“All that is solid melts into air, all that is holy is profaned.” In his 1848 The Communist Manifesto, Karl Marx anticipates how capitalism depends on constant technological innovation with increasingly efficient machinery in his time and, now, with the globalization of the marketplace, an ever-improving internet. For Marx, this process always results in worsening and thinning relationships between human beings. A person's value increasingly becomes defined as transaction; vestiges of humane, more ethical bonds between one another disappear. Connections between people that had once been solid and stable dissolve over time becoming always more ephemeral and instrumental. As that process within capitalism reaches its denouement, Marx insists, “Man is at last compelled to face with sober senses, his real conditions of life, and his relations with his kind.”
For now, because of the pandemic, only “virtual” psychoanalytic relationships are possible. For us, the sanctity and solidity of the consulting room has been upended, dramatically replaced by the technological limitations proscribed by the internet. Long before the coronavirus, psychoanalysis struggled with how enthusiastically to embrace this new technological capacity that enables the therapist to practice his or her trade absent in-the-room interaction. Today, we are faced with no alternative: We exist in a post-viral age. What had suddenly occurred, I imagined, was the degradation of my working day. What had been holy between me and my patient was profaned.
Months into our lockdown, I do not speak so confidently. The virtual experience, as a rule, is not as bad as I imagined. Without a doubt, it is a different way to engage with another. No longer can I ensure a physical space for my patients to explore their inner worlds or the privacy of their own thoughts. Instead, they confront the real constraints imposed by their living arrangements. Some of my patients have adapted more successfully than others. The few patients who decided to take a hiatus from treatment, while expressing various reasons including “not having anything to talk about,” nonetheless seem less able to pursue their own self-exploration.
Jeffrey Prager, Ph.D., is research professor of sociology, interim chair of the Department of Information Studies at UCLA, and training and supervising analyst at the New Center for Psychoanalysis in Los Angeles.
I will return to this at the end of these reflections.
Still, there are many features that remain the same. When I reflect on my reaction to the script “the internet connection is unstable” in session, as an accusation that I haven't adequately provided for my patient, it's not much different than when we shared the same space. It reminds me of those rare occasions when someone, like a delivery person, would knock on my consulting room door during a patient hour. Then, annoyed at the disturbance, my concentration and focus broken, and protective of the patient's privacy, I would quickly handle the breach, apologize to the patient for the intrusion and, more to the point, feel as if I failed to provide the kind of safety I implicitly promise. When I am unable to provide a stable and strong internet signal, I similarly experience impatience as if I am letting down the patient. Even that has receded, as we together adjust to the realities of today's world. I am able to demonstrate my reliability, punctuality, and my capacity to create and maintain a sense of care and responsibility for the patient's well-being. Virtuality does not weaken feelings and behaviors essential to the analytic relationship.
Virtuality does not weaken feelings and behaviors essential to the analytic relationship.
There is nonetheless a truth to Marx's original assertion that this new technological capacity makes us all “face… our real conditions of life and [our] relations with [our] kind.” For those we treat and for ourselves, our new reality—the necessity for self-isolation and our dependence on internet technology—forces us to confront ourselves and our interpersonal relationships in ways that might otherwise have escaped our attention.
I find myself often exploring with my patients' fundamental existential questions otherwise obscured in the comfort and safety of the office.
In almost an instant, we were forced to accommodate to a new realization: our precarity to the danger of infection by a virus for which we have no immunity. However felt, in abandoning my office, the illusion of a vast chasm between my patients and me, at least for a time, powerfully dissolved. We were all doing the best we could to navigate treacherous waters. One patient reported feeling reassured, seeing me via Zoom in the safety of my home. She reported that until then it was difficult to hold a view of me as existing outside my office and, therefore, with the virus sweeping the world, especially vulnerable. I could hear her concern for me and my importance to her. Those feelings could no longer be so neatly bracketed off as when she could more comfortably think of us as in my office together “doing therapy.”
In the immediate aftermath of the lockdown last spring, my distress at not seeing my patients in person surfaced vividly. It was not unlike in the aftermath of a Southern California earthquake, when fear, danger, and uncertainty undid our routine. Then and now, I felt freer, even compelled, to share my own experiences with my patients, including what precautions I took to protect myself. In this instance especially, my own need to improvise with respect to the unexpected made me better appreciate their experiences of radical uncertainty. For both of us, we felt the contingent quality of decision-making as we tried to adapt to the powerfulness and complexity of a world over which we have little control. The asymmetry of power inherent in the analytic relationship, for a time at least, was rattled. The actual conditions of mutually shared precarity became front and center.
