No Time To Lose

Photo by Matt Metts, on

In the past year we have seen the power of technology to impact human lives in sad and brutal ways. More cases of cyberbullying, live camera feeds in dorm rooms, Facebook page harassment. We have seen young people take their lives, go to jail, shun their peers. We have read about a grown woman setting up a MySpace account,  pretend to be a teen’s peer and persecute her. Every day people experience emotional assault, risk of job loss, conflict, infidelity, insult and cruelty online, ingame, via email and social media.

And still my colleagues often talk about how they can’t possibly learn to use Facebook. Or lack the skills to go on Second Life or WoW; or have never heard of blogging; or think “Tweeting is for the birds.”

I’ve said it to you before, and I’m saying it again: You cannot afford to remain ignorant of these things. I’ll say it more strongly: It is hurting your patients. It is driving referrals from your waiting room–People who need to talk with you desperately about how their life struggles and hurt play out in the virtual and digital environment. I’m not even talking about the business you are losing, I am telling you as clearly and as forcefully as I can, that you are practicing suboptimal treatment.

The days in which the laptop was the exception rather than the rule have ended. The majority of people now use technology on a daily basis. And they use it for psychological reasons, emotional reasons, personal reasons. In the above tragic stories, technology was not the problem; it was the arena the problem played out in, maybe even the weapon used. But the problem is the emotional distress and violence.  The people using technology as a weapon and expression of hatred are people. We are STILL talking about human relationships here.

It’s high time we stopped confusing technology with pathology and tools with abusers. And it’s high time we stop being complicit in the problem. Every therapist I know has a continuing education requirement each year, yet how many of us fulfill part of that requirement by taking a webinar on social networking, or a workshop on online therapy, or listen to podcasts on gaming? Very few, if the patients I have heard from over the past 10 years are to be believed. I’ve heard tales of colleagues judging their patients about how much time they spend on the computer, without having the least understanding about what their patients may be doing there. I’ve seen how people have been “trained” by prior therapies about what they are allowed to talk about, and Web 2.0 is not on the allowed list. This is what we call in the business an “empathic failure.”

You may think by the above tirade that I am exempting myself from this, but I am not. I still catch myself shying away from talking about online gaming because I worry we won’t talk about the “serious stuff.” I still struggle to refrain from interpreting that conversation about blogging as avoidance. I still send dozens of nonverbal cues that shape the expectations about what can and cannot be considered important in the therapy room. I do it too, and this is a work in progress.

You may also think that I’d be happy as a businessman to have found a niche that few of my colleagues are tapping into.

I’m not.

I used to be, but now my practice is mostly full, and when I have a request to take on a patient who wants a gamer-affirmative therapist, or a therapist who does not view blogging as social phobia, or a therapist who takes virtual affairs in Second Life seriously, I don’t know who to refer them to. I have many names to offer for EMDR, IFS, CBT, DBT, psychoanalysis.  I have many trusted colleagues who have years of dealing with mood disorders, anxiety, trauma and bereavement. But I have only a handful of peers who I can refer to and trust that technology talk will not be taboo or overlooked.

I need your help, and I need you to care enough to learn. People are dying, or living alone in pain, because not enough of us are staying in learning mode. People are flunking out of school, losing jobs, ending good relationships and beginning bad ones, and they don’t have time to explain to you and I what Twitter is on their dime. Please begin to push yourself. Download a new iPhone App for the DSM IV ($.99,) , or surf over to Technorati (free) and read a few blogs, or create a free character in Second Life.

This is continuing your professional education:  This is important.


  1. Hi Mike, I think your post is really timely and interesting for me as an American reader living in the UK. My impression has been that people/therapists in the US are far more open to blogs and posting than I find here in the UK. Maybe I’m wrong. Maybe the same issues exist just with a different cultural, social nuance.

    I agree with you that there is no point resisting these new forms of communication via technology because they are here to stay. If we want to engage with the world around us and people in it of all ages and generations, we have to embrace social media. I am fascinated by the opportunities for meaningful communication that social media can provide, and I have written about this on my blog in recent posts called Unexpected Guest and Friendship and Blogging:

    I also agree with you that if problems present via these media, they are problems to do with people not the media – and they would present in other ways outside the media, or if the media did not exist.

    I feel I am more or less at the advent of non-celebrity blogging here in the UK as none of my friends or work colleagues have blogs. This is exciting but also at times uncomfortable, as it makes it easy for one’s writing and activity to be misunderstood.

    I wholeheartedly second your encouragement for others, not just therapists but anyone who engages with people in a supportive, caring or educative relationship (eg social workers, mental health workers, teachers, consultants etc), to engage with social media and explore to exploit its positive potential to shape relationships and influence our world.

