Intimacy in Psychotherapy Online

This is such an interesting article, I wanted to share it. Although i believe that face to face connections are truly the best in so far as doing somatic psychotherapy, I do understand and can honor what Walter Logeman has to say about it.

The relationship with the therapist is an important, some say the most important aspect of psychotherapy. Many of the core difficulties that bring people to therapy stem from some difficulty with intimacy. The psychotherapeutic relationship can provide a corrective experience to promote the personal growth and the character development that is needed. Intimacy an essential part of psychotherapy. Therapeutic intimacy differs markedly from the experiences of intimacy in ordinary life, it is proscribed, contained and for a specific purpose. In a sense it is artificial yet genuine for all that. Can therapeutic intimacy happen in cyberspace?

We are close in cyberspace. When you write and post using the Internet I can see inside your mind when you are in solitude. You can quote and link to my words and send them to others. You can save what I write, print it or delete it. You can respond to any word of mine at any time, we have equality as author and reader.
Cyber-language

There is an over rated idea that because there is no body language in cyberspace that there is a lesser quality in the relationships. To quote the Ethics Committee of the APA (This was from the 1995 version and removed from it in 1997):

"On the other hand, Internet is a methodology without nonverbal cues, and appears to be a more limited medium for the delivery of therapy services than telephone or teleconferencing."

But is it? Cyberspace adds dimensions of intimacy, a sort of intense virtual eye contact, even as it removes physical cues, perhaps because it removes those cues.

Using email we develop a cyber-language in addition to the actual words we use. This language is more obscure in the face-to-face world, if it exists at all. When we meet face to face I can't see your email!

Emails have SHAPE. The paragraph and line length and use of space all have impact. The use of quoting means I can get an impression of a dialogue. The flow of emails through time has a form. The conversation develops a shape of its own. There are cues in the email addresses people use, the naming is often highly symbolic and different addresses may have built in meaning. Emails have a subject line. As the posts accumulate in their folder there is a list of subject lines which often tell their own story.
Time - the eternal now

Speed of light delivery combined with luxury of languishing over a letter, both features of time in cyberspace. While like a letter, email is not a letter. A letter is not instantly available once it is sent and the flow of a letter exchange is a different means of relating. We can't have a discussion by letter, we correspond. We have email discussions.

The flow of email discussion is created by the participants. The flow adds meaning, in the way body language adds meaning in face to face contact. We notice the silence in email flow.

An email is solitude compacted into a small capsule. Writing, though designed for the reader is a mirror for the writer. The client and the therapist can meditate on their own, and each others words in their own time. Email takes us into the asynchronous realm, where we are not together "at the same time" but we are in an eternal now, where we can have a virtual connection at any time. I can be with their words longer than they took to write them - or shorter - depending on what I sense is right for this moment. Online chat, of course, is different - though the transcripts can be saved. Chat in real time, (live or over the phone or in IRC) restrains us by having to work at our mutual speed and by having to be awake (and even alive!) at the same time. In my own practice I prefer email as the main modality - the ability to be with my client is enhanced.


The shape of the container

Options of who we relate to are instantly and constantly available. Email is social.
This may sound like a long way from intimacy in psychotherapy online, it is not. You can instantly surround oneself with peers, or experts, or learners who are interested in the things you hold dear. While the therapist keeps the therapy totally confidential the client can send it where they choose. If you are concerned about the quality of your therapy, you can send it to a professional body for review .This is an instant safe guard to over-developed intimacy that is possible in psychotherapy. While there may be less safe-guards online in some ways, the prospect that a record of the whole of the therapy may be posted anywhere safeguards against inappropriate closeness. That possibility enhances the true intimacy.

The container for face-to-face psychotherapy therapy is governed by hourly appointments at a physical place. Time and place become more fluid online and so the containment of the therapy has to be created more consciously. In this way it is akin to ordinary life! Yet appropriate boundaries need to be formed, this involves skills on the part of the therapist that are not included in usual face to face training.

Text - a dimension of intimacy

I celebrate the return of text implicit in email. Words are digital and liberated from lead, paper and ink. No matter how ubiquitous graphics and images become, text will remain. I have seen it happen in video conferences, where, for all the images and sound, there is the request: Send me an email! Synchronous encounters, face-to-face or via video or audio will need to resort to asynchronous textual modes for specific needs, sometimes intimacy needs.

