Psychotherapy via skype, although it still is a controversial topic, has been accepted by IPA (International Psychoanalytic Association) in the 2010 meeting: " psychoanalysis must adapt to the current social reality, especially in case of people living in rural areas, businessman and young people that grew up with technology."
Psychotherapy via skype is always a second choice when a traditional therapy is impossible, although there are proofs that confirm the advantage of skype therapy in some cases, such as social phobias or high levels of shame, etc.
It is crucial to bear in mind the technical problems that might occur, know how to tolerate frustrations related and, above all, to make sure about a good internet connection.
Psychotherapy via telephone has been practiced by psychoanalysts since the 1970s (Robertiello, 1972-73, in: Scharff, 2013) and skype therapy seems to be its more modern and improved version. However, there is still a lot of controversy considering this way of doing psychoanalysis. There are very few scientific articles on the use of skype psychoanalysis. In the 2009 IPA meeting, the topic of skype psychoanalysis was broached and it was concluded that psychoanalysis must adapt to the current social reality, especially in the cases of people living in rural areas, businessmen travelling and young people who have grown on technology (Scharff, 2010).
Bayles (2012) points out that the way we understand the nature of interaction has changed since 1984 (intersubjectivity theories, attachment and Implicit Relational Knowing, among others) and we should ask ourselves about the elements of physical proximity that are essential to the therapeutic process. Is therapy a meeting of the minds or a meeting of the bodies? Considering the implicit aspects as being equally important to therapy as the explicit ones (relational psychoanalysis), some may question the validity of skype therapy. I should argue, however, that although virtual interaction is clearly different, it does not necessarily mean worse. There are some case reports that suggest the benefits of cyber-contact over the real one. The lack of bodily presence via skype may help some patients go through shame by creating a secure setting. For others, when the psychoanalyst connects with them via skype, enters their channel of communication, which helps establish good rapport. However, not having any quantitative studies, we cannot assume the superiority of neither.
Setting and space in skype therapy are important aspects to be considered. Skype is a peer to peer communication, where the analytic third becomes an e-third (Stadter, 2013), different from Ogden´s (2004) analytic third concept – a third space as an intersubjective space created by the subjectivities of the analyst and analysand. A machine becomes a third party that can influence the relationship and technical problems may cause frustration, as called by Ziemann “machine loathing” (2011). It is a setting which does not only depend on the analyst and which is co-created by the analysand, as two peers. Skype gives us, at the same time, an expanded control over the space and space excluded from our existence (Gumbrecht, 2010). It is easier to “leave” and “come back” by clicking one button (Dettbarn, 2013).
Change brings disruption to the status quo but is unavoidable in order to respond to cultural developments. “At times and under certain circumstances, the traditional setting has to be re-imagined to fit the demands of the modern world” (Aryan, 2012).