Our ways of communicating with one another have changed dramatically in the last decade. Whereas, we used to write letters or place telephone calls, many of us now e-mail, fax, tweet or send messages on Facebook. Furthermore, we can now employ search engines to find out about almost anyone's education, financial status, publications and other information. Patients have used these technologies for gathering information about their analysts; on occasion, analysts have used these same technologies to communicate with and learn about their patients.
Has communication via new technologies altered analytic intimacy? What are the advantages and disadvantages of using video or other technologies as tools in analysis? How does their use relate to issues of defense and of developing transference? New technologies have not only changed the therapeutic landscape, but also the teaching of analysis as well. How does one measure the benefits and drawbacks of distance learning and treatment? Furthermore, how might the use of new technologies in society affect child and adolescent development?
Our Study Group on New Technologies (one of the largest of the COPE groups) has begun to explore how the advent of new technologies affects our work as analysts, both the techniques we use and the theories of the mind we employ. The members of the group are Ric Almond (Palo Alto), Alice Bartlett (Topeka), Vera Camden (Cleveland), Steven Clarke (Minneapolis), Ralph Fishkin (Philadelphia), Philip Freeman (Boston), Richard Honig (Stockbridge), Sarah Knox (Cincinnati), Scott Murray (Portland, Oregon), Gerald Melchiode (Dallas), Jill Scharff (D.C.), Ernest Wallwork (D.C.), Nancy Winters (Portland, Oregon) and Lyn Yonack (Great Barrington).
We have had four meetings so far: the first to introduce ourselves and our interests to one another; the next two by teleconference to share experiences of telephone analysis and treatment via video face time. We began by discussing the use of the telephone, which has its own unique qualities, different from other forms of analysis. We tried to understand what those qualities are: What do they allow? What may they inhibit in terms of communication? Certainly, non-verbal forms of communication are limited in telephone analyses. We also noted that certain aspects of separation anxiety on the part of both analyst and patients might be greater in telephone analysis. Both parties may become concerned as to whether they are in fact still “connected” or if the line has “gone dead.” This may make silences more difficult to bear. The impulse to call a patient who has not called at the appointed time may also be greater because of concerns about whether the patient was able to get through.
It was noted, too, that telephone analyses gave analyst and patients greater freedom in terms of body position and movement and in terms of the physical space from which one spoke as well as the state of
dress of the participants. Some colleagues request that their patient lie on a couch, others do not, trying instead to analyze the choice of environments from which patients speak to them.
We agreed the use of the telephone and the physical distance it creates might have different meanings for different patients and different meanings at different stages of an analysis. For instance, it might provide a sense of needed safety for the patient who has been severely physically traumatized. For another patient, very dependent on measuring the slightest reaction of the analyst upon entering and leaving, the absence of visual guidance might awaken deep feelings of aloneness or disorientation. For still others, Oedipal conflicts explored at a physical distance provides either relief or frustration. When might each party long for the physical presence of the other? When might they be relieved by its absence?
How much does the smell and decor of an office, whatever it may be, contribute to the memories and affects of patients? Absence of these features of typical analyses, our group felt, may not mean a less intense interaction, just a different one. It is essential, to analyze the way in which the use of new technologies helps shape transference and countertransference.
At our third meeting, we began a discussion of our experiences with VSee and other video technologies. We will continue this discussion when we next meet. Our last meeting was taken up with how we might best serve the membership through our study group. We will begin by:
Implementing a survey about frequency of treating candidates in analysis via video conferencing or telephone. Study group members felt the incidence of this mode of treatment analyses is on the rise both in training analyses and analyses done by candidates. Surprisingly, there is no data currently available about its use.
Surveying whether there are courses offered at institutes on the use of these new technologies. This survey has already begun under the leadership of study group member Lyn Yonack.
Publishing on the APsaA website a bibliography on the uses of new technologies in treatment and education, along with annotations on some of the works cited.
Fostering workshops, further panels and publications on the analytic uses of new technologies.
Collaboration with the APsaA Discussion Group, “Psychoanalysis and New Technologies,” chaired by Nancy Winters and Scott Murray.
APsaA members interested in the work of this study group should feel free to contact me at .