Mental Health Advice for Sex Workers During COVID-19
By: Carin Freimond
Tags: Covid 19, Sex Workers, Sex Work, Mental Health Treatment, Pandemic

Carin Freimond is a therapist in Victoria, Canada

As a therapist working primarily with people who work in the sex industry, I am concerned for my clients at this time and would like to share some information that may be helpful.

It is important to acknowledge that sex workers are experiencing concerns similar to other in-person service providers and self-employed people during the COVID-19 situation, but they have additional, unique concerns that need to be acknowledged and addressed during these uncertain times.

Social stigma and criminalization of the sex industry lead many sex workers to hide their occupations from friends, family, and even their therapists. This secrecy may prevent them from being able to turn to others for emotional support during difficult times. Whereas servers, cooks, taxi drivers, baristas, and other service providers may feel comfortable telling others about being let go or having their work hours reduced, sex workers may not. Rather than turn outward for support, they may be suffering alone.

As well, many sex workers are concerned about whether they will be eligible for emergency benefits that are being announced by the government. Some sex workers may not have declared income in the past, or may not know how to explain their work situations if they are asked for documentation of their work history. Some may be working in a country that they don’t have permission to work in.

Prejudice is another challenge facing sex workers at this time. Though sex workers tend to engage in safer sex practices and often have better hygiene practices than the general public, they are often referred to as “vectors of disease” even during the best of times. During a pandemic, the “dirty whore” stereotype is brought up in full force.

As sex workers face the challenges that many other workers are facing at this moment, in addition to their own unique challenges, I urge my clients to consider what they can do to take care of their mental health during this time.

If you work in the sex industry, here are some strategies you may find helpful:

Remember, you are not alone

There are other sex workers out there going through what you’re going through. Even if nobody in your family or friend group knows what you do, and you don’t have friends in the sex industry, you are not alone. Many sex workers do their work in isolation, and you are not the only person in your situation. If it feels safe and comfortable for you, consider connecting with other sex workers online. There are vibrant sex work communities on Twitter and Reddit. Often, you will be able to gain access to private group chats that operate out of the public eye.

If you are already connected to a community of other sex workers, or of supportive friends or family, consider reaching out to them to ask for emotional support. Be sure to let them know how they can help you. Do you want a shoulder to cry on? Someone to listen to you? Advice? Telling your support people how they can best support you right now will help them help you.

Setting and Maintaining Boundaries at Work

You may still be working right now, and if you are, consider what kind of work you are willing to do, and under what circumstances. Many sex workers are reporting that business is significantly slower than usual, and so they are considering offering discounts. Others are reporting that clients are trying to haggle with them or push them to offer services they don’t normally offer. Many sex workers who are under ordered or voluntary lockdown are trying to move their work online.

Give some thought to your boundaries. Are you willing to work for less money? Are you willing to offer services you don’t normally offer? If yes, consider that you may need to implement additional self care practices or set up new safety guards to reflect these changes to your work. If no, consider how you will respond to clients who attempt to haggle with you or who attempt to pressure you to offer services you don’t want to offer. If you do in-person sex work, consider what additional safety measures you may need to put in place.

If you are moving your services online, what are you willing to do and not do, and for how much? Remember that it’s okay to not know, and it’s okay to change your mind. You may be doing online work for the first time, and you may need to get some experience before you have a better sense of your boundaries.

Setting and Maintaining Boundaries with Your Social Connections

At this time, people are responding in different ways to news of the pandemic. Some people are more calm than others. Many of us have a friend who is urgently texting us or sending out the latest updates and articles on the COVID-19 situation. If you find this stressful, you may want to consider setting some boundaries with this person.

Boundaries can look like asking people not to send you texts about the news, or limiting conversations about the news to specific times of day (such as only in the daytime and never at night), or to specific amounts of time (such as 5 minutes, or 20 minutes). Let others know what your boundaries are. Before you set a boundary, give some thought to how you will respond if your boundary is not respected. Will you end the conversation? Ignore the text? Ask the person again to respect your boundaries? How will you set and maintain your boundaries in a way that feels manageable and healthy for you?

Setting and Maintaining Boundaries with Yourself

Many people are checking the news more frequently than usual and spending more time on social media than they usually do. Consider whether this is helpful for you. Do you need to set some boundaries with yourself about how much time you will spend online? Boundaries can look like making an agreement with yourself that you will only spend x amount of time on social media per day, or only check the news once or twice per day. You may consider implementing a “no news before bedtime” rule with yourself, and perhaps even a “no news right after waking up” rule.

You may have fallen out of some of your usual self-care and wellness routines. If you used to go to a gym and it has now closed, you may not have come up with an alternative yet. Perhaps anxiety has interfered with your routine, leading you to skip workouts, or to stay up later than usual.

Check in with yourself about how you are doing with your self-care and wellness practices. What does self-care look like for you?

“Cave Person” Self Care

It is easy to forget that we are animals. We have the same biological needs in our modern age as we did during “cave person” days. In order to be healthy and well, humans need to sleep enough, eat well, and move our bodies on a regular basis in accordance with our abilities. These practices are not luxuries — they are needs.

Check in with yourself about how you are managing your sleep, eating, and movement routines. Are you taking care of yourself? If yes, what do you need to do to maintain these practices? If no, what are you able to stop, start, or change that could help improve your sleep, eating, and movement practices?

