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Finding Intimacy, the Unconscious, and Embodied Place in the ‘Limbo-space’ of Telepsychoanalysis
from Division Review
by Molly MERSON
Like many psychoanalysts, since 2020 my sessions have been facilitated by some kind of telephone or video media. Unlike many psychoanalysts, I have remained using telepsychoanalysis as my primary medium for facilitating the work, using both telephone and video to mediate sessions. The observable reason for the change from in-person-mediated psychoanalysis to telepsychoanalysis was part of a collective response to the COVID-19 pandemic. This pandemic has been, and continues to be, deadly and devastating. Fortunately, many of my patients and I had the privilege to work from home or some other place. I have remained utilizing this technological medium because this format continues to work for me and my patients, and I have been able to experience the multitude of profound ways the unconscious works through whichever medium is available to it.
While navigating and enduring the intensity of a pandemic, I grapple with how to live with integrity and accountability to environmental, social, and cultural transformations. I engage such questions in my clinical and personal life daily: How might we practice in such a way that addresses and dismantles white supremacy, climate catastrophe, the rise of fascism, wealth disparity, economic apartheid, and the anti-Blackness and anti-life of the carceral state? Can psychoanalysis support the queering, the world-building, and imagination that is required for creating new metaphors and resourcing new ways of living1?
Telepsychoanalysis is not an omnipotent cure for our catastrophes— in fact, the energy expenditure and mineral extractive practices used to power the Internet and devices are extensions of extractive colonialism, and devastate communities and climate— but telepsychoanalysis may be a way for us to keep talking and keep imagining while also shifting our relationship to our assumptions, including assumptions around movement, location, and what I call placefulness, or being connected to place. Through my embodied experience of telepsychoanalysis, I am coming to recognize that even if my patients and I are not in the same immediate body-to-body location, this embodied sense of place has not left us. As Anzaldúa (1987) says, “I am a turtle, wherever I go I carry ‘home’ on my back” (p. 21).
Interestingly, through telepsychoanalysis, place becomes an even more visible and nameable element of our work. Patients, clinicians, and students are visibly accompanied by our places: we may see backgrounds change, hear the sounds of one’s location, and watch the light shift in the environment. Some even write our pronouns or the name of the traditional and ancestral Indigenous stewards of the unceded lands next to their own name on Zoom. The ongoing decolonial practice of naming pre-settler landscapes, culture, people, and ontologies is part of refusing the cultural seduction of denial of the oft-forgotten catastrophes of our time. Each time I name that I live and work on the unceded homelands of the Coast Miwok, Lisjan Ohlone, Patwin and Suisun people 2, I hold myself accountable to a practice that roots myself into place by uprooting whitewashed cultural norms and reckoning with my settler-colonial heritage and its violent relation- al implications. This accountability practice reminds me of how to be in right relationship with place and its human and more-than human constituents. When I feel in right relationship with place, I can be in right relationship with work, love, and the emergent experience of unconscious phenomena.
It feels important how place shows up in a treatment. Even when we are not in the same place, we still share something of each others’ place. Telepsychoanalysis invites disruption, connection, rage, love, and a place where affective turbulence comes alive; where deadness is real, where emergence is possible. The walls may look different, the seat may shift, and our backgrounds may change the more we talk and the more unfolds. Is this what no memory or desire (Bion, 1967) looks like, when the background changes from session to session? I find telepsychoanalysis requires a focused attunement and evenly-hovering-attention (Freud, 1912) to the dynamism of the setting. This practice feels like an emergence of new and queer ways of being in communication with unconscious phenomena.
Not without some uncanny timing, Hannah Zeavin completed the final draft of “The Distance Cure” (2021) just before the pandemic took hold. Highlighting the history of teletherapy, Zeavin takes us through Freud’s letter-mediated (and father-mediated) analysis of Little Hans; the use of radio by anti-colonial movements including Fanon in Algeria and by Winnicott as he offers parenting advice for the British masses; the heyday of call-in advice shows; documentation and critique of the rise of so-called Artificial Intelligence therapy; and reminds us of the origins and necessity of suicide hotlines and warm chat lines. Zeavin invites psychoanalysis and psychoanalysts to contend with questions such as, hasn’t psychoanalysis and psychotherapy always been mediated? Is technology going to “take us over” and exploit us in a kind of repetition compulsion of disavowed colonialism? Can technology-mediated psychotherapy be useful, transformative, and real?
