ABOUT MY GUEST
Today, I have the pleasure of speaking with another friend of the podcast, Dr Gillian Isaacs Russell, a celebrated author, psychoanalyst and psychotherapist.
Member of the British Psychoanalytic Council, the British Psychotherapy Foundation, the American Psychoanalytic Association, and the International Psychoanalytical Association, Gillian is a Registered Psychotherapist in the state of Colorado and has been in private practice in the UK and USA since 1988.
Her fascinating book, Screen Relations: The Limits of Computer-Mediated Psychoanalysis and Psychotherapy, examines how some of our most intimate relationships, including that of analyst and patient, are affected by technologically-mediated communication.
Having served on the Editorial Board as Book Reviews Editor, Gillian currently serves on the COVID-19 Advisory Team for the American Psychoanalytic Association, where she received the 2021 Distinguished Service Award.
This episode is sponsored by Pleo, whose event, “Forward”, I will be hosting on 9th December 2021. Join me and grab your free ticket here: pleo.io/en/forward
Recorded on 15th February 2021.
RESOURCES
Produced by Caro C. Written & recorded by Nathalie Nahai © 2021.
TRANSCRIPT
Nathalie: Gillian, thank you so much for joining me again in conversation on The Hive.
Gillian: It’s lovely to talk with you, I’ve missed you. It’s always wonderful when the two of us get together and think together.
Nathalie: Thank you well, or the feeling is very much mutual and I’m very excited to dive in and get a take on how you might begin to answer this question which is the one that I think you’ve already answered but I’m going to ask it again. Given where we are right now, and we’re recording this in mid-February, what do you think is currently happening in the global human psyche, if we use that frame?
Gillian: That’s a really good question. I think we can think about it a bit in terms of disaster psychology. And when you look at a graph there is a change in the way that people respond to disaster and I think we can think of the pandemic as an ongoing trauma in that in the beginning there’s a big uptick in the graph where everybody gathers together and there’s a great feeling of we can do it and a feeling of wanting to help and to participate.
There’s a lot of energy and that is reflected in perhaps in different countries in everyone singing from their balconies together, in people hooting horns and banging pots and pans when there’s a shift change, the 7:00 PM shift changed for the first responders and hospitals. There was that enormous kind of energy. And for me, that happened… I was asked to join the American Psychoanalytic Association’s COVID-19 Advisory Team because of my previous experience working with technology and treatment.
And so we got very active in creating worldwide peer groups for clinicians and support for the public who had questions about what was happening psychologically for them, various other projects. So there is that great rush and what happens after that rush is a huge swoop down into a feeling of disillusionment, of despair, of despondency. And it may be different in different places but certainly I think right now for us here in the U.S., even with the rollout of the vaccine, even with hope that things are going to change we probably are at the bottom feeling like we have dealt with about a year of lockdown and of uncertainty.
And so hopefully from there, the way that we deal with traumas to make meaning to understand what’s happened to us and slowly to rebuild, so I think that’s probably where we are now. As a person in one of the peer groups that I facilitate said, “I didn’t sign up for this when I trained to become a psychotherapist, and how do I know that you’re not just all virtual avatars that I’m looking at?” Because we’re all on Zoom.
Nathalie: That’s such a tricky question to answer as well because you do get into this weird space where everything feels quite flat.
Gillian: Yes. And I know you were interested in the idea of resilience, and I think that this is something that’s been a tremendous challenge for all of us because one of the things that helps people to be resilient is being part of the community and to be able to feel that you have traditions, cultural traditions, faith traditions, takes a village traditions working as a community together. And when you think of the Blitz Spirit in the UK during the war, that that was possible because you could work in a community but we’ve all been in a particular kind of isolation since the beginning of the pandemic, which has made being resilient very challenging.
