Open access peer-reviewed chapter

From the Couch to the Screen: Psychoanalysis in Times of Virtuality

By Valeria Corbella

Submitted: July 2nd 2020Reviewed: November 20th 2020Published: December 3rd 2020

DOI: 10.5772/intechopen.95092

Downloaded: 226

Abstract

The purpose of this chapter is to study the implementation of technology in today’s psychoanalytical scenario. Many historical and cultural changes have taken place since Freud up to these days. To the contemporary subjective constitution, the human being is complex and determined by a myriad of biological, psychological, and social factors. Thus, culture is not external to the dimensions making up the subject, and technology plays a key role in people’s current lives. Within the psychoanalytical technique, the setting has changed and adapted to the different social contexts, to the needs of each subject and also of the analyst. Contemporary psychoanalysis faces the challenge of setting up new scenarios to fit a new present that is taking shape. These are mixed settings, where the physical and virtual presences complement each other, simultaneously and alternately. Both the virtual and the physical realities are different and, therefore, do not replace each other. Thus, the purpose of this chapter is to reflect on the conditions that make possible the analytical encounter mediated by technology.

Keywords

  • psychoanalytic setting
  • psychoanalysis online
  • psychoanalytic technique
  • technology
  • acculturation
  • subjectivity
  • contemporary psychoanalysis

1. Introduction

This chapter aims to study how technology is implemented in today’s psychoanalytical scenario. Many historical and cultural changes have taken place since Freud up to these days. To the contemporary subjective constitution, the human being is complex and determined by a myriad of biological, psychological, and social factors. Thus, culture is not external to the dimensions making up the subject, and technology plays a key role in people’s current lives.

Within the psychoanalytical technique, the setting has changed and adapted to the different social contexts, to the needs of each subject and also of the analyst. From the beginning of the 20th Century, the use of the couch has been the most distinctive feature of psychoanalysis to differentiate it from other psychotherapies. By the middle of that century, written correspondence, the email, and the telephone also became part of the typical scenario. They were considered valid resources for patients who needed a closer contact to be able to be emotionally regulated.

The beginning of the 21st Century marks the advent of technology as part of the psychoanalytical setting, and with it, the movement known as e-psychoanalysis, which makes use of virtual platforms, including the use of the camera in online sessions and the use of electronic devices, such as the cell phone. These changes sparked heated debates, with voices in favor of and against the validity of online sessions.

Nowadays, there is mounting research supporting the validity and efficacy of the setting modified by technology. Many authors [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11] assert the value of online psychoanalysis, claiming that the same processes can be found in in-person analyses. By means of vignettes or clinical cases, they make reference to the display of transference and countertransference and the presence of unconscious communication, free association and free-floating attention, emotional support, interpretations and the expression of defense, among so many other clinical phenomena.

On the other hand, the findings of neurosciences about unconscious communication, mirror neurons, and implicit memory help to strengthen the feasibility of online analysis. This way of communication takes place through various perceptual means, which can be visual, auditory, sensory, and interactive [10, 12, 13]. In other words, technology does not stand in the way of the development of the analytical process.

With the coexistence of in-person and virtual modalities, contemporary psychoanalysis faces the challenge of building new scenarios to adapt to a new present. These are mixed settings, where the physical and virtual presences complement each other, simultaneously and alternately.

The setting modified by technology has been studied mainly in analyses that resorted to the use of the phone or applications with video cameras, but other technological resources that are also part of the analytical field have been left aside. Thus, reference will be made to the use of WhatsApp and social media, which have not been deeply studied in connection to our discipline. In this sense, all the treatments are mediatized by virtuality, even when meeting in person. Therefore, further research into its uses, functions, and results is of the essence.

An essentially social practice, psychoanalysis is now facing a new present. The idea is not to set a limit to what is already known but to combine two logics that always go hand in hand: what is already known with what is about to be known. This ever-changing present demands new practices with tools that, although not novel, are being implemented on a large scale for the first time in the psychoanalytical community.

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2. Tracing its roots

Going back in time, it is known that Freud started to outline the psychoanalytical technique based on his clinical practice treating patients with hysteria. He wrote his technical essays in which, although he did not give shape to a specific technique, he shared some tips. In them, transference is understood as a powerful work tool, which became the rule for the quintessential therapeutic dyad: Free association and floating attention. With these processes, it was possible to go around the repressive processes that hinder the approach to the deeper reasons behind mental suffering.

