This old hammer killed John Henry: An Object Relations/Phenomenological Exploration of Technophobia, Racism, and White Privilege

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 21st 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 21st 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.

Good Money

 

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?

Collegial Conversation with Diana Clark

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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Race and Psychotherapy: The Interior Lives of Blacks and whites

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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An Open Letter to Parents, Teachers & Administrators Now That School Is Officially Closed

The following is a letter I wrote in response to Massachusetts’ School Closures Due to COVID19. It may or may not be applicable to your school system.
Hello all,
 
I decided to jot down a few thoughts, which you can take or leave with a grain of salt, as someone who has been a teacher, special educator, school social worker, psychotherapist, special needs foster parent and researcher over the past quarter of a century. I have been a Gen Xer since birth. I have heard how stressed parents have been getting trying to deal with online learning and although I can’t dispense clinical advice online, I have some informed opinions. This may not be what you want to hear, but here goes nothing:
 
For parents:
 
1) Please stop trying to be so productive. Our country is obsessed with productivity, it is part of what makes so many kids and adults so anxious. Let your kids eat untoasted pop tarts, sit and watch their iphones, hum to themselves, whatever.
2) Do not cook for your children all the time. Color code microwave speed buttons and have the oldest learn to “cook” for the youngest when possible. Leave out bread and some plastic knives and forks and materials for PBJs. They will be fine if they only drink milk for a day or three. They are in home quarantine not on a cruise ship, and you are not “the help.” If you refuse to let them fend for themselves and become resentful it is ON YOU.
3) Stop worrying about online learning, schools are going to need to assess kids’ academic baseline when school commences in September and reteach anyway. I give you permission to ignore the constant emails from school. They are anxious too. Consider sending your teacher a courteous email saying that your family has determined that your family’s emotional health and domestic harmony takes precedence over math and science facts, but that you may have your kiddo record a brief Youtube explaining a principle in Physics they learned playing Portal 2, or the concept of sequencing as evidenced in Plants Vs. Zombies. Assure their history teacher they will do the same for someone in Assassin’s creed. What are they going to do, suspend your child? THERE’S. NO. SCHOOL. Please don’t worry about this. If your child is an overachiever and feels more secure or relevant doing all assignments disregard the above. If your child had frequent suspensions or school phobia because education WAS their primary stressor please do not try to recreate the stress at home, but instead embrace this divine gift for the next few months.
4) Try to throw money at problems if at all possible. If everyone is online at home invest in the highest speed internet plan available. Get an extra iPad or PC or if possible get one for everyone. For every article about too much screen time I can send you two that discuss the benefits of screen time. If you all can Netflix/game/chat simultaneously without lag you will get along much much better.
5) Please don’t worry about screen time. Please don’t worry about video games causing violence. That is a moral panic and poorly correlated research concept. In fact, more of us have been on screens/gaming this year than ever, and it is the first March in 18 years we haven’t had a school shooting in the U.S. There are lots of articles which can show you how to use video games for educational purposes I can share with you: This is only to calm you down—play is inherently beneficial to cognitive development, so ideally you would just let kids play the games they like.
6) That said, if your family wants to sleep in the traditional fashion, i.e., at night, please switch from visual things (screens, reading, staring contests) to auditory ones (Audible stories, music, campfire songs) 90 minutes or so before your target bedtimes. When our eyes are working they tell our brains to stay awake. Listening to talking puts them to sleep—you probably know this already if you still attempt talking to your teenager.
 
