ABSTRACT
Innovation in psychoanalysis and technology moves beyond the empty seductions of technologically mediated remote treatments. Instead, it places the radical differences between local therapy and remote therapy, including the inevitable losses and limitations distance requires, at the center of clinical decision-making. To understand these differences, the concepts of “affordance” and “presence” are discussed and placed in both technological and psychoanalytic contexts. Differences in clinical processes in local and remote treatment are examined, including those in the facilitating environment, in free-floating attention and reverie, in memory, in the introduction of a “technological unconscious,” and in the potential for regression. The consequences for practice made by these differences are discussed, including recommendations for whether and how to offer remote treatment.
