In the early days of telehealth, the promise was simple: therapy for everyone, anywhere, anytime. Convenience replaced commute, and the screen became our window into another person’s world. For a while, it worked—especially during the isolation of the pandemic. But lately, I’ve found myself saying something I never expected to say aloud: When I hear a commercial on NPR offering help from over 30,000 psychotherapists from anywhere on line, I wonder how healing this kind of psychotherapy can be from therapists, no matter how well intentioned, who can’t see the whites of my eyes.
That phrase, born on a battlefield centuries ago, meant don’t act until you’re close enough to truly see the other. It was about proximity—about being present when presence mattered most. And that’s exactly what’s missing from so many on-screen sessions today.
The Subtle Distance of the Screen
When a client sits across from me in my office, I can feel the tremor in their breath before a tear forms. I notice the way their eyes drift, the micro-expressions that whisper, “I want to trust you, but I’m still afraid.”
These small cues—the tiny tremors, the fragile pauses—are what guide the healing process.
Online, even with the best camera, those subtleties are softened or lost. The pixel flicker between us dilutes what’s sacred: that moment of human contact when two nervous systems begin to regulate each other. In that moment, empathy is not an idea—it’s an exchange of breath, tone, and trust.
Presence as Medicine
In-person psychotherapy isn’t just about words. It’s about co-regulation, resonance, and the unspoken reassurance that says, You are safe here.
When someone sits in the same room with a caring, compassionately curious psychotherapist, they experience not only understanding but embodiment. Their nervous system begins to calm because it feels the other’s calm. This is what neuroscientists describe as neurons that fire together wire together for connection.
That’s something no bandwidth can deliver.
During both Marriage Counseling and Therapy and Ketamine-Assisted Psychotherapy, for example, presence becomes even more crucial. The medicine softens the noise so the soul can speak and the therapist holds a lantern so the client can find the lost parts of himself hidden like embers in the ashes. It’s the therapist’s grounded, compassionate attention—the steady eye contact, the felt sense of safety—that allows healing to unfold. As a psychotherapist, I can never offer that kind of knowing through a screen. I need to be there. To see the whites of their eyes.
What Happens When We Truly See Each Other
Seeing the whites of someone’s eyes is more than a metaphor for closeness; it’s a mirror for authenticity.
When a patient finally meets my gaze after months of avoidance, something ancient and human happens: their shame begins to loosen, their story finds breath.
And sometimes, I see my own reflection there too—a reminder that therapy is a shared act of courage. Healing happens not through advice or technique alone, but through the deep recognition that we are both alive in this room together.
Why We Still Need Rooms in which to meet face to face
Screens will always have their place. They connect us across miles, allow continuity of care, and help when travel or illness intervenes.
But for true transformation—the kind that touches the body, heart, and soul—there is no substitute for the living presence of another human being.
Because healing requires more than understanding.
It requires being seen. And they can never see the whites of my eyes – nor can I ever see the whites of their eyes – on-line. It’s absolutely crucial to be in the same room together.
Call Andre Moore, LMFT at 212 673 4618 for a consultation.
