In 1997 I presented a paper at the annual convention of the American Psychological Association entitled "You can't do Psychotherapy on the Net (yet)." For a complete discussion of these issues you should see the full text of that paper. Dr. Razzaque's site claims that psychoanalytic psychotherapy can be conducted in chat sessions. This modality gives you only bare text on a screen. You do not hear my tone of voice. You do not see my facial expressions. You can't tell how loudly or how fast I'm talking. You can't judge my mood. You have no idea how good my personal hygiene is.

Using the telephone adds a little to the interaction. I can then pick up some cues about your mood. I can notice whether your speech is slow or fast; loud or soft; monotone or full of inflection. Videoconferencing adds even a bit more information, although most of the methods that use regular phone lines allow only very small and very jerky images.

Psychoanalysis has been somewhat slow to embrace the Internet. This is the traditional Freudian form of therapy which can take years. Woody Allen popularized it in the movies. In its pure form the patient lies on a couch facing away from the therapist and talks about whatever comes into his or her mind. The fact that the patient does not see the therapist makes this form of therapy seem especially adaptable to the Internet. After all, the patient can't see the therapist in a chat room either. The therapist does face the patient in psychoanalysis, however. The therapist, in fact, is very attentive to the verbal and nonverbal components of the communication; and is usually taking notes. Chat rooms usually allow transcripts to be saved, cutting back on the need for note-taking. These transcripts obviously lack any reference to nonverbal communication.

What types of interactions between a lay person and a therapist are possible Online? The Forums at this site provide some examples of what is possible. Before this site existed I provided consultations over the Internet. My Shareware Psychological Consultation site made it very clear that these consultations were not therapy, and I ask people to pay me only if they find the consultation helpful. I focus on helping a person solve a problem in their life, and I make no attempt to diagnose or to provide "treatment" for any disorder. I believe that this much can be done ethically Online.

There are other ethical issues which have to do with Online privacy. Online chat rooms are potentially vulnerable to eavesdropping in a manner similar to unencrypted email. The telephone should be more secure, and videoconferencing by a direct telephone connection should be even more secure.