ABSTRACT
This chapter considers questions about computer-mediated treatment through four essential dilemmas brought upon by the introduction of screens into contemporary living. Many clinicians engage in computer-mediated treatment with positive results. Meanwhile, research continues to underscore the way that screens and ever-present digital technology can fuel disconnection and prevent intimacy. When a therapist instead recognizes or acknowledges the presence of the digital third in screen-mediated therapy, there is the potential to explore the joint unconscious creation of meaning between therapist and patient that arises from the use of the screen. Therapists may be tempted to ignore the presence of the digital third and bypass these dilemmas, achieving a sense of resolution at the expense of losing sight of dynamics impacting the therapeutic encounter. But quite simply, it is an inherent aspect of screen-mediated treatment that requires understanding.
