Gamertherapist

AI Art M. Langlois

“What is dangerous is not technology. Technology is not demonic; but its essence is mysterious… The threat to man does not come in the first instance from the potentially lethal machines and apparatus of technology. The actual threat has already afflicted man in his essence.” –Heidegger, The Question Concerning Technology

“There are the hands that made us, and then there are the hands that guide the hands.”—Guardians of the Galaxy 3

Whiteness likes its technology as it likes its privilege—invisible. If we have grown used to a technology, our pencils and printing presses, abaci and atlases, qanat and cranks, we enjoy the power they give us, the way they amplify our efforts, speed, and knowledge. But when technology first emerges the pattern is always the same: at best, awe and bewilderment, at worst fear and demonization.

For some time I have been troubled by the way some of us, especially in my field of psychology, have greeted emerging technology with this attitudinal stance, even though I understand it in both the psychodynamic and philosophical terms I’ll outline below. I have struggled to articulate the implicit connections I sense between technophobia, racism, classism and other forms of prejudice and oppression. It is unlikely that this beginning work will do more than make some of these connections more explicit, spark conversation and thought in others, and spur on colleagues to research these ideas in academia and beyond.

I originally considered writing this in an academic style for academics, and from that vantage point I have already failed miserably. The ideas I wish to convey require more playfulness, the issues and people at stake require more passion. I hope that the plates I set spinning in an attempt to resonate these ideas will move you to carry on those more rarified but important discussions as well.

Science and research often rightly say “show me the evidence to support your claims.” However, this stance is also often co-opted intentionally or unintentionally by oppressors to silence people speaking truth to power. No one today asks us to provide evidence that chattel slavery harms the human psyche, but there was a time when neuropsychology cited the research of phrenologist Fritz Galls to assert that Black slaves were not quite human even to have a psyche. (Galls, 1835) Until an oppression is made visible, such as racism or homophobia, we can use science as a handmaiden to oppression. Show us the evidence, we hear, while conversion therapies harm the minds of LGBTQIA+ human beings, and then we will take action. Prove that health disparities exist between BIPOC and white human beings, as if four centuries of chattel slavery and Jim Crow cannot be taken as givens. I am grateful to colleagues who will take up these charges, but I do not have the time or patience. As Bettye LaVette says, I’ve got my own hell to raise.

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So let me ask a series of seemingly unrelated questions: Why is the IT guy always put in the basement? Who really wins when a Black man takes on a steam drill? What was the 3/5s Compromise? Why are we so scared of AI? And what does Heidegger’s hammer have to do with any of this? An answer from the perspective of psychoanalysis can, I believe, be found in the work of Klein and Bion. Buckle up, it’s going to be a hermeneutic sort of ride. And trigger warning to my BIPOC readers, we will be making explicit ideas which it hurts you to be reminded of, as if you ever really are allowed to forget.

I bring up AI not because it is trendy, but because I have noted with dismay that people speak about it in the same words and tone that Enlightenment thinkers like Jefferson used to describe Black chattel slaves; “that in memory they are equal to the whites; in reason much inferior… and that in imagination they are dull, tasteless, and anomalous.” (Knoles, 2006) Compare that to how we speak with mistrust about the technology of AI: it lacks creativity and imagination, relies on human input to be successful, it cannot be trusted, it can be manipulated, it is not capable of thinking and feeling as we do. Suddenly I am unsure if we are in the 21^st century or the Pre-Reconstruction Era.

If you bristle at the comparison between our attitudes towards AI and race, I take you back to 1787 when Charles Pinckney Suggested the 3/5 Compromise, proposing:

Three-fifths of the number of slaves in any particular state would be added to the total number of free white persons, including bond servants, but not Indians, to the estimated number of congressmen each state would send to the House of Representatives. (Pinckney, 1787)

This “compromise,” made by whites for whites, was created not to dignify Blacks in any way, but to count them as “creditable” in determining congressional power in U.S. Government. Much like today’s debates around AI, it was a given that we weren’t talking about Black chattel slaves as human or deserving of human rights. But it also indicated the beginning of an historical reckoning. Because once you identify a thing, or a human being, as countable, you change things. Over time whites began to think of Blacks as 3/5 human, almost human. Suspiciously human, dangerously human. We hear these echoes in current debates about AI. The technology is not transparent.

Am I suggesting that AI, hammers and video games are the same as BIPOC human beings? No. What I am suggesting is our relationships to all of them are linked, in the Bionic sense (1959). Less than 100 years ago, such a linking between a Black man and emerging technology was explicit in the folk legend of John Henry. Henry, a Black man used as labor for the railroad industry, was reported to have beaten a steam drill in the drilling of the Big Bend Tunnel (Johnson, 1930). Although the ballads and oral history frame this as a competition between “mighty muscles against steam and steel,” the juxtaposition of the Black as technology with the emerging technology reveals itself. The idealizing of the heroic Black was also equating him to technology, at least under the white gaze of the sociologist collecting oral tradition. Whites still tend to link BIPOCs with technology, in both love and hate, envy and gratitude. They are linked in an anxiety which we retreat from into moments of psychosis.

