Online Sessions: A Real Option When the Setting Is Right

I have been offering online sessions since well before the pandemic. Video conferencing is not a compromise or a lesser alternative; it is a genuine clinical tool, and I believe the first psychoanalysts would have used it had they had the opportunity.

Online sessions make psychoanalysis accessible to people who cannot attend in person: expatriates, people living outside Riga, those with mobility constraints, or patients who travel frequently. They can also serve as a complement to regular face-to-face work during periods of absence or transition.

That said, not every situation is suited to online work.
Except in some very rare situations, I do not begin a psychoanalytic treatment online. The first sessions need to take place in person, in the consulting room. Something is established in physical presence, in the shared silence of a room, in the body's unspoken participation, that a screen cannot initiate. Once this foundation exists, online sessions can sustain and extend the work across distance, travel, or periods of transition.

This process also demand a particular discipline from the patient. Without a dedicated, private, undisturbed space on your end, the setting collapses, and the work suffers. This is not a flexibility issue; it is a clinical one.

I assess the suitability of online work on a case-by-case basis.

An online sessions remains a session.

Some rules

  • Privacy

    You need to be in a calm place where your privacy is insured without a third party being able to listen to our session. You are not allowed to record the session

  • Technical Issues

    Report asap any technical problem that would affect the session (for example : make sure in advance that you have no battery or connection problems that could prevent the session from taking place)

  • It's tough but...

    if a moment becomes painful or overwhelming, which will happen, I ask that you stay. Hanging up may feel like relief, but it closes the very space where something important was about to emerge. Hanging up brings no solution.

  • Courtesy and involvement

    Every session scheduled is due. If you have to cancel or postpone I want to know it 48h in advance. Only force majeure cases will be accepted.

  • As a consequence

    …if too many sessions are cancelled or these rules are broken I will be forced to consider stopping our work.

  • Apps

    If you have specific concerns about privacy or a preference for another application, I am open to discussing alternatives.

I use Microsoft Teams as a main option.
This app can be used through your browser, on your smartphone.

It is necessary you agree with Terms and conditions of sales or C.G.V (French version) before we work together.

Important : I consider the confidentiality I owe to patient as a secret duty. If you have reluctance to use one particular messaging app, or visio system I’ll do my best to meet your expectations. The very fact you are my patient falls already under this confidentiality. I am very reluctant to use digital calendars. Paper serve the same purpose and modern options brings, in fact, a very small benefit.
Though I take all the measure to preserve your privacy and mine, I decline all responsibility in case a third party would be able to access the content of our conversations. I keep working on trying to find the best option to ensure security and confidentiality.