Nathalie: It’s interesting to that point about community. I’ve started reading a book called The Power of Ritual by Casper ter Kuile who is someone who works at the Harvard Divinity School. It’s a really interesting book, I’m really blazing my way through. It was quite unlike books for me, I’m usually quite slow. And one of the things that he talks about is how at this point in time we’ve come to internalize this sense that rather than depend on our community in the village to scaffold and support us and nourish and help us, that we somehow have to do that entirely for ourselves within the constructs of our own minds with whatever self-help apparatus you want to develop or build upon or whatever. And it’s so interesting to think of it in that way that the loss of community, the loss of ritual, and the turning inward, especially when we’re more disconnected than ever how isolating that can be and how difficult it can be because we haven’t socially evolved to be separate.
Gillian: And I don’t think we will be socially evolving to be separate.
Nathalie: Very well.
Gillian: It’s a challenge. And I think the only way to meet it is to be aware that this is something that we’re lacking and that means that we end up grieving, grieving the loss. A lot of resilience comes from childhood experience and the feeling that at one point in one’s development one had a stable and committed relationship with a supportive parent or caregiver. And also I think there’s a biological component to it too. So people are set up to deal with this worldwide trauma, this ongoing strain trauma in different ways already, perhaps biologically and from nurture. So it’s a tremendous challenge that I think that we’ve found that there’s a parallel mental health pandemic along with the viral pandemic and that people are working harder than ever in my field to meet the needs of the general population.
Nathalie: And actually this mass migration to virtual interaction, as you mentioned, it connects to our sense of mental health and wellbeing. What do you think we’ve lost from no longer being able to communicate and physically touch and be in person? I’m thinking here about some of the fascinating pieces you’ve written about sense of presence, what is it and why is it important?
Gillian: Right. Well, just to say first of all that the virtual interaction that we’ve had to use that we’ve had no choice about during the pandemic has been in that way a blessing. It’s a blessing that we do have the technology that we have some way of being able to continue our communications with our loved ones, with our intimates, and also in my case, to be able to work with my patients. So there is a tremendous positive in having technology. But it is true that it is not a functionally equivalent experience to be relating to someone through the screen or through the phone. And what we lose is that we’re wired to relate in an embodied way. In fact, I think maybe we’ve talked about this when we’ve spoken before, that 65% or more of our communication is non-verbal, and there’s no way that this can be captured on a screen, on a two-dimensional screen.
So what we’re losing by losing touch, by losing being able to be in the same room is a tremendous amount of communication. The communication is paler, it’s more anemic than it would be if we were together in-person. When communication via technology works it’s because we have an illusion that we’re present with each other and that’s called telepresence. So being present, you are asking about the actual experience of being present, that’s a core neuro-psychological phenomenon.
And that stems from an organism’s capacity, and that’s any organism not just human beings, to locate itself in an external world according to the action that you can do in it to impact it. And people experience presence if they’re able to act out in an external world and successfully transform their intentions into actions. So it’s not the same thing as emotional engagement, presence isn’t the same thing as absorption or the degree of technological immersion. And for humans, these actions specifically include the person’s capacity or even potential capacity to interact with another person in a shared external environment.
So, as a once said to me, “When you share a physical space, there’s always the potential to touch. Even if you don’t, even if you don’t act out whether that means kicking or kissing.” So the sense of presence enables the nervous system to recognize that, that one’s in an environment that’s outside oneself and not just a product of your inner world like dreaming. And so to make technology work we have to have this illusion that what’s going on between us isn’t mediated, and the illusion is achieved when you experience temporarily appropriate feedback.
For instance, when we’re talking right now, as I’m talking to you and you’re talking to me and there’s an immediate temporally appropriate feedback, it may be that the fact that I have earphones on that I’m looking at the screen at Zencastr, which is telling me that the recording is in progress, but that falls away and that I’m imagining your face, that I’m feeling like we’re in the same room talking to each other. But that according to the people who do research in human computer interaction, that can’t be maintained all the time. There are things that interfere always when you’re using technology. That means that the illusion that we’re together, that we have a sense of presence gets shattered, it falls away and needs to be reestablished as we go along.
Nathalie: It’s fascinating what you described there as well about the possibility to reach out or to enact change in our physical environment. And I think it was through one of your papers actually that I read about these UCLA neurophysicist that found space mapping neurons in the brain and how they react differently to virtual reality than they do if we’re in real world environments-
Gillian: Yes.