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In his work Being and Time, Martin Heidegger talks about technology in terms of “equipment,” and uses the hammer as an example. We do not tend to think of a hammer as separate from our involvement in the act of hammering. When technology is “working” (meaning working in concert with our wishes) we do not see it. It is transparent to us.  We see the project we are engaged in, be it hammering, psychoanalysis or plantation work, as happening. The hammer implies our connection to it as a way of making our being stronger, faster. We never experience that hammer as separate from us until the moment it stops working. At that point the hammer becomes alien, a thing, a source of frustration, and we skip over understanding that it is an entity in itself and go right to experiencing it as other. In this moment, we may even experience it in a psychotic state, where we attribute motivation to it, devalue it as broken, and rage at it as if it was deliberately attempting to defy us.

What is coming up here is the activation of our projective identification. Technology becomes the bad object. Klein (1946, 1957) described and Bion (1955, 2013) elaborates on how the human psyche uses splitting off and expelling from ourselves, and yet keeping close by, those parts of ourselves we cannot bear to acknowledge. This creates moments or pockets of psychosis in us, vestiges of the earlier Paranoid-Schizoid position. In this psychotic state the bad object becomes monolithic and imbued with destructive intent. AIs, like the Cylons, like the Mexicans, like the Blacks, are out to get us, and they have a plan.

In no place is this racial divide more clear than in emerging technologies, technologies not yet transparent, not yet “mastered.” While white elites debated the concept of screen time, social media gave a promise of Arab Spring, which remains largely unfulfilled (Robinson et al, 2020). While white middle class families angst over Facebook and depression, BIPOC families are ensuring their children learn how to use smartphones as a security device for protection and surveilling of police brutality (Battle, 2017; Markussen, 2022.) And for decades while overwhelmingly white clinicians and educators have been decrying the internet as threatening to children, Black and Latino youth are struggling to get on it at all (Dolcini et al, 2021). These differing concerns when confronted reveal how siloed down whites still are when it comes to both technology and race. And I would like to suggest that as a resonant form of projective identification, technophobia becomes a proxy for racism, classism, heterosexism, ableism and genderphobia.

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What happens when we have been using human beings as technology and they break? If we are to believe the stories and ballads John Henry died of it. For centuries whites used BIPOC people to amplify our power, economy, and even bodies through fieldwork and rape. When BIPOCs were transparent, when they did not have to be moved to reservations or march the Trail of Tears, whites could consciously experience pleasure, ease, libidinal discharge and gratification. To focus solely on BIPOCs as property misses an important point for an ego-defensive reason. Surely we don’t think of BIPOC human beings as property now? But as technology, to amplify our cleaning, manufacturing, health, and other human projects, whites still attempt to keep and use BIPOCs as a transparent technology. The backlash to the past and present Civil Rights movements is in part white anxiety towards the technology of race broken and thus not transparent. White privilege has been used to attempt to keep them transparent, and it has failed. The hammer is not working, we think, it is not useful. It is broken, and it threatens us with its becoming visible.

I must speak about Black Twitter here, at least in brief, as a form of technology that dares to make Black interiority visible to whites if they wish to see it. Encompassed in Black Twitter are the raucous interests, academic musings, jokes, reviews, and spirits of a multitude of BIPOC human beings on display. Not made for whites but visible to them, Black Twitter shows us Black interiority and challenges us whites to move out of our psychotic state—for it is, I assert, a psychotic state to view BIPOCs as having no interior life to be curious about, to wonder about, but instead to project our own bad objects upon. Even in our own professional psychoanalytic organizations, white analysts often scry rage and pathology, but nothing more, when viewing our colleagues lives and lives of the mind. (Ellis &Langlois, 2016; Hamilton & Langlois, 2020; Langlois et al, 2020)

The McCormick reaper arrived just prior to the Civil War, when the technology of slavery was beginning to break. Its benefit was apparent quickly, albeit more quickly in the North and Midwest: Blacks could be discarded, a broken tool, for the faster gathering, reaping and automation of the new technology. If there was anxiety about technology taking jobs, it was assuaged in the North and Midwest by factories which became the new home for many Black workers. (Ironically, the co-inventor of the McCormick reaper, a Black slave named Jo Anderson, could not legally hold a patent: Property could not have intellectual property. (Brumfield, 2018)) Once rehoused in the factory, the Black as technology became transparent again in the North, which is in large part what allowed the Civil War to be fought and won by the North.

And that is why the tech guy is always in the basement, in a room without windows. Class as well as race is present here, the worker a technology we want transparent. The room without windows where the tech guy sits has a phone, so that we can call him, call him into existence because our PC is not working. He sits in that black box as uninteresting to us as the inner world of the Civil War slave or the 21^st Century Black, until we need to use him as the technology to repair our technology. And then he/she/they are expected to go back into their box, labeled with all our attempts to other them again: neurodivergent, incel, geek, nerd. Fun fact, a majority of my neurodivergent and trans patients did BETTER during COVID—no bullying, no anxiety to be crushed into the white heteronormative widget that education tries to make of us. I learned of the McCormick reaper in school, you did too–but did you learn about Jo Anderson?

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Our humanness and the essence of technology are intertwined and it is in fact our humanness that allows us to have object relations at all. But the irony that I think Turkel (2005, 2011) gets within striking distance of is that just because technology is not human does not mean we cannot experience it as an object. And just because a human is not technology does not mean we cannot attempt to treat them as such. And thus our problematic relationship with our own object-relatedness emerges in our technophobic phantasies and statements. It is not Skynet, HAL, Ultron, or the Matrix that is homicidal, it is us. That part of us we can’t quite own and so must push outside us but not too far, because we need it. This projective identification, this psychotic moment, is the basis of technophobia. Its lesser known and secret counterpart, introjective identification, I name here: white privilege. AKA, the good old days.

