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SXSW: Online Therapy… Naked? Post-Mortem

SXSW: Online Therapy... Naked? Post-MortemI recently had the pleasure of appearing on a SXSW panel organized by Dr. John Grohol called “Online Therapy… Naked?”

Joining me were Audrey Young and Julie Hanks, along with Dr. Grohol. The topics discussed ranged from the kinds of clients we’re all seeing online to the software we use to the differences between in-person and online therapy to the details of my practice, Naked Therapy.

Besides describing their own online work, there was a vibe from my co-panelists that Naked Therapy, while cute, had come from another planet. And in a way they are right — it has come from the Internet planet with a history very different from their psychotherapeutic backgrounds.

The current definition of NT (now just over a year old) is a form of talk therapy in which the client and/or the therapist gets naked. This is a new kind of therapy bred from new ground and I am in the early stages of assessing its possibilities.

My co-panelists expressed some concerns over my methods, much of it centered on the question of my training and whether or not what I’m doing might be “harmful” to my clients due to my lack of psychotherapy training, while also admitting that online therapy is a new field that is still trying to find its parameters and those parameters might include, given the ecosystem of the world wide web, nakedness in a therapeutic context.

The discussion left me invigorated by the horizons of online therapy in general and Naked Therapy in particular, but it also left me with some thoughts/questions that I’ll now elucidate.

It strikes me that much of what we’re discussing (or trying to discuss) when we talk about online therapy and how it presents a number of new conditions and/or problems for the therapist and/or client is the complexities inherent in a new world — and I mean “new” in a profoundly distinguished sense. Identity on the Internet is operating in a practically new world, very much based on and informed by, but also very different from, the non-Internet world.

So when we talk about conducting therapy online, we are not talking about something such as what it’s like to play tennis on a clay court after playing it on a grass court for over 100 years. The “court” of the “virtual” is far more different than the “court” of the “real” than is grass from clay. It is almost more like asking what it’s like to play tennis on Mars after playing on Earth for so long. Tennis is a physical game, and when you change the basic physical environment, you deeply alter the reality and possibilities of the game. Therapy, on the other hand, is a psychological game, and when you change the basic psychological environment, you change what therapy is, can be, and even should be.

Operating in a New World

Much of what seemed to be brewing largely unstated beneath my co-panelists concerns about online therapy and Naked Therapy involved ethics. A broad and detailed code of ethics has been built into traditional therapy to prevent therapists from hurting clients. Yet how that hurt might take place and what that hurt might be are precedented on the assumptions that the therapist and client are operating under and the environment in which their sessions are being conducted. When you alter these assumptions and this environment — as the Internet has done — you alter the kinds of hurt and thus the ethics that need to be considered as relevant to prevent that hurt.

For instance, one of my co-panelists said (and I paraphrase) that she was worried that I might be “hurting” (that much is a direct quote) some of my clients by removing my clothes for them and allowing them to feel aroused by me.

When you visit a Naked Therapist online, you deeply expect that she will remove her clothes.

Yet this concern is based on the assumptions and environment of traditional therapy, namely, that when you go see a psychotherapist in her office, and she is licensed, you do not assume — in fact you deeply expect the opposite — that she will remove her clothes. However, when you visit a Naked Therapist online, you DO assume — in fact you deeply expect — that she will remove her clothes.

Someone who goes to see a traditional therapist who suddenly, against all assumptions and ethical dictates for that environment, removes her clothes and elicits arousal in the client, might well be hurt by such an experience.

But someone who goes to see a Naked Therapist who suddenly, against all assumptions and ethical dictates for that environment, refuses to remove her clothes and elicit her client’s arousal, would also experience hurt. In both cases, the client might feel shame, rejection, and anger that he has been tricked or lied to or ripped off. Why? Because he was not given what he was told he would get. Just like the client of the traditional therapist would be the victim of what we call “indecent exposure” if his therapist suddenly stripped, so the client of the Naked Therapist would be the victim of “indecent non-exposure” if his therapist refused to strip.

In essence, besides simply making the point that “hurt” in clients is very much based on doing what we as therapists say we’ll do and not doing what we say we won’t do (for in a certain sense that is why most clients see therapists — after suffering too many dissatisfying relationships with people who haven’t done that, they seek in us a satisfying relationship with someone who does do that), I believe online is such a different reality from offline that we need to fully reconsider what the ethics relevant to the therapeutic relationship are in this new virtual environment. And this is not to say that ethics do not apply online. I very much believe they do apply, as much as they do offline.

But they are different online, because we are different online. We want different things (due in part, as Dr. Grohol informed me, to what is called “online disinhibition” effect), we have different identities (I personally know psychotherapists who use an alternate identity for non-work purposes), and we do different things (for instance, we are willing to engage in activities online that we are not willing to engage in offline, some of which we partake of when overtaken by what I have termed “arousal frenzy,” e.g., former US Representative Anthony Weiner and his Twitter problem).

Closing Thoughts…

So, those are my preliminary thoughts about the panel. Here are some others:

I really enjoyed how, when I stated that I was not a licensed psychotherapist (indeed, that I cannot be because my methods are grounds for dis-licensure) and that I thus consider myself a “lay therapist,” that there was some laughter on the panel and in the crowd at the double entendre. Humor is almost always a good thing!

On the issue of licensure, Dr. Grohol pointed out that “therapy” is something that has been conducted for centuries by people who have not been licensed as psychotherapists, such as hair stylists, rabbis and priests. To that list I would add friends and family, bartenders, nurses, doctors, masseuses and yogis, just to name a few.

Wouldn’t it be interesting to offer “online identity therapy” in which the therapist is willing to delve into offline behavior but primarily focuses on online behavior as the history relevant to the online (and offline) identity in an attempt to help the online identity come to grips with what it’s done, how it feels about what it’s done, and how it hopes to behave in the future? If you’d be interested in being a client in such sessions, email me!

To me, Naked Therapy is about meeting men where they are. Many men are online, seeking a variety of experiences with naked women, and instead of saying “stop doing that and come see me,” the Naked Therapist says “keep doing that and come see me.” It accepts men’s desire to be aroused by nakedness — in fact, it sees that desire as so integral to what men are it actually prefers to conduct therapy within that context of desire so that it can get closer to what is integral to men. Naked Therapy or online therapy in general may not be for everyone, but it is for some, and that’s enough to justify the further exploration of a methodology.

Thanks to Dr. Grohol for inviting me to SXSW, to my co-panelists for sharing the stage with me, and to the audience for attending!

SXSW: Online Therapy… Naked? Post-Mortem

Sarah White, The Naked Therapist

Learn more about Naked Therapy.

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APA Reference
The Naked Therapist, S. (2018). SXSW: Online Therapy… Naked? Post-Mortem. Psych Central. Retrieved on September 29, 2020, from
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Last updated: 8 Jul 2018 (Originally: 18 Mar 2012)
Last reviewed: By a member of our scientific advisory board on 8 Jul 2018
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