I don't think I could ever open up via email, Skype, or even the phone. I have enough trouble with it in person My T's office is very comfortable and warm, with lots of floor to ceiling bookcases, leather sofas, oriental rugs, etc. It feels safe when I am in there. There's also kinda the feeling that there's no escape and I can't run away. When I'm in there with him, I need to face things. For me, t any other way would be a waste of time - it would be too easy for me to hold things back.