Another Twitter story, one that APA Div39 listerv members are so familiar with: Our current president, a BIPOC woman, was vilified in part because of Tweets she made on Twitter. Tweets that disappeared, her detractors pointed out, and that was proof of malpractice, malfeasance. But what got lost in the argument was the question of why she had no right to express her interiority, even a portion of it, as a leader, educator and psychoanalyst. Why did she need to become invisible again? Why could we in our field not see a breaking beyond the using of her as technology? She was declared unprofessional when the very definition of profession includes the act of declaring. She became the broken hammer, the bad object, that we needed to reduce her to and keep close in hatred so we would not see ourselves.

I use the terms break and broken deliberately, but not to push racial identity and BIPOC human beings back into a sense of thingness, but because broken captures the violence we visit upon BIPOC people when they stop “working” as technology for us. From whips to whiteface, sharecropping to segregation, profiling to police brutality, white supremacy seeks to subdue, tame, surveil and diminish the technology that cries out that it is not a broken hammer to be fixed or discarded; but rather the implication of whiteness’s heavy hand reaching beyond itself for more power.  In this moment, the insatiable grasping for that Kleinian breast is revealed, our greediness for omnipotence, to gulp down goodness while pretending we have had it all along, makes whiteness stagger under the weight of its own heaviest hunger.

And in terms of power, we arrive at one of the true dangers Heidegger discusses in “The Question Concerning Technology,” a revealing of human nature that “puts to nature the unreasonable demand that it supply energy which can be extracted and stored as such” (1977, p. 321). In this way we come to see humans as “human resources” and seek to extract and store their energy into standing reserves. Although he was speaking about the danger of future misconstruing of technology, Heidegger’s idea reveals to us the way we have used and continue to attempt to use BIPOCs as technology. John Henry cast in contrast to the steam drill does more damage to our shared humanity than the false idealization that he is a hero for competing. And always invisible, the white owner of the technologies, pitting them against each other in the service of gaining and keeping power.

These two things, racism and technophobia, collide in the form of object relations, specifically the use of projective identification to disown our intrapsychic violence by disowning parts of ourselves. And they are largely successful, because no racist thinks they are psychotic, no technophobe either. The danger is clear and present, the technophobes assure us, and that explains the psychic energy and intensity even they cannot repress from conscious awareness. Children are in danger from video games and the internet! Predators abound! As if there was ever a time when children were kept safe and protected; as if starvation and genocide in all parts of our world were less clear and present dangers to children’s lives now; as if more people with guns than Xboxes don’t kill children every year. The technophobic are right of course; there is a danger, and we keep it as close to ourselves as we can tolerate but far enough to hate. I should add here that the technophobe, like the racist, is not someone else. My old therapist once said to me, “there’s a bit of the hysteric in all of us,” and there is a bit of the technophobe in all of us too.

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If this is not yet a coherent argument by your estimation, please forgive me, for I am putting out fires. There are so many fires. Fires of racial violence, health disparities; fires of transgender rights suppression, fires of a woman’s right to choose rather than being reduced to an ultrasound or week number. It was not the technology of writing but the 1787 Constitutional Convention of white men that gave us the 3/5s Compromise. I know you see that now. But can you start to see that it is not the ultrasound but the use of it in service of oppression? It is not the technology of hormones and surgery but the people who seek to hold dominion over others’ minds, bodies and identities. It is not the video games but society’s fear of playfulness, excitement and joy. It is not the internet but those who benefit from hindering collective organizing and the revelation of injustice.

There are so many fires, running rampant back to when our mythic ancestor Prometheus stole that first technology. Using technology has always been an act of rebellion, a stealing and then a hoarding. Because who knows better than a thief that they can be robbed?

References

Battle, V. J. (2017). COMMENT Drop the Phone and Step Away From the Weapon: The First Amendment, the Camera Phone, and the Movement for Black Lives. Howard Law Journal, 60(2), 531–560.

Bion, W. R. (2013). On arrogance. Psychoanalytic Quarterly, 82(2), 277–283. https://doi.org/10.1002/j.2167-4086.2013.00028.x

Bion, W. R. (2013). Attacks on Linking. Int. J. Psychoanal, 82(2), 308–315. https://doi.org/10.1002/j.2167-4086.2013.00029.x

Bion, W. R. (1955). Differentiation of the psychotic from the non-psychotic personalities. British Psycho-Analytical Society, 266–274. https://doi.org/10.4324/9780203358832

Bonilla, Y., & Rosa, J. (2015). #Ferguson: Digital protest, hashtag ethnography, and the racial politics of social media in the United States. American Ethnologist, 42(1), 4–17. https://doi.org/10.1111/amet.12112

Browning, C. R., Calder, C. A., Ford, J. L., Boettner, B., Smith, A. L., & Haynie, D. (2017). Understanding Racial Differences in Exposure to Violent Areas: Integrating Survey, Smartphone, and Administrative Data Resources. Annals of the American Academy of Political and Social Science, 669(1), 41–62. https://doi.org/10.1177/0002716216678167

Brumfield, D. M. (2018). Cyrus McCormick mechanical reaper co-invented by Augusta County slave. Newsleader.Com. https://www.newsleader.com/story/news/history/2018/05/29/augusta-county-slave-co-invented-reaper-revolutionized-agriculture/650716002/

