March 25, 2020

Toilet paper. Toilet paper! That's what people are hoarding in the USA. It's hard, at least for me, to believe. I can understand an oral regression manifested by hoarding of food. But an anal regression? Fortunately my wife and I keep a apply of toilet paper just in case and just in case just arrived. All levels of government are attempting to follow the advice of physician scientists: maintain a distance from other persons, wash your hands frequently and well; keep your hands off your face. There has been no push for persons without symptoms to wear masks. The greatest danger seems to be contaminated surfaces like door knobs.

It is likely that the ongoing pandemic will make a permanent difference in the way we live thanks to distance technology allowing us to communicate without being in the physical vicinity of the person with whom we are communicating. It will greatly influence psychotherapeutic practice. Patients will not have to come to the doctor's office, saving time and transportation costs. Confidentiality can be greater; no waiting in a waiting room. Persons who could not otherwise get psychotherapeutic help because of their remote location will now have access to care.

Does the therapist need to be in the same room as the patient? No. Remote treatment is probably as effective as in-person face-to-face treatment. I have personally conducted treatment of individuals more than 100 miles distant but have not tried to deal with unconscious process, rather, have given advice and prescribed medications. There is now a substantial literature on doing psychological testing online.

Hence, the technology that enables us to stay apart can actually bring us closer.

Myron F. Weiner, M.D.
Emeritus Professor of Psychiatry
University of Texas Southwestern Medical Center
Dallas, Texas USA
Just to add to prof. M.F. Weiner's optimistic note:

Having more than 4000 hours of therapy, psychoanalysis and supervision online (starting daily online work in 2003), I can assure that an experienced analyst / therapist can perform good therapy not only in its Ego-supportive or cognitive modes but in evocative as well as long as s/he takes into consideration two important limitations – functional blindness and limited perception. There are other "know hows" too but the two above mentioned are most important. Functional blindness means that all seems to function normally, yet you don't know what it would be if the same material would unfold in face to face setting – "normal functioning" may betray you and your patient. Limited perception means that you inevitably miss important details – odors, body movements, dress and makeup details, environment etc. This being said, my experience convinces me that one can do a really good psychoanalytic therapy, deeply enough exploring unconsciousness and at least some transference- countertransference constellations. Whether we call it psychoanalysis or psychotherapy doesn't matter much to our patients nor to ourselves.

I refer the reader to my own presentation opened to public on this site (unfortunately only in Russian language).
— Levas Kovarskis MD, psychoanalyst (IPA)




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