Caring through things at a distance: Intimacy and presence in teletherapy assemblages

The COVID-19 crisis in the UK precipitated a sharp rise in the use of remote technologies to provide therapy during the lockdown. With mental health care services migrating to devices and video-conferencing platforms, nearly all forms of therapy had become 'teletherapy'. Drawing on interviews with UK-based practitioners, this paper explores how existing ideas of intimacy and presence are challenged when care is practiced at a distance. Against the background of concerns that remote technologies erode intimacy and degrade physical presence, the argument is made that presence, distance, intimacy and control are reconfigured within mediated therapy. Analysis of practitioners' experiences of teletherapy examines the material and expressive components of 'assemblages' characterised by their stable and fluid properties. Two assemblages are identified and discussed: emergency care assemblages and assemblages of intimacy, both of which are aligned with specific sectors of mental health care. Evidence that therapeutic encounters are constrained by technologies are considered alongside the material conditions and inequalities of vulnerable groups, while assemblages with relatively stable properties are generative of new ways of relating to clients online. These findings highlight the material and expressive components of human and nonhuman assemblages that create new kinds of affective relations in distanced care.