Body and presence in online psychotherapy: a relationship beyond the distance
Digital Psychology – (n. 70) The body dimension in the therapeutic online relationship
Today thousands of patients regularly carry out sessions of Online psychotherapy. The Covid-19 pandemic has accelerated a process already underway and led to a quick and widespread diffusion of digital practices. What was initially an emergency response was transformed into a stable clinical work method chosen by many professionals and patients for reasons of accessibility, flexibility and continuity.
But what happens to the therapeutic relationship when you meet at a distance? How does the clinical process change when the shared space becomes digital?
Il body It has a role: it is not a simple “container” but an active and constitutive part of the experience. Thoughts, emotions and relationships emerge from the dynamic interaction between body, environment and social context. The presence is not limited to physical proximity but arises from the quality of the embodied interaction (GarcÃa et al., 2022).
Understand how this dimension can also be supported online leads to questioning how the body dimension You continue to support the therapeutic process even at a distance.
What is embodiment in online psychotherapy
Also in the therapeutic relationship i body signals give rhythm and depth to the exchange. The body Of the patient and that of the therapist, they communicate continuously and implicitly: in posture, in gestures, in the rhythm of the breath, in the prosody of the voice, in facial micro -novaments, in the breaks, even in the visceral sensations that emerge during the session.
All these elements constitute what Carroll (2021) calls embodied intersubjectivity: an embodied dynamic, made up of relational micro-adventments that occur in the present moment also below the threshold of verbal awareness.
To influence this meeting is not only the bodies But also the space that welcomes them. Embodiment, in fact, also concerns the environmental and sensory context in which the relationship takes place: lighting, sounds, arrangement of the furnishings, temperature and even the aesthetics of the study contribute to modulating the shared experience (Carroll, 2021).
It does not only count what is said but also how it is said: the tone, the rhythm, the context, the quality of mutual presence, the possibility of co-burying a space perceived as sure. The body It becomes an instrument that supports the therapeutic alliance and facilitates emotional opening (Rizzo et al., 2024).
From physical to digital setting
In the setting online There is a structural modification: the mediation of the screen implies the loss of physical co-president and with it of many of the bodily and sensory coordinates that give shape to the therapeutic interaction. In presence, the body It is visible in its entirety; Online, however, the visual field almost always narrows to the upper part of the bust, which limits the perception of postures, movements and spontaneous gestures.
Essential elements of bodily dialogue such as breath, orientation in space or postural changes become less accessible, when not entirely invisible: this can alter mutual perception, reduce spontaneity and accentuate the self-monitoring of one’s own body On the screen (GarcÃa et al., 2022).
The therapeutic space is also transformed: if the study of the therapist represents a protected and intentionally structured container, the context from which one connects does not always guarantee the conditions of privacy and containment required by therapeutic setting.
To this is added a thinner but equally incisive aspect: the alteration of the relational rhythm. Latence delays, involuntary micro-silenzi and the difficulty in maintaining visual contact can compromise emotional tuning (Carroll, 2021).
In addition, the Online psychotherapy Eliminates moments of transition such as the journey, the wait or the return home, which help to make the entry into a more gradual and less compressed session between daily activities (GarcÃa et al., 2022).
Body techniques and adaptations in the online session
Many therapists have been able to enhance the Online psychotherapy adapting bodily and relational techniques to distance context without giving up the centrality of the body as a connection tool. Approaches such as the Psychotherapy Sensorimotor, Somatic Experience® and EMDR have been reformulated for digital, thanks to guided instructions, dedicated tools and greater attention to body regulation even at a distance; Techniques such as Mindfulness, Grounding and Breathing are also used effectively (Rizzo et al., 2024).
Some therapists propose to transform the patient’s domestic context into a therapeutic “mini-setting” using symbolic objects (such as cushions, sheets or specific lights) to recreate, as far as possible, the perception of containment and safety. Others introduce digital rituals such as, for example, ask the patient to make a symbolic gesture before starting the session. These small gestures help to mark the threshold between everyday life and the therapeutic space (Carroll, 2021).
Another point is that online asymmetry traditionally implicit in the therapeutic relationship is faded. By connecting from their personal spaces, clinical and patient are no longer placed in a “therapist” setting, but in a more horizontal setting. This equal configuration experiences a greater sense of agency and active participation (GarcÃa et al., 2022).
The body remains in the center also in the digital clinic
The experience of the Online psychotherapy He showed how central the body remains central to the therapeutic relationship, even when the screen seems to divide us. In digital practice, embodiment does not disappear: it modifies, adapts, sometimes it attenuates and can also re -emerge in new, unexpected forms (Rizzo et al., 2024).
Many professionals have been able to find creative ways to preserve, and sometimes enhance, the body dimension of clinical work. As the Study houses reported by Carroll (2021) show, digital has stimulated adaptive practices: to move the video camera to allow movement, propose symbolic games with children, or introduce expressive exercises with voice and body. Even if born from practical needs, these solutions have created no less significant connections than those built in traditional settings. As Giampà (2024) observes, the EMBODED approach is not in contrast with digital: it rather requires a conscious redefinition of practices and a new sensitivity towards the body remote.
And while technologies advance, the body continues to be our main connection tool. In an increasingly dematerialized world, where contact passes through screens, codes and algorithms, the body remains – also, and perhaps above all, when it is physically far away – to keep the possibility of really feeling in relation.
