Teleanalysis Does Not Have to be "Muted": On the Crucial Role of the Analyst's Internal Frame in any Setting.

Given that practicing teleanalytically is relatively new and more widespread than ever, questions about to practice and teach it effectively have increased and are more pressing than ever. To contribute answers to these questions, this paper addresses long-standing and persisting negative views of teleanalysis as an inherently muted, remote, and pale experience with reduced therapeutic effectiveness. I propose that this view of teleanalysis as inherently inferior to in-office analysis limits or even precludes its therapeutic usefulness because it allows analysts to avoid making analytic use of the disturbing feelings hiding within the experience of practicing teleanalysis.

Teleanalysis: Slippery Slope or Rich Opportunity?

In certain cases, and under certain conditions, extremely useful analytic work can be done on the phone or through videoconferencing. Contrary to what some critics of teleanalysis maintain, with patients who are motivated and can make use of analysis, physical distance between analyst and patient and/or occasional technological difficulties do not limit or preclude successful analysis. Clinical material from three teleanalyses demonstrates various conditions that help make teleanalysis useful.

Finding Control Cases and Maintaining Immersion: Challenges and Opportunities.

Given that surveys, as well as frequent observations by institute faculty, indicate that many candidates have difficulty finding control cases and maintaining immersion and that many graduate analysts face similar challenges, it would seem that psychoanalytic training does not prepare candidates adequately for finding patients and practicing analysis while in training and, for many, after they have graduated. Although external challenges are formidable, it is by identifying and making use of internal challenges to finding cases that candidates can develop an analytic mind: the identity, approach, and skills necessary not only to graduate but to have the choice to practice clinical psychoanalysis post-graduation. Some of the internal challenges and their manifestations in different phases of initiating analysis (referrals, initial consultation, recommendation) are discussed and two detailed examples are offered to illustrate the productive use of candidates' countertransferences in finding cases and maintaining immersion.

Supervisory countertransferences and impingements in evaluating readiness for graduation: Always present, routinely under-recognized.

Utilizing detailed, in-depth material from supervisory hours from around the world (explored in End of Training Evaluation groups), this paper shows that supervisors are subject to multiple, diverse and, at times, ongoing intense countertransferences and impingements on their ability to evaluate candidates' progress. Multiple external and internal sources of these impingements are explored. It is suggested that supervisory countertransferences and their manifestation in parallel enactments remain under-recognized, their impact underappreciated, and the information they contain underutilized.

Analysis begins in the analyst's mind: conceptual and technical considerations on recommending analysis.

For certain patients who approach analysts for treatment, analysis remains the only treatment that can provide the urgent and at times lifesaving help they need. At the same time, recommending analysis presents analysts with a surprisingly challenging emotional task. Because patients will not be able to get analytic help unless the analyst recommends it and facilitates the patient's engagement, it is vital that analysts identify the conditions that make the beginning of analysis possible.

The analyst's ambivalence about continuing and deepening an analysis.

Of the many variables that affect an analyst's capacity to analyze, the analyst's ambivalence about analysis has received minimal attention. A previous paper (Ehrlich 2004) addressed how the analyst's ambivalence manifests itself in reluctance to recommend analysis and address the patient's resistances to the recommendation. The present paper examines the analyst's ambivalence about maintaining and deepening the analytic engagement.

The analyst's reluctance to begin a new analysis.

Given the decline in the average psychoanalytic practice, it is crucial to examine the variables affecting the individual analyst's practice. One such variable is the analyst's reluctance to begin a new analysis. Literature exploring its origins, possible manifestations, and effects on the analyst's thinking and practicing is reviewed.