ABSTRACT
After more than two decades of conducting phone and, more recently, Skype therapy and psychoanalysis with patients in the two distant cities where I practise—Syracuse, NY and Washington, DC—I am convinced by personal experience with a diverse group of patients, as well as by the reports of colleagues, that good-enough psychodynamic therapy and analysis can be conducted with most patients with the help of the new technologies. The benefits of remote treatment are not for everyone, however. Some patients are just not able to engage affectively via telecommunications technologies. But most are, and for these patients, the benefits of continuing and deepening a treatment by phone and Skype can be enormous and, often, life-altering. The same ethical principles apply in both in-person analysis and teletherapy but there are some unique ethical aspects of teletherapy.
