From freud's reclining couch to the modern digital screen in South Africa: An argument for the adaptability of the psychoanalytic situation

The COVID-19 pandemic has forced both a reflection on and a reconsideration of how psychotherapists provide services to their patients. In particular, a reconsideration of how to provide psychoanalytic psychotherapy in this context would inevitably affect the frame. Psychoanalytic psychotherapy has always presumed the presence of the therapist and the patient in a consultation room that is uniquely set for the psychoanalytic endeavour. This chapter aims to trace the journey of psychoanalytic setting from Freud's reclining couch, through the post-Freudian setting requirements, and finally to the modern smart gadgets to which the pandemic forced the provisioning of psychoanalytic treatment specifically in South Africa. It uses Kohut's description of the analytic setting as a lens to reflect backward to Freud and forward to the COVID pandemic moment. It provides an illustration of a psychoanalytic process through a vignette reflecting a psychoanalytic process that started on a face-to-face basis and was forced into becoming a virtual consultation, where it has remained until the time of writing this chapter. The chapter also reflects on the implications of these changes both against the guidelines of the Health Professions Council of South Africa (HPCSA) on telehealth and for psychoanalytic theory as it applies to the analytic setting.