Teachers:
 
1) Be subversive. Please try to avoid passing on institutional expectations if you think they are performance-based. If you are still a fan of performance-based expectations at this time please seek out therapy. The rest of you make silly videos of yourselves that showcase the creativity that got you into education in the first place. Dig deep I know it is there, I have worked with many of you and know that most of you don’t hold to the old adage “never let them see you smile before Christmas Break.”
2) Take care of yourselves. Meet colleagues online for coffee via Zoom and complain about the children or your families or whatever just like you used to during your 5 minutes of unscheduled time. Revel in the new freedom that comes from being able to use the bathroom whenever you want without worrying about 25 people waiting for you in your classroom. Do not assign any homework that you are not looking forward to reviewing 30 times while your spouse is playing the television too loudly. Remember those headaches, they haven’t been there for several weeks have they? Take the hint, don’t assign any homework at all.
3) Focus on your student’s parents more than the students. They don’t know how to be you, most of them weren’t trained to be you. Try not to point out that this demonstrates how you do more than childcare and deserve the summers off. Don’t go there. Please just reassure them that they are doing enough to keep their children safe and psychologically sound, and that their children will not be unemployed and living in a cardboard box at the airport, or worse still at home, when they are 30 because school stopped early this year.
4) Create a filter for email from your school admins. Do not look at it more than once a day. They are so overwhelmed they will not notice. They may have children at home they are feeding pop tarts to. They are probably dealing with budgets now. They are definitely giggling inappropriately sometimes.
 
School Administrators:
 
1) Please don’t be defensive. I know, nobody understands what you do, and they never call you unless there is a problem. It is lonely at the top, and now the top has multiple abandoned buildings that still are falling apart. It is also true that the Bureau of Special Education Appeals is forging ahead with zoom like the rest of us, so no respite there. And even though you all look (and are) tough I know you feel responsible for every single adult, adolescent and child in your district for everything. You aren’t but I know you feel that way. Try to remember that every one of the 200 emails/calls you got today doesn’t know about the other 199. Only you do, and it is exhausting. So breathe—getting defensive will only make it worse.
2) Model Self-Care. Mention loudly to your teachers and principals and assistant principals that you are in therapy, have a zoom peer group, whatever you are doing to keep yourself from going off the deep end. Limit your exciting emails about resources to one digest a day at the end of the day. (They won’t be reading them until the next morning anyway, see Teachers, 4, above.)
3) Encourage silliness wherever possible. Anticipate filling out state waivers for EVERYTHING this summer. Kick every can that has “MCAS,” “Curriculum Frameworks” or other bureaucratic jargon down the road you can. Be aware that you are demonstrating unprecedented leadership in our recent history. Did Churchill talk about “standards-based assessment” during the Blitz? I think not.
4) Plan to pivot. There are many reasons to believe that there will be another round of this in the Fall/Winter. Use the current closure to plan intentionally with your colleagues. Develop a district-wide pandemic plan if you don’t have one. But only do work “work” a few hours a day. The rest of the time have fun or be outrageous. Stream you and a few students playing Call of Duty on Twitch for the District. Pioneer using Tik Tok for Social Emotional Learning (SEL in 20 second increments? How can that NOT fit somewhere in the middle school schedule?)
 
There, I know that none of you may have wanted to hear that, and you may not agree, but I thought I’d give it a shot. I’ve been hearing too many of you being way too hard on yourselves during this pandemic, confusing “need for structure” with “maintaining standards.” This is not Lord of the Flies: Society will not fall into chaos if we relax our educational and parenting goals for a few months, but we might be able to lower the incidences of domestic violence and substance abuse if we can reorder our priorities a wee bit. Thanks for reading.

So Now What? : Education During a Pandemic

Parents, Educators and School Administrators are beginning to realize that this isn’t a break or a blizzard. Many of them are hitting the ground running, some are laying as low as possible this week and hoping things will settle, a few are immobilized. And every teacher I know or talk to is trying to figure out a strategies. Teachers, you know it is true: You LOVE strategies. And I love you for it. But these are strange times, and if your strategies or lack of them are making you feel stuck, maybe some of this will help. I have my two cents and then a list of resources for you.

First, my two cents, based on working in special education, public education, higher education and clinically over the past 25 years. The most important thing right now for kids right now is to stay calm, connected and establish new flexible routines at home. No homework packets, no busy work to keep them “occupied.” As tempting as this may be to administrators, educators and parents, that does not really lend to good learning, in fact it is this adherence to the status quo that partly got us into this problem to begin with.

