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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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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Tetris Beats Nazis: Video Games & Worry

This week I have two stories about video games, one that causes worry and one that effects it.

The first, worrisome, one concerns white nationalism, video games and propaganda. For as long as we have had Nazis, Aryanism, or White Nationalism, we have had its propaganda. Art is one of the most powerful medium that propaganda gets disseminated: Paintings by Erler and Feuerbach; film by Leni Riefenstahl; and music curated by Axis Sally were all examples of how the art form was used to convey Nazism. It should surprise no one that 21st century art mediums such as video games have their own share of deplorables.

One example, which I won’t link to, from the early 21st century was “Ethnic Cleansing” which came out in 2002. Since then there have been games like “Muslim Massacre” and “Zog’s Nightmare.” The games primarily target, Jews, Blacks, and Latinos, and are often on or linked to Nazi sites. Meanwhile, young people may find themselves being solicited online, where low-to-no moderation servers and bulletin boards like Discord and 4Chan provide a safe place to foster white supremacy.

Today, NPR came out with a story worth your attention, on the rise of recruitment efforts by white hate groups in online gaming environments. Now please don’t blame Fortnite. Most video games, even the violent ones, do not blatantly pedal nazi propaganda. The few that do are pretty explicit about it. What we need to worry about is how disillusioned and disenfranchised young men are vulnerable to being recruited by domestic terror groups, and of course they will be doing recruitment where youth are, including video games. My recommendation? When hate crimes or white supremacy comes up in your family discussions please ask your kids if they ever here things online that sound like hate speech or stereotypes. Assure them that you are more interested in hearing about what they may be experiencing than pulling the plug on Call of Duty, and that this is just one thing that people need to keep an eye on in online communities.

If anything shows up in their chat, consider taking screenshots and sending it to Discord or the chat platform you are using to let them know about the hate speech or recruitment. Both things are violation of TOS, and if your child doesn’t send it and someone else does they be banned themselves. Above all, keep an eye on gameplay, the content and the chat happening while it is happening. You don’t have to be Big Brother all the time, but let family members know that occasionally the games and chat need to be without headphones so you get a sense of who their “friends” are, just like you would if the friends were visiting your home in body.

Now that I have you worried about something new, go play some Tetris. That’s right, a recent study published in Emotion, a psychology journal, found that Tetris helped distract people from worrying by helping them achieve flow experiences. I have discussed before how distraction gets a bad rap and is actually evolutionarily adaptive. Here is some more research to support that theory!

So, now that I’ve made you worry, go play a little Tetris. You can do that here. Then, tomorrow, go vote.

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Yeah? Tell That to Squirtle: The Fallacy of “Screen Time”

Recently, the American Heart Association release an “statement” decrying the dangers of screen time. The report, according to USA Today, said screen time can lead to sedentary behavior increasing the odds that kids can grow up obese. The statement says among other things,
Although the mechanisms linking screen time to obesity are not entirely clear, there are real concerns that screens influence eating behaviors, possibly because children ‘tune out’ and don’t notice when they are full when eating in front of a screen.. (USA News & World Today, August 8, 2018)
Most people won’t dive deeper than the article and it’s quote, which is problematic in itself. “Although the mechanisms linking screen time to obesity are not entirely clear,” is really a way of saying what “this is a correlative statement, which is very different than causality.” If you are unfamiliar with the vast difference between the two, this is a great video to explain it. Come back when you’re done.

The problem with these studies, once they get amplified, is that they fuel the ongoing panic we have with emerging technologies. Once again, here’s my reminder list:

1. Doing any activity for more than several hours in a row is unhealthy, with the exceptions of sleep and meditation.

2. Not all “screens” are equal, have identical lighting and spectrums, and therefore identical impact on sleep.

3. Research shows that using your eyes at night stimulates the areas of your brain that arouse you. So reading, looking at your aquarium, crosswords, and even knitting will also hinder the onset of sleep if you use your vision.

4. Whether in a scientific journal or Trump’s “400 lb guy in a basement,” can we please stop fat-shaming people? Not every heavy body type is the same, nor is obesity a moral issue. Why not focus on teaching your children to be kind, critically thinking and funny humans than focusing on their bodies so much?

In fact, I can make a very different correlation, based on my experience with PokemonGo. This summer I increased my gameplay of this screen-based smartphone app quite a bit. To date I have walked over 150 miles catching Pokemon. I also have lost 5 lbs. My experience would predispose me to conclude that increasing this screen time has actually decreased the sedentary nature of my lifestyle, and lowered my weight. Of course, the fact that I spend half of my time in a rural community with friends who like to hike in the summer doesn’t hurt either, but that’s correlation for you.

