Telephone Associated Pathology: Clinical Case Studies and Discussion

The advancement of modern technology shapes and develops new expressions of psychopathology and accompanying treatments. This is most apparent with the telephone, an instrument of contact and communication for the patient, and assessment and intervention for the therapist. The telephone both constrains and creates unique constellations of patient symptomatology. This paper will examine one such telephone symptom complex-the habitual over use of the telephone by non-bipolar patients. The frequent monopolization of the phone seen in some bipolar patients will not be considered, though the elements of intrusion and aggression discussed in this paper are probably shared by manic patients. A review of the psychiatric literature reveals a surprising paucity of writing about the psychodynamic significance of patient\u27s use of the telephone, even in the area of sexual paraphilias and sexually obscene phone calls. Freud describes the telephone as a representation of the body, and as a metaphor for psychoanalysis (1,2). Stekel (3) discusses the telephone as a sexual symbol, and Harris (4) relates phobic anxiety of the telephone to castration anxiety. Fliess (5) is the first to write of telephoning as a symbol for masturbation, an idea elaborated by Shengold in his paper The Symbol of Telephoning (6). Alman si, Socarides, and others have written of the use of the telephone in sexual paraphilias (7,8) . The bulk of writing in the mental health literature, however, focuses on the use of the telephone in counseling services and suicide hotlines. With the ever increasing utilization of the telephone by patient and therapist alike, this limited analysis of the meaning and uses of the telephone in the psychiatric literature is an intriguing deficiency in the understanding of patient behavior