Given that the prophetic title of the 2020 BACP Private Practice conference in September was ‘Communication: can you understand me?’, it’s no small irony that, in an unprecedented year in which the vast majority of talking therapy has been delivered online or over the telephone, I’ve lost count of the times in which either I, or a client, have begun a session with the words: ‘Can you hear me?’.
I don’t think any of us could have comprehended, a year ago, that we would shortly be forced by external circumstances to make the seismic shift from being mostly in the room with our clients to working purely remotely. While there was already undoubtedly a place within our profession for a certain amount of therapy, supervision or therapy training to be delivered online, or over the phone, this amounted to only a small percentage of the work. And, I would argue, rightly so, in a profession such as ours, which has always emphasised the primary importance of embodied relationship. We could certainly not have predicted that we might continue to work in this way for well over 12, possibly even 18, months.
We’ve yet to discover what the long-term implications of this sea change in the way we work will be. But I’m starting to fear that we might be facing a permanent shift in the way in which clients expect to receive therapy – with a preference for working online, for the ease it affords (no need to leave your own home and travel to your therapist’s place of work). And possibly, even, a creeping feeling among therapists that working remotely from home isn’t so bad after all: no room rental to pay or commute to make (for those of us in private practice who don’t work from home). And, I’m even starting to hear talk of the potential for therapy trainings to continue to be delivered online, in addition to in person (once that becomes possible again). Not as a substitute but as an acceptable alternative.
My concern is not born out of any resistance I’m aware of holding, in relation to what it’s possible to achieve when working online. I’m the first to admit that, despite my initial reservations, I’ve been relieved to discover that it’s absolutely still possible to achieve relational depth when working remotely. And I’ve experienced this as much as a client in my own personal therapy and supervision, as I have as a practitioner. And yet, at this point, after almost 10 months of working in these strange, uncharted waters, I also know that I can’t sustain it indefinitely. Sometimes I even doubt whether I can hold out for as long as it takes for a vaccine to come.
This is in part due to the daily headaches I’ve been experiencing, which I can only attribute to the six hours I average every day staring intently at my laptop. (I’m hearing reports of similar-sounding ‘Zoom headaches’ from therapist colleagues too.) But more than the physical pain it’s causing, working so intensely online for all these months has confirmed my conviction that while it might well be the next best thing to working face to face in the room, when there’s no alternative available, remote therapy cannot be, nor should ever be considered to be, in my belief, a comparative equivalent to being in the room.
If the necessary enforced isolation that COVID-19 has brought has taught us only one thing, I hope it will be this: that, for optimal wellbeing, we need to be in embodied relationship with one another. In the same place, at the same time, as living, breathing bodies, responding in myriad conscious and (mostly) unconscious ways to one another. And not as disembodied, disconnected voices on a phone line, or as postage stamp-shaped heads and shoulders on a computer screen.
John Daniel, Editor privatepractice.editorial@bacp.co.uk
