The purpose of this article is not to criticize Telehealth or Zoom meetings.  On the contrary. There are so many important benefits to virtual meetings(1), not the least of which is the ability to stay connected during this very critical period. My goal is to identify some of the concerns which have been raised about using virtual interactions and then summarize some ways to eliminate the long term, less desirable effects. Whether you are zooming with friends, listening in class, engaged in a business conference or connecting with your doctor or therapist, I hope you find some of these observations interesting and the solutions helpful.

Similar to other therapists during the COVID-19 crisis, SPS turned our regular in-office therapy sessions into virtual Telehealth services. While I am forever grateful that we are able to continue delivering services to our clients via virtual platforms, the SPS therapists, and I, have noticed a phenomenon which we have called “Zoom fatigue.” We do not believe that our clients are experiencing that much Zoom fatigue during the actual session each of which is between 45 minutes and an hour in duration. However, our therapists, who can spend many hours during the day conducting their appointments, have reported the effect of “Zoom fatigue.” I imagine any business which relies heavily on social interaction and meetings is hearing something similar from their employees. I know that my kids who are sitting in a virtual classroom all day have had similar complaints. So, last Monday I ended our staff meeting early, gave all the therapists a Zoom break, and decided to look up what there is to know about Zoom fatigue and how we can get some relief.

CAUSES OF FATIGUE

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1. Difficulty Making Eye Contact

Sustained eye contact is tiring even in person-to-person communication. However, my sense is that eye contact is even more tiring on video chats when … “it’s a little bit off”. Not exactly a scientific explanation! However, most of us can appreciate that it is impossible to make eye contact by looking into your computer camera while simultaneously looking at the person you are speaking to. 

2. Misunderstanding Out-of-Sync Non-Verbal Cues

In an interview with the BBC(2), Gianpiero Petriglieri, an associate professor at Insead, one the world’s largest business schools, explained that being on a video call requires more focus than a face-to-face chat. “Video chats mean we need to work harder to process non-verbal cues like facial expressions, the tone and pitch of the voice, and body language; paying more attention to these consumes a lot of energy. Our minds are together when our bodies feel we're not. That dissonance, which causes people to have conflicting feelings, is exhausting. You cannot relax into the conversation naturally,” stated Petriglieri. 

Particularly noteworthy is the problem of “turn-taking”.  It is almost impossible to have more than one person talking at a time and the cue for who is up next to speak can be hard to discern.  Concentrating on whether or not you can talk or interrupt is much more tiring on a video chat.

3. Feeling Restricted 

In our normal workday, many of us are used to getting up and moving around.  Whether it is a short distance to the coffee machine or a longer stretch up a flight of stairs, we are still able to build up a certain number of “steps” in a day.  Sitting in front of a computer eventually causes a feeling of restriction and limitation.  As I affectionately call it “numb bum!” 

Also, we are used to arriving at and leaving different environments, each of which has very different cultures and values.  A Zoom lunch with a close friend followed by an executive board meeting is quite a social shift.  However, you are still sitting at the same table and chair. Petriglieri refers to something called self-complexity theory which posits that we need a variety of different contexts and roles and that when these are reduced we can become more negative and vulnerable.

4. Experiencing Up Close & Personal

A Zoom interaction using normal settings looks like you are right up in another person’s face. The brain is particularly attentive to faces, and when we see large ones, we interpret them as being close. Our “fight or flight” reflex responds.  One study at Stanford by Jeremy Bailenson(3) showed that when people are exposed to large virtual faces, they flinch physically. This may be part of the reason Zoom is so exhausting—for every minute we are in Zoom, we have staring faces inches from our own. 

Jeremy Bailenson, a professor of communication at Stanford University and founding director of its Virtual Human Interaction Lab, states that “this isn’t what people do in a classroom, or a meeting, or most social situations. In the real world,” Bailenson says, “when someone gets that close up, we get aroused. There’s probably some type of a conflict situation, from an evolutionary standpoint — or we’re going to be intimate with them.”