Writing activates the imagination, the psyche, the soul. Words like the eyes, are windows into the soul. Text is a channel for intimacy because it is linked to the collective unconscious. The love letter and the poem are testaments to this idea. When we are in emotional pain -- writing is a way to cathart, to heal, because we link to our depths via the words. Writing to others can connect us at this depth.

Written words display their epistemological roots. Words are like just the surface icon for the archetypes of the unconscious. The written word, when we have time to focus on it, is so bold we shy from its impact. The :-) smiley in email, supposedly to make up for the lack of facial expression -- is there to dilute the power of words. We feel exposed when we read what we have written so we add the smiley, a digital fig leaf.

Words add a level of imagination to the things they describe. What we call things matters, it matters particularly in relationships. The words we use to interrelate create the tone of our connection. This happens in verbal speech, of course. While writing on a computer, because of the ability to edit text as we write, we have a moment of surplus reality, a world around each sentence as we work with it. While writing we heighten the scope for imagination. Intimacy is not in the physical presence, even when we are physically present. Intimacy happens in a shared imaginal space.

Words, written in silence, are a meditation. We don't loose the sound of the word in our mind's ear. We do not need to loose the actual sound either, for greater impact emails that are part of psychotherapy can be read our loud, the power of that can be dramatic.

Where are we heading?

With digitally enlivened text, in silence, in our own time and rhythm, we are entering a qualitative leap in communication. Just how this impacts the soul, the hidden flows of life may not be fully understood for a long time. Yet in online psychotherapy we are leaping into the new realms of connection, learning and exploring as we go. Face-to-face psychotherapy in its many incarnations from Freud onwards has consistently evolved, and our understanding is still expanding.

WEB Psychotherapy- now available with alison leigh, mft

Web Counseling Sessions
Can’t make it to the office? Out of town?
Travel for work? Overseas?
http://www.skype.com/
http://images.google.com/imgres?imgurl=http://farm2.static.flickr.com/1187/1028441939_be27555e83.jpg&imgrefurl=http://www.flickr.com/photos/criminalintent/1028441939/&usg=__dY7DJ35SSp3fYBNaitDR7mB72NY=&h=397&w=500&sz=142&hl=en&start=172&sig2=FHSF2b0huJOVrlwHwfQIWw&tbnid=pe3uey5ly5uveM:&tbnh=103&tbnw=130&prev=/images%3Fq%3Dvideo%2Bconference%26gbv%3D2%26ndsp%3D18%26hl%3Den%26sa%3DN%26start%3D162&ei=IQjcSt3gIZm6tAO94OSxCQ
On the WEB Counseling is the perfect idea for you!
I am pleased to announce the addition of my therapeutic skills practice for those whom can not make it in person. In my experience, I have found working with Skype video conferencing sessions to be very effective and a great time saver in a world of increasing speed.

BENEFITS of Telephone/ Internet therapy:

* Increased flexibility- you can call from anywhere and make it more convenient for your busy schedule to find time to take a break.
* Quality and support are always there- just email me and we can set up a time to talk
* Save money because you won't see me in person, there is no car, or travel fees. It is a free service to have Skype
* Earn free sessions by buying a package that includes many more opportunities to connect.
* Length of sessions are/can be modified. Choose less or more time and make it work into your schedule.

Guided Imagery / Medical Hypnotherapy by Alison Leigh, MFT

Middle Ground Therapy is just that. It is the answer to so many people's questions in psychotherapy: "How do i balance my life?", "why do i get so angry and why can't i help my outbursts?", "how do i negotiate living within my means, but at the same time allowing myself freedom to be carefree?'

Because there is no "right" way to answer these questions, i ask you this, "how do you know when you have gone too far with something, someone?" "What is your personal boundary? Professional?" Do you know what boundaries are?

Answers to so many of these questions lie in the unfolding of the psyche. One of the many techniques i use to dismantle the cognitive mind and allow the unconscious mind to come through is Guided Imagery.

"Many non-verbal techniques are still used today and even more than that, are becoming increasingly more popular with the rise of somatic psychologies."

