Now I See You, Now I Don’t: Screen Services, Short Stature, and the Fear of Being Seen

As psychoanalysts venture into the online world, they are confronted with both anxiety and opportunity. In this paper, I attempt to add to our collective thinking about the perils and potentials of introducing technologically mediated communication (e.g., Skype, FaceTime) into the treatment situation. I present the case of an 11-year-old boy of short stature, or Dwarfism, for whom screen relations–based sessions were used as an adjunct to face-to-face psychoanalytic psychotherapy. I argue that the introduction of screen relations provided the patient with a temporary respite from the narcissistic pain of being seen. Indeed, although I agree that relying on screen relations risks the possibility of relational disconnection between analyst and patient, it may also provide a means for the patient to begin to exert a degree of control over impinging reflected appraisals of himself via the analyst’s visual, auditory, and physical copresence without banishing them entirely. In the case I present, the introduction of screen relations presented the analytic dyad with an opportunity to work through important relational meanings attached to the patient’s experience of being small. Over time, the patient was able to risk new, increasingly intimate forms of engagement both inside and outside of the consulting room.