Rejection of the Visual in Telepsychotherapy

Abstract

Despite the progressively decreasing cost and complexity of videotelephones and computer videoconferencing, the telephone remains the preferred instrument of most psychoanalysts and psychotherapists for treatment at a distance, some even proclaiming the advantages of neither seeing nor being seen. This communication addresses possible causal and consequential implications of this rejection of the visual. Pertinent contributory factors considered include: individual variations in preference for sensory modalities, a neophobic reaction of anxious befuddlement in the face of new technology, habit, and institutionalized bias. The psychoanalytic rationale for the use of the couch with its attendant visual deprivation is reviewed in the light of linguistic theory and research advances in the neuropsychology of nonverbal communication. A survey questionnaire is offered to the reader to help answer some of the questions raised.