The couch underwent a similar evolution. At first, Freud used it due to his personal rather than scientific impossibility, since he found it difficult to hypnotize patients and to hold his patients’ constant look. The couch became a trademark of psychoanalysis in that it prevented any censoring and moralizing mechanisms that could be expressed in the look.

At that time, he also raised the issue of the frequency and payment of sessions, as well as of the analyst’s vacations and the behavior they should adopt. Thus, he set out a mode of work similar to an employment contract with guidelines for those who were new to the profession. Those first steps, which were related to the technique, allowed Freud’s followers to delve more deeply into the conditions that made it possible to work as an analyst.

Looking back, it is possible to see two key aspects of the Freudian technique which are still relevant today: The work with transference and the fundamental rule. A third element could be related to the good exercise of the technique, especially when it comes to the transference and countertransference phenomena: the analyst’s analysis. Defined as the second fundamental rule, it is the analyst’s ethical positioning that governs their good professional practice.

Freud did not mention the setting, but he did talk about possible paths related to the conditions needed to develop the analytical process, which have been the focus of analysis up to now. First made back in 1910, these suggestions have changed over time, and not all of them are currently implemented by analysts.

Many authors [14, 15] agree that the first ones to talk about the setting were Winnicott [16] and Bleger [17], who thought that it was the set of conditions that make it possible to psychoanalyze a patient. Both of them established their ideas within their own reference frameworks. Thus, the English author linked the notions of an enabling environment and holding needs with the emotional atmosphere of the analytical encounter. Following Winnicott, the holding was understood as an emotional support, which evokes the primary needs of the self necessary for a suitable emotional development, referring to the first mother-baby bond. Physical care is not related to holding but to handling. In this differentiation, Winnicott makes reference to the importance of an affectionate connection, which is maintained beyond the physical encounter, since analyst and patient build shared mental spaces that allow the other in. Thus, the analytical encounter is displayed in the transitional zone, a non-physical space for an exchange that is conditioned by the features of the play. It is a creative space between two subjects, which sits at the crossroads between the intrapsychic and the interpersonal dimensions.

Although from a different theoretical framework but supported on Kleinian ideas just as Winnicott, Bion [18] used the container-contained metaphor on which he underpinned the idea of reverie. The model also sheds light on aspects related to the baby-mother bond and the reciprocal influence of their mental processes. Just as Winnicott, and following the features of this primal bond, this author stresses the mental processes that take place in the analyst’s mind when interacting with the patient’s mind. Therefore, it could be said that also in this case the analytical setting sits within the analyst’s mind.

Within the framework of the theory of symbiosis and influenced by River Plate psychoanalysis, José Bleger posited that the setting was a non-process that has stable variables which make it possible to differentiate the process from its circumstance. While Winnicott announces an intersubjective and relational model based on the bond with a good enough mother and an enabling environment, the Argentine author follows the guidelines towards the systematization of the analytical process. There is an independent variable that must be controlled (setting) so that what happens with the dependent variables (process) can be understood and interpreted. Some elements in the scenario remain stable; however, some aspects of the setting may become a process. Its rigidity may result in the deposit of psychotic or undiscriminated aspects of the personality: often silent, they crop up when the setting is modified [19].

There is a close link between the setting and the process or analytical situation. Without going deeply into the specific features of the latter term and the differences in how it is conceived and named, just as it was mentioned ([14], p. 491) “The analytical situation calls for a framework where to sit, which is the setting, wherein lie the rules that make it possible. These rules derive from the theories of psychoanalysis and of the psychoanalyst, and arise from an agreement between the parties that make up the analytical contract”. This is an important point: the setting, which makes the development of the analytical encounter possible, relies on the theories of psychoanalysis and on the analyst.

Psychoanalytical theories, as well as psychoanalysts, have undergone a change as this discipline evolved. This is due to the social and cultural influence of the different moments in time and the advances taking place thanks to scientific research. The beginnings of the 20th century are very different from today. Treatments and their settings have been modified by different reasons, among which can be mentioned the emergence of borderline and narcissistic pathologies, specific techniques to approach different clinical cases, research studies on the factors that play a role in the efficacy of treatments, among others.

