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A commentary on the paper: “Clinical Issues in Analyses over the Telephone and Internet” by Jill Savege Scharff (Int J Psychoanal (2012) 93: 81–95) in the light of the present crisis
I am a psychoanalyst working within the German public health system, the “kassenärztliche Vereinigung.” I spend my days in my consulting rooms in the centre of Berlin, which I share with a young English-speaking colleague, who will take over my practice when I retire in a few years. About half my patients are German-speaking. The other half are English-speaking and come from all over the world. Usually, I see my patients in person. If they are used to the German social traditions, we shake hands in greeting. If they are English-speaking and come from elsewhere, we might not touch.
A few weeks ago, the handshake was the first thing to go. Then we started to disinfect the rooms. Luckily, I had some disinfectant at the back of my store of cleaning materials in my cellar at home. Most people working in the health system could no longer obtain disinfectant—or only at an extortionate price. We cleaned and disinfected the rooms as they had never been cleaned before.
But then social distancing was installed, at first as a recommendation, but later as an injunction with increasingly draconian fines for those who broke the rules. People should only come close to each other and should only travel to see other people if it were absolutely necessary. Thus, we were confronted with the question: was it absolutely necessary to see our patients in person? We had already decided that shaking hands was not absolutely necessary. We could touch elbows or feet instead, or simply say “good morning” or whatever. The public health system refused to pay for psychoanalysis sessions carried out on the telephone, which had seemed to be the natural alternative if we were not able to see people in person. Telephone contact was a “known,” something we had to do now and again. But now the telephone was considered to be no