Facilitating or Forcing It? Comfort, Fear, and Online Therapy

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Online therapy is a fertile mix of the comfortable and uncomfortable. You can have a session in your pyjamas, and never look your therapist in the eye. There’s nothing wrong with comfortable…or is there?

Sometimes it feels so good to do things just the way it suits me. If I have no time to cook, I stick a frozen pizza in the oven. If I don’t really feel like talking to anyone on the phone right now, I write a text message with just the information that needs to be conveyed. It frees up my time, it makes me feel comfortable.

Nothing wrong with comfortable, right?

Sometimes I push through the edge of comfortable, and I don’t regret it. When running, the moment when the desire to just stop, rest and have some kind of treat I haven’t really earned comes quickly! But carrying on through the burn, and catching my second wind, brings not only an eventual sense of achievement, but a whole different level of sheer pleasure at the time. Sometimes I start that conversation I’ve been avoiding for weeks/months or a whole lifetime, and afterwards think “why on earth didn’t I do that before?”

Online therapy is a fertile mix of the comfortable and uncomfortable. It is often an option chosen for practical reasons, or reasons of comfort. You don’t have to commit to a regular time when your schedule is irregular, you can write snatches when the inspiration strikes, you can set the mood for your own session in your own house, you can wear your pyjamas and listen to music — in a Skype text or email session the therapist will never know. And even if you are on a Skype camera, you need never look them in the eye.

Sometimes we may feel there is something wrong with catering for our needs for comfort, as if there is a necessary virtue in suffering. As if it were selfish, somehow, to take care of your needs and do what you need to do to feel relaxed. If you feel you can’t do something, then forcing yourself to do it will be good for you. But this is not an invariable principle, nor is it a compassionate one. For some therapy clients, say people on the autistic spectrum, the lack of the physical presence of the therapist might be a hugely facilitative factor. Once, when I was having trouble verbalising something, a therapist handed me a piece of paper and a pen. It was an ‘easy way out’. It was also an act of understanding and care that meant I spent the remainder of the session fruitfully exploring the tangle of issues in my head, rather than fighting with an all too familiar block, repeating and further entrenching the pattern, when I could have, with help, simply stepped around it.

So, online therapy is an ideal way to have therapy very much on your own terms. It also presents some new sources of discomfort. When a Skype connection starts to buzz and whir at a fragile, intimate moment, when you find yourself crying alone at the computer and suddenly feel that the presence of another human being would be soothing, when there is a protracted misunderstanding in emails and a long time to wait before the next one, when your therapist’s words on the screen seem suddenly distant and off-putting and you would like to see the expression on their face to check whether it’s really like that or whether it’s ‘just you’…

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In face to face therapy, on the other hand, there is no escape from what our bodies say about us and how we are experiencing the session. This does offer the opportunity for a whole new dance of communication. There is a sense of containment and sometimes achievement in the active maintenance of a routine, actually carving out the time and travelling to the office. There is nothing like the moment when, after months of desperate anxiety, the thing we thought no one could ever accept about us just comes out of our mouths, and the world does not end, and the anxiety dissolves. There is nothing like the moment, after months of avoidance, when we finally find ourselves looking our therapist in the eyes for a second.

There are also times when the kids are ill or the roads are blocked with snow and we just can’t make it to a session we have been preparing for in our heads all week; there are times that our inability to get the words out does nothing but frustrate us; times that the therapist reveals something in her body language that she did not intend, and sets the whole process back. Of course, if these moments of discomfort can be expressed, it is all ‘grist for the mill’. But at the end of the day, whether the format is online or traditional, does the rule “no pain no gain” really expand into “more pain, more gain” when it comes to therapy?

All clinical material on this site is peer reviewed by one or more clinical psychologists or other qualified mental health professionals. This specific article was originally published by on and was last reviewed or updated by Dr Greg Mulhauser, Managing Editor on .

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