Dolcini, M. M., Canchola, J. A., Catania, J. A., Mayeda, M. M. S., Dietz, E. L., Cotto-Negrón, C., & Narayanan, V. (2021). National-level disparities in internet access among low-income and black and hispanic youth: Current population survey. Journal of Medical Internet Research, 23(10). https://doi.org/10.2196/27723

Ellis, K. & Langlois, M. What white people need to know about Black Twitter. 3/11/2016 UBSSW webinar, Technology in Social Work. https://youtu.be/OlUWX1NOzoY

Gall, F. J. (Franz J. (1835). On the functions of the brain and of each of its parts : with observations on the possibility of determining the instincts, propensities, and talents, or the moral and intellectual dispositions of men and animals, by the configuration of the brain and hea (W. Lewis & N. Capen (Eds.)). Marsh, Capen & Lyon.

Hamilton, J. & Langlois, M. “Race and Psychotherapy: The Interior Lives of Blacks and whites” 10/6/20 Simmons CIBER Series https://youtu.be/HbKVUs81dYQ

Heidegger, M. (1962). Being and time (J. Macquarrie & E. Robinson (Eds.)). Harper.

Heidegger, M. (1977). The Question Concerning Technology and Other Essays. In Technology and values: Essential readings.

Johnson, G. B. . (1930). First Hero of Negro Folk Lore. Modesto Bee and News, 22.

Klein, M. (1957). Envy and gratitude. Tavistock Publications.

Klein, M. (1975). Notes on Some Schizoid Mechanisms ( 1946 ) 1 Melanie Klein Z. Internation Psycho-Analytical Library, 1(104), 1–24.

Knoles, L. Z. (2006). Northern Visions of Race, Region and Reform: The Press and the Letters of Freedmen and Freedmen’s Teachers in the Civil  War Era, An American Antiquarian Society Online Resource. https://www.americanantiquarian.org/Freedmen/Intros/questions.html

Langlois, M. et al (2020) Signifyin’ with Memes & Hashtags: The Power of Black Twitter. https://youtu.be/Ivot_oJTdtk

Markussen, H. R. (2022). Conceptualising the smartphone as a security device: appropriations of embodied connectivity at the Black Lives Matter protests. Critical Studies on Security, 10(2), 70–84. https://doi.org/10.1080/21624887.2022.2128596

Pop Civ 3: Three-Fifths “Compromise” – http://www.johnmarshallcenter.org/. (n.d.). Retrieved May 9, 2023, from https://johnmarshallcenter.org/pop-civ-3-three-fifths-compromise/

Robinson, K., & Merrow, W. (2020). The Arab Spring at Ten Years: What’s the Legacy of the Uprisings? Council on Foreign Relation. https://www.cfr.org/article/arab-spring-ten-years-whats-legacy-uprisings

Turkle, S. (2011). Alone together : why we expect more from technology and less from each other. Basic Books.

Turkle, S. (2005). The second self : computers and the human spirit (20th anniv). MIT Press.

Dear Colleague,

Dear Person at the Book Publisher Table,

To Whom It May Concern,

I’m standing here at this book publishers table at a psychoanalytic conference with my post cards and I’m wondering—but I should have started differently.

I steal my first book on psychoanalytic theory when I am 14. It is Karen Horney’s “The Neurotic Personality of Our Time” and I steal it from a book store in Worcester. I steal it because I can’t pay good money for it because I don’t have a job yet. I steal it because in its index it has an entry, “Bisexuality, discussion of, 132 ff.” I want to understand. I have never seen me in print that way before. It is so amazing to finally see me in print that way! I may never see a book like this again, so I steal it. (I still have that book. Like most of my books I have from my teens and twenties it has my name on the first page, and page 77. Each book has two signatures, because one of the first things you learn from stealing books is to rip off the first page where the previous owner signed it. But no one looks on page 77.)

That book is the gateway drug for me into psychoanalytic theory. Freshman year I read Freud and others in high school study hall. We don’t have a psychology class, I have gotten a scholarship to a prep school that describes its curriculum as “no frills.” It is an expensive school and I got a scholarship and it’s going to get me into a college and my parents are paying good money to have me go there. So when I finally get caught stealing books I can’t say much, especially about bisexuality, so I get a job as a dishwasher for minimum wage ($3.50 an hour) because if I need to read so much they tell me I am going to have to earn some money.

I go to school and two weeknights and weekends I bus tables and scrape dried egg yolk off plates, which is why I can tell you we hate it when you stack your plates because although you think you are being helpful it means the bottom ring of the plate gets yolk on it from the plate underneath and we have to scrape twice as much then. I know you didn’t know that but now you do. And I start drinking because the nice cook who’s on probation buys me stuff after work from the packy next door. But I know that I need to make more money and that washing dishes doesn’t help me get experience with people’s psyches, so when I get an opportunity to become a nursing attendant my junior year I quit dishwashing. I start washing people, but I get to talk to them too, and I like that. Most of the time. But not the seeing people with dementia part, which is a lot.

It is a lot and we don’t have “processing” back then. I grow up in a small mostly French-Canadian mill town. I never hear of processing. So I don’t process the 70 year old man who punches me in the face when I walk in his room. I don’t process putting restraints on a crying woman who looks like my grandmother. That was just in one day’s work, but I am making $7 an hour now. I am16. I am 16 and I am reading Freud about bisexuality and getting punched in the face and I am in high school. I am in high school.

