Psychotherapy in Cyberspace

The destructive aspects of certain Web-viewing habits have been increasingly documented in recent months and years. It is now, perhaps, appropriate to discuss one of the positive and therapeutic advantages of the Internet. A significant part of my private practice is conducted at a distance via e-mail. Some correspondents are former clients who have moved out of the area; others have sought me out because they seek an understanding psychotherapist who will not be shocked by their paraphilias—erotic sado-masochism, cross-dressing, fetishes, etc. (an area in which I was working long before these became a popular fad); and some live close enough to my office but are too embarrassed to talk face-to-face. They reach me mostly through word of mouth. It is a modality that can be both highly efficacious and cost-effective. I know of only two practitioners (both in New York State) who use this modality; perhaps the description below will encourage other therapists to explore it.