The patient, at home:
Time for my session. Should I chill in PJs? Make an ‘effort’ in jeans? It’s not like I need to get dressed. I’m not going anywhere: My shrink is coming to me. I’ve got to figure out where we should talk. We could sit on the sofa. Or lie in bed! I mean, I’d lie in bed; my shrink will be on the phone. The thing is, I really get the best reception in the bathroom, but like… that’s pushing it. He wants to video-chat at the beginning and end of the session, cool. In between I can put him on audio, which means I can be literally anywhere. I won’t feel him judging me behind my back, the way he does at his office. At my place, I can put him wherever I want. Bonus: Over the phone he won’t hear my stomach grumble, and I won’t hear him drum his fingers when I get on his nerves. I’m pretty sure I still get on his nerves, but his annoyance is less palpable via 3G. I don’t hear him squirm in his chair. Which, honestly, makes it easier to talk to him. Talking this way is pleasant, even sexy. Yes, sexy, a word I was too embarrassed to use in his presence. But with distance, the risk seems to evaporate. I can’t believe I used to whine about being too close to him. I’m starting to miss that contact, the way I’ve come to miss all his little office knick-knacks. But reclining on that couch was so awkward. I never knew how to position myself. Now, over the phone, words flow. I tell him about the kids’ homework, how loud my neighbor is. About all the deaths. About the permission slip we need to leave the apartment during lockdown, which I dreamt about last night. Where are my notes? The dream evoked a memory from my childhood, about borders. Back when we were still meeting in his office, I wonder if he noticed the way I’d bounce my foot when I was restless or nervous. Now I know he doesn't see my body. But I still hear his voice; it seems more … intense. Look at that, I can record it without him noticing. To keep a part of him. Are you still there? Now, at least, my shrink answers. He speaks more, too. The same phrases over and over, but it’s something. I miss his smell at the end of the session, when I would walk by him on my way out. I don’t miss the smell of the patient who had the standing appointment before mine. I definitely don’t miss the lingering warmth of the guy’s body on the couch. No more smells, phew. And I don’t have to worry about cash, which is dirty. Bank transfers are clean.
The analyst, at home, at the office, or both:
Confined, like my patients. The asymmetry inherent in the doctor-patient relationship has fallen victim to the virus. Do we suspend treatment, conduct sessions over the phone, Skype? What’s the best way to maintain continuity? Also, where should I put the patient? By which I mean, obviously, the phone. I could place it on the couch, but that seems like a ridiculous charade. I could sit at my desk, headset on – again, though, what’s the point. In the pro column, the Situation allows me to avoid her clammy hand, the almost ritualistic way she goes to the bathroom before each appointment, her lingering gaze on my desk, the languidness with which she slips into her coat and collects all her many belongings at the end of the session. Analysis becomes more delicate when it’s remote. It’s harder to focus on a disembodied voice, to disregard the distance; something’s missing. There’s a weariness. I hear pots and pans clanging in the background (didn’t she complain her husband doesn’t cook?). Her grievances are always the same. Yes, I’m here. I try not to interject. At least I can shift my weight, relieve the tension that builds in my back when I feign immobility. Oh, a childhood memory. That’s a first. I’m going to have to invest in a better telephone, a better computer, or a better headset. I’ve got to accept modernity and its benefits. Some changes are definitive. Is she fidgeting with her ring the way she used to? Jiggling her foot, belying the zen she tries to impose on the rest of her body? The absence of these tells, of her presence, is off-putting. That heady perfume of hers is gone, too. Switching gears: post-apocalypse, post-confinement – won’t it be risky to see each other again, to sit side by side? The couch is hardly ‘socially distant’ from my chair. There’ll be all these new issues to consider: Do we lead sessions remotely or in person? If the former, with a headset or on speakerphone? If the latter, do we wear masks? Should I get a washable cover for the couch? Really looking forward to the inevitable protocol debates with colleagues.
Despite the virus, this patient and her analyst are communicating. They’re connecting. But they’re not breathing the same air, sharing the same space, hearing the same sounds. They didn’t seek this distance; it was imposed. The situation has its advantages: no commute, for instance. We’re all at home, in our own bodies. Doubly confined. The body, that ancestral receptacle
– the locus of our needs, our wants, our desires, our pleasure, our pain, our sexuality and, now, this virus
– has become dangerous.
Analysts’ couches, like so much else, lie bare in this new reality
– a reality that, pre-pandemic, we were already making increasingly virtual, antiseptic, odorless, innocuous, risk-free. As if risk were something we could control. Long term, will we be able to conduct our analyses remotely, without a human being on the couch? How will we confront our patients’ taboos and frustrations, without the very body that is their seat? How will we deal with transference, with regression, with urges and drives, if the patient’s physical form never meets the analyst’s? More pedestrianly, will the absence of a commute, of any contact with the office, impact treatment? This new reality, no matter how forced, may provide an opportunity to reimagine our fundamental framework.
The body’s absence highlights its presence on the couch. Our confinement forces us to recognize the significance of the corporeal, of flesh and blood. Which begs a reconceptualization: If the patient’s body and the analyst’s couch can no longer coexist, it’s time we shift our focus from the furniture to the form. We must re-conceive analysis as a body without a couch.