Screen Relations: The Limits of Computer-Mediated Psychoanalysis and Psychotherapy

Increased world-wide mobility and easy access to technology means that computer-mediated communication is being adopted rapidly and uncritically by psychoanalysts and psychoanalytic psychotherapists. Despite claims of equivalence between mediated and shared environment treatments, there has been no research on the efficacy of technologically-mediated treatments.

Can an effective therapeutic process occur without physical co-presence? What happens to screen-bound treatment when, as a patient said, there is no potential to “kiss or kick?” Our most intimate relationships, including that of analyst and patient, rely on a significant implicit non-verbal component, carrying equal or possibly more weight than the explicit verbal component. How is this finely-nuanced interchange affected by technologically-mediated communication?

The author draws on the fields of neuroscience, communication studies, infant observation, cognitive science and computer communication studies, finding the common ground where they intersect with psychoanalysis in their definitions of a sense of presence, upon which the sense of self is dependent, to explore these questions.

To this emerging body of literature and research was added a collection of ethnographic key informant interviews with senior psychoanalysts experienced in computer-mediated treatment. This new data reveals surprising, and non-intuitive, elements.

Based on these findings, the author makes a series of valuable clinical recommendations for practitioners using computer-mediation, helping them to anticipate the particular gains and losses of which they must be aware in order to be most effective.