While I’m at it, since folks are so concerned with the public health of our children here are some pro-active suggestions based on other possible correlations:

  • Stop fat-shaming kids so they seek escaping reality so much.
  • Fund schools better and test them less so things like recess are longer than 15 minutes.
  • Institute better gun control so children and their families aren’t afraid to go outside and get shot.
  • Decrease stigma of trans youth so they can safely explore gender in ways other than just an avatar of a different gender.
  • Make playgrounds and athletic teams universally accessible so that kids can play and engage regardless of physical differences.

You want to connect some dots, there, I got you started. Now stop going for the low hanging fruit and blame something other than Nintendo.

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Can’t We All Just Game Along?

I had a powerful reminder about the prosocial nature of video games this week, and it was nowhere near a console screen. I was on my way home and ran into a Dunkin’ Donuts, in a town I’d never been to before and was unfamiliar with. I ended up waiting in a rather lengthy line and was a bit grumpy. I happened to be wearing a T-Shirt which said this:

I hadn’t worn it for ages, and had forgotten in fact I was wearing it until the cashier called out to me, “I love your shirt.” Cue the endorphins.

“Thank you,” I said, and smiled (which thanks to state bound learning probably cued my body to produce even more endorphins.)  Waiting in the line seemed much more pleasant by this point. I ordered my coffee and sandwich and while waiting for them received another compliment from a customer walking by.

The third person to compliment me was a man in his 40s, scruffy and in jeans and t-shirt. “I love that game,” he said. “I haven’t played it in a while though.”

By now I was in a mood that allowed me to initiate conversations, so I asked “What are you playing nowadays.”

He proceeded to tell me that his 14 year-old daughter had gotten him into Fortnite. She had enjoyed it initially for the crafting, he said, because she really enjoyed Minecraft; but now that they were playing together she was enjoying the combat as well. His face lit up as he recounted how much fun they were having together. I told him about a study that had been done by Brigham Young that indicated increased levels of protective factors against depression. He smiled at that, and we both went on our way.

We spend so much time debating the neurological impact of playing video games that we often lose sight of another dimension; that of talking about playing video games. Talking about arts and culture is a powerful social adhesive. It identifies commonalities, allows for compliments and increased levels of engagement with others, allows us to recall exciting moments and share them. All of these activities in turn facilitate attachment, and increase a sense of well-being on the neurological level. That was the best line I’ve waited in a ages!

We need to find a way to get that message to Salty Sally the Social Worker and Morose Martin the Mental Health Counselor, whose eyes grow dull at the mention of gaming when their patients bring it up. “How much time are you playing Candy Crush?” they say, in uninviting tones, and eye such T-shirts as a clear sign of video game addiction. The next patient, who comes in with a T-Shirt of Monet’s “Water Lilies,” will get a compliment on it and no such screening for an Impressionist Art Addiction. In fact, the WHO didn’t include Art Disorder this go round at all, unless you include the art form of the video game.

In this current political climate, where we are so polarized, I wonder how many bridges (Minecraft or other) might be built if we paused to ask strangers in line if they play any games? I imagine Republicans, Democrats and Independents alike play something.

If Teams Valor, Instinct, and Mystic can all get along together raiding in Pokemon Go, perhaps we can too..

 

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Taking Leaps: Fortnite, HIPAA & Psychotherapy

“You keep dying,” Sam* said. The annoyance in the 9 year old’s voice was palpable. I looked at my avatar lying face down on the screen. Another of the 100 players in the game, appearing as a brunette woman in sweats sporting a ponytail, was doing a victory dance with her rifle over me. Sam was nowhere to be seen on the screen, but I knew he was hiding somewhere in the game, and seething.

“You’re disappointed in me,” I said calmly. A moment of quiet.

“Yeah.”

“You were hoping I’d be better at this, as good as you or maybe better, and it’s frustrating.”

“Yeah… Can we try again?”

And so we tried again and again, and while we did I talked with Sam about the other adults who were disappointments to him, who kept leaving or letting him down. And I guessed that we were also talking about his frustration and disappointment in himself. And at the end of our appointment I promised I would practice Fortnite, the game we had been playing. We had turned on our webcams again so we could see each other to finish the session, so I could see that he brightened at this idea.

“Nice to see you again,” I said. He smiled faintly.

“You too.” His screen went dark.

As I reflect on the work I do with patients, meeting them where they are at, I am struck by the same issues, opportunities, and conversations that can happen in an online play therapy session. I only wish more of my colleagues would try it. What gets in the way? For some it is a dismissal of emerging technologies which masquerades a fear of trying something new. For others it is a worry about running afoul of HIPAA and being sued. If you are one of those people who wonders about how to integrate video games online into your therapy practice, read on.

 *  *  *  *  *

Quick, without Googling it; what does the “P” in HIPAA stand for?

If you are a psychotherapist or other health provider, you probably guessed “privacy.” At least that’s often the consensus when I ask this question at my talks. It would be understandable if this was your guess. You’d be wrong.

The correct answer is “portability,” the basic premise that individuals have the right to healthcare treatment that moves with them as they go through the vicissitudes of life and work. That is also where technology comes in– electronic health records, telemedicine, etc., are ways that technology increases portability by collapsing time and space so that the patient and the healthcare professional can get to work.

