Our sudden switch to teleanalysis during a pandemic: Finding our psychoanalytic footing

Abstract

How do we maintain our psychoanalytic footing during a frightening crisis that affects us all? How do we work effectively within a medium that most of us have not been trained for, might have little prior experience with, and that some worry is not effective? Even more daunting, how do we manage these two monumental challenges simultaneously? This paper will consider these predicaments and explore the conditions that promote useful psychoanalytic work while meeting on the phone or through videoconferencing amid a pandemic. It will include clinical material that illustrates a patient’s negative response to switching to teleanalysis and his reactions to the global pandemic, the analyst’s countertransference, and how considering their meanings allowed for the analytic work to continue and deepen.

Key words:

• teleanalysis
• transference–countertransference
• analytic setting
• resistance
• pandemic

Acknowledgments

I am grateful to Joshua Ehrlich for his copy-editing assistance.

Notes

2 To make the reading of this paper less arduous, I will be referring to both telephone sessions and online videoconferencing as teleanalysis.

3 For an extensive discussion of controversies, see Ehrlich (2019).

4 As one example of this, when I presented process notes to experienced analysts in my study group, they could not tell the difference between the tele- and the in-office sessions unless the patient spoke explicitly about the frame.

5 Other analysts who also attest to the usefulness of teleanalytic treatment include Robertiello (1972), Lindon (1988), Zalusky (1998), Leffert (2003), Bassen (2007), Hanly (2007), Scharff (2010, 2012, 2013a, 2013b, 2018), Eckardt (2011), Mirkin (2011), Migone (2013), Essig (2015), Lemma (2015), Abbasi (2016), Merchant (2016), Wooldridge (2017), and Marzi (2018).

6 Our capacity to create an external setting conducive to good-enough psychoanalytic functioning rests on a good-enough internal setting. However, creating a good-enough external setting in turn supports our internal setting and therefore our psychoanalytic functioning. The internal and external settings form a feedback loop that can contribute either positively or negatively to our analytic efforts (Bridge, 2013; Parsons, 2006).

7 Looking back, I also understand it in part as a sign of anxiety about whether I could maintain my inner analytic setting in my new location.

8 I have myself experienced and hear others reporting that they having been feeling very tired since practicing telenanalytically full time. Although this feeling is multiply determined, I believe it stems in part from starting anew with all our cases at once and dealing with the cumulative intensity of all these beginnings and their accompanying affect storms amid a pandemic. I discuss other determinants later in this paper.

9 Interruptions and vacations in the analysis evoke similarly painful feelings and memories related to separations and losses.

Additional information

Notes on contributors

Lena Theodorou Ehrlich

Lena Theodorou Ehrlich is a training and supervising analyst of the Michigan Psychoanalytic Institute, and a clinical supervisor in the Department of Psychiatry, University of Michigan Medical School, USA.