What’s more, the interdisciplinary work and the contributions of other sciences have helped to more deeply analyze the influence that social changes have on the subjective structuring. Nowadays, few are the approaches that do not consider the social aspect as part of their theories. Both social and humanistic sciences and the hardest factions of cognitive sciences, including neurosciences, posit the existence of a culture that recursively intervenes alongside the biological and psychological constitution of the mind [20, 21].

These transformations have been possible thanks to changes in the epistemological paradigms that make different disciplines scientifically consistent. In particular, psychoanalysis gave its first steps following a scientific method that merged with German idealism. This singular alliance of a scientific method and the ways to knowing, which persists until today, can be observed in the coexistence of systematic research studies that resort to the scientific method and those that implement methodologies stemming from hermeneutics and social sciences [22, 23].

With the inclusion of complexity as a new epistemological framework, the understanding paradigms begin to undergo yet another transformation. Binary logics, either in favor of or against methods, failed to account for the complexity that is typical of human beings. These epistemological innovations paved the way for cross-discipline research studies by which it was possible to approach the phenomena that were to be understood, and they did so in a more realistic way.

Thus, the subjective constitution of humans and their minds could no longer be excluded from the social and cultural context in which they live. The research methods typical of social sciences started to be valid –validity they had been denied in the past. These movements also relied on neuroscientific developments about the social brain. Gazzaniga [24] was the first to claim that the brain had a component he called “the interpreter.” In other words, this scientist shed light on the fact that human beings know their reality by using different functions, depending on the situations they find themselves in. One of them is the interpretation of oneself and of others, as well as of behaviors, bonds, feelings, and the world around them. Hermeneutics and the art of interpreting are also ways to know and be in the world, and this does not seem to be just a theoretical presumption anymore, but part of human biology itself.

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3. E-psychoanalysis

The beginning of the 21st century brought about important advances in technology. For instance, the Internet has certainly changed humans’ lives. Globalization, post-modernity, and technology are the three pillars on which most of contemporary humans’ lives take place. The lifestyle typical of the 20th Century seems prehistoric if compared with the hectic pace of post-modernity.

Technology is present not just in daily life but also in the subjective constitution. According to Tisseron ([25], p. 264), “digital tools […] are causing a real anthropological revolution”. The use of screens affects identity, the notion of time and space, some cognitive functions, and the concept of sociability, including transformations to the notions of what is public and private. More than a mere sociological reflection, these topics are part of the agenda of contemporary psychoanalysis.

The following sections will use a denomination often applied to the web. In a playful comparison, this naming is applied to Psychoanalysis, having moved together with these cultural and technological movements, from the inclusion of the phone and platforms with webcam to the incorporation of social media and their influence on the professional practice.

3.1 Psychoanalysis 1.0

This is the very first version of psychoanalysis. It dates from its start, back in 1900, when a couch, an analyst in floating attention, and a patient making free association would be enough for the transference phenomena to be displayed and help lift defenses, release the unconscious and dispel the symptoms.

The analytical situation was shaped by transference oscillations driving the unconscious processes. On the other hand, the in-person encounter was the rule. The distances did not pose any issues, except for questions about how to expand the frontiers of psychoanalysis. Distances were not easy to shorten, and mail correspondence as well as the phone communication proved to be possible alternatives –although not for many. Several analysts crossed the Atlantic Ocean both ways, seeking to be analyzed by the first experts in the field and then taking the method to other places. This is how psychoanalysis was transmitted, and in so doing it also adapted to the local cultures and possibilities. Anyway, the guidelines already mentioned were considered in the setting, and now the analyst’s attitude should be added: neutrality and abstinence. The therapeutic bond typically entailed the doctor-patient model marked by the understanding, interpretation, and remission of the mental suffering.

After some decades, Heimann [26] and Racker [27] make use of countertransference as a key tool of the technique. This paved the way for the encounter with the patient as a field where forces coming from both participants of the therapeutic dyad interacted, and where unconscious fantasies sprang up [28].

