Is It Worth It? A Question from Both Sides of the Couch

Peter Gross

In August 2021, after 16 months of varying degrees of isolation, masking, and social distancing, I had my first day of seeing clients in the office, and coincidentally seeing my analyst again in person. I have been able to maintain my own analysis four times a week throughout the pandemic: I stretched out on my recliner while my analyst looked over my shoulder from my laptop. I’m in my fifth year of working with her, so I have logged in many hours dealing with that traffic. We spent a good part of that August in-person session talking about how it felt to be in her office again. I maintained the belief that the sessions on Zoom were just as effective and meaningful as they had been in person, that it was a successful adaptation to these extraordinary times. My office in Fairfax, Va. is 30 minutes away from hers, located in Washington, D.C., and the drive takes me through some of the thickest traffic the city has to offer. We agreed I would come to her office once a week on Wednesdays and have the other three sessions on Zoom because Wednesday is the only day I have scheduled in-person sessions for my clients. I live an hour away from my office, and so making the drive to and from work to sit in front of the Zoom camera seemed unnecessary. I had been able to maintain effective clinical relationships with all of my clients, including children, during the past 16 months. As things open up and people are vaccinated, conversations about returning to the office have been more about the convenience of meeting on Zoom and not fighting traffic. But at the end of that first day back, I started to consider possible unconsciousdynamics of my experiences and those of my analysands.

I began my formal psychoanalytic training and psychoanalysis with my first training case three months into the pandemic. I picked up my second training case this past year so the entirety of my psychoanalytic training, my supervision, the classes, and all of my analytic sessions have been conducted over Zoom.

I and the first analysand I saw that day had similar experiences with this change in the analytic setting. This was a new experience for me as an analyst with him, and it would be my first time back with my analyst after 16 months of Zoom sessions. I had been meeting with my analysand four times a week for six months, and it still felt like a new experience with each other in the room. We talked about my office: what it was like getting to the office and sitting in the waiting room. As I sat in my chair in the traditional position, off to the side and just behind him, I felt a new anxiety and tentativeness in engaging with him. The session had a reserved quality to it, and, at the end, when I brought up the idea of making Wednesday the day for us to meet in person he said no, he wanted to remain on Zoom all four days. He said the drive out to my office was difficult and anxiety provoking. After my visit with my analyst, the drive back to my office was also difficult. I wound up five minutes late for my next client who happened to be my other training case. I felt myself retreating from the convergence of these events, longing for the simpler and safer routines of working from home. This was a different risk of exposure: The repressed and split-off parts of myself were now in the room with my analyst.

As things open up and people are vaccinated, conversations about returning to the office have been more about the convenience of meeting on Zoom and not fighting traffic.

I spent the next morning organizing an argument to present to my analyst in favor of our continuing on Zoom four times a week. The convenience of just closing the door to my office on Wednesdays and setting up my laptop was very appealing. I wanted to remain in the safer space. I began our session with a closely reasoned argument. Like any good analyst, she didn’t just buy it but instead helped me to think about what I was saying. I was defensive at first, sticking to my argument. I told her there really isn’t a significant difference between being in her office or being on Zoom. I referenced the many productive hours we’ve already logged on the Zoom platform. She reminded me that when we met in her office, I commented on how much more personal it felt to be there. This opened up a new consideration for me. I made the association to how I manage my experiences of vulnerability, how I minimize the intimacy of a four-year analytic relationship. My analyst failed to prevent the pandemic and protect me from the deprivation of my time in her office, an unacceptable feeling that remained repressed for sixteen months. I started to think about the metaphor—navigating traffic as an integral part of my work in analysis. For four years, I had navigated congested roads, construction, and lane closures to get to and from her office. Our sessions technically began when I lay down on her couch and ended when she said we are “at time,” but arriving at her office and then returning to mine was all part of the work. I remembered being anxious about being late, and the drive back to my office was always spent thinking about our session. Those times of anxiety and reflection disappeared with the pandemic. Sitting in my sunroom with my analyst on my laptop allowed me to continue my analytic journey but at a safer distance. All I had to do was sit up and click off the screen. Thinking about this, I became aware of the flux of safety and distance in our relationship; I began to recognize how Zoom sessions provided a more comfortable process because they shielded me from my unacceptable anger at her and my ambivalent feelings related to our work.

Then I began to think about my analysand’s apprehensions and dread about his drive to my office. He must also be experiencing vulnerability in my office as a consequence of the shift in setting. Maybe even more so because he had never been to my office before, whereas I’d had four years of that drive to and from my analyst’s office. My anxiety about my first in-person session as an analyst might have contributed to his unease. My other training case also expressed reluctance about coming into the office for the first time. My analysands starting in-office analysis has been a focus in supervision as my supervisors and I identify the metaphors each analysand brings into sessions and their connection to transference and counter-transference dynamics. Did I fail to prevent the pandemic from depriving them of beginning analysis in my office? Are they holding unacceptable conclusions and ambivalent feelings about me, the way I did in my own analysis?

As we transition back to being more fully in a world that is slowly a little safer, I begin to wonder about the safety I and my analysands experienced by remaining within our homes. The success of teletherapy with both psychotherapy and analysis has allowed my clinical work to continue. The paradox of that success became apparent in my reluctance to return to the office. The convenience of receiving therapy in the comfort of home enabled me to continue analysis with a feeling of safety that prevented me from exploring unknown and unsettling parts of myself. And with my own analysand, my anxiety about our first analytic session in the room might have contributed to his resistance. Now I see what my analysands face: The investment of time and effort to meet in person, in a room together, was a given before the pandemic. It is now an option we need to consider. The question “Is it worth the trouble and inconvenience of dealing with traffic and parking?” begs exploration with each of my training cases and within myself. APSAA

Peter Gross, LCSW, is a second-year psychoanalytic candidate with the International Institute for Psychoanalytic Training. He has been providing mental health services to children, adolescents, and adults for 39 years. He is a Partner at the Child & Family Counseling Group in Fairfax, Va.