  1. Play is OK. There is a wealth of research out there on the benefits of physical and digital play on cognition, visuospatiomotor skills, social emotional learning, and more. Allowing kids to engage in stress-relieving fun will make them better learners, keep them in contact with their peers, & feel mastery at a time when all of us are feeling little.
  2. Look for the embedded learning in the activity. This is different than trying to structure learning too much. When you are able to focus on your child between other things you are doing as a parent or online educator, try to identify what learning is happening with the play activity and maybe share it when the child is done. I say maybe because first and foremost this is for you to reassure you and calm your anxiety that your child or student is falling behind and will end up living in a cardboard box on the highway because they are playing Portal 2 rather than doing math sheets. Instead, watch the game a bit, and ask yourselves, are there things about physics embedded in the game? Does Plants Vs. Zombies have an opportunity to discuss task planning, sequencing, or math skills (hint, it does: all of the above.) Try to see the things that kids are always learning in play. Now don’t interrupt and ruin it.

Ok, I know that’s not enough for many of you. So here’s a list of some things educational innovators are offering for parents, kids and schools as resources for online learning:

From Continuity with Care to Zoom Memes for Self Quaranteens–My Internet Responds to COVID-19

Parenting (in RL) during a pandemic

Resources For Teaching and Learning During This Period of Social Distancing

THE COLLECTION :Explore thousands of artworks in the museum’s wide-ranging collection—from our world-renowned icons to lesser-known gems from every corner of the globe—as well as our books, writings, reference materials, and other resources.

Educators can also join one of my free Zoom groups (download free software at (http://zoom.us )

Thursdays 3-4 EST

COVID19 Educator Support: Not tech support. This meeting is to provide psychoeducation and collegial support for educators adjusting their teaching to COVID19

Meeting ID: 906-040-691

Password: 02554

Coping With COVID19: Advice for Parents & Educators

As anticipated, I’ve begun to receive a few communications from therapists, parents and educators about the social distancing impact on them and their children. The first question I get usually is something like “I’m worried about my kid playing too much video games, should I be setting limits on this with them?” I’m going to give you an answer that you may not want to here, but may actually improve mental health.

First, as I mentioned earlier this week, we are all going through an adjustment reaction to a rapidly emerging situation that is impacting everyone you know at the same time. This alone is rare in that usually some of us are not dealing with psychological upheaval when some others are. But this time, whether you are denying, minimizing, remaining guardedly calm, scared, or overreacting, you too are on the same continuum that we all are. So welcome. 😊

Local governments and schools, comprised of similarly recalibrating individuals are doing what they can to get ready for the wave of shut-downs, and this includes for many teachers and kids a break for 2 or more weeks and then perhaps online learning. Many workplaces are closing and reducing hours, which means that families are about to spend more time together in closer quarters with less emotional and financial resources than usual.

So, what can you do?

Here are my suggestions which are based on my work, research and thinking about psychology and technology over the past 25 years:

 

