I prefer working with patients in person as much as possible. For psychodynamic psychotherapy and psychoanalysis in particular, I think there can be something important about two people being physically present together—and about having a space for therapy that is separate from the rest of one's life.

A young woman in a plaid shirt reclines on a bed, earbuds in, waving at her laptop during a video call — the flexibility of online therapy in Washington, DC, where an online therapist washington, dc offers psychotherapy in Washington, DC from home.

The question, however, is whether it has to be in person or online. At times, the most useful arrangement incorporates both.

The Convenience of Online Therapy Is a Real Advantage

Online sessions can also make it easier to maintain continuity when life becomes complicated. Travel, a sick child, transportation difficulties, or an unusually demanding workday do not necessarily have to mean missing a session.

For someone attending therapy multiple times per week, this flexibility can be especially important. Plus, research suggests online sessions can be comparatively effective.

Convenience isn't trivial. If a more flexible arrangement makes it possible for someone to engage consistently in meaningful therapy, that matters.

Being at Home Isn't Necessarily the Same as Having Psychological Privacy

One disadvantage of online therapy is that having enough physical privacy for a session does not necessarily mean feeling psychologically separate from the rest of your life.

You may technically be alone in a room, but your spouse is downstairs. Your children are nearby. Your work computer is sitting in front of you. Your phone is receiving notifications. There is laundry in the next room and an email waiting to be answered.

The external world can remain very close.

There is a difference between having a private conversation and entering a space in which you can temporarily turn your attention away from everything else and turn inward.

What Changes When We Are in the Same Room?

One reason I prefer in-person therapy is that communication is not entirely verbal.

When therapist and patient are physically together, there is access to more of what is happening between them.

But I think there is something beyond simply having better access to "body language."

There is a different experience of being physically present with another person.

A silence can feel different when two people are sitting together. So can sadness, anger, embarrassment, or vulnerability. There can be something meaningful about having another person remain physically present with you while you encounter something difficult.

Psychodynamic therapy pays close attention not only to what someone says but to what develops within the relationship between therapist and patient. For me, being together in the room adds something important to that work.

The Trip to Therapy May Be Part of the Therapy

A woman in a white blouse gazes out a train window, hand at her chin in thought — the transitional reflection that psychodynamic therapy in Washington, DC values, via a psychodynamic approach in Washington, DC or psychotherapy in Washington, DC.

The commute is usually described as one of the disadvantages of in-person therapy. And practically speaking, it is.

But psychologically, the commute to therapy can sometimes serve another important function.

On the way to a session, you may begin thinking about what you want to talk about. Something from the previous session may return to your mind. You may notice that you are looking forward to going—or that you really don't want to go that day.

Your mind has already begun moving toward the session.

Something similar can happen afterward.

Perhaps you walk for a few minutes, sit in your car, take the Metro, or simply have some time before returning to work or home. A thought from the session may continue developing. Something you hadn't quite understood while you were talking may become clearer.

In this sense, therapy does not necessarily begin the moment you enter the office or end the moment you leave it.

The transition can become part of the process.

Online Therapy Can Collapse That Transition

The efficiency of online therapy can also be one of its disadvantages.

You can finish a work meeting at 2:59, begin therapy at 3:00, talk about something deeply painful until 3:50, and answer an email at 3:51.

There may be almost no transition between very different psychological states.

For most people, it is difficult to move immediately from doing, managing, and responding to other people into the more inward state that therapy asks of them.

The same issue can arise at the end of the session. Something important may have emerged, but ordinary life is waiting on the other side of the screen.

During COVID, I remember many patients remarking how much they missed the transitional space between sessions.

It can sometimes be useful to intentionally recreate a little of this transitional space—perhaps by taking a short walk before or after the session, closing work applications early, or simply leaving a few minutes in which nothing else is scheduled.

I Prefer In-Person Therapy, but It Doesn't Have to Be All or Nothing

In my own practice, I prefer to work in person as much as possible.

I value having the therapist and patient physically present together, and I value the separation that an office provides from the rest of the patient's daily life.

At the same time, people's lives are complicated.

There may be days when work obligations make getting to the office impossible. A child may be home sick. Travel may interfere. Transportation problems arise. Or someone attending therapy multiple times a week may find that coming to the office for every session makes an otherwise workable treatment difficult to sustain.

I don't think the choice always needs to be all or nothing.

When appropriate, we can arrange a hybrid schedule, with some sessions taking place in person and others online. Someone meeting several times per week, for example, might come into the office for some sessions while meeting virtually for others.

A therapist takes notes on a clipboard as a man in a blue sweater sits across from her — the in-person work of a psychodynamic therapist washington, dc offering psychodynamic therapy in Washington, DC and psychotherapy in Washington, DC.

This allows us to preserve something valuable about in-person work while also recognizing the realities of a patient's life.

The balance can also change over time. There may be periods when meeting primarily in person makes sense and others when greater flexibility is necessary.

I think it is important to stress that a hybrid schedule is possible when appropriate. There are some scenarios in which I think it would only work to meet in person for sessions. It depends on what I think is best for the patient.

Where I’m Located in Washington, DC

I’m located in AU Park along the DC and Maryland border, on the DC side, between NW DC and Bethesda, MD. The closest metro stops to me are Friendship Heights and Tenleytown (one mile away, each). There is plenty of street parking available, so you wouldn’t be in a situation in which you’re looking for parking for 15 minutes, as you would be if my office were in downtown DC. I’m conveniently situated in the DMV area. Even though I am in DC, I am:

15 minutes away from Northern Virginia via 495 near Cabin John
15 minutes from downtown Bethesda
And 20 minutes from downtown DC

Start Online or In-Person Psychodynamic Therapy in Washington, DC, Bethesda, MD, and Chevy Chase, MD

If you're weighing in-person against online therapy, it doesn't have to be a permanent choice. I prefer the depth of working in the same room, and my office in AU Park — on the DC side of the DC/Maryland border, a mile from the Friendship Heights and Tenleytown Metro stops with easy street parking — makes getting here simpler than a downtown commute. But when life gets complicated, a hybrid schedule can keep the work going. Schedule an appointment with Nina Van Sant, LICSW, to start finding the balance that makes sense for you.

Other Services Offered with Nina Van Sant, LICSW

Psychodynamic therapy isn’t the only service that I offer. I’m trained to offer several mental health services via in-person and online therapy. Other services offered include postpartum therapy, therapy for teens, and therapy for older adults at different developmental stages. I also work with expats and international professionals who are managing cultural adjustment, relocation stress, and the emotional weight of significant life changes. You can learn more helpful info by visiting my blog today.

In-Person or Online Therapy? Pros and Cons of Each