The Inanimate Third: Going Beyond Psychodynamic Approaches for Remote Psychotherapy during the COVID-19 Pandemic

Br J Psychother. 2022 May;38(2):316-337. doi: 10.1111/bjp.12720. Epub 2022 Mar 1.

Abstract

The COVID-19 pandemic exposed the field of psychotherapy to the need to provide treatment remotely. We discuss the question of whether remote therapy can be curative and if the electronic device used to manage these sessions unites or separates the therapist and the patient. We term the electronic device as 'the inanimate third' in the therapeutic process and discuss the objectivity of the device as opposed to the subjective emotional processes involved. We deal with emotional themes relevant to the COVID-19 pandemic and associated social distancing practices, such as longing, loneliness, the perception of the future and the lost past, and the efficacy of the therapeutic stimulation of fantasy and hope. We also evaluate the possibility of existing transference and countertransference processes while working remotely. We suggest the term 'social paradox' to describe the situation in which an objective entity such as the digital media symbolizes both distance and intimacy as well as separation and unity. We conclude by stating that containment of the social paradox by the therapeutic dialogue is possible as the existence of the dialogue eliminates elements of the paradox.

Keywords: COVID‐19; HOPE; HUMANISTIC APPROACHES; INTERSUBJECTIVE PSYCHOANALYSIS; LONELINESS; PSYCHODYNAMIC PSYCHOTHERAPY; REMOTE PSYCHOTHERAPY.