I would like to comment particularly on Andrea Marzi’s contribution to the issue of identity of the analyst with regard to the digital world, a virtual reality. There are two main topic discussed in his paper; first the identity of the analyst in treating a patient who has entered this virtual world, or who has evacuated objects into it, or who has some other type of involvement with it. The second is the identity of the analyst as a potential practitioner of Skype or other remote analysis using this virtual world as a vehicle for working in analysis.
Marzi proposes that we are looking at a new type of dream-space, a new aspect of the unconscious. Since every analyst lives within the current culture, he cannot escape its influences, nor should he. But, in order to generate a productive field between the patient and himself, he must think seriously about the characteristics of this new reality and its ability to shape that field. Antonino Ferro uses the metaphor of cooking in the kitchen to make feelings and ideas digestible for a patient. We could extend this metaphor to say that the elements of virtual reality are a new type of space food, requiring a new type of cooking to make them digestible for the patient. We don’t know very much about the metabolic activities required of us in relation to these patients who are addicted to the internet in various ways. We need to enter into this world, to see its objects, to realize what sort of kitchen is necessary for the metabolism of what turns up in this new sort of field. Marzi discusses a case in which entry of the analyst into this virtual space was necessary in order to treat the patient, and we need to learn more about these kinds of approaches.
The second issue concerns the use of the internet as a medium through which to conduct an analysis. Parsons, in his review in this issue of the several papers on identity, suggests the book by Gillian Isaacs Russell (2015) as the “essential text” on this topic. In this book, Russell makes the point that in-person analysis and Skype analysis are not equivalent, that there is “a myth of functional equivalence” and that what is lacking is the “presence of another”. She is surely right, that if we simply carry on as usual and merely switch from “in-person” to “via Skype” we will find the situation lacking. But Marzi has quite another point, and this is not acknowledged in the commentary. Marzi suggests that we need to think about Skype in terms of how it changes the identity of the analyst, what it does to the frame, and how it shapes the field. Only when we can look at it as something completely new, to be examined in a fresh way, will we be able to see how it can be used to advantage, and how our method needs to respond to its constraints and its opportunities. We don’t know, for example, whether “presence of another” can be established between the analytic pair in this kind of setting, whether it requires a particular kind of imagination, a particular use of metaphor, a particular dialogue, a particular appreciation for aspects of the field.
Marzi’s implied point is that, certainly, we cannot carry on as usual. We need to overcome our fear of what is new, and think about it and study it. If psychoanalysis is a “science”, as Freud so often claimed and wished, then it should be capable of assimilating new developments in science and technology, and moving forward with an expanding and deepening understanding of the human mind and body. If it is also an art, then we should be capable of making it relevant and useful for our patients as we find them today. For sure, they are interacting in extensive and profound ways with virtual reality, and we need to meet them in this domain because this is where the field must be constructed by the analytic pair. Imaginative thinking and a willingness to look at virtual reality in fresh ways would be an essential first step. It should go without saying that the identity of the analyst will be changed as he undertakes this task, just as it has been changed, and continues to be changed, by all the other classical and more familiar tasks he has undertaken, and undertakes, in order to carry on in his profession.
Shelley Ann Cross MD
Emerita, Mayo Clinic