Analyzing from Home: The Virtual Space as a Flexible Container

Psychodyn Psychiatry. 2021 Fall;49(3):425-440. doi: 10.1521/pdps.2021.49.3.425.

Abstract

This manuscript explores the experience of teleanalysis for analyst and patient during the COVID-19 pandemic through the lenses of embodied intersubjective relating, the neurobiology of social engagement, and technologically mediated human interaction. At the beginning of the pandemic, many analytic dyads were embarking on remote work for the first time. More than a year later, we are facing the question of whether we will ever return to in-person work. In order to unpack this question, it is useful to consider how in-person analysis and in-person interaction more generally differ from remote interaction. Multiple nonverbal modalities are responsible for affective coregulation in intersubjective relating, including voice, body, and shared physical space. While conscious awareness tends to concentrate on auditory and visual inputs, other sensory inputs also impact affective experience. The impact of physical distance upon psychoanalytic treatment is compared with that of the couch. The shift in the balance of power introduced by teleanalysis is considered. Analyzing and being analyzed from home bend the frame of psychoanalysis, complicating notions about distance and intimacy and opening new spaces in which meaning can be cocreated. The COVID-19 pandemic presents an opportunity for psychoanalysis to engage more deeply with the questions raised by teleanalysis in order to enhance our understanding of its impact on treatment.

Keywords: COVID-19; couch; embodiment; intersubjective relating; teleanalysis; telepsychotherapy; teletherapy.

Publication types

  • Review

MeSH terms

  • Attitude of Health Personnel
  • COVID-19 / prevention & control*
  • Humans
  • Mental Disorders / therapy*
  • Pandemics
  • Psychoanalytic Therapy / methods*
  • SARS-CoV-2
  • Telemedicine / methods*