I start working the 11-7 shift on weekends. No one hits you on the night shift. I like that. People are sleeping and don’t need restraints and everyone gets washed up right before you are done for the day. So I do my homework overnight and maybe take a sitting nap in the middle. My sleep never returns to normal and I get 4 hours on a good night.

I get into college with an almost full scholarship. Almost. But I can take out a loan for the rest, they reassure me. I can go to college! I don’t give another thought about the loan and enroll in a psychology course first semester. College scholarships don’t cover a lot so I get a job writing for the school press office, then another one as a tutor, then a third one working at local pet store on the weekends. Three jobs on top of school is a lot but I can afford a laptop now. I can also afford alcohol. I don’t understand classmates who can hang out and party in the evenings but I do understand that when you come home from a day’s work you deserve to drink. Everyone I ever worked with knows that. I’ve known that since I was a dishwasher and the nice cook who was on probation bought rum for me.

My scholarship, which is donated in the name of a wealthy alum who died, requires me to write a letter to her parents each semester telling them I’m grateful to be at the college and describing how hard I am working. They never write back. The second year I am asked to come back to school early for student orientation. They put me on the Minority Panel to tell the incoming class what it is like to be a student on “financial assistance.” I could tell them they should stack their plates carefully in the cafeteria because of the yolk stains but I don’t. I don’t tell them about signing on page 77 either–I’m sure I’m the only one who has stolen things here.

My senior year I meet with a psychology professor about grad school. She has talked about poverty and architectural design for the urban poor, so I hope it’s okay to ask her what the quickest course of study is so that I could become a therapist. I can’t afford 5 years of clinical psychology, I tell her. I hadn’t known that it would take so long, I tell her. She tells me I can get a social work degree in 27 months! So I go to Smith.

Smith is confusing. I want to understand. The first day I am on campus I stand at the main iron gate and feel nauseous with gratitude. It is so fancy and they have receptions where white people talk about racial justice and when they do my Black classmates are quiet and look uncomfortable. But we are finally talking about psychoanalytic theory and I know people want to be in private practice but they won’t talk about it in class. We are supposed to go into agency work, case management or macro, one of my classmates from a place called the Upper West Side tells me. But that doesn’t pay much, I tell her, you can make good money being in private practice, can’t you? She stares at me and that is when I know that I am supposed to be ashamed about wanting to make good money now.

I know better than to tell anyone that I am getting my degree to save money and time. I know better than to tell anyone that I’m already in more debt than anyone in my family has made in a year. I know better than to be difficult when my loan check doesn’t arrive on time, or the next week. And I know better than to tell anyone that my credit card is maxed out when we go for coffee. I can never get a higher line than $500 so it is always maxed out, usually because I need cash to buy a car. I am on my third 20 year old used car, a truck I have to start each morning by popping the hood and pulling on an ignition chain.

First year placement I luck out. I get a volunteer job at a food pantry and they let me bring home a bag of groceries each week. Even so, one week I run out. A friend of mine who is also in grad school in Boston comes to visit me and shares her food stamps with me so we can buy groceries. I want to understand. We are in Masters programs. We are using food stamps. I am not supposed to want to make good money.

It all comes to a head my second year. My second placement will be working with adults, and so I need to wear dress clothes at my agency. I don’t know what to do, I tell one of my classmates. She’s a 50 year old radical lesbian former lawyer from CT who has talked about labor in a few of our classes so I think she’ll be ok with me. Can I wear turtlenecks? Will that be ok?  That weekend she drives down to CT where she has a group of friends who are still lawyers. She comes back to campus on Monday and presents me with two bags on the steps of our dormitory. Dress clothes. They bought them. For me. I start to feel ashamed but these women are smart. They have anticipated this. They tell me I can pay it forward someday. I will. I promise. In graduate school I learn that gratitude is always accompanied by nausea.

I apply for jobs. I get interviews and even offers. I ask about salaries and no one will tell me an amount. I want to understand. Where I come from everyone knows what the minimum wage is. And everyone knows what the going rate is. Everyone knows what good money is. I have $60,000 in debt. How can I know if I can afford to take your job? I can’t pay things forward if I don’t make good money.

Good thing I learned Spanish. Good thing I’m a man. Good thing there are a lot of Latino boys in Lowell that scare people. I end up in a new mill town working with people who make sense to me. I can wear sneakers to work because I am going to the projects. My dress clothes still fit. And it’s a union job so I am now making more money than anyone in my family has ever made, more money than my parents and grandparents together. That must be good money!

Time passes. I work in public schools. I open up a part-time practice because I have learned that part-time practices are ok if you have a real job. I get to live in Somerville on the Cambridge line, as opposed to Cambridge where no one ever says on the Somerville line. I can afford to shop at Whole Foods. I develop a taste for expensive stinky cheeses.

I am getting to the post cards I promise.

One day I am at the cheese aisle in Whole Foods, and I see a woman who looks familiar. We start talking about cheeses and I want to understand more about them. Turns out her name is Goldie and she’s a Smith alum. She becomes a friend. I’m sorry Goldie I never told you until now that I’m a thief and stole books but I couldn’t bear it. She gets me a gig supervising at Harvard Medical School. I don’t ask if they pay at the interview. It is Harvard Medical School. I am eating stinky cheese and supervising people at Harvard Medical School which I soon learn to call Harvard Med School or better HMS.

