The Pets in My Practice

I’ve been a clinical psychologist for over 30 years. Trained in the psychoanalytic method, I spent most of my career in an office seated behind clients who lay on a couch. Then, three years ago, after several followers of my blog asked if I would be willing to work with them by Skype, I started practicing face-to-face video psychotherapy with clients all over the world. Usually I “meet” them in their homes.

Often, I meet their pets as well.

Consider Cheyenne, a ginger cat who often jumps onto the desk where my client has placed her laptop. If her owner does not respond to this demand for attention, Cheyenne will walk directly in front of the laptop’s camera and has even gone so far as to show me her backside.

Then there is Rufus, a midsize dog of uncertain parentage who erupts in outraged barking nearly every time I talk with his owner. Rufus understands that his job is to scare off the U.P.S. man, whose daily deliveries coincide with our session time.

Or Lola, a rescue dog who last week carried her food bowl, clutched between her jaws, into her new owner’s home office. I could see Lola’s face — full of longing, desperate to be fed, a puppyhood of pain and neglect written on her features.

Or perhaps I’m projecting.

When I first started using Skype, I considered these animal intrusions to be an amusing but irrelevant feature of the work. Over time, I’ve come to see them as a useful way to gain additional insight into my clients.

Brianna, a woman in her late 20s, often strikes me as much younger than her actual age. It would be easy to think of her as mired in perpetual adolescence, unable to fully and financially separate from her parents. If I had been meeting with Brianna in an actual office, I would never have heard the sweet note of maternal concern that colors her voice when she interrupts our session to tell me, “Sorry — Katie really needs to go out.” When Katie, a Siamese cat, returns from doing her business, Brianna often cuddles her as we continue.

“Do you need some water?” she sometimes asks, her lilting voice rising in pitch as she strokes Katie. At such moments, Brianna shows me the loving and attentive mother she will one day be when she “grows up.”

By contrast, Lyle seems annoyed when his cat, Thorndike, needs tending during a session. As I watch, he will open the door to his room and unceremoniously shove Thorndike out, closing the door behind him, then return to his chair looking peevish. Lyle sought treatment for help with “certain narcissistic tendencies.” It’s one thing to read those words on my client questionnaire, and another to witness the lack of empathy in action.

Noelle, a 42-year-old woman living in the Australian outback, reached out to me for help coping with a midlife crisis. She had recently learned she would never be able to bear children and was in profound grief. She usually spoke with me from her bedroom, where she would sit cross-legged on the bed. Often I heard her dogs, three Shelties, barking in the background. One day when they seemed especially obstreperous, she gathered them onto the bed with her. I will never forget the agonized expression on her face as she told me, “These are my children.”

As she wept, she held one of them close and buried her face in his fur. My chest ached and tears came to my eyes. Rather than the existential loneliness of weeping on a couch, staring up at a blank ceiling, hers was a grief shared with her animals. Although across the world and thousands of miles away from her, I shared it, too. We were together, all five of us, in the pain.

Although Sigmund Freud’s psychoanalytic method encourages the analyst to present a blank screen, concealing all details of his personal life, thoughts and feelings, Freud himself practiced from his home and included Jo-Fi, his favorite chow chow, in many of his sessions. Freud supposedly relied on his pet’s reaction to a client for help in assessing the person’s character. He also felt that a dog’s presence helped to calm his clients.

I practice from a home office, too, and sometimes my dog, Alice, takes part in sessions. A well-mannered (for the most part) white lab, when she finds herself alone she will bark softly outside my office door. The first few times this happened, I tried to ignore her barks. One day, a mildly exasperated client said, “Why don’t you just let her in?”

And so I did.

Now when there is barking outside the door, a client’s face will often light up and he or she will ask, “Do I hear Alice?” When I let Alice in, she appears on camera, paces in a circle, and settles quietly at my feet. “Good girl,” I will say, affection obvious in my tone of voice. I might even stroke her fur before getting back to work.

“There’s the bootsky girl,” a longtime client says when Alice comes in, applying a term of endearment she and her husband invented for their own cats. She smiles. I smile. There is a precious feeling of closeness in such moments.

After all my years in practice, I’ve come to understand that the greatest influence on the healing process in psychotherapy, at least the way I practice it, is the love I feel for my clients and the love they come to feel for me. As a professional, I’m uneasy speaking this truth aloud, and my clients often don’t feel entirely comfortable with it either. The love we feel for our pets helps ease the way. I witness the affection they feel for their pets, they see mine for Alice, and it brings us closer.

I’m sure that if my teachers and supervisors from analytic training were to hear about the work I now do and my views on the healing power of love, they would shake their heads in disapproval, concerned that I had gone to the dogs. But I would never trade my video connection with people all over the world for a sedate office where I meet only with local clients.

Nor would I trade away the pets, my patients’ and mine, who have made our contact more human.

Some details have been altered to protect patient privacy.

Joseph Burgo is the author of the forthcoming book “The Narcissist You Know: Defending Yourself Against Extreme Narcissists in an All-About-Me World.”