Self-Soothing Strategies

Those of us who struggle with substance use issues, anxiety, depression, or other mental or physical health challenges might be having a harder time than usual. During times of stress, it can be harder to maintain a healthy routine, or to avoid a behaviour that we don’t want to engage in (such as drinking, Internet use, self-harm, or binge-eating). What are some practices you can draw on to take care of yourself during this time?

Many people find it helpful to exercise, meditate, take deep breaths, listen to soothing music, light candles, take bubble baths, watch funny movies, or connect with friends. It can also be helpful to do something active or creative, like exercise, play games, or do chores. During stressful times, some people need to be active and some people need to slow down. What helps you? What can you do to take care of yourself at this time, big or small?

Reality Acceptance

Sometimes we cause ourselves more stress than we would otherwise experience when we refuse to accept the reality of the situation. Perhaps you are in a situation with no ideal option. You may be in a position where you are forced to choose between only bad options (such as the choice to work for less money or not work at all), or you may be dealing with an unexpected challenge (such as not being able to pay your rent, or trying to juggle work and childcare because your child’s school has closed). Whatever your situation is, I encourage you to acknowledge the facts of what has changed in your life.

Denying reality is an avoidance coping strategy than can help us manage stress in the short term but which often increases stress in the long term. Denying reality can look like continually raging about it (such as, “I can’t believe this is happening!” or “Can you believe x?”) and ruminating about it (such as thinking the same thoughts over and over again but getting nowhere new). Allowing ourselves to feel our emotions is extremely important. At the same time, we also need to find a way to accept what is happening.

Accepting reality does not mean liking it, or approving of it. We may hate our situation. We may feel anger or despair about what is going on in our lives. Accepting reality simply means acknowledging the facts of the situation. Once we accept what is happening, we are better equipped to move into problem solving mode. Of course, not all problems can be solved. Many people are facing situations that don’t seem to have solutions. However, after assessing the facts of your situation, you can ask yourself, “what is the best I can do, given my situation?”

Managing Overwhelm

It is common to experience feelings of being overwhelmed during a crisis. If you feel overwhelmed by what would normally seem like small things to you, such as checking in with a friend, buying groceries, or taking a shower, there is nothing wrong with you. It makes sense to feel overwhelmed in a crisis. In all likelihood, you were not anticipating a pandemic, and were not emotionally prepared ahead of time for how to handle this situation. Most of us are figuring this out as we go.

Your emotional experience is valid, and your response makes sense.

If you feel overwhelmed, it can help to take a break from whatever you’re doing and try to slow down your breathing. If you can, take ten slow, deep breaths. If possible, inhale for a count of 4 and exhale for a count of 6. Slowing the exhale can have a calming effect. Take ten slow, deep breaths and see how you feel. You may need to repeat this exercise several times in a row, and that’s okay. I invite you to listen to your body and do what feels right for you.

Another way to manage feeling overwhelmed is to try a grounding exercise. Grounding helps you to focus your attention on the here and now, and can help relieve feelings of panic and overwhelm. Many people find the following 5–4–3–2–1 exercise helpful.

To try it, go through the following steps:

Name 5 things you can see around you. It could be a chair, a pen, a spot of the wall, your shoes.

Name 4 things you can touch around you. It could be the ground, your sweater, your hair, a table.

Name 3 things you can can hear around you. If you can’t hear 3 things, then name your 3 favourite sounds.

Name 2 things you can smell around you. If you can’t smell 2 things in the room, then name your 2 favourite scents.

Name 1 thing you can taste. It can be gum, toothpaste, or coffee. If you can’t taste anything, then name your favourite taste.

This exercise can help us feel more grounded and calm. You can do it whenever you need to throughout the day, and you may find it helpful to use several times a day.

Self-Compassion

However you are feeling is okay. You may be feeling anger, sadness, confusion, fear, numbness, disassociation, regret, guilt, jealousy, or even joy. You may be experiencing mood swings. You may go back and forth between these emotions daily, hourly, or even by the minute. That’s okay. There is no right or wrong way to feel right now.

If possible, allow yourself to feel whatever you are feeling. There is nothing wrong with you for feeling this way, and you are not alone in your experience.

Many people find it helpful to practice a self-compassion exercise. Dr Kristin Neff has an excellent 5 minute guided audio exercise available for free on her website. I invite you to check it out at the link here.

Let yourself cry

Many of us were raised in a culture that discourages crying. As children, we may have been told not to cry, or we may have been shamed for crying. In fact, crying is one of the best tools the body has for releasing stress.

If it feels safe and comfortable for you, I encourage you to listen to your body, and cry if you need to. We often feel much better after crying because it can relieve a lot of the tension we are holding onto in the body.

Shaking and trembling are other ways that the body releases stress. If it feels safe and comfortable, allow your body to move in this way. Many of us were raised to feel uncomfortable with this reaction, but it’s actually normal and healthy for the body to shake and tremble as a way to release stress.

Resilience

Sex workers face many of the same concerns facing everyone else right now, as well as several additional challenges. It is important to acknowledge that stigma, prejudice, and criminalization of the sex industry make sex workers lives more difficult.

At the same time, sex workers are among the most resilient, resourceful, creative, and loving people there are. Sex workers are helping each other during this time and coming up with strategies to try to address many of the problems now facing the industry.

Carin Freimond is a therapist in Victoria, Canada. Her current focus is on sex work, trauma, and PTSD. She works at Peers Victoria and maintains a virtual private practice. You can find her on Youtube, Facebook, Instagram, Twitter, and Medium.