There is professional consensus that teleanalysis, the practice of psychoanalysis conducted remotely using the telephone and the Internet, is increasing in response to more mobility in the population. But there is controversy as to whether the use of technology leads to a dilution of analysis or to adaptive innovation that is clinically effective and true to the tenets of psychoanalysis. The author reviews the psychoanalytic literature and shows the development of analytic thinking about this technology-assisted practice of psychoanalysis. She summarizes analysts' perceptions and experiences of the advantages and disadvantages, and considers the indications and contra-indications. She focuses on the clinical concerns that arise in terms of the frame, resistance, and the development of analytic process through the unconscious communication of internal objects, unconscious fantasy, transference and countertransference. She gives vignettes from the analysis of a man with trauma-related depression to address the concerns raised and to support her argument that analysis using the telephone and the Internet is a viable, clinically effective alternative to traditional analysis where necessary.

Teleanalysis-remote psychoanalysis by telephone, voice over internet protocol (VoIP), or videoteleconference (VTC)-has been thought of as a distortion of the frame that cannot support authentic analytic process. Yet it can augment continuity, permit optimum frequency of analytic sessions for in-depth analytic work, and enable outreach to analysands in areas far from specialized psychoanalytic centers. Theoretical arguments against teleanalysis are presented and countered and its advantages and disadvantages discussed. Vignettes of analytic process from teleanalytic sessions are presented, and indications, contraindications, and ethical concerns are addressed. The aim is to provide material from which to judge the authenticity of analytic process supported by technology.

OVERVIEW OF BASIC THEORYObject relations theory has emerged as the psychoanalytic theory most applicable to a model of marital interaction and family dynamics.l-5 An individual psychology drawn from study of the relationship between patient and therapist, object relations theory holds that the motivating factor in growth and development of the human infant is the need to be in a relationship with a mothering person. According to Sutherland6 and D. S~h a r f f ,~ object relations theory is an amalgam of the work of British Independent group analysts Baht,8 Fairbairn? Guntrip,l0J1 and Winnicott, and of Klein and her follower^.^^,^^ Of them all, Fairbairn gave the most systematic challenge to Freudian instinct and structural theories.Fairbairn's18 schema of the endopsychic situation was picked up by Dicks19 who applied it to his work with spouses. The influence of Dicks's work on the psychoanalytic model of marital interaction was acknowledged by Bannister and Pincus, 2O Clulow,2l Pinc~s,2~ and Sk~nner,2~ all in Britain, and F r a r n~,~~ Martin?' MeissneqZ8 Nadels0n,2~ D. Scharff and

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