Introduction - Analytic Work in the Pandemic

ABSTRACT

When the seriousness of the COVID-19 pandemic became apparent in March 2020, questions about the role teletherapy could play in mental health treatments and psychoanalysis of children and adolescents suddenly moved from the hypothetical – can it work? – to the essential – how will it work? The two papers in this section provide an early snapshot showing challenges and possibilities brought about by the necessity of moving to distance technologies to preserve and protect analytic work despite the global crisis.

KEYWORDS:

• COVID-19
• pandemic
• teletherapy
• distance technology
• child psychoanalysis

In March 2020 our lives changed as the reality of the coronavirus hit world-wide. Not only cities, but entire countries shut down, schools closed and began online learning, and therapists of all sorts moved to teletherapy. Practical questions such as what platforms to use, licensing and ethical issues, insurance coverage, HIPAA compliance; as well as technical issues of how to do psychotherapy and psychoanalysis virtually, often from home, plagued us all. Seminars, study groups, and forums seemed to rise from every corner as we struggled with how to best work. Now, a year later, these issues and questions persist as it became clear that this pandemic was not going to end any time soon.

Anna Freud once called the work of the War Nurseries (1939–45), established to care for children separated from their families during the London Blitz of WWII, and the resulting major scientific conclusions “an experiment of fate” (Kennedy 1995, 318). The nurseries came about because of a horrific external event, but what we learned about children, separations, and residential care, continues to be pertinent today. Perhaps this pandemic, another tragic external event from which we might be able to advance our understanding of children and psychoanalytic technique, can be similar.

In light of the multitude of questions and concerns that analytic work in the pandemic raises, we offer two papers which address psychoanalysis in this new environment. Daniel Prezant’s paper offers his assessment of the issues raised in making the rapid adjustment to teletherapy that COVID-19 ushered in. He outlines changes for patients and analysts during this transition and the subsequent anxieties that resulted, especially as they relate to therapeutic work with children and their parents. He concludes that, although everything seems to have changed, much remains the same as we continue to use our analytic minds to understand the meaning patients have made of their lives, and to translate this meaning into the increased awareness of their own minds that leads to change.

Caroline Sehon takes us further in regard to the question of what is different and what remains the same as she presents the analysis of a seven-year-old girl who had been seen face-to-face in the office for three years prior to the pandemic. She describes the first 6 months of the teleanalysis, demonstrating how the child used the technology as a play object to express her struggles, how unconscious communication persisted even though patient and analyst were no longer in the same room, and the ways the transference and countertransference were analyzed.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Denia M. Barrett

Denia M. Barrett, MSW, is a child and adolescent supervising analyst and faculty member of the Chicago Psychoanalytic Institute. She is in private practice in Chicago, IL. She is a past president of The Association for Child Psychoanalysis.

Jill M. Miller

Jill M. Miller, Ph.D., is a child, adolescent and adult Training and Supervising Analyst and faculty member at the Washington Baltimore Center for Psychoanalysis. She is in private practice in Washington D.C. and supervises child candidates at a number of Institutes. Dr. Miller is a Clinical Professor of Psychiatry at the University of Colorado Medical Center, and a past president of The Association for Child Psychoanalysis.