Online psychoanalysis: Interview with Paolo Migone

Paolo Migone: Psychoanalysis via the Internet is certainly possible, and the theoretical premises are the same as those underlying “normal” psychoanalysis, that is, psychoanalysis not involving the Internet. I have used quotation marks for the adjective “normal” to imply that it is a theoretical error to think that there is a normal psychoanalysis, which is in fact a myth (recalling the myth of the “classical technique,” which exists mostly in books). Psychoanalysis is a general theory that is applied to infinite clinical situations: different settings, different weekly frequencies, groups, couples, families, emergencies, brief therapies, severe diagnoses, and so forth. In each of these cases, psychoanalysis must be adapted to the situation and needs of individual patients, at least according to ego psychology, the important psychoanalytic school, which began as early as the 1930s and spread mainly in the USA in the middle of the twentieth century. To make things clearer, I will give an example: if we, in order to remain “psychoanalysts,” will not modify our so-called “classical” technique with patients who need it to be modified or who cannot tolerate it, paradoxically we cease to be psychoanalysts, or rather we are bad psychoanalysts. The thought that psychoanalysis is just the one referred to as “classical” (outside the Internet, use of the couch, high weekly frequency, etc.) does not mean only impoverishing, but also misunderstanding it and showing a lack of comprehension of the theory of technique. It means using a stereotyped technique, learned in the wrong way. I will say more: to think that online and offline therapy are “different objects” means having a theory of technique that makes us make mistakes even in traditional therapy, that is, therapy not involving the Internet. It also shows a lack of understanding what “communication” is about. It is obvious that an online and an offline therapy are very different, but in the same way that two offline (i.e. “normal”) therapies can be extremely different from each other, and there can be more difference between two offline therapies than between an online therapy and an offline therapy. Thinking that diversity resides only in the communication methods means not knowing what the main variables at play in a therapy are. And it is equally obvious that a patient, for transference reasons (or a therapist, for countertransference reasons), may prefer Internet therapy (some patients may want to defend themself, without realizing it, from the “real” relationship, or rather from the fantasy they have of the real-life relationship, for example being afraid of dependency, etc.), and it would be the therapist’s mistake not to see and not to interpret this defense. However, it is equally obvious that a patient and a therapist can defend themselves from the fantasy they have of Internet therapy, and often this defense is not analyzed precisely because the therapist considers “normal” only a therapy not via the Internet (in the same way they may consider “normal” the classical technique, for example the use of the couch, and therefore do not consider cases in which a patient may use it defensively). The therapist is thus acting according to a prejudice, in which the clinical data are not interpreted but are given a priori, as in a sort of labeling theory, and therefore to a theory that we could define as “nonpsychoanalytic.”