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Is Anyone There? Use of the Telephone and Use of the Couch

Many therapists have been using the telephone for analytic sessions during the Covid 19 pandemic This paper considers the ways in which the use of the telephone resembles the use of the couch and revisits the value of the couch in order to assess the value of the telephone The questions raised are whether analytic therapists still find the use of the couch helpful, and if so why This is then linked to the experience of using only the telephone The paper considers the ways in which the two techniques increase or diminish shame and the willingness to disclose difficult material An anonymized clinical illustration is used of a woman who began in face‐to‐face work with a purely practical problem, but in telephone sessions was able to acknowledge her need to understand her own mental state in order to be able to change at a deeper level Conclusions are drawn about the positive usefulness of the telephone in contrast with the view that it is just the best that we can do in some circumstances