Since we live, work and play in a geographical hotbed of both psychoanalysis and technology, it seems important to reflect upon how the two may or may not converge. I attended the Web 2.0 conference in town this week, and the dominant theme was how people use technology (e.g., behavior, community, social rules). There was much discussion about "social networking," the phrase du jour, how do people connect, communicate and feel part of a larger tribe online? Those of us who work in the here and now in the room with a patient may doubt that IM, text, live chat, chat rooms, webcams and phone will ever supplant the real. Still, telemedicine marches on, and as we've seen on the battlefield, the "golden hour", when soldiers are more likely to be saved medically, is better utilized thanks to extremely advanced mobile health technology delivered instantly to the field. Yes, patients might be better served in a proper hospital, but that's not always possible or practical.

In addition to my private practice in the office, I'm in an online community of therapists (and other professionals) who are part of a web site (owned by AT&T) where people can select professionals, read info about them, look at user reviews, and then call a toll-free number to pay to talk by the minute. Over the past year, I've been working steadily each week with two patients, out of the immediate geographic area. It's not traditional, but there is still a frame, strong transference and countertransference, and I feel we are doing good psychoanalytic psychotherapy work, especially if this kind of treatment is all the patient can tolerate at present. As Lew Aron brilliantly commented, "Whatever managed care says, and whatever drugs they are given, people still want to be listened to in depth and always will. That's why there will always be people who want an analytic approach." With technology, how and where we can do this seems open for debate.

Cleopatra Victoria, MFT