5 Questions
Telegraph
Hannah Zeavin, Berkeley Lecturer and Author of The Distance Cure Your new book is about teletherapy, which has become more commonplace during the pandemic. Tell us how you define the subject.
I decided to use the most broad idea of teletherapy, thinking about what “tele” means, which is “at-distance.” I incorporate letter writing, the advice column, and broadcast radio. But of course, things like telephone, email, FaceTime, Zoom—all of that would be teletherapy. The case I start with is Freud, who worked via letter with many people and had a full-blown analysis with a five-year-old boy who was agoraphobic. He wouldn’t leave the house. So the father (a student of Freud’s), Freud, and the little boy all worked together via post—and it helped.
The best argument is that teletherapy will disrupt, à la Silicon Valley, and fix what is wrong with mental health care. But of course, it’s much more complicated than that. And, across its long history, teletherapy has been escorted by a democratizing promise, that it’s for everyone who doesn’t have access to mental health care. The problem is, the way teletherapy is often deployed now is as a replacement for in-person therapy. And it’s not because of the pandemic, but because of the appification of mental health care, which promises “therapy” for all but doesn’t fix the access problems. Not really. Do you think the moral panic around teletherapy is valid?
COURTESY OF HANNAH ZEAVIN
CAFE OHLONE: MOGLI MAUREAL; GINSBERG: CHRIS PIETSCH/THE NEW YORK TIMES/REDUX
What is the best argument for the current forms of teletherapy, compared to an in-person model?
It’s like any moral panic around technology—that it’s ruining our most intimate relationships. A lot of these apps are not supplying care that is either deep, nor for people who otherwise wouldn’t receive treatment. People who evangelize contemporary teletherapy argue that they do those things, but they don’t. That doesn’t mean no one’s ever had a successful interaction. And it doesn’t mean that some therapists don’t love it. A central claim of the book is to remind readers that distance is not the opposite of presence—absence is. But it would be really disappointing if teletherapy became only synonymous with corporate apps.
Can you talk about the history of teletherapy in the Bay Area?
The suicide hotline was first pioneered by an Anglican priest named Chad Varah who saw that mental health crises in his parish often had to do with questions that people couldn’t ask—not even in a confessional. He realized they needed the protective qualities of anonymity and distance. In the United States, the hotline idea got imported to the Bay Area in the late ’50s, early ’60s, run by Bruce Mayes. He advertised on the inside flap of matchbooks: “Thinking of ending it all? Call Bruce.” He sends a bat signal, if you will, that it is a queer-friendly, queer-run hotline. This was the moment of the Lavender Scare and raids on the gay bars of San Francisco. At the time, San Francisco had the highest per capita suicide rate in the world outside of West Berlin. Mayes wouldn’t allow any trained social workers or psychiatrists to work the hotline because he believed those disciplines carried such intense judgment about queerness and suicide. He didn’t feel this way. He wanted to help people who wanted to be helped, but not punish or criminalize those who didn’t. So he starts this hotline, and the suicide rate in San Francisco cuts in half within one year. Now that the pandemic is easing, will we see a return to more inperson therapy? If not, what have we lost?
We know that what we license in an emergency often sticks with us on the other side, and we need to be really careful. Is it only good that we can now do therapy sessions on FaceTime, or is there a cost—and is the cost privacy? —Daniel Lempres, M.J. ’21 CALIFORNIA FALL 2021 13
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8/23/21 11:12 AM
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