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  • Writer's picturePierre Cachia CPsychol

Making a new contribution to the practice of online psychotherapy


The field of online therapy is relatively new and while many practitioners have been forced to venture into cyberspace, our understanding of how the medium might facilitate therapeutic work is still in its infancy. In this publication I focused on the visual aspect of the therapeutic scene available via modern digital media and proposed the concept of mise-en-scene as a framework for identifying elements worthy of analytic scrutiny.


Psychology and particularly psychoanalysis, has always appreciated that the environment we create around us reflects and effects our sense of self. Gazing at the image available on the screen seeking to discern beyond what is immediately apparent, is a discipline that has served me well. It has enriched both my work with individual and couple patients as well as my experience in supporting other professionals through supervision. In reality, the visual is only one aspect of the online therapy experience, and we do well to extend our reflections to the quality of the auditory experience, as well as to the choices made in terms to the technologies employed both by psychotherapists and their patients.


Cyberspace is a reflection of the minds that create it and therefore an expression of the richness of the human psyche, whether engaged in creative and life-enhancing acts, or destructiveness and sterility. The mise-en-scene, like all other aspects of the psychotherapist’s experience with patients, merits thoughtful consideration. Our reflection on its various elements presented on the online set serves to deepen an appreciation of symbolic content projected onto the digital tapestry of our screen.

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