How i can be of help to you:
I provide Guided Imagery and Medical Hypnotherapy to anyone for stress relief, pain management and mind/body psychosomatic issues (any emotion that occurs due to an imbalance in the mind/body connection).
http://www.alisonleigh.net/guided.html
What is GI?

GUIDED IMAGERY
Patients who feel uncomfortable "opening up" in a traditional therapist-patient session may feel more at ease with a self-directed therapy like guided imagery.

Guided Imagery is a therapeutic technique that is used to promote relaxation and healing. Imagery (thoughts or mental representations with sensory qualities) can help people to achieve a variety of health goals, such as alleviating anxiety or depression, overcoming phobias, trauma recovery, reducing health-endangering habits (overeating, smoking), healing from physical illness, and physical symptom reduction (i.e., headaches, high blood pressure, insomnia, G.I. problems, chronic pain).

Guided imagery is a two-part process. The first component involves reaching a state of deep relaxation through breathing and muscle relaxation techniques. During the relaxation phase, the person closes her eyes and focuses on the slow, in and out sensation of breathing. Or, she might focus on releasing the feelings of tension from her muscles, starting with the toes and working up to the top of the head. Once complete relaxation is achieved, the second component of the exercise is the imagery, or visualization, itself.

Guided imagery also gives individuals a sense of empowerment, or control. The technique is induced by a therapist who guides the patient but does not dictate where or how they go about their journey. It is up to the individual to chose their own destination, thus leaving the patient in total control and not at the mercy of the therapist. The resulting mental imagery used is solely a product of the individual's imagination.

The original founder of this technique, Martin Rossman, describes IGI like this, "
What is Guided Imagery?

A mental image can be defined as “a thought with sensory qualities.” It is something we mentally see, hear, taste, smell, touch, or feel.

The term “guided imagery” refers to a wide variety of techniques, including simple visualization and direct suggestion using imagery, metaphor and story-telling, fantasy exploration and game playing, dream interpretation, drawing, and active imagination where elements of the unconscious are invited to appear as images that can communicate with the conscious mind.

Once considered an “alternative” “or complementary” approach, guided imagery is now finding widespread scientific and public acceptance, and it is being used to teach psychophysiological relaxation, alleviate anxiety and depression, relieve physical and psychological symptoms, overcome health-endangering habits, resolve conflicts, and help patients prepare for surgery and tolerate procedures more comfortably.

Mental images, formed long before we learn to understand and use words, lie at the core of who we think we are, what we believe the world is like, what we feel we deserve, what we think will happen to us, and how motivated we are to take care of ourselves. These images strongly influence our beliefs and attitudes about how we fall ill, and what will help us to get better.

All healing rituals involve manipulation of these images, either overtly or covertly, and thus guided imagery can be considered one of the oldest and most ubiquitous forms of medicine. The healing rituals of various cultures that have persisted over time all have a certain level of clinical efficacy, and while we may attribute these therapeutic benefits to ‘placebo effects’, they have real and measurable effects with important implications for our understanding of the healing process.

In the early 1970s, inspired by the pioneering work of Irving Oyle, Carl and Stephanie Simonton, Robert Assagioli and others, Drs. David Bresler and Martin Rossman began to develop and research contemporary imagery approaches for patients coping with chronic pain, immune dysfunction, cancer, heart disease, and other catastrophic and life-threatening illnesses.

By integrating techniques originating from Jungian psychology, Gestalt therapy, Psychosynthesis, Ericksonian hypnotherapy, object relations theory, humanistic psychology, and advanced communications theory, these approaches were constantly redefined, expanded, tested, and codified, giving birth to Interactive Guided Imagerysm, an extremely powerful, yet remarkably safe and rapid therapeutic approach for mobilizing the untapped healing resources of the mind.

In 1989, the Academy for Guided Imagery was founded to provide in-depth training for clinicians and health educators, to raise public and professional awareness about the benefits of imagery, and to support research, professional communication, and the dissemination of imagery-related information.

Since then, the Academy has obtained professional accreditation, recruited an interdisciplinary faculty, sponsored and conducted clinical research, and set the highest contemporary standards for Professional Certification in Interactive Guided Imagerysm.