CRITICA

I’m moving to San Diego.

I turned 60 this past August, and my husband and I made a spontaneous decision to uproot our lives to Southern California. As my new decade begins, we are reorganizing around family. At 85 years old, my aging parents just sold their house and are also moving there. My older brother and his husband already live close by.

COVID has removed the necessity of staying in place. The patients in my practice will join me virtually. Many of my San Francisco patients have already migrated to places outside of the Bay Area. Of the ones who have stayed in San Francisco, most prefer the convenience of meeting virtually and do not intend to come back to the office.

I love seeing patients in person. However, like many of my patients, I can see advantages in not meeting face-to-face nor being tied to a particular location. Since the beginning of the pandemic, I have added six new patients to my practice. Only one resides in San Francisco. Three are from out-of-state. Teletherapy has increased my geographic reach, and I am grateful for that. 

Nor do I feel as though the quality of my treatments is suffering because of virtualization. I agree that I am in receipt of much more information when a live body is present in the room. However, my patients seem nonetheless to bring their transferences, connect emotionally, and work consistently through the virtual media in as committed a fashion as they did in person. 

Life around us is changing. People are not staying put. I often must ask at the start of a session, “Where are you today?” Tahoe? Palm Springs? Honolulu? Mexico City? COVID seems to have freed many of my patients from their ties to a work location, as well.

There is room here to consider whether location independence and virtualization will be the new normal for psychoanalysis. In a profession that has, for so many years, insisted on the necessity of in-person treatments on the couch, I wonder to what degree we will stay in-step with the cultural changes taking place. Will, for instance, the IPA continue to accommodate virtual sessions after COVID? What of the couch itself in our understanding of the psychoanalytic frame? Are we prepared to consider the possibility that these aspects of our practice may be optional or even unnecessary? 

As I think about PINC and our evolution as a community, I must consider the impact of this new location independence. I will move to San Diego but hope to be as involved in my PINC community as I have been as a San Franciscan. Several of my PINC colleagues have migrated from their Bay Area perches during COVID. We may already be a more dispersed community than many realize. Our directory lists 380 members (including Community Members). Of these, I note conservatively that 62—or 16%—live well outside of the Bay Area. (I count San Jose, Campbell, and Los Gatos as within the Bay Area.) As our Distance Learning Program grows, our geographic identity as an institute will likely lessen. This year, five of our ten newest candidates come from beyond the Bay Area.

Location independence through virtualization has also had a remarkable impact on our programming. During the last academic year, a record number of people attended our programing on Zoom, from Visiting Scholars to the South Bay Reading Group. Just to give you a sense of the numbers, PINC’s Event Revenue was about $20K higher this past year than in our last pre-pandemic academic year—an increase of just under 30%. No doubt more people are attending our programs because of the convenience and greater geographic reach that virtualization permits. This comes at a loss—we don’t get to see one another in person. But there is also a gain—we are accessible to many more people.

Ironically, the name of our institute ties our identity as a community to Northern California. Nearly all psychoanalytic institutes are named after their geographies. But times are changing. We are changing. As PINC’s first distance president, I hope that our community will work hard to make a welcome place for those of us who live wherever.