"The Communication Cure: Tele-Therapy 1890-2017," is a patient-centered social history of therapies deployed beyond the classic consulting room. Over the last decade or so, there has been a rapid expansion in mediated treatment aimed at populations beyond the reach of traditional therapy, and at individuals who have access but, for one reason or another, are reluctant to make use of it. Starting with a reading of epistolary conventions and Freud's treatments-by-mail, my dissertation shows that tele-therapy, far from being a recent invention, is at least as old as psychoanalysis itself. Subsequent chapters focus on the American context and demonstrate that psychotherapy has always operated through multiple communication technologies and media, including newspaper columns, radio broadcasts, crisis hotlines, the earliest mainframe networks, home computing, the internet, and mobile phones. Practitioners since Freud have almost completely resisted reflecting on these channels; my aim has been to do just that. Therapy was never only a "talking cure:" it has always been, I argue, a communication cure.

The history of tele-therapy also provides a unique frame for examining our current concerns and panics, both theoretical and ethical, about the impact of media on clinical relationships. "The Communication Cure" contends that media technologies have always played a central role in these interactions, producing medium-specific forms of what I call "distanced intimacy," which allow for unexpected and new kinds of relation and help, while also posing a threat to traditional models of self-disclosure and therapeutic understanding. I track the decline of the primacy of the paid clinician and the weekly face-to-face meeting as they give way to disseminative models, activist and volunteer labor, peer-to-peer aid, and algorithmic therapies. In parallel, as patients become clients and then consumers, access to treatments that have been historically unavailable for the general population becomes more thinkable. In examining the available archives of these practices, practitioners, and the participants in these new forms of care, my project illuminates how providers rethink their practices and demands that we evaluate and weigh the effects of these therapeutic technologies in their specific social and cultural contexts. Methodologically, I draw on archival research (Freud's letters, radio transcripts, suicide hotline call logs), discourse analysis, auto-ethnography, and interviews with practitioners, programmers, and CEOs.