The intensity of that moment has passed, the novelty of our meeting on Zoom has worn off and the pre-existing routine has returned, more or less. But I know that the forcefulness of a permanent and solid world we relied on has been profoundly shaken. We don't yet know whether the visceral realization of human fragility in the world will be more permanently inscribed in our consciousness. Will the universality of this shared experience of human vulnerability make us all more ecologically mindful? Will the largely unchecked impulse to master nature, as if it were possible, generate instead a more authentic relation to our real place in nature?
The pandemic brought a rapid retreat into our homes, halting immediate plans, calling into question long-range ones, and squelching visions for the future. We were required to reside more fully in the present and live within our inner selves. We shared in the experience of solitude, radical downscaling expectations in which we became less reliant on the outside world of people and things for stimulation. What now seems to be a nearly compulsive desire for novelty of experiences—travel, restaurants, entertainment, new cars, new people—has been called into
question. For many of my patients, this scaled-down life has come to feel surprisingly centering, offering a greater confidence in their own capacity for self-care.
Simultaneously, as physical and emotional vulnerabilities are confronted, so too is the reality of one's own death. We are forced to acknowledge our own finitude. Many of my patients, with a more stripped away perception of time, feel greater urgency to realize their life. I have found this especially among people of color. For them, their finitude is more profoundly experienced, especially because of recent reminders that life can be instantaneously taken away because of the color of their skin. Seeing their own vulnerability with greater clarity, they engage their treatment with a more vivid sense of time passing and opportunities potentially lost.
In short, the locus of personal experience has shifted away from the “mundane”—the life world—and toward more “sacred” existential issues of being. Here again, more than reliance on a new technology, our retreat to Zoom comes to represent existential uncertainty. Zoom becomes a prod to face the “real conditions of life” rather than superficial distractions.
For many, especially young people, Covid-19 threatens to evaporate hard fought gains in creating a place of one's own—a sense of forging and securing one's individuality and personal autonomy. This experience is surely aggravated for some by the near-absence of any collective expression that unites their own responsible behavior with serving a public good or the common welfare. We live in a nation that, rather than providing a sustaining linkage between individual initiative and the collective good, demands that individuals fend for themselves and socially isolate. This contributes to loneliness, feelings that one does not matter to anything or to anyone. Anger, defiance, denial, anxiety, somatization, lethargy, and retreat all function to defend against loneliness.
In this moment, anti-racism and anti-loneliness are powerfully linked together.
By loneliness, I mean not an existential crisis but rather an expression of profound social failure. For me, keeping this kind of patient in treatment has presented a serious challenge; without social supports to encourage idealistic, even grandiose, purpose for which to prepare, the uncertainty of any planned future, and financial insecurity, the motivation to work on oneself becomes very precarious indeed.
No one could have anticipated the sudden acts of near universal condemnation of police brutality, systemic racism, and racial injustice in America in the midst of the pandemic. Following the death of George Floyd in May 2020, massive multiracial demonstrations throughout the country burst forth and they have endured. They take place in big cities and small, and in urban, suburban, and rural parts of the country. The starkly disproportionate number of Black Americans who have died from the virus highlighted the undeniable truth of racial inequality.
This social uprising would likely not have attained either the breadth or intensity of expression had it not been for the Covid-19 lockdown and the social isolation it created. The protests required individuals to forswear best practices that otherwise serve to protect them from infection. This “acting-out” occurred as a unified vision of America, one no longer divided by racism, gained strength and urgency. Protesters stood against systemic anti-Black police brutality and a political leadership refusing to articulate a common national purpose and a collective vision for the future. In my view, the ubiquity and durability of the protests express a refusal, especially by the young, to tolerate simultaneously drastic social isolation and a radical rejection of white inhumanity toward Blacks. In this moment, anti-racism and anti-loneliness are powerfully linked together.
Marx's invocation that new technology forces us to confront, in the new ways, “the relations between [our] kind,” might capture, at least in the U.S., today's moment in ways that Marx could not anticipate. The rallying cry that “all lives matter only when Black Lives Matter” suggests a new sensibility and a new subjectivity among people—dramatically forged in the course of these protests against police brutality, with the pandemic as its backdrop. Beset by the affective realization that life is both precious and brief, the uprising embodies the realization that overcoming loneliness requires a world that cares for everyone, not just some. Millions of protesters proclaim that America cannot be whole until “our kind” has no racialized referent.
Only now has the reality and morally bankrupt character of white supremacy come into sharp focus. This is not a new insight for African-Americans, but it may be for others. What is solid that has melted into air may not be our discovery that therapy can occur without a physical office but rather our complacency with which we imagined that, following the pandemic, our nation will return to the way it was.