Intimate Solitudes: Unique Qualities of Psychoanalysis by Telephone

Abstract

In this paper, I discuss qualities of emotional receptivity, depth, and engagement that can occur in psychoanalysis or psychotherapy conducted by telephone, and I explore dimensions of in-person, screen, and phone treatments that may enhance or detract from therapeutic efficacy. In some cases, the absence of visual presence afforded by phone treatment may paradoxically allow both participants to attune to subtle emotional dimensions in themselves and the other with greater acuity than may be achieved in person or on a screen. I also examine screen modalities, which are preferable for some patients and dyads, but not for others. I present an analysis conducted by phone that made abundant use of our intimately connected solitudes, and I describe the patient’s experience of the phone as the “emotional umbilical cord” she was denied in early life.