At the same time, the psychoanalysis with intersubjective and relational approaches gained momentum, and the transference-countertransference couple took on new meanings in a stage where two minds met. So along the 20th century, the setting shows a movement from the external conditioning factors into the analyst’s mind. Many of Freud’s tips by 1910 would be considered secondary, depending on the clinical criterion applied by each analyst.

However, it has been Klein and Winnicott who gave shape to new specific features of the setting based on different theoretical models. Taking object relationships as a basis, Klein built a model to analyze children with a special technique. The scenario for the analytical encounter would serve as a stage for the introjection and projection of unconscious fantasies lying in the transference relationship. In this model, the doctor-patient link became a dyad, between the analyst and the analysand, in which elements of the relationships with the first objects, especially with the mother, would be represented.

The incorporation of pathologies of the self brings about changes to the theories and the setting. Winnicott discusses the need for a modified setting for patients with deficit self-structures. These modifications are not only about physical aspects of the office but also about the emotional availability on the analyst’s part, which is related to the role of “a good enough mother.” The setting is thus understood as a space built by two, an intermediate space between the objective reality and the inner subjectivity. Winnicott’s original contribution is the idea of the setting as a therapeutic element synonymous with reliability, affection and creativity.

The analytical encounter is seen from different angles depending on how the therapeutic stage is represented. In line with Farate [29], the models so far presented can be described by three metaphors: (a) the paternal metaphor, originating in the influence that the Freudian Oedipus complex has on the analytical setting, (b) the metaphor for the intrasubjective mother supported on the Kleinian model, which considers the notion of unconscious fantasies and object relationships, and (c) the intersubjective metaphor, proposed by Winnicott, wherein the analytical encounter is marked by a space sitting between two subjects.

Civitarese and Ferro [30], focusing on the contributions by Baranger, put forward a fourth metaphor: The analytical field. They posit that the analytical situation is a dynamic field, where unconscious bipersonal fantasies come up, which cannot be merely considered as the expression of instincts. Bion’s ideas are implicitly present in this metaphor since the reciprocal actions of the mind of the mother and the child are the essential forces of that bond. This is possible by means of the communicative projective identification. It is a dynamism that will be projected in the analytical situation.

The contributions made by these authors occurred more or less at the same time, and are the first theoretical transformations to deeply influence the analytical setting. According to Lewis [31], it is the turning point from a “one-psychology-person” to a “two-psychology-person.”

Represented by four metaphors, this historization gains relevance because the analytical situation and the setting are connected by the theories in the analyst’s mind. The 20th century Psychoanalysis has been defined by major transformations, ranging from the understanding of the psychic apparatus to the subjective constitution of a person in relation to others.

Although the technical developments did not include technology at these first foundational moments, some indicial threads [32] anticipated what would happen with the virtual analytical settings.

Detailed below are the comments by some authors on this issue:

  1. Martin ([33], p. 39) claims that “This patient wanted to be in touch with me. She had difficulty over what was aroused by the perceptual experience of the analytic hour but her feelings about me she could not express, so she made remote contact many times over the telephone”.

  2. Hannet ([34], p. 69) mentions that the phone served a specific role for patients who needed to appease their anxiety because they absent due to sickness; “the majority, however, registered their anxiety by telephone calls, asking the usual questions regarding what was wrong, what progress was I making, when would I be back, and so on”.

There are previous references in the literature pointing to the use of the phone as a technical aid. This was authored by Saul [35], a pioneer in using technology within the analytical setting, although he suggests that other analysts at that time might have been implementing it –as is also mentioned in the references above. Upon a patient’s request, this author systematized the use of phone sessions, in combination with in-person meetings, in order to lower the very high levels of anxiety caused by the physical encounter with the analyst. This is an impactful citation because it is quite ahead of its time and of the technology available back then: “In view of these considerations, one wonders if the idea of using modern technology in the form of the telephone, as an adjunct to psychoanalytic technique, will be met with horrified resistance, or whether most analysts are already far ahead of this in their thinking and anticipate experimenting with televisual communication if and when this becomes practicable” (p. 287).

Saul foresaw the possibility to communicate visually through technology but it was necessary to wait for more than 50 years until platforms including webcams would make it true.