During this time I start having ideas. They are good ideas, I think. I start working with video games in therapy. People start coming to me because they are tired of other therapists pathologizing them for playing video games. I notice things. I disagree with things that people are saying about them in my field. Goldie and other people say I should go get a doctorate. I am now $90,000 in debt. I want to understand. I have good ideas and I work for Harvard Medical School for free and I am $90,000 in debt. I cannot afford to go for a PhD. I cannot afford an institute or I will stop making good money so I can afford to work for Harvard Medical School for free. But I can afford to do some courses and I buy books now. And I can do more, I can afford a website and a blog.

I start blogging about gaming, technology and therapy, I blog sometimes twice a week. Sometimes I even dare to talk about class, ask why the “tech guy” is always in the basement room without windows, assert that when we say we aren’t interested in video games we are also talking about class. Some people read these blogs. They argue with me. They agree with me. I am recognized by peers. I ask to do a workshop in the library of Cambridge Hospital on World of Warcraft. Did I mention that I am part of Harvard Med School? They let me use the space for free. Next year someone asks me to do a session at an HMS conference, and then another. They do not pay me. I want to understand. I can’t pay things forward if I don’t make money. But if I can afford stinky cheese I can afford to volunteer I guess.

After a year I take all my blog posts and edit them. Here, I say, I liked thinking and talking about gaming and psychodynamic theory so much that I wrote a book about it. Here, I do not have a doctorate but I have these good ideas. And then I publish the book myself. Yes, I write a book on Psychotherapy and Video Games and publish it myself. You can buy it or even read it free on Amazon.

Which brings me to the post cards. I spent $200 on postcards when I knew I was going to be presenting at this conference, and I come over to the table and tell you that I have a book, an e-book and wondered since I am presenting today if I could leave a stack of these post cards next to the other presenters’ books. And you say, unfortunately you can’t. For the next several presentations, for the next decade, you say I can’t put my postcards there. I keep them in a bag in my basement.

I get reminded of the book table when I am at a conference in NYC. My supervisor has encouraged me to attend. She is an amazing woman. I met her at one of those courses I took for my continuing education. I pay good money to work with her and she is worth every cent. I sit next to her during a session on class and fees. I am very nervous because I’m worried that she feels obligated to invite me to sit there. Something comes up about debt. My heart is beating. I take the hotel pen and scribble $126,000 on it and show it to her. I immediately feel regret that I did. My supervisor accepts my invitation to have lunch at the conference the next day and I start off by telling her I think I need to talk to her about my class history our next appointment, but of course not now. Of course not now.

But then we are talking about using comparisons as an attempt to minimize to defend and I am telling her how I suddenly realized in the last workshop that I have been doing it for a long time in terms of class and not saying. And then I am crying and realizing that shit I am “processing” things. I am in Le Pain Quotidien in Midtown Manhattan and I am processing things and I’m probably going to write about it. And this woman who supports my writing, read my book, she’s going to probably read this blog post and then she is going to know that I am a thief who stole books.

And I am apologizing for crying not to her but because you all, capital P psychoanalysts are always going to think of me that way: As a clumsy thief who needs more education and help getting dressed up. Up. Even though I am the first person in my family ever to go to grad school. Up. Even though I am a faculty member at Harvard Medical School. Up. And I know, I know, I know enough about projective identification to know that some of this is all me. But I know you know, or, I want to believe you know, that some of this is all you.

And so that brings me to you, to this book table, to the sales rep and those of you browsing colleagues. I wasn’t going to say anything at first, because I know it is just your job. And I know you’re not in charge. I don’t know if any of us is in charge. But I keep seeing you year after year at these tables, at these conferences, and I still have these postcards. I still have these post cards. And I have paid. I have paid to be a member of a psychoanalytic association which this year finally voted that I can vote now. I have paid to join another psychoanalytic association, even paid extra for the section membership for Psychoanalysis for Social Responsibility. But I still have these postcards. I paid good money for these postcards.

Now you see, right? I have some ideas. I may have paid for some of them, stolen others, but some of these ideas are mine. I have been told I own them. APA says so at the start of every workshop now when they talk about intellectual property. I have some ideas and I think they are worth something–to me, to you, to us. I was a book thief but I wrote one to pay you back. I’ve read my Dimen, I know that my good money isn’t really good, that it doesn’t entitle me to anything. Except maybe it entitles us to some uncertainty?

As a collective can we get less certain about who owns things? I am not certain I am grateful any more, but I know I’m not nauseous. I am not certain that there isn’t room for my postcards on your table or your post cards for that matter. We want to be careful once we start parceling out the real estate of ideas given our history. Are you certain there is no room for me there? Are you sure?

In this collegial conversation with Diana Clark I discuss video games, flow states & the power of gaming for our mental health.

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For those of you who missed it, this is part one in a series I am producing with CIBER, the Center for Innovations in Behavioral Health and Education Research at Simmons University. This training discusses the interplay of race and mental health in the treatment room and in a world amplified and accelerated by technology. Dr. Johnnie Hamilton-Mason and I engage in a dialogue informed by their individual practice experiences, interpretations of theory from differing racial perspectives, and their shared interests in internalized racism and subjectivity, psychological liberation and resistance.

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As I write this, human beings are in the midst of mobilizing public health and psychological defenses against what will most likely be declared a pandemic by the World Health Organization this week. WHO and the CDC as well as state and local governments have issued guidelines, countries have begun self-quarantine, and as I write this Harvard just made the decision to move to virtual classes until further notice.

