The common ground in in-person and telehealth psychoanalysis: Some considerations from theory of technique and empirical research

Abstract

Teletherapy–the practice of psychotherapy conducted remotely by telephone or video conferencing–is nowadays widely practiced, also by psychoanalysts and psychoanalytic psychotherapists. However, it is controversial whether it can constitute authentic psychoanalysis or represents a dilution of it, if not something entirely different. Focusing on five elements that jointly determine the essence of psychoanalytic technique (i.e., transference analysis, technical neutrality, countertransference analysis, interpretation, and the analytic frame/setting), the authors discuss theoretical and practical concerns about psychoanalysis via teletherapy in light of recent empirical research findings. Subsamples of patients for whom teletherapy may be particularly useful or even necessary, as well as the challenges of connection and intimacy in teletherapy, are also discussed. The authors conclude that since each foundational aspect of psychoanalysis can also be practiced in the teletherapy context, the essential elements of the psychoanalytic technique can be maintained. However, it remains important for the teletherapist to reflect on their own attitudes, behaviors, and enactments toward the teletherapy setting.