3.2 Psychoanalysis 2.0

The previous period slowly gave way to a more frequent use of telephone psychoanalysis, although it took longer to consolidate and become widespread among analysts. The most important drivers for this transition are to be found mainly when borders opened up, as did the migration of both patients and analysts. A social and cultural movement, globalization transformed lifestyles. The advance of technology and its large scale use made it easier to access mobile devices that help to shorten the communication distances. What was just for a few in the past has now become massive, reaching almost everyone.

Along with these cultural and technological movements, intersubjectivist and relational perspectives gained strength in different theoretical frameworks. According to Lewis [31] these approaches do not make up a specific school but they gave shape to perspectives that can be incorporated in all psychoanalytic streams. The main core moved towards the therapeutic bond, and the external factors, both spatial and temporary, which framed the setting of classical schools, were but secondary to the analytical encounter. The movement kept evolving very slowly, and by the end of the 20th Century and beginnings of the 21st Century several scientific articles about online psychoanalysis were published [36, 37, 38, 39, 40, 41].

Within the telephone setting, several elements of the in-person setting were no longer present: the physical presence first, besides the visual and smell sensory perception. Bodies are muted yet not absent. Hearing is sensibly more acute and the voice penetrates into the ear in a slightly different way from the way it does in in-person meetings. As a patient said: “Your voice goes straight through my ear and reaches my mind. There is no air to soften the sound of your voice, I cannot stop listening, it has a direct impact and I cannot get you out of my mind.” The transference resonance, even in virtuality, makes itself heard, consolidating an analytical encounter in which the dynamics of unconscious processes takes place.

In 2003 Skype was launched, and online communication platforms using webcams started to be incorporated into distance analyses. If the phone proved similar to the couch, since the patient did not see the analyst during the session, the webcam made it possible to work with patients that needed the analyst’s look. The couch-face to face polarity became more flexible, and the absence of the couch did not mean that it was less psychoanalytic.

The tailormade analytical setting was a technical perspective that also adopted the use of technology in the office. The demand of patients who migrated and did not want to stop their analyses, long business trips, and temporary sickness or surgery leaves were the most frequent reasons given to analysts, whose resistance to the new modality started to recede, though not to the same extent in all cases. While research into online psychoanalysis moved forward, conflict arose over its validity.

By then, some analysts questioned the method, arguing that “it is difficult to accept the idea that psychoanalysis –or we psychoanalysts– have to go after society and the changing times. Our task is to understand and interpret the change” ([42], p. 15). Although criticism is understood and it is always wise to consider the latent meanings that could underlie a request for online analysis, thinking about psychoanalysis as detached from society and the changing times it goes through implies untying it from culture. From the mid 20th century, psychoanalysis has emphatically underscored that the contribution of culture is one of the main components of the subjective constitution. If psychoanalysis is detached from its moment in history, the subject will necessarily be considered to be separated from its historical context –which is neither possible nor desirable. Although it is true that analyst and patient live in the same moment, distance psychoanalysis not always takes place within the same culture. This is an important aspect to take into account because when a virtual setting is used with foreign patients, the analyst takes special care to bear in mind the cultural differences between both. Cultural diversity does not hinder the process. Quite the opposite: it is often the driver of unconscious processes. This was implicitly said by a patient, who although belonging to a different culture, looked for an analyst of the same nationality as their late mother. Once again, it is possible to assert the feasibility of transference processes within the virtual setting.

The year 2009 proved key to the progress in scientific development since an International Psychoanalytical Conference was held, where several analysts [112] posited the conditions in which the analytical encounter was possible when conducted virtually, showing, by means of clinical materials, the feasibility and efficacy of those treatments. From then on, different advances have made it possible to further understand the processes implied in the virtual mode [2, 3, 4, 5, 6, 7, 8, 9]. A great deal of criticism [43, 44, 45] has been refuted with many clinical examples proving they were feasible [10]. Thus, notions such as neutrality and abstinence, holding, free association, transference, and unconscious communication took a life of their own online, by means of the clinical cases studied.

On the other hand, the virtual space was considered by many [46, 47, 48, 49] to be a transitional space in a Winnicottian sense; “on this regard, the transitionality of the virtual space could provide a suitable path to encourage creative and collaborative processes between analyst and patient, in order to produce non-integrated affectionate states” [47].