On a interpersonal and sociological level, we have begun to see the signs of adjustment reaction in conversations with others and on social media. The Nieman Foundation for Journalism has a page on Covering Pandemics which is very salient to us all in explaining adjustment reaction. It refers to the ways people attempt to recalibrate themselves psychologically during such traumatic and disruptive events, vacillating between overreaction and underreaction, minimizing and denial vs panic in their attempts to master confusion and anxiety in ways both adaptive and maladaptive. Perhaps you have noticed that (to paraphrase a comic I saw this week) all of your friends on Facebook who were constitutional scholars last month are now epidemiologists.

Recently I was seeing a longterm patient of mine, I’ll call her Randi*. Randi is 65, and began seeing me 10 years ago for help with dual diagnosis addiction and major depression. She also has a chronic pulmonary condition. I’ve been seeing her online for the past several years, most recently from her home in Costa Rica. This session was full of uncertainty and questions: She was scheduled to return to the US to renew her visa, should she come? Should she be holding hands at AA meetings? Should she be attending them? She has begun to follow the CDC recommendation of social distancing, and was worried about the impact of this on her mental health.

The guidelines we are being issued by public agencies are as clear as they can be during a time where data is still changing and community responses are fluctuating. At this time several suggestions are consistent from the CDC and can be found here.

As clinicians it is not our responsibility to learn epidemiology or get a degree in public health. However, we have a very important part to play in addressing the mental health issues that will accompany and/or be exacerbated by COVID19. I am listing the ones I have seen emerging in the hopes that we can help provide ancillary support for the mental health and behavioral health of our patients. If you are a therapist, please consider these. If you are a lay person, these are for you too.

1. Reality-testing requires research. One of the main goals a therapist provides to the patient is supporting accurate reality testing. As mentioned above, reaction adjustment impacts our reality testing. Patients may present minimizing or panicking. To intervene, we need to know what the research as it is current says. Currently the mortality rate is 3.4% so yes, it is more lethal than the flu. We also do not know how this figure will change when more people are tested. But that is what we know. So the therapist needs to model both an not-knowing stance and assert what is currently known. This includes implicit communications (hand sanitizer in waiting room, offering teleheath sessions) as well as explicit ones (confronting extreme statements on either end, sharing what you know and verifying the source of your information.) Keeping abreast of the research allows you to help patients who are in higher risk populations shift their thinking and behavior to the new situation, while reassuring patients in lower risk populations understand their risk. Pointing out overreacting and under-reacting requires us to know what it is possible to know at this time, as well as manage our own countertransference response as we go through our own period of adjustment reaction. As this is all in flux be prepared to have discussions that are in flux.
2. Address the needs that public health agencies aren’t in regards to social distancing. While it is becoming clear that more people are being advised to practice social distancing, the impacts of that on mental health are not being adequately discussed. This is absolutely understandable as the primary goal of public health in is to reduce infections to increase population survival. But helping the individual person-in-the-environment is where we come in as therapists. We know the importance of decreasing isolation for good mental health. We need to anticipate an increase in depressive symptoms, anxiety, and substance relapse may occur if the psychological impact of isolation is not addressed. We will need to help patients explore how to renegotiate boundaries as they rethink whether to hold hands at an AA meeting or a second date. We will need to help people shift to online therapy and self-help groups rather than avoid them. Social connection will need to be more planned and intentional, more technologically dependent for many. We may need to assert that immunocompromised individuals stay out of our physical offices for their safety, and explore the feelings this evokes for them.
3. Support patients in preparation for managing their psychopharmacological needs. Help them anticipate pharmacy delays and encourage them to follow the recommendation that they get 2 months worth of prescriptions whenever possible. Be prepared to offer more case management with them as they negotiate resistance with health insurance companies.
4. Confront and redirect the inadvertent demonization of touch. This one is huge. This past week many have become acutely aware of how often they touch their face, or others without asking permission. To control the spread of infection this is crucial, and yet we need to also resist the urge to begin to perceive touch as unnecessary or lethal. Touch and reaching is a part of healthy infant development (Beebee, 2016.) It plays a significant role in focusing attention and attachment security in adolescence (Ito-Jager, 2017.) Children need to touch themselves as part of learning motor imagery (Conson, 2011) body ownership (Hara, 2015) and the assembly of “self” (Salomon, 2017.) Research has shown that adolescents in America already touch each other less and are more aggressive to peers than in another country sampled (Field, 1999); and for all of us touch quite probably helps us with emotional self-regulation (Grunwald, 2014.) Self-touch is a cornerstone of mindfulness and compassion meditation practices. Therapists need to help patients and their families practice everyday precautions while at the same time reminding them of the necessity of touch for basic neurological and psychological well-being. We need to anticipate that we may be asking people to do something which conflicts with adaptive self-soothing responses to distress. We may be unintentionally causing a reenactment of a trauma survivor’s bodily domination by the abuser when we start telling her what she can and cannot do with her body. We may be taking away a kid with ADHD’s main way of focusing. So the goal of therapy becomes the reduction of shame and irrational demonization of touch, and the development of adaptive ways to continue giving ourselves touch so we do not become a planetwide Harlow monkey experiment.
5. Last but not least, hold the therapeutic frame. The majority of our patients were working on things in therapy before the events of the past two weeks. I have asked each in the last portion of the session “what do you imagine you would have been talking about in therapy if you hadn’t been discussing the coronavirus.” In the case of Randi, that question prompted her to remember that someone had attempted to break into the apartment where she lived alone, itself a pretty distressing event! Another patient, a 30 year-old male with Dysthymia, had made two major and difficult behavioral changes that week, a success that would have been crowded out by COVID-19 if we hadn’t paused to discuss earlier events. We need to keep an eye on the ongoing work, how the patient’s neurotic styles vis a vis pandemics are often in keeping with their style overall,and what other events have occurred in their week.