Nathalie: … the rat studies. And so I wonder when we’re no longer able to reach out or even potentially reach out to another person in physical space, what might that mean for the quality of the relationships that we then engage in and specifically for things like our sense of psychological safety?
Gillian: Well, I think that the huge change is that we all get responsible for our own safety because we’re in different environments. The traditional way, for instance, that a psychotherapist/psychologist provides safety for their patients is that they provide the environment. The patient comes to the office to the consulting room, and we can no longer do that. So people are all separate in their own environments and not everyone is as well equipped to provide safety. That means even your cat coming into the room or somebody interrupting, hearing noises from the outside, being distracted it’s much more difficult to provide that kind of safety when you’re in different environments.
Nathalie: And you also wrote recently that eliminating being bodies together largely confines the therapeutic process to states of mind versus states of being, that’s such a beautiful turn of phrase. Can you explain a little bit more about what this is and how this influences us?
Gillian: Yes. I can’t take credit for that phrase. That’s from my different, wonderful British psychoanalyst, Michael Parsons. He was in fact talking about technology, but what he was talking about is that you can’t eliminate or forget nonverbal embodied communication, implicit communication. Even when you’re together in the consulting room it shouldn’t resort to completely verbal, we don’t just pay attention to the verbal. And so, as Damasio said, we’re embodied, we’re not simply embrained.
And that means that we perceive and communicate through our whole body, not just through our words, our verbal, explicit communication, and not just through what goes on in our mind. So, we need to communicate with human beings from our state of being, from our entire body and not just from a verbal or a thinking place. And to know that that is even though it’s implicit, even though we may not know what’s happening non-verbally between us and another person, that is extremely important to feel a full and sort of vibrant communication.
I think what’s happened, the challenge for us is trying to recreate something of that through our virtual interactions. And the best that we’ve come up with thinking about this during the pandemic is engaging in a sort of waltz. And the waltz is that at times it’s a sort of paradox, you’re having the illusion of a sense of presence. It says if you are speaking directly with someone that the screen that the phone, whatever is mediating your communication falls away and it’s as if you’re in the same room. But that is always stopping, it’s always being interrupted.
And the other side of the paradox in this waltz is to waltz to an observation that telepresence has fallen away, and to be able to talk about it, to be able to put it into words. So for instance, if I’m working with a patient and the screen becomes very pixelated and I can’t see them, or I lose the communication verbally I can’t hear them, research shows that what we tend to do is plow ahead. That we ignore those interruptions because what’s more important than anything is keeping the connection, but in fact, in order to really work with working via technology we have to actually out loud notice that something different has happened.
So to notice that, as you were saying that I didn’t hear the last bit of your sentence, or I can’t quite see your face, it’s very pixelated at the moment but you look very sad. Is that what I’m perceiving? In sort of curiosity and humility and I’m noticing that the technology is there, so that if you can do this sort of paradoxical waltz between letting the technology disappear and noticing when it interferes, I think that it can somehow anchor a kind of communal experience between you and the people or person you’re communicating with.
Nathalie: And of course one of the other issues that we bought up against time and again especially with the technologies that we now have because we use them for everything, is the problem of continuous partial attention.
Gillian: Yes.
Nathalie: Can you describe a little bit what that is-
Gillian: Yes.
Nathalie: …And how that can get in the way, because there’s a lot of these stumbling blocks. If you know about it then you can, as you mentioned, create a more of a communal discussion and approach around it.
Gillian: I think that’s right, knowing about it is the key. Continuous partial attention was noticed and described by someone named Linda Stone. And it’s a kind of distraction, a state where you’re hypervigilant, anticipating potential connection from all sorts of sources, always on anywhere, and so you’re so accessible that in a sense you’re inaccessible. And that happens for instance because your computer contains all sorts of ways that you communicate, email, program windows pop up, you may have a phone on your desk at the same time that you’re communicating with someone set on silent but available for a glance if texts come in.
