The International Psychotherapy Institute (IPI) and its psychoanalytic training program, the International Institute for Psychoanalytic Training (IIPT), were founded as distance-learning programs. So, the question of how to conduct effective teaching across geographical distance has always been front and center in IPI's conceptualization of programs and in its teaching. I wrote an article for the Journal of the American Psychoanalytic Association about this in 2015 in order to share what the Institute had learned on the topic to that point. But events in the intervening years have overtaken what could be said then, so I am most appreciative to TAP editor Alan Sugarman for inviting me to update our learning in light of the suddenness with which all institutes and psychotherapy training programs have had to move online in the spring of 2020, most with little or no preparation.
The first thing to say is that good online teaching is centered in good teaching. If teaching technique does not work well in the in-person classroom, it will not work online either. For instance, a teacher reading from a paper or from lecture notes with his head down for an extended period of time is ineffective in a classroom, and even worse online. Now that we all have experience, it may come as no surprise that promoting discussion using Zoom—which I consider the best and most common platform—works similarly to classroom teaching.
IPI has used distance teaching at many levels of scale. When the Institute began using it in 1995, “distance education” meant that all our students had to travel several times a year to join us in Washington, D.C. This was expensive for out-of-town students; nonetheless, many found it worthwhile because they came from places without psychoanalysts, or even analytic psychotherapists, from whom to learn. Others came because they wanted access to our theoretical orientation in object relations psychoanalysis. Recall that in the late 19th and early 20th centuries, Americans wanting to learn psychoanalysis typically went to Vienna or Berlin, and later London. That was possible only because trans-Atlantic travel and travel by rail had improved over the previous decades, making it finally practical to travel long distances. Although the telephone was invented around the turn of the 20th century, calls were too expensive to be useful for treatment, education, or supervision.
Twenty-five years ago, phone service became inexpensive, so we at the International Psychotherapy Institute used it for individual supervision, small group “conference call” seminars, and group supervision. And it worked pretty well. We might have wished we could be in a room together, but it was nevertheless satisfying to be sharing ideas and clinical experiences over the phone. Then, in the late 1990s, came the internet and a subsidiary technology called the “intranet” offering the possibility to link sites for real-time audiovisual communication. It was relatively expensive but could link up to four sites at a price IPI decided it could afford. We linked Washington, D.C. with London, Salt Lake City, and Long Island. In that way, we could import teaching from London or New York to three American sites where students gathered. As far as I know, we were the first in our field to do this. One of our board members cautioned that there was considerable wisdom in being the second to try something new, thus letting someone else work out the bugs. But we forged ahead. Despite frequent technical glitches, we found that a great deal could be learned together as a group working across the four sites. We partnered with two divisions of the Tavistock in London over several years, the Tavistock Clinic and the Tavistock Institute of Marital Studies (now called Tavistock Relationships), sponsoring seminars online and international conferences in London and Washington, with benefit to students on both sides of the Atlantic. In addition, the IPI intranet made it possible to include a wide array of presenters and guests from the richness available in the New York area, or occasionally to invite someone located near or visiting the other sites.
Then the technology mushroomed. Suddenly we were able to offer large group seminars to individuals sitting at their own computers in the comfort of their offices or homes. Now we could invite guest teachers from anywhere in the world. At first, the available technology was clunky and often subject to disconnection. But as we all know, with the advent of current platforms (Zoom, Doxy.me, FaceTime, Google Groups), it has “Zoomed along.”
Here is what we do now at IPI:
We provide large group seminars where all participants are able to join in and speak during discussion periods. We do not do webinars because they constitute one-way delivery; over time, we found the webinar format to be the least effective teaching medium. People learn best when there is discussion in a group, regardless of size. We typically have groups that range in size from about 20 participants up to 150. (Our Zoom contracts allow 300 participants without having to buy a more expensive license,
David E. Scharff, M.D., is co-founder and former director of the International Psychotherapy Institute; Supervising Analyst in IPI's psychoanalytic program; co-chair of APsaA's Covid-19 Advisory Committee; and a member of APsaA's Distance Analysis Study Group. He directs training programs in China and Russia.
although larger group sizes are available.) We ask presenters in our seminar series to speak for approximately half the time. For instance, we ask for a one-hour presentation in a two-hour seminar, with several pauses throughout for discussion. That way, the audience feels listened to and the presenter receives feedback. Even though only a minority of participants speak in any large group, the possibility of speaking changes the receptiveness of the entire group. Participants also use the Zoom chat function to comment or ask questions. We strongly believe in interactive learning, no matter the size of the group.
