, tired leggings, the stains dotted about her shirt, her long dark hair and round grey-blue eyes ( ? I’m colour blind ). I guessed at the face behind the mask and settled on a weathered rosy complexion version of Ma Larkin. Indeed, she had given me the first impression that she was an unserious mental healthcare professional. She had the bearing and import of a farmer’s wife and I imagined her busy at home with a brood of children and animals. I have been constantly forced to reevaluate Sally Mungall over the years but that earthy aspect is something that has stubbornly refused to shed.

Yet, there was a discrepancy, something that didn’t match with my first account of Sally Mungall. This time around she wasn’t wearing a wedding ring. I had been quite dismissive about her during my first meeting. I hadn’t actually looked for a wedding ring the first time round but I’m reasonably certain that she had been wearing one. This is an important observation that became relevant much later in ‘art therapy’ ( I’ll return to this later ).

The Covid 19 mask remained a frustrating interference. I asked her, politely, if she might remove it during ‘art therapy’ sessions but she declined, giving her reasons.

I accepted her preference for wearing a face covering but asked if she would remove it, if only once, so that I could see who she was and establish a human connection.

Faces are powerful, informative visual stimuli for human perception of identity, gender, emotion, age and race (Freud et al., 2020). Faces enable facial speech analysis and understanding emotional conditions of others via expression analysis (Carbon, 2020). Language engages in profound metamorphosis through translating speech signals to meaning. The language of masks may conceal speech information, impairing encoding performance (Trecca et al., 2020). Changes to our psychosocial environment, including facial interpretation, can influence our very virtues, transforming aspects of self (Cooper, 1999).

She obliged.

I stared at Sally Mungall for less than several seconds while tectonic plates seemed to shift.

This moment marked the true beginning of my own psychological transference.