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Gillian Isaacs Russell’s exceptional book Screen Relations: The Limits of Computer-Mediated Psychoanalysis and Psychotherapy provides a much needed counterpoint to the seemingly inevitable advancement of computer-mediated treatments. It was a pleasure to read Dr. Russell’s investigation into the practice of computer-mediated therapies, as she is a skillful, thoughtful, and provocative writer. She convincingly lays out the case that these treatments are not equivalent to the experiences of in-person treatments. Using a wide range of evidence, including descriptions of computer-mediated therapies from both patients and therapists, findings from attachment and neurological literature, and studies from information and technology companies invested in working remotely, Dr. Russell argues that screen treatments perpetuate the mind–body dichotomy that has long haunted traditional psychoanalysis. Because screen therapies are constrained by the limitations of available technology, they capture at best only a very small aspect of each individual’s physical experience. This is because typically only the upper body of each participant is transmitted, and even this is often overly pixelated or slowed down by computer and Internet lag. As a result, most of the “presence” of both parties, as well as the actual environment of the consulting room, does not get transmitted back and forth.
This is not solely a hardware/infrastructure problem that will disappear or fade out as technology improves. Rather, technology does not seem capable of fully capturing or simulating the ongoing implicit nonverbal and embodied communications that occur between people. This has numerous limitations, especially for therapists, as we are dependent on these processes for successfully
getting to know others and for providing them with treatment. Consequentially, computer-mediated treatments force therapists to pay almost exclusive attention to the verbal and rational, excluding the exploration and exper