ABSTRACT

In this chapter, the author provides a commentary, and draws on the analyst’s observations and descriptions of her countertransference and on the reactions to the clinical material presented at a teleanalysis clinical research working group in which the co-authors participate to study analytic process material of sessions conducted by telephone and/or encrypted video teleconference. The co-authors discuss the impact of the teleanalysis setting on the analytic relationship and review the patient’s choice of setting and its visual impact on the screen to convey the unconscious dynamics. Brent is a fifty-eight-year-old man who is isolated, obsessive, resentful of a long history of mistreatment, and was an insomniac until successfully managed with a continuous positive airway pressure machine. In traditional psychoanalysis the analyst provides a uniform setting for all patients, and the patient’s unconscious is expressed in relation to the analyst, the frame, the analyst’s office environment, and in the use of the couch.