The therapist will see you now. But where?
For a century, when we’ve thought of therapy, many of us have thought of the places where it happens: the clinic, the ward, the institution. Most prominent among these spatial associations may be the so-called consulting room and its accoutrements: a box of tissues, a covert clock, chairs and perhaps a couch, the waiting room, buzzers, a white noise machine humming, out-of-date magazines. Beyond the iconicity of the container itself, the office has also offered patient and therapist alike a reflective space seemingly apart from their experience of the world. The office allowed patient and therapist to meet in a confidential, secure location, one ostensibly free from the distractions or sounds of work and family.
But for the last year or so, this de facto and idealized therapeutic place has been unavailable to most mental health care providers and their patients because of mandated social distancing. As a result, FaceTime and Zoom, proprietary medical platforms, and apps have become the dominant spaces of therapy.
Before the pandemic, teletherapy—mental health services delivered via technology—was considered the shadow form of mental health care. It is now the default. But as vaccination rates rise in the United States, therapists and their patients are now increasingly able to consider where they might want to see each other once again. For some, vaccination has marked an end to teletherapy and a return, quite literally, to the physical treatment space.
Given the long-held attachment and import of the therapeutic office, it makes sense that for some therapists, a life of Zoom sessions was an exception, rather than a new rule. These therapists argue for a swift and immediate return to the office—or have already been there, masks on and windows open, sanitizing between sessions. These clinicians are committed to the idea that a certain kind of therapeutic co-presence can only be achieved by two (or more) bodies in the same room. I’ve even heard more than one therapist use the analogy, on listservs and in hushed voices, of sex with condoms (in the negative) to describe video therapy. Remote therapy is posed as a barrier, even as it has diminished other blocks to treatment.