    Thanks for this,

    • Thanks Karin, I am glad to hear that you are allowing yourself to stay with the discomfort that comes from being on the leading edge of things. I think in the years to come we will see a increased emphasis on “content” vs. “celebrity” and this will push us to be more discerning about what we read, tweet, like, and blog. Hope you subscribed, and I look forward to checking out your blog! I just realized after reading the blog, that we are already connected! “Oh, THAT Karin,” I thought as I re-read the blog. I think this illustrates my above point, content will become the way we know and remember a whole range of people as this unfolds, and contact first via content is what I consider an evolutionary stage in the human being in a globalized era.

  2. Good post and it is so true that helping professionals need to stay updated to find more ways to reach and assust our clients in this complicated society.

  3. P.S. Excuse the typo. Tried to correct it. Come and visit me any time at

  4. Are you for real? I can’t even begin to express my excitement at finding a gamer therapist! My husband is also a gamer AND a marriage and family therapist. We’ve gone round and round on whether he has an interest in actually doing therapy with that demographic. (His ideal client is not the typical gamer…) I was a very heavy IRC user in the mid 90’s and know exactly what you mean about virtual affairs and their power.

    I just wrote in the last Networker issue on how therapists need to engage in the online world … serious passion of mine! 🙂 I just followed you on Twitter and would love to talk more (maybe FB?) about our shared interests. I’m the daughter of a well known MFT and am finally entering the MFT world (after a 12 year stint “in the real world’) and help therapists market because I am passionate about connecting therapists with the clients seeking them online.

    Big *woot* to finding you today! 🙂

  5. LOL, Yes Elizabeth, I am real. Although in this case I am also virtual. I refer to myself as a gamer-affirmative therapist, and doing work with gamers via online therapy and f2f is a growing part of my writing and teaching. This is a population I love working with. You can check out snippets if you click the link to “My Recent Webcasts.”

    I’d love to see your Networker article. Feel free to connect via FB, LinkedIn, and I’ll do the same. Woot to you as well!

  6. Great post, Mike! CNN is doing a whole expose on bullying this week and the online piece is huge.
    I allow my clients to bring in their cell phones, lap tops and we look at their social world together. To not do so is to not treat the client where they are at. I also like your tone and urgency….we therapists need to shift in big ways and get over how things “used to be” or “should be” done. Freud started a revolution by innovating, we need to follow that lead.

    • @Thanks Susan. Isn’t it interesting that we end up citing the “old guard” even as we struggle to embrace the new. Hey, that reminds me of our undergraduate days, remember “Tradition and Innovation?” Please feel free to tweet and subscribe. Talk to you soon!

  7. Well said Mike. I sense your frustration with your colleagues. Communication is what we as a profession are all about…. I continue to shake my head at those who refuse to acknowledge and adapt, but expect those “older”practitioners who chose to ignore this will experience a great awakening as their practice referrals dwindle –( because lets face it the emerging generation of therapists are wired) 😉 @shrinkgurl

  8. Hi Mike–

    I love your comment about refusing to engage in blogs as avoidant. There are times (yesterday, in fact) that I posted on Twitter how boring my peeps are, generally speaking, of course. You are not engaging if you promote your latest blog post or services ad nauseum.

    I also have more respect for my clients than to think ‘the threapeutic relationship may be compromised’ because I engage in social media. My clients have better things to do than to stalk my Twitter feeds. I also have more respect for them, than assume anything different.

  9. Thank you for this thought provoking blog. As I read this, the title: Don’t get left behind” came to mind. It would be interesting to compare what I call the “Newbie therapists” vs. the “Veteran therapists” in the world of technology. As therapists, I believe that we must remain on the forefront of cutting edge tools–this is one of them.

  10. Mike,
    One more thing, the idea is not different at all from the world of medicine in that I would want my cardiologist to stay abreast of all new development with regard to my heart/health. So, as therapists, we must do the same.

  11. Hi Mike,

    Thanks for the great article. I would like to know more about gaming, the virtual world, etc. but as Susan Giurleo pointed out in her blog post (which referred to yours) there aren’t any trainings in the therapy world related to this. How would you suggest a therapist get training in this area? How did you get more knowledge?



    • Hi Lynne, there are in fact some trainings on this stuff. I know, because I do some of them! If you click on the “Recent Webcasts” link on the left side of the blog it will take you to 2 free intro webcasts I have done on the subject. I also offer workshops on online gaming in real life, and soon, webinars. In the meantime, I am available to provide case consults and intro work on virtual world and gaming subjects. Also, check out the online therapy institute link. It will send you to the site where you can find lots of info on Second Life. My colleague Deanna Merz-Nagel can be reached there, she is the SL guru! Hope this helps!


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