Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

Transitional Objects During Physical Isolation


Encourage patients to identify items that remind them of people and places that they love but cannot be near right now. This may help ease feelings of loneliness and longing.

Connecting with Patients | July 28, 2020 | 4 min read

By Nadia Jenefsky, MPS, LCAT, Michelle Munson, LMSW, PhD, Cheryl Walpole Tiku, MPS, LCAT, and Andrea Latvis, MA


When the package from my mother arrived on my doorstep, a warm feeling spread throughout my body. It wasn’t just what was inside it, it was everything about it—my mother’s handwriting on the address tag, the Swiss stamp, the careful fold of the tissue paper. And inside it, a handmade mask, made with Snoopy sheets relegated from my childhood bed. It even smelled like home. As clinicians, practice-based researchers, and teachers, our offices, our materials, and ourselves can be transformative objects/spaces for learning, emoting, creating, and ultimately becoming.



Since the coronavirus pandemic has limited meeting in-person, we’ve had to create new and different ways of connecting with patients. In our work at New York University we transitioned our group meetings for the Youth and Young Adult Mental Health Group, holding our research and planning meetings via Zoom to discuss young adults, ongoing projects, and how we’re feeling and doing. Importantly, we also talk about how we can be present for one another in our individual experiences with the pandemic. This became a healing place for us, our colleagues, and our students.



After moving an art therapy group online, our intern Andrea Latvis had the wonderful idea to mail art kits to all of our Zoom group members. She collected materials from the office and made little bags for contactless pickup. Everyone was thrilled and having the same set of supplies as everyone else increased our sense of connection. From this spark was born the idea of expressing both our care for our patients and our desire to bring a piece of us to their homes by developing care packages for them to create with, maintain the connection to our practice, therapy space, and ultimately safety and care.



The transitional object

Dr. Donald Winnicott coined the term transitional object in his book “Playing and Reality.” He was referring to the power imbued upon inanimate objects by young children as they individuate from their caregivers. The transitional object offers a way to substitute actual physical contact with a caregiver or loved one with sensory reminders of that person—something to hold, smell, see, something that reminds you of that person when you can’t be near them.



In the past months we’ve been delivering care packages to our patients as transitional objects to keep the continuity of the therapeutic relationship alive during physical distancing. There’s a meaning greater than the sum of its parts in these deliveries. They are proof that the therapeutic space still exists. That we continue to care for our patients. It’s life-affirming and relationship affirming. The materials donated, not from a store but from our own shelves, with the wear and tear of the hours and days of use for creative purposes, of the touch and interaction of the many who share our space, with their distinct art supply smell, which people often remark on when entering our office, have both intrinsic and relational value. On our end, it was a powerful and holistic experience to simply put something together (and with love), and to send that package of love out into the world. Maybe we assemble some of ourselves in the process too?


Our coloring book, a distillation of our care and our mission to help people help themselves and soothe themselves, is another component, which we mostly delivered to our colleagues on the frontlines of COVID-19 in NYC hospitals. And finally, a small plant, grown by Cheryl Walpole, our horticulture therapist, who when the office closed continued to come in and tend to her seedlings, a manifestation of life going on, of continuous growth, of the tender nurturing of people and their souls in this isolating and grief-stricken time.


Four ways to use the concept of transitional objects during physical distancing:


1. Encourage patients to identify objects they own that remind them of people they love but cannot be near right now.

This could be a photograph, piece of clothing, or a gift from that person. Have your patient create such an object if they don’t have one.


2. Consider using the postal service to send physical messages rather than only relying on email.

Seeing someone’s handwriting, the paper they chose, and being able to keep it and hold it adds value and depth to the communication.


3. Share printables if physical delivery or mailings are not possible.

Making a selection of items for your patient to print shows that you have been thinking of them and allows them a touchstone to refer to between sessions.


4. Invite your patients to connect to the sensory experiences surrounding the people and places that they love, including the therapy office.

Help your patient remember what it smells like, the soundscape, and what’s hanging on the walls.


Soon we will meet again. Until then, we can use our imagination and our senses to maintain continuity between ourselves and the spaces and connections we are missing.