My training as a therapist is in Transactional Analysis, and my orientation within Transactional Analysis is towards its relational approach. This is an approach which can be considered as a move away from cognitive insight as the central vehicle of psychological change, and a focus instead on relational interactions as a primary means of growth, change and transformation. While this is a form of depth psychotherapy, in reality, the cognitive and relational work together. Still, there is a question for me about how a relational approach to therapy can work as an online therapy. I approach this topic – or concern – from a personal experience of ten years of face-to-face therapy, which has sat alongside the maintenance of a strong online presence in my personal life. My own feeling has been that an important part of my own transformation has needed that face-to-face presence as part of a transformation process. How then, can online therapy provide for that deeply relational experience that I have had in my therapy? Or does it in fact offer something completely different?
On doing some brief research on this topic, I came across Aaron Balick’s blog and the idea that in any therapy (face-to-face or online) there are different aspects to the relationship which can be described as the “real relationship” and the relationship held in mind, or the transferential relationship. He clarifies, considering these elements of the therapeutic relationship, that the entire relationship is never all in the room. There is always something brought it from the outside. Perhaps, then, bearing this in mind, with online therapy there is just an issue of shifting the balance between “in the room” and “outside the room” parts, but the actual potential for effective therapy is unchanged, whether your particular brand is cognitive behavioural, person-centred, or in my case relational transactional analysis.
Balick emphasises that meaning is crucial in depth work, and this is part of my concern as I begin the process of adding online therapy to my work. What I am coming to realize though is that the potential for uncovering meanings is not removed by moving therapy out of a face-to-face context. Online work does not deprive either therapist or client of the potential for a relational experience, and for the relational interactions to be the primary means of growth and change. Rather, it is the case that meanings are changed, and relational interactions are different. Perhaps there are new meanings that emerge from the use of technology, from the absence of visual clues (in text-based work) or even from disinhibition processes.
So, where relational therapy and online therapy actually meet is in the opportunity to create meanings. Different kinds, perhaps, but meanings, and depth, are available in the processes all the same. Granted, my own over the last several years have emerged within a particular therapy room in my offline world, but having reflected on how a therapeutic process may develop online, I see no reason for thinking that different but no less effective ones might have evolved if my therapy had been online.
Liz Jeffries is a Transactional Analysis Psychotherapist currently working towards certification and UKCP Registration. She has a small private practice in South Manchester, and previously worked as a volunteer therapist for Lancashire Women’s Centres in their IAPT service in Accrington. Liz is training on the OTI Certified Cyber Facilitator Course.
Balick A. (2015) The Psychology of Online Space: Where is It? Available at http://www.mindswork.co.uk/wpblog/the-psychology-of-online-space-where-is-it/ (Accessed 24 May 2015)