These are some of the most important “new” responsibilities I see us having as therapists when dealing with the emerging coronavirus crisis. I imagine more will be revealed, and I imagine that at some indeterminate time in the future it will become more clear what the psychological impacts of adjustment reaction, social distancing and touch aversion had on human development. In the meantime, please consider sharing this with your colleagues and patients so that they do not lose sight of important impacts on their mental health caused by necessary public health precautions.

Such interventions and frame maintenance model an adaptive stance in that they are hopeful: That there is a lot of work to be done is always an expression of hope, never despair.

*patient identification changed to protect privacy

References

Beebe, B., Messinger, D., Bahrick, L. E., Margolis, A., Buck, K. A., & Chen, H. (2016). A Systems View of Mother–Infant Face-to-Face Communication. Developmental Psychology, 52(4), 556–571. https://doi.org/10.1037/a0040085

Conson, M., Mazzarella, E., & Trojano, L. (2011). Self-touch affects motor imagery: a study on posture interference effect. Experimental Brain Research, 215(2), 115–122. https://doi.org/10.1007/s00221-011-2877-7
Field, T. (1999). American adolescents touch each other less and are more aggressive toward their peers as compared with French adolescents. Adolescence, 34(136), 753–758.

Grunwald, M., Weiss, T., Mueller, S., & Rall, L. (2014). EEG changes caused by spontaneous facial self-touch may represent emotion regulating processes and working memory maintenance. Brain Research, 1557, 111–126. https://doi.org/10.1016/j.brainres.2014.02.002

Hara, M., Pozeg, P., Rognini, G., Higuchi, T., Fukuhara, K., Yamamoto, A., Higuchi, T., Blanke, O., & Salomon, R. (2015). Voluntary self-touch increases body ownership.(Brief article)(Author abstract). Frontiers in Psychology, 6. https://doi.org/10.3389/fpsyg.2015.01509

Ito-Jäger, S., Howard, A. R., Purvis, K. B., & Cross, D. R. (2017). Attention focus and self-touch in toddlers: The moderating effect of attachment security. Infant Behavior and Development, 48(Pt B), 114–123. https://doi.org/10.1016/j.infbeh.2017.05.001

Salomon, R. (2017). The Assembly of the Self from Sensory and Motor Foundations. Social Cognition, 35(2), 87–106. https://doi.org/10.1521/soco.2017.35.2.87

Triscoli, C., Olausson, H., Sailer, U., Ignell, H., & Croy, I. (2013). CT-optimized skin stroking delivered by hand or robot is comparable. Frontiers in Behavioral Neuroscience. https://doi.org/10.3389/fnbeh.2013.00208

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Let me start by saying I’m a huge fan of meditation. I’ve done certificate trainings in mindfulness and clinical practice, classes on guided imagery and visualization, and meditation to enhance neurological development. I’ve seen the research on how meditation positively impacts the brain in general and specifically white matter connectivity as we age. More personally I have been a lifelong student and practitioner of meditation in various forms: I’ve chanted in ashrams, done walking meditation, participated in Dzogchen talks and practice, engaged in mindfulness practice, Benson’s relaxation response, yoga, the Eight Gates of Spontaneous presence, and many more. That’s a lot of meditation! I don’t do it as consistently as I wish, but I have a healthy respect for the various forms of meditation, and refer patients to it regularly.

This is one reason why I find it troubling how so many fans of meditation hate on video games and gaming. The same folks who are speaking about compassion and mindfulness and calm sound like raging fundamentalists when they start speaking about “screens” and the spurious research that video games are adversely affecting our lives and neurology. They seem to think that meditation has to occur on a bamboo mat in a candlelit rock garden to be meditation. Cultural misappropriation aside, this really limits the potential audience who could benefit from meditation.

Part of this is due to the recent popularity of mindfulness meditation, which made DBT sexy and available to the mainstream, much as psychoanalysis expanded from treating hysterics to the general population with our neurotic styles. This is wonderful, mindfulness meditation is very useful and effective. And it is only one form of meditation. Less talked about nowadays are the focusing or concentration meditations, and guided visualization meditation. But when we do remember those, the impulse for many is to imagine that the object of focus has to be something low tech. We think candles and mandalas, but what if video games could also be objects of focus? In fact, what if playing video games is a form of concentration meditation?

Recently, I decided that I wanted to do my part to make meditation more available and gamer affirmative. In particular, I have developed a guided visualization meditation called “Your Powerful Video Game Avatar.” Through the support of Insight Timer, I am now happy to share it with you. I hope you will find it of benefit. If you are a gamer new to meditation, I hope this may be the Welcome mat that invites you to try meditating. If you are not a fan of video games, I hope this deepens your insight and compassion into that art form. Mostly, I hope it brings maximum playfulness and status bar boosts to all sentient beings. 😊

Your Powerful Video Game Avatar

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