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Peering through the spyhole: The importance of eye contact in therapeutic engagements via webcam

03 November 2016    Carole Francis-Smith

Many therapists are being drawn to working online for various reasons, not least because there is evidence that clients would seem to welcome the convenience. Most therapists seem to begin by considering working by webcam – mostly because it is probably deemed or ‘assumed’ to be the platform that most closely replicates working face-to-face.

However, there are many things to consider when working with webcam; remember that this is the window to your therapy room! So, apart from reflecting on safety, technology and practical issues, therapists will also be considering the psychological impact of working remotely. Core trainings emphasise the importance of building a therapeutic relationship face-to-face.  Many therapists express doubts about the idea of being able to create this relationship effectively in an online space, perhaps due to the lack of non-verbal communication (NVC) cues or physical distance. “Aha” you say, “but using the webcam means I can pick up on non-verbal cues….”. Let us explore further the role and reality of eye contact in webcam therapy.

‘The eyes are the windows to the soul’ an old English proverb tells us, and researchers in the field of neuropsychology stress the importance of ‘gaze’ and facial movements in the formation of relationships (particularly early in life). This leads to the theory that the ‘gaze’ of the therapist is crucial in helping clients develop healthy attachment styles. Within webcam interactions, direct eye contact is likely to be considered to be central to both reading NVC cues and conveying empathy.

Both are equally important to the therapeutic process. However, it could be argued that therapeutic containment is the responsibility of the therapist, and one way of facilitating this is by looking directly into the eyes of our clients. For most of us this means looking down the camera spyhole (as suggested in most ‘advice for working by webcam’ pages), which paradoxically means we are disabled from tracking NVCs in our clients to the same degree. There are of course some things we can do to try and counteract this problem, for example by placing our cameras (if we have external ones) as near to the eyes of the person on our screen.

Personally, I take quite a down to earth attitude to my therapeutic work, and sometimes ‘model’ an imperfect online communication. I recall a time when I had placed myself perfectly in front of the camera, drawn my curtain behind me, made sure there was enough light on my face, framed myself on the screen, smiled and waited…

After a while it seemed clear my new client was unable to connect so I leaned forwards, looking for the appropriate icon to close the session, and the client popped up on the screen. Their first vision of me was one big eye and the top of my head – no wonder they looked so alarmed!!! We got past it thankfully (-;

In all seriousness, like many other online therapists I recognise the importance of having the other person ‘see’ me looking into their eyes, and feel frustrated in webcam communications when this means missing the rest of the picture (however good one’s peripheral vision is). Being born in an age when the highest form of tech in my school was a lever pulled calculator, I sometimes feel overawed by the speed of technological breakthroughs, but some are particularly exciting and worth noting.

Eye tracking technology has been around for a while and would certainly help fill the ‘seeing me seeing you’ gap, but costs have kept it beyond the reach of most self-funded private practitioners. This might be about to change with the advent of some affordable software that works with several mainstream webcam providers, called CatchEye™. The principle is that the software will control the eye contact for you, by directing your webcam automatically. If this can be made to work smoothly, it could be a game changer for those frustrated with the webcam eye contact mismatch, and an exciting addition to the repertoire of the online therapist.

Some of us are currently trialling the software and will soon report back to you, so watch this space Online Therapy Hub members!