What To Do When Your Therapist Turns Into A Kitten

kitten

I have been working with patients online for about 6 years, and even now I have some interesting surprises in the work.  Recently I was meeting online with one of my long-term patients for their regular session.  I use my laptop but have a better web camera and monitor hooked up to it.  The bigger monitor allows me to see the patient’s image, but also keep an eye on my image so I can see what the patient is seeing.  The laptop monitor stays dark, and the laptop’s built-in webcam goes unused, at least most of the time.  But this particular day the laptop webcam decided to switch on 15 minutes into the appointment, and hijacked the webcam I was using.  So from what my patient could see, one minute I was there listening empathically, and the next minute I had disappeared.

Those of you who enjoy object relations theory should be enjoying this story by now.  Wait, it gets better.

As I was explaining to my patient why I’d disappeared, I was trying to turn off the laptop’s built-in webcam.  Instead I turned on a special program the laptop has that replaces the screen with the image of a kitten, the one seen above in fact.  Suddenly I was not invisible, but a kitten.  Better yet, the kitten was lip synching and moving its mouth when I spoke.  Fortunately this wasn’t happening at a particularly delicate moment in the therapy, and we both had a good laugh at it.  I apologized to my patient and said, “you know, I studied a lot of things at grad school, but they never taught me what I’m supposed to do if I turn into a kitten when I’m with a patient.”

Many psychotherapists have the sort of relationship with technology that resembles the folks they treat with Borderline Personality Disorder:  They alternately overidealize and devalue tech, often in the same breath.  “Skype” will be the way we salvage our dwindling practices, we’ll be able to reach people all over the planet, make our own hours and go completely self-pay because most insurance doesn’t cover it.  It will be wonderful.  That’s the overidealizing part, the devaluing part is more subtle.

Because I do a growing amount of therapy and supervision online, I often get requests for a consultation session to help therapists who want to do online therapy and “need my help getting on Skype.”  At this point I try to explain that Skype is not HIPAA-compliant, and that there is more to it that getting a webcam, but here’s where the devaluing of technology comes in.  It’s as if some folks think that the only thing one needs to know in order to be an online therapist is how to download a program and turn on the camera.

Most therapists who decide to get Basic EMDR training wouldn’t bat an eye at needing to go through two weekend trainings and a minimum of 20 didactic and 20 hours of supervised practice in order to be certified.  And yet many therapists don’t consider that working online and with emerging technologies requires more than learning how to flick a switch.  It’s sort of the way people often treat the IT guy at the workplace:  With one breath we describe ourselves to him as “clueless” about technology; and yet we really want him to stay in that basement office until we need him to come up and fix our email.

Graduate programs teach us next to nothing about how to use technology in our practice, except perhaps to warn us to avoid it at all costs.  Think about it.  Do you know what to do if you disappear in the middle of talking with a patient?  Do you know what to do if you turn into a talking kitten?  More importantly do you know how to prevent yourself from turning into a talking kitten, or turn yourself back from one if you do?  And perhaps most importantly, do you know how to help patients anticipate the glitches with virtual therapy, process the unique empathic failures that can arise, and create a good-enough holding environment online?

People like my colleagues DeeAnna Merz-Nagel and Kate Anthony founded the Online Therapy Institute for just this reason.  They offer dozens of different 5 hour courses on various technologies, from video conferencing to text chat to conducting therapy in virtual realities like Second Life.  The takeaway here is that there is a lot more to learn about online therapy than downloading Skype.

Look, I am not trying to discourage people from doing online therapy, in fact the opposite.  I know that it can be a very effective treatment modality, and easily accessed by a growing global population.  I’m not even trying to get you to sign up for consultation with OTI or me or anyone in particular.  The point I am trying to make is that it is an additional skill set that needs to be learned and integrated into your clinical repertoire.

Psychotherapists don’t just buy chairs and a couch and start talking.  EMDR isn’t just wiggling your fingers in traumatized people’s eyes. Both take time, case supervision and specialized training.