Little by little, the virtual environment began to be more deeply understood. The analysis of similarities and differences with the in-person setting showed the specific features of each and also some warnings. It has been seen that the pathologies related to substance use, patients with suicidal ideation and psychopathies are not safely treated with this new modality. Further, the analysis of children through virtuality calls for further consideration and research since the child plays before the analyst, who may or may not intervene in this game.

Psychoanalysis 2.0 is still present nowadays and its use is expanding considerably. Between 2019 and 2020, due to the COVID-19 pandemic and the mandatory isolations in place in most countries, a large number of psychoanalysts have moved their offices online. To some, this was new news, although to many others this was already part of their routine practice. Yet although online practice is not novel –its first steps going back to 1951–, its large scale implementation certainly is. Detractors and defenders alike moved their practice online in order to continue the treatments needed by patients, but also in order to keep their source of work. A lot has been accomplished when it comes to understanding this new environment that combines physical and virtual spaces. But there is still a lot to be known. These times will probably prove to be fertile ground for debates on the new environment, which hopefully will give rise to multiple scientific productions to account for the results that analysts have obtained in their online practice.

3.3 Psychoanalysis 3.0

In 2006, anyone could open a Facebook account if they so wished. This gave rise to the advent of social media at a massive level. Twitter appeared in 2006, and Instagram, WhatsApp, YouTube, LinkedIn, Snapchat, TikTok, among others, were launched in 2010, adding more features to meet users’ communication needs. These communication platforms give rise to the web 3.0 and also to psychoanalysis 3.0.

Social media have drastically changed the way to communicate with others, and this is relevant to contemporary psychoanalysis. Analysts sometimes see that patients are constantly connected to their phones while on the session. Almost as a ritual, they look at the incoming messages, they apologize for reading them, for having to answer and then they comment on the content of the message. Others forward whole conversations to the analyst so they can read it before the session and then work on them. Are these the new ways for the free association? They show photos, videos, and they make us listen to songs they like. The first telephone contact with a potential patient has now mostly been replaced by a WhatsApp message. Many others, even if they have received recommendations, look for us on LinkedIn or google our names. If we pass the market test, they might send us a message. Others send us a friend request on Facebook, Instagram or they recommend visiting their Blog.

Countless situations may point at a setting that has been modified by social media, and to those who are not too familiar with them, these behaviors may seem invasive or indicative of resistance, to say the least. But are they? In line with the psychoanalytical view, it must be said that it depends on each patient, each situation, and each therapeutic bond. The fact itself does not determine the meaning; it should be further explored. Yet it is also true that, at least for the youngest and the not so young, social media are the communication environment in which they have built their subjectivity.

However, once again the bond between the setting and the way to conceive the analytical encounter becomes visible. What may be considered a resistance in some theoretical frameworks, in others it is an opportunity to research into new aspects of subjectivity [50].

Up to this point, light is shed on the intrapsychic and social field of the patient through the Internet. This aspect has been the most analyzed in research works, so there is more information available about it. But what about the analyst in the social media?

As far as I know, this new update of online psychoanalysis focuses on social aspects and modes of communication of the patient through the Internet. But much is yet to be understood when it comes to gaining insights into what happens with the analyst in social media. Despite the lack of a consistent understanding of the emotional and bonding effects of these new modes, the use of social media is an unavoidable fact that is present in the therapeutic relationship [11].

From the very beginning, the analytical setting was related to the analyst’s neutrality and abstinence. Although these concepts have changed over time and due to new theoretical approaches, they are still present in contemporary analyses. One of the most compromising elements for analysts in the web is their anonymity. Macro data come from the corporate and consumption domains. Advertising is fed from them to pursue its commercial and service offer purposes. Demand is not explicit but it is conducted through online browse algorithms. Users expose their own data so that they can be used by the market [51].

It is very naïve to think that these terms are distant from psychoanalysis, since they are not: our discipline has also become part of the market. Psychoanalysis is also spread through the Internet. National and international psychoanalytical associations have websites showing activities, training courses, and the analysts that are members of the scientific community. Psychoanalysis is offered as a service within the Internet but also psychoanalysts as subjects are part of the web.

Patients and analysts share the same space, in which they upload aspects of their public and private lives, and which is not always protected by security policies. Classical terms such as anonymity, neutrality, and abstinence find barriers that come from today’s lifestyle. One just needs to google a colleague’s name to get at least some personal data.