Perhaps, to queerly use Sara Ahmed’s Queer Use (2019): if our environments are shaped by us and we them, then might technology be defined by the way in which we use the technologies available to us, and the ways we allow ourselves to be used by them? Zeavin’s book emerged at the right time for me, as I have been navigating creatively queer considerations of “What is psychoanalysis?” in the psychoanalytic community. Normativity, and thus belonging, in psychoanalysis is often framed as what the stance of a psychoanalyst “should” be rather than the how of psychoanalysis and its praxis as emergently idiosyncratic to the dyad. Specifically, while I resonate with the desire for a grounded experience of being body-to-body in session, I don’t agree with my colleagues’ sentiments of telepsyhcoanalysis being a lesser model. Instead, while I do agree that teleanalysis is not generative for every dyad or constellation, I believe our field may too easily rely on the sensory input we are accustomed to for information about and in experience of the unconscious. Here, as in other areas of my life, I have had to learn how to find myself in-between.
The “distance” work of telepsychoanalysis is also challenging my own adherence to culturally specific and normative notions of such things as, what is located as “inside” and “outside”; what the experience of “private” and “public” feels like to different people; how the analytic frame is assembled; and what gets imbued, projected, repressed, or denied in the enactments of private life in public spaces. I am now playing with theories of public spaces, private psychic space, privatized space, and what is communicable or not by meeting in person, or by phone, or video— or by dream, poem, or happenstance on the street. In addition, I wonder, why has psychoanalysis thus far only taken up the question of technology as mediated by digital life? What about other technologies, such as the technology of relationships between beings and spaces and the nooscape (Chayne, 2018-present)? Micha Rahder describes nooscape as an ecology of knowledges, the ways in which “our practices of knowing are built with the rest of the living [and nonliving] earth…[nooscape] is an activity we undertake with the world around us.” (Chayne, 2018-present) I wonder, what other media or technology, including epistemologies and ontologies, may be available to us that may invite emergent aspects of psychic life and redirect or foreclose others? How does a seed know the conditions in which to sprout and when to stay underground, in potential space (Winnicott, 1971) (Kimmerer 2013)? How do we know when to make an interpretation and when to stay with silence? How might we as psychoanalysts, if we learn how to listen in new ways, know what to try next?
Speaking of the underground, Harney & Moten (2013) describe “The Undercommons” as a fugitive phenomenon in antagonism to institutions that unsettles the normative plantation autocracy. An uncomfortable yet profoundly possible (non)space of transformation, this is an ethic and not a concrete location, is part of a movable frame, an ontology rather than a static ideology. In aiming to work among and from this undercommons with my patients whom I meet via telepsychoanalysis, I come to feel rooted. It evokes images of mycelium networks which communicate between each other and on behalf of plants and other rooted beings across the entire planet. Here, I evoke Deleuze & Guattari’s (1988) notion of rhizomatic re- lations, but with more of a queer, Star Trek: Discovery 3 sensibility.
With my patients who participate in telephone-mediated psychoanalysis, I suspect we may be working on the same things we might be working on in in-person mediated psychoanalysis. But I have no way of knowing whether it would be different. I know I feel differently now than I did when I spent hours in the office. For some, my cartographed and Google-mapped office may be the place, the location, of transformation, of wonder, and of connection. For some, and I notice for me, place becomes mutable and specific in its own way. Via placefulness, wherein we call up our own singular and specific places and locations, psychic and otherwise, many of my patients and I seem to have found more capacity for closeness that is more tender, less intellectual, and more willing to open their intimate private internal life to us both, and to learn other ways of demarcating the edges and boundaries of places they do not wish to go.
Not all folks find this medium and technology and distance to be generative or useful. Some find it harsh, cold, unyielding, and the aloneness too terrifying. Most of my patients stayed in my practice during the transition, some increased frequency, but a few patients left; feeling concerned about surveillance, a sense of disembodiment, lack of control, and needing the reason of my office to interact with the world, and having lost that, we seemed to lose a sense of meaning in the work. I have never seen the faces of some of my patients; one I just recently saw their face for the first time in almost two years, mediated by video, which was quite thrilling for me, mostly because the patient finally asked for something for themself, but also, it was just nice to see them.
Case material
Here I share with you something about how technology and distance can mediate and facilitate intimacy using one particular clinical experience. With previous years of working together with this patient around loss, attachment and annihilation anxieties closely related to making decisions that dissent from others’ opinions, therapy over the phone has enabled an opportunity to experience an enactment of what we over the years called “the drop,” in the form of a dropped call.
There are many clinical moments I’ve tracked lately where technology or the various media I’ve used hasn’t worked properly; and many interpretations have been made about what it means to not hear someone, hear parts, see parts, freeze, and so on. This particular patient could not tolerate having sessions by phone at first. Notions of movement of place as I described earlier were too intolerable and too evocative of unpredictability and disaster. Telephone mediated therapy was a non-starter at first, because it was too distant, too separate, too disorienting. When the pandemic started, we stopped treatment for a while, but they eventually returned, as they were considering making a large geographic move.