So, you’re always attending to many, many different sources of communication, and that does mean that the potential for the mediation to drop away is reduced. In fact it’s been found that the mere presence of a mobile phone on a nearby table even if it’s turned off or turned face down can lessen the quality of a co-present conversation. It lowers levels of affinity and trust and empathy between participants, especially if they already have a close relationship.
So what we’ve found in facing the pandemic and having to take our entire practices online is that you have to take practical measures to deal with that continuous partial attention, that distraction. And so we’ve given guidelines to patients, taught us again I wrote a series of guidelines which are available on the American Psychoanalytic Associations website. When you begin to work remotely, and one of the things that we suggest is that you turn off or put to sleep all devices other than the one you’re using to make the call, including watches, laptops, other phones.
And if you use a smartphone or a computer do your best to quit or programs other than the one you’re using and turn off all notifications. There are practical things you can do but that still doesn’t stop your mind from knowing that that computer on which you’re communicating you might also use for shopping or in some cases for watching films, some people might use it for porn or other things that intrude in a semi-conscious way.
Nathalie: It’s so interesting. Actually, I sit and read every morning, it’s a habit I’ve tried to build into my day and it’s a really enjoyable ritual. And I’ve found that the only way that I can read peacefully and not be distracted is actually to hide my phone from view.
Gillian: Yes.
Nathalie: Because if it’s visually there just as you’ve described, I glance at it.
Gillian: Yes.
Nathalie: I notice myself glancing at it and it doesn’t matter that with the best intention and real in the world, I am so hardwired now and conditioned if you like to look to it for awards and distraction and so I have to literally get it out of my sight so the phone just doesn’t come into play. It’s quite a remarkable thing to have that exert such a huge power.
Gillian: Yes, yes. And something that only a couple of decades ago wouldn’t have been an issue.
Nathalie: So another thing that I think is important to note now that we’re talking in this domain of how we deal with technologies, difficulties, and challenges, of course video conferencing platforms have been such a boon in this time, especially for keeping in touch with family or with work colleagues. But seeing ourselves reflected back on the screen, which I’m sure we’re all familiar with, especially in that little self you. I don’t know about you but it makes me so self-conscious and distracted and less able to offer my full attention that I actually just, unless I’m doing a professional presentation in which case I need to see if I’m being positioned correctly in the screen and the rest of it, I usually just switch it off or I hide the self-view. What do you think happens to the quality of our communication or relationship or interaction when we’re self-surveilling or self-monitoring in that way?
Gillian: I have the same experience as you. I know other people have told me that they like to be able to check out what they’re communicating or how they’re communicating by seeing themselves, but for me it’s extremely intrusive. I do turn my own view off if I can and I ask my patients to do the same because it splits your attention. Again, it makes you in a really unnatural way aware of your face and your appearance when what you really want to be doing is concentrating on the communication with the other person.
I personally feel that that does interfere with the experience of telepresence, the experience of being able to communicate with someone with the illusion of being in the same room. That is a reminder that we’re not in the room and that I’m on a camera. So I agree with you, although now many thousands of people that we’ve talked to in our role with the COVID-19 Advisory Team since the beginning of the pandemic, there are people who say they like it and that it makes them more aware of how they’re performatively communicating. That isn’t the case for me.
Nathalie: And I think the key word there is the performance-
Gillian: Performance, yeah.
Nathalie: …Of the thing that you’re doing in order to convey something intentionally, then I imagine it could be a useful tool but otherwise it can get in the way because it takes you out of flow. It’s like you wouldn’t talk to someone by looking at yourself in the mirror.
Gillian: Exactly.
Nathalie: And it’s basically a similar effect to that.
Gillian: Exactly.
Nathalie: So I’m curious from your perspective, obviously we were talking about relationships and your experience in a therapeutic context. But if I were to ask you how you think for instance business leaders might better engage with their workforce or people who continue to work remotely, if we are using these technologies moving forward, and I think it’s probably a fair assumption that we’re going to have at least some sort of blended version of how we work in the future. What are some of the tips or advice you might give them to help support their employees to be engaged and to form relationships where there is greater psychological safety?
