the virtual couch

Working primarily from a psychoanalytic perspective, rarely did I consider working virtually unless I truly knew the person very well and could trust that our therapy relationship had already stood a test of time and effort. There have always been candidates in my practice for whom I have maintained a distance therapy relationship with, some for over a decade. I have had evidence that utilizing technology such as phone or video, have been effective in maintaining not only the therapy relationship, but also, importantly, the personal growth and development of my patients. The tenacity and resilience in maintaining a therapy process through the use of technology, mourning the loss of “coming to my office”and experiencing “being together in the room” are not resolved easily or swiftly. These processes are examined, and reexamined as they materialize in the process of therapy.

So, when a pandemic such as the one that we are living through simultaneously, immediately forced us all to realign our lives and in particular, our therapy process, to one that is exclusively virtual, I believed that the adaptation would be possible, painful at times, and enduring. It became clear to me that as we struggle to make sense of our inner lives the parallel process of making sense of our external lives cannot be ignored. To me, it has to be integrated. This integration has equated in completely shifting my private practice from in person with some distance work to exclusively virtual in order to make sure that the safety of all beings is secure within the therapy frame.

What does it mean to work virtually from a psychodynamic perspective? I imagine it being similar and different. Similar in the sense that whatever it is on your mind, you are free to speak of. Different in the sense that when you speak and I listen, there is a different mirroring effect, in  that we will not make “direct” eye contact, however, my attention and gaze will feel closer to you than if we were in person. And I will experience your gaze to be closer to my eyes, as well. It also means, working in this way, that speaking about our contact, connections and communications are essential and welcomed. Acknowledging our existence of being together while apart may be have relevance in our therapy process.

One of the more obvious differences is that I will no longer be providing my patients with the physical space that creates the frame, containment and safety for the unconscious to feel free from intrusions that I once heralded myself to do with an office. Now, we both carry that responsibility. On my end, I will be in a room of my home that is completely confidential and mostly free of distraction. The video platform that I use is Zoom and their security policies can be found here. As a new patient, before we begin therapy, I always speak on the phone first and during this time, should we schedule a meeting, I will clearly explain the process of using video conferencing, it’s limitations and usefulness, and provide you with as exact directions I would have if you were coming to my cottage in Santa Barbara. You’re being able to arrive is of utmost importance.

At this moment in time, virtual psychotherapy is the safest way to practice and I am able to provide specialized psychodynamic psychotherapy in a broader capacity. To schedule an assessment, submit an inquiry form using the button below.