Online therapy, and integrating social technologies into your therapy practice is no different.

 

Like this post?  I can speak in person too, check out the Press Kit for Public Speaking info.  And, for only $4.99 you can buy my book.  You can also  Subscribe to the Epic Newsletter!

The following two tabs change content below.

Mike Langlois, LICSW

Mike consults, writes and teaches about online technologies, video games & psychotherapy. He provides private supervision for psychotherapists who seek to start, grow, & market their private practice.
About Mike Langlois, LICSW

Mike consults, writes and teaches about online technologies, video games & psychotherapy. He provides private supervision for psychotherapists who seek to start, grow, & market their private practice.

Comments

  1. This is great. My wife teaches online for Georgetown University. The whole class meets in a virtual room with webcams. A couple of weeks ago she was in the middle of teaching her class when her webcam turned her live image into a lip synching cat. It took about 30 minutes and lots of time on the phone with tech support to wrest control of her image from the cat avatar. Now my 5 year-old daughter asks my wife, “are you going to turn into a cat and teach students today?”

  2. Your kitten morph made me laugh! Thanks for the mention! We do offer free resources such as our ethical frameworks (always a good place to start) and our magazine! http://onlinetherapyinstitute.com/free-resources/

  3. I’m currently in training to become a supervisor in clinical pastoral education (teaching chaplains in the hospital setting). Besides interpersonal relations with our peers in a group setting and leading our own groups of students, the biggest part of our training is individual supervision to discuss our practice with an already-certified supervisor. At all the regional meetings I’ve attended the last four years, people bring up Skype as the next frontier for training supervisors in regions of the country where travel time means that individual supervision happens rarely. Right now there is such a fear of this technology that people are still saying remote supervision will never happen. I love reading about how you provide therapy via online sessions.

  4. Great post Mike. As I imagined this kitten, made me laugh. Good example of being prepared for tech gliltiches.

  5. dorleem says:

    Great post on a very important topic. It’s funny but I too had a couple of long-distance sessions while I was abroad caring for my mother at the end of her life (at the time, I did not know that skype was not HIPAA compliant and truthfully, I’m the one updating my therapist on technology)… In any case, we had a number of technical glitches… However, thanks to my comfort with technology and my therapist, I was able to tell her/question when things looked off – like once she tried speaking to me using her iPhone… and have a pad on her lap – the end result was that it made it look like she was working on her computer while talking to me – not something I expected… so I asked her about it…She then explained and then stopped (because naturally it was not a comforting feeling for me on the other end to feel like she is multi-tasking).

    So I love that idea of being able to see not only the client but how you look to the client – this would prevent that temporary breach in our communication. I will definitely take that into account when I will be ready to take on this role.

  6. You turned into a kitten! It’s a good job you were working with someone who did not have real attachment issues! I have not approached working on Skype yet and your point that I would need to think about more than buying a webcam to do this has hit home. Thanks for the post.

  7. Hey Mike, love you work and site. Although I am not a gamer, I do believe in Google Hangouts and social media as excellent tools. So I have a question, how do you see the ACA (Obamacare) impacting private practices for counselors/social workers? Especially insurance payments. Mike Logan

  8. As a gamer and a therapist just striking into private practice, I have been weighing my options with regard to online therapy. I admit, it never occurred to me that a lip syncing kitten avatar might be a viable way of communicating with therapy participants. I was thinking of using a psychedelic female version of Max Headroom as an alternative. Thoughts?

    In all seriousness, thank you for wonderful articles on technology and therapy. This has been a great site for me to poke around in.

    Jennifer LIles, LCSW (Maureen O’Danu is my writing pseudonym)

Trackbacks

  1. [...] for online work to an entirely new level. I don’t know if this rivals Mike Langlois’ What To Do When Your Therapist Turns Into A Kitten but I think it comes [...]

Add Comment Register



Speak Your Mind

*