Gillian: I think firstly the key is the word you use, blended. That it’s very important to know that one’s sense of the other’s physicality and the embodied presence needs to be refreshed. So while it may be convenient to work from home in a mediated way some of the time, it’s extremely important to get teams, to get employees, to get people who work together together in-person from time to time. It was much before the pandemic that, I think it was Yahoo, decided that they needed to tell people to come in in-person because the way that the teams of people work together were not as effective, not as creative, not as efficient and productive if they were all working from home. So blended is I think a hybrid kind of approach, is what is going to have to be.
Back in 1998, Rocco did a study which showed that trust breaks down in electronic contacts but can be repaired by some initial face-to-face contact. And so I think that even something both simple and essential as trust needs to be promoted for people working together by having face-to-face meetings from time to time. Psychological safety is a word that you used and I know that that’s a very specific concept in business in terms of knowing that you’re not going to be punished humiliated for speaking up with ideas and questions or concerns or making mistakes.
And for me in the psychological field, that’s an incredibly important thing to build into business because it actually springs from the idea that you can’t play as a child unless you feel you’re in a safe environment. And play, if you think about Winnicott, is what leads to creativity and the use of imagination which I would assume all businesses would want to encourage in their employees because it means that somebody becomes trustworthy, creative, confident, and productive.
Again, I think in order to produce an atmosphere of psychological safety one needs to be able to meet in-person. I don’t know if you saw it, it was an interesting BBC article which I read online about team building and that virtual team building is not very successful, it’s really difficult. That people don’t have a special environment where they have a day off to be sharing together something different which is part of the idea of those team building days, retreats and exercises. What it means now is that they actually spend more time on the computer and experience Zoom fatigue.
I think the other thing to look at with that is, there’s that really common exercise that people do to build trust where somebody falls backwards in the group catches them, and of course that isn’t physically possible when you’re online, there is no risk online. And if there’s no potentiality to be dropped then you can’t truly be held. Again, I think that when things are safe again, when it’s safe to come back to work, that whereas there may be for convenience times that people will work from home in a mediated way, that coming back together as a community is essential for I think a safe and productive business practice.
Nathalie: That’s such a beautiful way of looking at it as well about the potential to be held if we take the risk to fall. I wonder, is there a question that you think it would serve people in business whether it’s employees or leaders to ask themselves as we start to rebuild our way out of this pandemic?
Gillian: I think the question needs to be, how did it actually feel or how does it actually feel when people are not able to be together? And I would say that in my experience of talking to people in my field, there are very, very few people who don’t mourn the loss of being in the presence of other people. And that those messy, spontaneous full communications when we’re embodied in a shared environment must be protected because it is the way that we’re wired to operate and we’re not going to evolve in some way to lose that. So to consider that, people working together in safe teams need to feel that they can get the measure of the other person, truly get the measure of them by being in the room with them. That that’s something that we’ve learned to celebrate and to treasure during the pandemic and to mourn the loss of, we hope temporarily.
Nathalie: I’d like to ask another slightly more open question like the first one, and that’s, what kind of world would you like to build?
Gillian: I think you may have asked me that last time at the beginning of the pandemic.
Nathalie: I’m sure I did.
Gillian: I’m still working on it. I think what kind of a world would I like to build? I think a world in which we all can value the importance of the other, of other human beings, of community, of the reality of being able to actually take someone’s hand rather than imagining that you’re going to do so. I understand that with the enormous emotion into the use of technology during the pandemic that people will become more proficient, that they may feel that it’s easier to stay at home and not commute, not waste the time getting to somewhere, but the positives of being together are also very important.
And I don’t think there’s anyone that I’ve talked to who hasn’t been mourning the loss of being able to be together in families, in communal groups, and I think that goes for work as well. It’s something very important about leaving home for work in the morning, even if as it is for me, it’s just walking across the courtyard to another building. That kind of time that we spend in movement thinking and preparing for the day and then actually coming together with people, that can’t be underestimated, the value is enormous.
