Working Online During the Contemporary COVID-19 Pandemic1

Within the psychoanalytic school there has been substantial and ongoing debate about the efficacy of teleanalysis. However, as a result of the current COVID-19 pandemic and the online work with which the Jungian analytic community has now had to engage, this paper initially focuses on analysts’ actual experiences of working by teleanalysis. These experiences highlight a range of issues like “Zoom fatigue”, “online disinhibition”, dissonance, confidentiality, the frame and working with new patients. Alongside these issues, there were ample experiences by analysts of both productive psychotherapy apace with analytic work involving transference and countertransference phenomena, all indicating that a genuine and good enough analytic process can occur with teleanalysis. An overview of the research and literature both prior to the pandemic and as a result of it, confirms the validity of these experiences so long as analysts are cognizant of the specifics of such an online modality. Conclusions to do with the question, “what have we learned?”, alongside training, ethics and supervision issues are subsequently discussed.     

Silicon in ‘pure gold’? Theoretical contributions and observations on teleanalysis by videoconference

Ideas about psychoanalysis via videoconference—videoconference teleanalysis (VT)—are presented with the general understanding that these settings produce a twofold split between various degrees of recognition/negativisation of the absence of the other, on one hand, and the expectation of physical co‐presence, on the other. This split has been put forward as dismantling the here, now, with me pre‐reflexive unity of the analytic experience. This article suggests that both members of the analytic dyad will seek to reappropriate the experience through a forced ego integration that interferes with accessing states of unintegration in the analytic treatment and produces subtle alterations to symbolisation work. The effort to overcome this condition is illustrated with clinical vignettes and therapists’ comments about feelings of inauthenticity and discontent when trying to sustain evenly‐suspended attention, as well as in the perception of a form of flattening of the alive nature of speech. However, this is not a constant for all VT, and mutual understanding can be an important mitigating feature. The focus of the discussion should be on the capacity of the analytic dyad to overcome such a split and not on a direct extrapolation of the perceptual limitations of VT to possible effects on transference / countertransference.     

The use of Skype in analysis and training: a research and literature review

Of recent years there has not only been an increasing use of Skype in analytic treatment, supervision and teaching, but also a number of writers have been endeavouring to assess its effectiveness. Whilst it is generally agreed that Skype can facilitate an analytic encounter where distance prohibits a face‐to‐face process, where continuity needs to be maintained and where analysands are in areas far from specialized centres, there is divergence in the literature as to whether analysis, as opposed to psychotherapy, can be successful using Skype. This paper reviews the literature and concludes that the essentials of a genuine analytic process are not necessarily precluded by Skype. One central reason is because there exists a cross‐modal communication channel between the human senses (underpinned by audiovisual mirror neurons) in addition to the recently discovered instinct for communication and interpersonal understanding, and these can override the need for physical proximity of the participants. The essentials of an analytic frame can thus be maintained, and the continuity that Skype enables means that containment is also facilitated and this counters the negative aspects of shuttle analysis. The critical issues for the profession then become the professional development for practitioners in the use of Skype and suggestions are listed.     

Working online due to the COVID-19 pandemic: a research and literature review

Given the contemporary situation of many analysts in the world now being forced to work online due to the effects of the COVID-19 pandemic, it is important to review the working online issue. Substantial debate over previous years has questioned whether a genuine analytic process can unfold through online work. This debate is reviewed with the conclusion that such a process is not necessarily precluded. Research outcomes are then reviewed to highlight those things that can facilitate positive outcomes when working online. These cover the ‘online disinhibition effect’, the therapeutic alliance, particular ways of using the screen, focussing on trauma, the importance of self-awareness, knowing the predictors of mental health, certain potential positives of isolation/quarantine and psychotherapy interventions that may be currently needed. Final recommendations and suggestions are then presented as in the diagnosis issue, professional development and guidelines to do with practical and ethical considerations.