5. Feeling Watched

Some people who videoconference have reported that they feel silently scrutinized or surveilled.  Zoom is also a mirror. Tanya Joosten(4), a senior scientist and director of digital-learning research and development at the University of Wisconsin at Milwaukee and co-director of the National Research Center for Distance Education and Technological Advancements states, “One of those boxes on the screen is you.” That might mean we’re all expending more energy monitoring our own nonverbal communication than we ever would in person. Perhaps that’s part of what’s so tiring.  “Though we may pretend to be looking at another person when we FaceTime or Zoom,” journalist Madeleine Aggeler(5) observes, “really we’re just looking at ourselves – fussing with our hair, subtly adjusting our facial expressions, trying to find the most flattering angle at which to hold our phones.” Videoconferencing is a little like talking while constantly glancing at ourselves in a mirror.  Personally, I have seen children and adolescents preening themselves, as if completely unaware of doing so.

There’s also often an added pressure to “perform” while on video chats. Marissa Shuffler, an associate professor at Clemson University, told the BBC(6) that there’s often social pressure when you’re on a video conference when you know everyone’s looking at you. “Being performative is nerve-wracking and more stressful,” she said.

6. Feeling Disconnected from the Reality of the Outside 

Another factor in the exhaustion, Joosten adds, is “that so many people want to project to others that they’re doing business as usual, even while the news is full of images of death, of illness, of economic downturn and collapse.” 

7. Experiencing Technical Errors

Trying to connect the audio and video can be a strain when there is a lag time between the two.  Frozen screens or loss of connection adds frustration to an already tiring process.  One 2014 study(7) by German academics showed that delays on phone or conferencing systems shaped views of people negatively: even delays of 1.2 seconds made people perceive the responder as less friendly or focused.

8. Compassion Fatigue

Let’s face it, this is not our “normal” and the main reason we are using video conferencing now is because we are in the middle of a pandemic. Most of us are worried about the people who we would normally see in the office or classroom. We check in on Zoom calls and we are relieved to see that everyone is present, particularly those people we have some responsibility for. “I think the exhaustion is not technological fatigue,” Petriglieri says. “It’s compassion fatigue.” 

HOW TO RELIEVE FATIGUE

1. Try limiting the number of meetings to ones that are either necessary, or to virtual interactions which you would like to join. 

Avoid the “shoulds”. Shuffler, associate professor at Clemson University, notes that Zoom fatigue can depend on how much you want to join the meeting versus feeling obliged to(8). If you feel like you “should” be in a Zoom meeting then you will also experience the feeling or need to be “on”. In contrast, a meeting which feels less like an obligation will help you feel more relaxed and more able to “be yourself”. Since most of us associate Zoom meetings with work, even happy hour with friends over Zoom can still feel like a work obligation. Try calling a friend and notice how “close” you feel compared to a Zoom connection.  

2.  Less is More.

Having fewer meetings of shorter duration can make video conferencing less exhausting. Consider streamlining the session and transmitting only the most valuable information to avoid stimulus overload, recommends Julia Sklar, MIT Technology Review’s social media editor, in a recent National Geographic feature(9) .

3. Make Turning on the Camera Optional.  

In some cases, video chats aren’t always the best option.  Sharing screens while also video conferencing can lead to stimulus overload.  Try using screen-sharing apps only to reduce the number of items which require attention. 

4. Take Breaks

In the “real world” we take lots of breaks during the day, sometimes unwittingly.  We may turn to talk to a friend at school, dawdle between classroom changes, chat over the coffee machine, or go outside for fresh air. We need to ensure that we build in those same refreshing transitions between Zoom meetings. “Don’t schedule back-to-back meetings,” suggested Suzanne Degges-White, a professor and chair of Counseling and Higher Education at Northern Illinois University, “take a break away from the screen between meetings and get fresh air.” 

5. Make Transitions

Sometimes it is hard to switch roles when you spend all your time in one room. One of the SPS therapists told me that he gets in his car and drives for 15 minutes before walking into his basement office.  At the end of the day, he gets back in his car, drives around for another 15 minutes before parking the car and coming through the front door to his home! Try changing clothes, rooms in your house, or the computer you use to signify moving from one role to the other.  

6. Manage Expectations

Some people report that they feel as though they need to perform their “best” during a time when people are losing their jobs or being furloughed. Heightened fear has led to people over-working and denying themselves down-time. Ensure that you take sufficient breaks, enjoy the weekends and maintain a work-life balance.

