‘Sea of trapezoids’: the analytic setting and virtual treatment during a pandemic

ABSTRACT

The Covid-19 global pandemic has, for the moment, upended the traditional setting for analysing transference and countertransference dynamics, vital components to the work of psychoanalytic child psychotherapy. The physicality of the customary treatment setting provides a basis for the experiences of containment and understanding, along with the corresponding and familiar technical considerations within that setting. The absence of these fixed physical elements when transferring cases to virtual and other non-conventional settings points to a new set of technical challenges. How do we understand projective identification, transference and countertransference with children when the modified setting does not inherently afford a child the physical means to make contact with the consulting room as a container? What resources do we have as clinicians for persevering through the psychoanalytic process, in the face of the current global uncertainties? In this paper, I outline some of the theoretical underpinnings in psychoanalytic child psychotherapy that elucidate the challenges to the work I have encountered with my child patients during the pandemic, and explore the clinical implications stemming from those challenges.

KEYWORDS:

• Transference
• countertransference
• projective identification
• treatment setting
• telehealth
• Covid-19

Disclosure statement

No potential conflict of interest was reported by the author.

Notes

1. Parental permission was granted for publication of the following material.

Additional information

Notes on contributors

Michael Garcia

Michael Garcia is a psychodynamic psychotherapist and maintains a private practice in the state of Virginia, USA. He has been treating children, adults and couples for over a decade. Prior to his work in private practice, he worked in a variety of clinical settings, including an adult psychiatric hospital, an adolescent mental health clinic and a home-based child psychotherapy programme. He has devoted his ongoing post-graduate studies to object relations theory and technique.