A few months into our resumed telephone mediated work, I asked them how the phone sessions were feeling. They said that the phone felt good. They reflected that something about how in-person work felt too close, and that the phone put up a barrier that helped them engage more deeply and honestly because it mitigated some of the overwhelming physical sensations of anxiety. They still felt the apartness, which held some tinge of loneliness for them; but, by our ongoing collaborative acknowledgement of us not sharing a physical space together, they were becoming more aware of how we build and hold a psychic space together. This was something they thought about often just before our sessions.
I reflected, “we are creating a different kind of waiting room, and a different kind of office, that seems to require something different of both of us.”
They agreed, noting that this psychic collaboration was helping them feel connected without feeling overwhelmed. They were reminded that they used to think they had to see me in person in order to keep me in mind, otherwise they would try to erase me from memory by forgetting me. As they spoke, I wondered if this was another way, they at- tempted to live life by refusing loss, as though forgetting could be a way to mitigate the pain of not having someone with you any longer.
Though in my reverie, I listened as they said, “There is a limbo to this. Something that feels good and interesting. It’s the right mode for what I am working on.”
My reverie continues: The limbo is no longer dead. It is alive, between us. I say, “Closeness and togetherness without being physically together. That does sound like what you are working on.”
As our sessions continue over the months, we continue talking about our usual themes: Feeling dropped, annihilated, the rug pulled out from underneath. Sometimes this was named directly, sometimes implied, but for the first three months of our telephone mediated therapy, the call dropped at exactly the same time each session. The drop became a predictable yet anticipated part of our sessions, and each time it happened, I called right back. At first, I did not ask questions, so that it could be alive with us and not so tightly analyzed. At some point, I interpreted this dropped call gently as “the drop” manifesting. They burst into tears. “Yes…. It is the drop. That’s what it is. But you call right back… you call right back, and we go on together.”
After that, the call never dropped again.
While I remain amazed by the way in which unconscious processes use what is available to them to communicate, I’m reminded: Isn’t this exactly what we are doing when we offer this kind of treatment, distance or otherwise? In Zeavin’s language, this “distanced intimacy” (p. 18) offers an umbilical cord of going-on-being, like the headphones that connect us to the devices and the devices to each other, which allows space for the unconscious to emerge. Zeavin argues, “distance is not the opposite of presence; absence is” (Ibid.). This practice highlights that the distance between us can invite both patient and analyst into limbo-space, to experience the lack between us, the disconnect that’s already always there, and the loneliness inherent in never really knowing the other’s mind. It also offers us a chance to experience our desire for connection and longing and hopefulness for something that may always be just distant and just close enough.
Acknowledgments:
Thank you to Lara Sheehi and Deborah Kim for your feedback on earlier iterations of this piece.
Endnotes
1. See O’Brien & Abdelhadi (2022) Everything for Everyone: An Oral History of the New York Commune, 2052-2072
2. Look up the names of the Indigenous stewards of your place here: https://native-land.ca/
3. Star Trek: Discovery is one of the more recent iterations of the Star Trek franchise, wherein a collaborative group of scientists have developed a way of transporting between galaxies using the mycelium network.
References
Ahmed, S. (2019). What’s the use?: On the uses of use. Duke University Press.
Anzaldúa, G. (1987). Borderlands/La frontera: The new mestiza.
Bion, W. R. (1967). Notes on memory and desire. Classics in psychoanalytic technique, 259-260.
Chayne, K. (Host). (2022, June 21). Micha Rahder: Thinking through the ecology of knowledges (ep361) [Audio podcast episode]. In Green Dreamer https://greendreamer. com/podcast/micha-rahder-an-ecology-of-knowledges
Deleuze, G., & Guattari, F. (1988). A thousand plateaus: Capitalism and schizophrenia. Bloomsbury Publishing.
Freud, S. (1912). The Standard Edition of the Complete Psychological Works of Sigmund Freud, 12:109-120
Harney, S., & Moten, F. (2013). The undercommons: Fugitive planning and black study.
Kimmerer, R. (2013). Braiding sweetgrass: Indigenous wisdom, scientific knowledge and the teachings of plants. Milkweed editions.
O’Brien, M. E., & Abdelhadi, E. (2022). Everything for Everyone: An Oral History of the New York Commune 2052–2072. New York: Common Notions
Winnicott DW. (1971). Playing and Reality,17:1-25
Zeavin, H. (2021). The distance cure: a history of teletherapy MIT Press.