7. Manage Your Technology in Advance

a) Practice Zoom with friends before you have an important Zoom meeting.  Familiarize yourself with all the features such as muting; your identifying name; how to send and receive invites, volume controls, screen sharing, different views.  Make sure you are comfortable with all the features to reduce the stress of “bumbling” during the video chat.

b) Earbuds and headphones can sometimes reduce the annoying reverberation between computers caused by replaying someone’s audio.  Use muting to avoid worrying about unwanted sounds and surprise noises!

c) Manage the lighting by directing a light in front of you onto your face. Staring into what looks like a cave on screen, and trying to discern someone’s face can be exhausting.

d) Try placing the computer screen at an angle which creates the best version of making eye-contact(11).  I have found that minimizing the video of the client and placing it directly under the camera has been most effective.  Another option is to set up an external webcam instead of using the inbuilt camera on your device.   

e) Make sure you have a “Plan B” if something causes an interruption.  Agree with your friends or clients that you will text them or call them in person if there is a break down in the virtual meeting.  Ensure that you have that information ahead of time.  

8.Taking Turns

Discuss a protocol for taking turns to talk. Some meetings use the icon for “raising your hand” and a mediator calls upon people. This helps reduce ambiguity but requires acceptance of less spontaneity. If you are the mediator, be aware that you will need to notice individuals who may need to be called upon versus individuals who volunteer all the time.

9. Avoid Multi-tasking

You might have found that multi-tasking is exhausting on the brain. As tempting as it may be to use Zoom appointments to multi-task, research informs us that we are not as good at multi-tasking as we think. Neurologically we are not wired to multi-task, we are actually hard-wired to be mono-taskers. One study(12) found that just 2.5 percent of people in the population are able to multitask effectively. The rest of us are experiencing performing two tasks rapidly and simultaneously - creating the illusion of multitasking!  Trying to multi-task using technology (such as texting and checking emails) has been proven to have a negative effect on performance and memory(13). 

10. Promote “Real” Interactions

I experienced feeling more authentic with clients when I was engaged in a virtual activity. Some examples of this include a teenager sharing their Spotify playlist with me and talking about the meaning of some song lyrics, playing a game or using a coloring app with a child, all of which have led to more spontaneous interactions. I have also shared my screen with an adult to fill out an online questionnaire together and learnt more from their participation than from the answers themselves. All these activities seem to have increased the feeling of reciprocity by making the real-time activity together less tiring, more fun, and fluid; it’s less pressured, stilted and staged.  

11. And Finally - Bring in the pets!

I can’t tell you how much the tone of a Zoom interaction can change when an animal or pet is invited onto the screen!  For the same reason there are hundreds of funny cat and dog videos. Animals just have a way of making us feel good. Enumerable studies have shown both medical and mental health benefits of interacting with animals. I would hypothesize this is also true of interactions across Zoom. 

The New York Post (14) featured an article about the “Goat-2-Meeting,” an initiative by Tech entrepreneurs Salpeter and Anna Sweet. Salpeter and Sweet co-founded Sweet Farm in 2016 as a way to promote the humane treatment of animals rescued from the stockyards.  During the Coronavirus lock-down, they devised a novel way for isolated workers to spice up work-from-home video conferences by inviting a barn animal to the chat. Even Fortune 500 companies have invited animals to improve the mood of a video call conference. “Sometimes people just want to watch a cow eat grass,” Sweet Farm co-founder Nate Salpeter tells The Post. “Because life is stressful, work is stressful, and working remotely can be challenging, … for our daily team Zoom meeting today I had Paco the llama call in from The Sweet Farm,” tweeted one satisfied customer!

I often use videos and photos of my animals as my background when I open a video meeting.  It is a great conversation starter with therapy-shy children and simply has the impact of drawing a smile from nearly everyone else. I miss my Equine Assisted Psychotherapy sessions at the barn. However, this is the closest I have managed to get my horse actually into the room!

Most of these observations and suggestions in this article are the result of my experience using Zoom over the last few weeks to conduct psychotherapy. I never pictured myself as a Telehealth therapist, vowed that there was no substitution for meeting in person and chortled at the idea of sitting on a beach conducting Zoom sessions (which now, as I think of it, might be a great technique to avoid Zoom fatigue!) In all seriousness though, my attitude towards virtual meetings has undoubtedly moved in a positive direction. If managed well, I believe virtual meetings have earned their place in the world, if nothing else, by virtue of rescuing us from isolation and economic disaster during Covid-19. My openness to working online, and the willingness of my clients to go on that journey with me, has taught me some valuable lessons:

  • We all have the capacity in varying degrees to adapt and be flexible in a crisis

  • Acceptance of a situation decreases exhaustion  

  • All human contact has the potential to be tiring or invigorating, and that we need to learn how to move flexibly between different types of interactions

  • Loneliness is the most tiring experience of all, and that some form of connection is better than the alternative of none at all. 

