With the growing demand for flexible and convenient mental health care, many people are turning to online therapy as a viable alternative to traditional in-person sessions. This approach offers numerous benefits (the comfort of engaging from your own space, greater scheduling flexibility, and the ability to connect with a therapist who truly fits your needs regardless of geographic limitations), but are there any downsides to it?
In fact, there is one unique aspect of therapy that can be impacted by this digital shift: the role of the body in the therapeutic process. Below, I'll explore the significance of a physical presence in therapy, and suggest a simple, yet effective tip to help you get the most out of your online therapy experience.
Key Points
Our bodies are very important, even when it comes to connecting with our therapists! How to be more engaged with the therapist in online sessions?
It looks like we automatically have developed some coping skills to overcompensate the lack of bodily engagement that is part of face-to-face but not online sessions 💪
The simplest tip to improve our interaction with our therapist is to put their video window full screen (and turn off ours).
The Somatic Dimension in Therapy
In therapy, the somatic dimension is a central and important part of the work. A study (Koole & Tschacher, 2016) discussed how during psychotherapy, patients and therapists often spontaneously synchronize their vocal pitch, bodily movements, and physiological processes. This phenomenon offers new insights into the therapeutic alliance and its role within psychotherapy. The paper discusses this in terms of an interpersonal synchrony as part of the model of psychotherapy. According to this model, the therapeutic alliance is based on the coupling of the therapee's and therapist’s brains. Since brains do not interact directly, movement synchrony may facilitate this inter-brain coupling (since we believe there is a mind-body continuity). This coupling provides both patient and therapist with access to each other’s internal states, fostering common understanding, emotional sharing, and supports the growth of a deep connection. Over time, these interpersonal exchanges may enhance patients' emotion-regulation, capacities and improve therapeutic outcomes. Beyond this study's findings, the somatic dimension in therapy is considered an exchange, as is considered the exchange through language. Combined with the study above, there is so much more to this shared bodily experience, that one can also wonder what are the possibilities when the therapist is aware of these physical workings, as well as what happens when this bodily interaction is absent.
Online Therapy: When the bodies are not interacting
With all of this said, how can we justify and explain the existence and recent rise of online psychotherapy? How does it compensate for all this embodiment and intracorporeally significance we discussed above? Is the absence of the coupling of the bodies and their engagement a big enough difference? Whether we like it or not, things have shifted after COVID-19 and more and more individuals are choosing online therapy over in person therapy. In their recent article, García, Di Paolo & Hanna De Jaegher, (2022), interviewed therapists and therapees that recently had to switch from face-to-face to online therapy. First, they found an increased difficulty in maintaining silence online compared to face-to-face therapeutic encounters. They suspect that silence, a significant therapeutic tool, is less bearable because of an overall increased use of language, which could be a compensatory coping mechanism due to the lack of all the other intersubjective and intracorporeal cues. In other words, it is possible that because we are missing a big part of the interaction experience (our bodies together), we might be using more language to compensate for that loss, and achieve the same levels of engagement only through an increased verbal attempt.
Second, they found that therapees experience more distractions in their engagement with their therapist. The authors suggest that this could have something to do with that window in video calls, where we see our own self. They introduce the phenomenological distinction between body schema and body image, where body schema is our body consciousness, so our movement, posture, kinesthetic intelligence and so on, whereas our body image is activated when we see our selves in the mirror or in a picture. In video calls, our body image is activated and that is why we often find ourselves looking in our own camera window. As discussed earlier, in face-to-face therapeutic interactions, because of the presence of our bodies, the is a coupling between the sensorimotor systems of therapee and therapist, where it is observed that there is a synchronization of physiological processes such as breathing and heartbeat, and even coordination of movements (Koole & Tschacher, 2016). This is a dyadic coordination loop of body schemas, which creates a deep engaged interaction between the therapist and therapee, something that the online setting can make rather difficult. Also, the fact that in a live encounter we do not see ourselves, we only perceive the body of our therapist, whereas in online settings, we do see our own reflection, could disrupt us from the engagement with them.
Conclusion
Our bodies are very important, even in connecting with our therapists! How to be more engaged with the therapist in online sessions?
For one, it looks like we automatically have developed some coping skills to overcompensate the lack of bodily engagement that is part of face to face but not online sessions 💪
Two, the simplest thing we can do to improve our interaction is to put the therapist's video window full screen. Either that or find a way to not see our own video window during the session. That way, our body image is not activated, and our attention is not drawn to it, something that is found to be the case otherwise.
Enjoy your online sessions!
References
García, E., Di Paolo, E. A., & De Jaegher, H. (2022). Embodiment in online psychotherapy: A qualitative study. Psychology and Psychotherapy: Theory, Research and Practice, 95(1), 191-211
Koole, S. L., & Tschacher, W. (2016). Synchrony in psychotherapy: A review and an integrative framework for the therapeutic alliance. Frontiers in psychology, 7, 191242.
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