The intimacy of the analyst is exposed in social media, which implies that anyone can peep into their social and family life. Births, trips, dinners, birthday parties, holidays, they are all part of the daily routine on Instagram, where storiesare the stars. The security conditions related to the privacy of information are not to be trusted and may be overcome with some knowledge on technology –millennials know this. A careless use of technology within our discipline may lead the analyst to tread on dangerous ground.

What happens when a patient contacts us on Instagram? What emotional effects does the active participation of their analyst in social media, with the corresponding promotion of their activities and thoughts, have on the patient? Without a doubt, narcissistic aspects come into play but, at the same time, these are today’s ways of communication. And once again, the same reflection: the fact itself does not make meaning but there might be unconscious signifiers behind them.

Just like Freud and his tips, some authors [52, 53] gave recommendations about how to safeguard one’s profession in social media. Sfoggia and cols. [11] point out some research works about the behavior of therapists in social media, claiming that most of them do not accept friend requests from patients in treatment, although a lower percentage of those surveyed have an open profile in these platforms. These inconsistencies are fertile ground for future research with which to understand the effects these ways of communication may have. Although they are part of contemporary culture, the analyst must reflect on them.

Analysts have lost anonymity in other moments, and the same has happened to abstinence if it is understood in classical terms. These changes have given rise to more empathetical, less authoritarian, and why not, more humane manners in the analyst. The rigidity present in the past gave way to a more elastic technique and a more flexible analytical setting according to the needs of each patient and the possibilities of each analyst. However, this calls for a responsible assessment of the new elements arising in the setting and from technology. They should also be analyzed taking into account the conditions that help or hinder the analytical encounter.

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4. Conclusions

The intention to name psychoanalysis by web updates is a metaphor for how technology advances into our professional practice. The manifold penetration of virtuality in humankind is an object of study typical of the complex times we are living through. The paradigms that made it possible to understand the culture and society of the 20th Century are not enough if one intends to grasp these postmodern times. Globalization and technology have come together to dress the professional practices in new clothes. The time and space categories have also been updated, and are no longer hindering the work practice. And it is this scenario that gives rise to e-psychoanalysis. The analytical field and setting have been modified not only for practical reasons but also in a deeper sense. The stage is constructed and deconstructed in the minds of its participants and no longer relies exclusively on specific and physical movements.

The historical transformations in the analytical setting have anticipated the possibility of a virtual setting. In my view, the main condition originated in those authors whose original contribution was to move the analytical setting into the analyst’s mind. They could get rid of the material borders and paved the way for what many have called the analyst’s inner setting. Sitting inside the analyst’s subjectivity, it gathers those internal theories that are deployed with their personality traits. As it was mentioned before: the setting depends on the theories and on the analysts themselves, while the social and cultural context set the pace. Virtuality is not only present in technology, but the mind is understood as an immaterial space.

This year has presented a new context that announces a cultural scenario mediated by technology. It has been possible to see the relentless nature of many of these changes, most of which are likely to linger on in the near future. The online setting will be able to coexist with in-person sessions, not without some tension. These will be cases of what is known as blended-psychoanalysis –a hybrid that meets the needs of contemporary men and women. It is a new language that takes into account the specific nature of psychoanalysis. The analytical encounter is a field of interaction between two subjects where movements of unconscious processes converge. In this sense, technology neither enables nor hinders the field –rather, it is just the medium that facilitates the encounter.

Anyway, one should not be naïve, and several disciplines are paying attention to its reach and, especially, to the consequences this technology advance can have. Posthumanism and transhumanism posit models in which the humanity of the subject becomes blurred as it is absorbed by technology. Online psychoanalysis is far from these positionings but it cannot overlook the risks entailed. The analyst is responsible for putting forward the tension between two overlapping logics: what is already known with what is about to be known about the conditions for the possibility of the subjective constitution in a world that moves at a dazzling pace.

© 2020 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution 3.0 License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Valeria Corbella (December 3rd 2020). From the Couch to the Screen: Psychoanalysis in Times of Virtuality, Psychoanalysis - A New Overview, Floriana Irtelli, Barbara Marchesi and Federico Durbano, IntechOpen, DOI: 10.5772/intechopen.95092. Available from:

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