In leaving, I quote Leonard Mlodinow:

“Social connection is such a basic feature of human experience that when we are deprived of it, we suffer.”  

So, grab a pet, stockpile some fun backgrounds, wear outrageous socks and remember to take some virtual breaks; this could take some getting used to. Happy Zooming!
 

A screen shot of a horse

Description automatically generatedPhoto Credit: Alison Johnson 

Psychologists Jeffrey S. Kahn, PhD, MAC, CGP, DABPS, and Alison W. Johnson, PsyD, had a vision.

They imagined a center where New Jersey’s most skilled psychotherapists—from all disciplines of applied psychology—could work under one roof. They saw a warm, welcoming, supportive space for individuals, couples, families, and groups of all ages. They pictured a communal environment that fostered counselor-to-counselor consultation and collaboration, and a spectrum of creative, innovative services.​

Most important, they envisioned a place where people could not only heal their psychological wounds—but also learn how to achieve their goals and live happier, more fulfilling lives.

Transforming dream into reality, Drs. Kahn and Johnson established Summit Psychological Services, P.A. in 1992. SPS has since grown to become one of the largest, most comprehensive private psychotherapy practices in New Jersey. Our Summit and Montclair offices have served thousands of people from northern and central New Jersey (Bergen, Essex, Hudson, Hunterdon, Middlesex, Morris, Passaic, Somerset, Union, Warren, and nearby counties); New York City; and Eastern Pennsylvania.

As an SPS client, you benefit from the best of all worlds: the comfort, privacy, and safety of a trusted therapist’s office; a wide range of services; and the depth and breadth of expertise offered by our multi-specialty team.

Summit Psychological Services offers two locations: in Summit at 482 Springfield Avenue and in Montclair, at 94 Valley Road. To reach us, contact Information@SummitPsychologicalServices.com or call 908-273-5558.

References:

1. Danna Markson, LCSW. Have you been wondering if online therapy really works? https://www.mindsoother.com/blog/the-amazing-benefits-of-therapy-online

2. BBC Interview with Gianpiero Petriglieri,  https://www.bbc.com/worklife/article/20200421-why-zoom-video-chats-are-so-exhausting.

3. Jeremy Bailenson, Experience on Demand: What Virtual Reality Is, How It Works, and What It Can Do. W. W. Norton, Incorporated, Feb 12, 2019. 

4. Tanya Joosten, Social Media for Educators: Strategies and Best Practices.  John Wiley & Sons, Apr 24, 2012.

5. Madeleine Aggeler, The Bizarre Intimacy of Video Chat, The Cut, New York Magazine, Mar. 20, 2020.

6. Manyu Jiang. Video chat is helping us stay employed and connected. But what makes it so tiring - and how can we reduce ‘Zoom fatigue’?, BBC Interview, 22nd April 2020.

7. K. Schoenenberg, A. Raake, & J. Koeppe. Why are you so slow? – Misattribution of transmission delay to attributes of the conversation partner at the far-end. International Journal of Human-Computer Studies, Volume 72, Issue 5, May 2014, Pages 477-487.

8.  Marissa Shuffler, Associate Professor at Clemson University.

9. Julia Sklar. ‘Zoom fatigue’ is taxing the brain. Here's why that happens. National Geographic, April 24th, 2020.

10.  Nicole Lee. Why is video conferencing so exhausting? Zoom fatigue is a real thing. Endgadget, April 27, 2020.

11.  https://personcenteredtech.com/2016/11/02/making-eye-contact-over-video-in-t elemental-health-services/ 

12. Watson, Jason & Strayer, David. (2010). Supertaskers: Profiles in extraordinary multitasking ability. Psychonomic bulletin & review. 17. 479-85. 10.3758/PBR.17.4.479.

13. https://time.com/author/cynthia-kubu-and-andre-machado/

14. Ben Cost. Invite a llama or goat to your next Zoom work meeting for under $100, New York Post, April 14, 2020  https://nypost.com/2020/04/14/invite-a-llama-or-goat-to-your-next-zoom-work-meeting-for-under-100/