A Few Words About Online Psychotherapy

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

A few words about online psychotherapy

Online psychotherapy is no better and no worse than full-time psychotherapy - it's different!

Online psychotherapy is not a new phenomenon, it has existed for a long time, but there has been and is a lot of controversy and doubt around its effectiveness, safety and appropriateness. When the quarantine dispersed everyone to their homes, many faced the need to reconsider their views and attitudes towards this form of providing psychological assistance.

That's what I want to tell about her a little. More precisely, to share my observations, after all, even before the quarantine, there were and are clients in my practice who, in the course of therapy, either moved to another city and online psychotherapy allowed me to continue the work already begun, or new clients from other cities and countries who chose me as their therapist. And when in the spring of 2020 everyone had to isolate themselves, the opportunity to move from a real office to Novoselsky 68 / 2, to a different space - the space of a flat screen, made it possible to continue working and be a support to our clients in the conditions of anxiety and uncertainty that the covid brought with it. In addition, I do my own analysis online, since my therapist lives in another country, and thus I have a variety of observations from different points of participation in the process.

How does a face-to-face meeting between a client and a psychotherapist take place?

I will only outline the general outline. A face-to-face meeting takes place at a clearly defined time, in a specific place, has a certain duration, on a relatively neutral territory - in the therapist's office, you come to him physically and completely, that is, with your whole body, it sounds, of course, a little strange, but still it is … When working online, the therapist and the client come to each other's spaces, but physically do not come completely. We see with our eyes where someone is, as well as the sound of a voice, overcoming kilometers, is very close in the same room or in an earpiece. Everyone is physically in their own space, but at the same time they create a common working intermediate space, which, of course, is created in face-to-face meetings. But here, in my opinion, we are dealing with something different, something interesting and possibly alarming.

I will deviate from the general line of presentation for the sake of an important, in my opinion, remark. An in-person appointment is not carried out at the client's home - this is a gross violation of the client's personal space and boundaries, as well as a very vulnerable position of the psychotherapist. I would have a lot of questions and distrust to this state of affairs. It happens that a psychotherapist accepts at home, then a greater burden and responsibility for ensuring the confidentiality of work falls on him. But this option is also somewhat ambiguous. Please note that this is an important difference between face-to-face work and online work. In full-time work, only the psychotherapist is responsible for organizing the work space in such a way that the client feels safe, is sure that no one will overhear him, no one will disturb him by his sudden appearance. When working online, this task falls on the client. He has to independently take care of the safety, confidentiality and intimacy of the meeting, which are essential for effective psychotherapeutic work.

Another important and interesting point that was noted by both me and my clients.

so that most of the information about the environment in which we are, we receive unconsciously, and just unconsciously process it. This is a very wise natural psychic barrier that allows us not to overload from the whole variety of manifestations of the world around us. Entering the psychotherapist's office, we note the air temperature, smells, colors, the general energy of the room, the convenience of the couch or chair in which it is proposed to sit, as well as the body language of a person that is nearby - this creates an impression inside us. Online psychotherapy does not offer this luxury. BUT! If some sources of information are not available, this does not mean that we will not be able to assess the degree of trust, safety and comfort in interaction. This means that we will use what is at hand - those senses that are involved in the process begin to work more sensitively, I'm talking about hearing, about vision, if we work with video, though there is a moment here too - after all, we see a friend a friend is not entirely.

Many of us, thanks to a dysfunctional childhood, learned to understand and evaluate the atmosphere around for our own safety, to catch the slightest mood swings of those important people on whom we depended when we were little, and to build our behavior in accordance with this. The limited ability to receive information in the usual way, with the help of all the senses, can be somewhat disturbing, however, it is useful and important to discuss with a psychotherapist, because voicing, discussing fears and anxieties opens the way to liberation from the past and self-knowledge.

I also heard the opinion that online therapy is not able to take into account feelings, that it is impossible to convey feelings in this way. In my experience, there are feelings that are difficult to convey in words. They are so strong, incomprehensible, frightening that, in principle, it is scary to meet with them, and what can we say about trying to tell about them in words to another, albeit a specially trained person. It may seem that only personal presence can ensure that the therapist fully understands the client's feelings. This is not entirely true. Practice has shown that there is no complete understanding anywhere. There is a joint attempt of two living, interested people to understand and give meaning to something that seems incomprehensible, meaningless, frightening, without a name …

It is my deep conviction that it is worth using, wisely and carefully, any opportunities that progress gives us, adapt to new conditions of reality, try to be flexible and remain open to new things. However, with regard to the therapy of children, here my opinion is unequivocal - psychotherapy of children in the online format is impossible! You can have a joint consultation with the whole family. You can work with adolescents, but not with young children, for whom the main tool of assistance is joint play and the personal physical presence of the person who is trying to understand and explain to the child his feelings!

Perhaps you have questions or want to share your own experiences or thoughts on online psychotherapy?

I would be very glad to have a dialogue or discussion!

Sincerely yours,