  1. Focus on social distancing (skip ahead if you already have embraced this idea.) This is the most important way we have to #FlattentheCurve and mitigate against higher more rapid infectivity. As has been written at https://staythefuckhome.com/sfw/ the concept of self-quarantine works to mitigate the spread of infectious diseases. We have known this since the 1400s. This is hard on social creatures, and can start to evoke guilt in caregivers. Compassionate ideas like visiting elderly shut-ins in person; babysitting groups and play-dates; local support gatherings are all bad ideas when it comes to a pandemic.
  2. Anticipate but don’t panic. It is very likely that more disturbing information and misinformation will happen in the next several days. If you note the way COVID19 is trending things are going to worse and scarier pretty quickly. Remember this is happening at a pace that is quicker than you may be used to and be prepared to change your mind and recalibrate family rules and limits much more rapidly and often. Be prepared to say, “I know I said X but now that I have more information it is Y, and I’m sorry that we keep changing the rules on you. Building that understanding with your child that things are moving quickly is part of the overarching message “I love you, I’m listening and I’m going to keep you safe.”
  3. Let kids play their games. I have mentioned elsewhere and will include below several posts debunking the common misconceptions that demonize video games. But here let me put it a different way: 2 or more weeks is a long time to be in your home nonstop with your children in a state of embattlement. Video games are a great way to practice social distancing: Kids can talk with their friends online, escape the heightened stress at home or in our communities, and feel a sense of being in control of something. It also provides you with the respite you know you are going to need after a couple of days. Lift restrictions if your authoritative parenting style can handle it. One exception here is helping kids build in 5 minute movement breaks every 45 minutes or so.
  4. Try to see it from their point of view. No matter how much your child or teen loves you, they are used to having several hours a day away from you too. Like you, they find being distracted from family life by work and friends reinvigorating, so please don’t frame this as an opportunity for more quality time. It’s disingenuous and sets everyone up to feel like a failure when the reality of quarantine sets in. Of course if they are open to spend time with you, accept the invitation as they deliver it: Now may be the perfect time for you to finally learn how to play Fortnite with them.
  5. No, YOU go outside and play. Often parents find themselves exhorting kids to go outside when they are secretly yearning for escape themselves. If your child can be left alone safely for a bit, go outside and take a walk, get some fresh air and calm down. You already believe that exercise will do you good, so focus on the one you can control, you! Of course, if your family walks/hikes/runs together and you are not looking for alone time, definitely invite them along with you.
  6. Get in the habit of zooming, calling, texting with others regularly. Your kids may be experts at this, but older family members may need help with the habit or technology. Or you might. Learn how to use Zoom, which is being offered for free for most kids. Call and help other folks learn how to set it up and test drive it. This week is the week to get practice before things get more hectic.
  7. Practice mindfulness games and meditation when possible. My colleague Chris Willard has some excellent suggestions on this here. Don’t force kids to do this though, as it will turn them off. If anything, trust that if they are intently playing a video game they may be engaging in a form of concentration meditation which isn’t bad either.
  8. 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. Practice everyday precautions while at the same time but remember that touch is necessary for basic neurological and psychological well-being. Find adaptive ways to continue giving yourselves touch so we do not become a planetwide Harlow monkey experiment.
  9. Special note to educators: Relax your curriculum and pedagogy. Please push back on your administrators on this one. You are all home because there is a global pandemic with all its increased stress and uncertainty; this is not a snow day or break. Kids should be focused on social connection, play and reduced stress. You aren’t going to hit your benchmarks this semester. There, someone finally said it. You can encourage your parents to read to kids, spend more time together, offer fun reading lists or math sites, but please let go of your own overarching expectations and resist any arbitrary ones placed on you as much as possible. If someone starts talking about lesson plans, say “this is a pandemic.” If someone starts talking about kids’ grades, say, “this is a pandemic.” Part of your job as an educator is to educate kids and their families about adjusting in reaction to events, I’m sorry you got stuck with this event, but there you have it.
  10. Pick one or two trusted sources to keep yourself and your kids informed. Two much information overloads kids and adults alike. Most of us don’t need to know what JCPenney or Walmart have to say about COVID19. On the other hand, I have found the info from Harvard very helpful. The Joan Ganz Cooney Center has some great thinking and writing for education and child development. Your Teen Magazine is very accessible to parents. Dr. Kristin Moffitt from Boston Children’s has a short but useful interview on how to talk to your kids about COVID19

 

If after all that you are STILL focused on screen time, please check out these items for your consideration:

 

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Treating Psychotherapy Patients in the Era of Coronavirus

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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Video Games & Meditation

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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Streaming, Path of Exile & The Repetition Compulsion

As many of you know I have begun streaming. My goal in doing this is to both have some fun, and reach a wider audience when talking about psychodynamic concepts. This is my latest attempt, in which I talk about the Repetition Compulsion in terms of farming for a unique sword in the game Path of Exile. Keep in mind that the conversation about the repetition compulsion during the stream if for a general audience, and should not be substituted for seeking out medical advice or a mental health professional. My hope is that you’ll share it with the gamers in your life, therapy practice, class, etc. And of course if you sign up to follow my Twitch channel I’d be delighted!

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