Online Psychotherapy: Transference and Countertransference Issues

Abstract

This paper arises from the shift, following the start of the 23 March 2020 lockdown in Britain, from clinic‐based to online psychotherapy within National Health Service (NHS) psychological treatment services. The paper draws on previously published observations about privately funded online psychotherapy. It also provides a snapshot of my own and my clinical psychology colleagues’ experience of providing clinic‐based and online NHS‐funded psychotherapy before and soon after the March 2020 lockdown began. I use these impressionistic data to illustrate transference and countertransference issues involved in online psychotherapy. In addition, I note problems relating to its setting or frame, and ways in which this form of treatment can obstruct empathic mirroring and the patient's experience of being contained. I conclude by noting limitations of this study based as it was on the immediate reaction of myself and my colleagues to the transition from providing clinic‐based to online psychotherapy, not on interviews with patients about their experience of this transition nor on any measure of the relative effectiveness of online compared with clinic‐based psychotherapy.