Left to Our Own Devices

Abstract

This paper considers the challenges and opportunities presented by computer-mediated treatments made possible by emerging technoculture. Clinical complexities arising from the introduction of screen relations into treatment has changed fundamental assumptions of the analytic situation; these complexities were observed in 26 in-depth interviews conducted with psychoanalytic clinicians on the topic of technology and professional practice. Selected excerpts from these interviews are presented within the context of a broader literature review alongside the authors’ theorizing about our current, rapidly changing technological climate. The authors highlight various dimensions of our newfound screen-based analytic relationships such as what the analyst can now “see” through the screen, the realistic and illusory elements of digital space, the “digital third,” and the experience of straddling digital and nondigital realities. A case example is used to illustrate these dimensions and explore implications for analytic process.

Keywords:

• computer-mediated treatment
• online therapy
• Skype therapy
• teleanalysis

Acknowledgments

We thank Adi Flesher and Eric Zinner for listening to our ideas and offering their own, for their edits, and their patience. Thanks also to Joyce Slochower and Paul Wachtel for their revisions and their support.

Additional information

Notes on contributors

Leora Trub

Leora Trub, PhD, is an assistant professor of psychology in the School-Clinical/Child doctoral program at Pace University and maintains a private practice in Manhattan, where she sees adolescents and adults. Her research focuses on the intersection of psychology and technology. In addition to her current project exploring the impact of technology on the therapeutic frame in clinical work, her recent work has investigated the role of attachment security and emotional regulation in technology use and examined the impact of an intervention aimed at increasing people’s mindfulness and self-awareness of the motivations underlying their texting and other technology use.

Danielle Magaldi

Danielle Magaldi, PhD, is a practicing psychologist and assistant professor in the Department of Counseling, Leadership, Literacy, & Special Education at City University of New York, Lehman College. Her interdisciplinary research explores our relationship to technology, spiritual/religious identity issues, mindfulness, and multicultural clinical competence. She is a candidate at New York University’s Postdoctoral Program in Psychotherapy and Psychoanalysis.