I offer psychotherapy and counselling consultations on Skype. Some of the people who see me regularly sometimes use Skype to ensure that, wherever they may be in the world, they can keep to regular appointments. Skype offers a greater depth of communication than the phone, because it is possible to convey a greater array of non-verbal cues (which for over 95% of all of our communications).
As per the words of some of my patients, “it works”. This means that they think and feel that they still receive what they need from a consultation that is conducted via this method of communication. However, is it possible, as a rule, to engage meaningfully with the process of psychotherapy on Skype (or even on the phone), whether the sessions are all or partly held via this medium?
Is therapy on Skype “real therapy”?
While developing this medium for my practice, I have carried out research into how it affects the therapist, the patient, and the therapeutic relationship. I wrote a short paper and gave a lecture on this topic at the Multilingual Psychotherapy Centre. You may read a short summary here.
I have noticed that, when using Skype, some of the traditional boundaries of psychotherapy are blurred. First, it is no longer just the patient visiting the therapist: the two parties physically see into each other’s spaces (rooms, offices) and are therefore invited into each other’s worlds. Second, both parties can see a “selfie” thumbnail superimposed upon the image of the other, like a moving stamp onto a moving postcard. And third, patient and therapist seem to become talking heads to each other, which begs the question of Skype being a watered-down version of its face-to-face counterpart.
These challenges are real, but my my experience of Skype is that it does not create new problems for therapy – it only highlights essential aspects of the human encounter, which become lines of inquiry in the therapy, and therefore means of helping the patient become conscious of themselves.
Indeed, therapists are always figuratively invited into the patient’s inner world – Skype makes it concrete. Similarly, we always see a reflection of ourselves in the other (this is supported by neurological research into the phenomenon of mirror neurons), and again, Skype makes it concrete. Finally, communicating via Skype helpfully brings into conscious focus the challenge that true relationship represents.
In short, I have found that, for all the challenges that it presents, Skype is a meaningful medium for psychotherapy, especially when it is combined with face-to-face sessions.