We use Zoom's large group meeting feature for institutional events: faculty meetings, meetings of our entire center, and Town Halls that draw participants from all over the world (China, Australia, South America, Europe) to discuss issues of mutual concern—racial issues, for example, culture and ethics, or Covid and its effects.
Small group seminars, the size of an analytic or psychotherapy class, also work well on Zoom. Teachers and students see and hear each other well. We encourage group discussion in these settings and discourage teachers from lecturing without group participation. That makes real learning, of the kind afforded by small seminars, entirely possible on Zoom.
Covid travel restrictions prompted us to offer our larger weekend conferences (from 75 to 100 students and faculty) online. Candidates, students, and other participants work with distinguished guests and IPI faculty in large and small group settings over three days of intensive learning. Enrollment has steadily increased during the pandemic, reaching numbers as high as 150 participants, in part because these conferences do not require the added time and expense of travel.
While I hear many complaints about “Zoom fatigue,” it does not have to be exhausting! With experience, you can learn to relax during teaching, just as you need to relax while conducting therapy.
Our six hard-won lessons for teaching online:
Always keep group dynamics in mind.
Monitor the group: Who is speaking? Is the group participating or only listening passively? Are one or more students hiding without participating, perhaps with their cameras off?
Involve the group members. Do you want candidates or students to prepare to present material, for instance, from the readings? Or to summarize a topic from their own study? Or to address questions supplied in advance to focus their reading?
Technical glitches will happen! Have you prepared a fallback plan to switch to another platform—FaceTime, Google Groups, or cell phones? Be sure to have everyone's email address and phone number so you can call or text easily about how to reconnect.
Periodically review with students how the teaching is going. There should be both formal review by the course or program organizer and by the teacher with their group. This is especially important online because there is diminution in non-verbal cues. But we can make up for that by reviewing the teaching and learning in tactful but overt ways initiated by the teacher. Otherwise, dissatisfaction can build through such impalpable forms of resistance as seen in the overly compliant student who learns little.
Finally: Learn to enjoy yourself in face-to-face connection with students over Zoom. You will have saved commuting time and enjoyed the comfort of your own office, just as they have. While I hear many complaints about “Zoom fatigue,” it does not have to be exhausting! With experience, you can learn to relax during teaching, just as you need to relax while conducting therapy. Teaching and supervising should be more than work; they should include the pleasure of helping less-experienced colleagues develop. We have had an incredible opportunity in our ability to continue teaching and learning in the time of a pandemic. And for sure, as this worldwide tragedy recedes, we will experience an expansion of what is possible in the teaching and availability of psychoanalysis.
What does not work as well is a so-called hybrid classroom, with some students in the room and some online. In a preliminary survey done by APsaA's Distance Analysis Study Group, candidates complained about these mixed seminars. They reported that this approach disadvantaged the distance candidates. Their preference was for “all online” or “all in-room.”
Supervision is especially convenient and successful online. In my own experience, there is no difference in effectiveness between in-room and online supervision and consultation. This applies equally to individual, paired, and group supervision. Unless a broadband weakness requires a disabled camera for improved transmission, I ask my supervisees to have their cameras on. Some supervision pairs prefer the telephone; that, too, is effective. Allowing the supervising pair to choose is as important as in clinical analysis or psychotherapy.
The largest downside of distance-mediated education, what we all miss most, is the informal time—meeting in the hallway over coffee or for a drink after class. It is possible to make some accommodation for this loss by scheduling a group chat for a class or faculty, but we look forward to being physically together as we creep back to normality. Reinstating the social aspect will be easier because we have stayed in touch online in the meantime.