In therapy, that work traditional has happened in an office setting. And in the case of children and youth especially, that meant play therapy which was bounded by the space and time of a physical office. From Uno to Sandtrays to the infamous “Talking Feeling Doing Game,” we have often assumed that play therapy needs to be the games of our own childhoods. But 21st century play can, and I maintain should, include 21st century play. That’s where video games come in.

In the days of the Atari 2600, there was no worry about patient privacy, because the system was hooked up directly to a television that didn’t even need to be connected to cable. But nowadays with SmartTVs, PCs and PS4s, video games are often played online with many other people and seamlessly connected to voice chat. This can be a concern for the psychotherapist who is unfamiliar with newer technology, especially with games like Fortnite, which boast Battle Royales having as many as 100 players at a time in the same game instance.

Videoconferencing programs and online therapy using video/audio chat have been around long enough to have specifications that adapt to HIPAA’s privacy requirements, largely because there is market force behind developing products that can be sold to the healthcare industry. Video games and their platforms, on the other hand, do not have a similar demand to give them an incentive to supply. Games like World of Warcraft, Platforms like STEAM, and streaming services like Twitch were designed for gamers, not therapists, and it is unlikely they will go through the technical and legal procedures to become HIPAA compliant anytime soon.

Some therapists have begun developing their own video games, which, like most therapy games are dismally boring. They are thinly veiled therapy interventions that are disguised as play, but lack any of the true qualities of play. True, they are more likely private; but they are also boring, and easily recognizable as “not playful” by patients. Mainstream games have broader appeal, critical user mass, and better graphics and gameplay in many cases, and are more immediately relevant to the patient’s life. But they are definitely not HIPAA-compliant. So what to do?

 *  *  *  *  *

My solution, which I’m sharing as an example that has not been reviewed by policy experts, lawyers or the like, has two parts:

  1. Due Diligence– Research the existing privacy settings and technologies to maximize benefit and minimize risk to patient privacy. So for example, I structure the “talk” part of therapy to happen over HIPAA-compliant software like Zoom or GoToMeeting. We start on that platform with video camera on, until we begin playing. Then we, turn off the camera to save on bandwidth and talk over this software, not the game. Previously, I will have sent the patient or their parent a snapshot of the settings of the game we are using with the voicechat disabled if possible. We also want to lower or turn off the game sound so we can hear each other. So in the case of Fortnite, the settings would look like this:

 

2. Limited HIPAA Waiver- This is the part most therapists overlook as even being a possibility. You can ask patients to sign a release waiving in a limited capacity their HIPAA rights in order to use noncompliant technology. It is entirely voluntary and I’ve yet to have a patient decline. I use a informed consent form that I developed that looks like this:

 

These are examples of how to engage with online technologies in a clinical way that is thoughtful yet forward-moving.

 *  *  *  *  *

Whether you love Freud or hate him, most experts agree that he was one of the fathers of modern psychiatry. He was also an early adopter. He based his hydraulic model of the drives on steam technology of his era. His concept of the “mental apparatus” was likewise integrated from the advances in mechanics and his formulation of ego defenses such as projection occurred simultaneously with the Lumiere brothers’ creation and screenings of motion pictures. Regulatory concerns aside, therapists can be early adopters. Doing so would probably help our patients no end, and definitely cut down on my waitlist.

* “Sam” is based on several patients whose identifying information has been disguised to protect patient privacy.

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The Crisis Behind Crises

So far in 2018 alone, I have worked nationwide with the aftermath of one homicide/suicide in a video game server community; one threat issued over another; and 3 new requests for consultations from clinicians on how to improve their work with families and individuals related to online technology. Schools are now fielding multiple incidents of threatening language in chat rooms that get brought to their attention, and not necessarily handling them well. Multiple arraignments in district courts are pending because someone expressed violent language on gaming servers that was deemed threatening. Youth are ending up on probation for this.

I know, you’re probably thinking that I’m about to blame the technology, the erosion of family values, the rise of violence or some other social ill. I’m not. As I reflect over several of these cases, the common symptom I see is not mental illness or family dysfunction, but a crisis in digital literacy.

What all of these cases have in common is that before they got to the emergent stage, there were several opportunities for kids to solve their own problems; for educators to teach; for parents to engage or for therapists to help; if they’d seen the opportunities and had some education in digital literacy. Too often we see the end result of our dismissing or demonizing tech use. “Just leave the server, or Facebook,” we say, unintentionally further isolating kids. “You need to stop playing so many video games,” we opine, citing sketchy research to take away the one thing a person may experience some competency doing.

As a therapist and educator who has worked for the past twenty-five years with emerging technologies in mental health, I have been helping schools, clinics and workplaces identify vulnerabilities before, during and after crises. I assure you that before is the most useful and least utilized. I’m hoping you and your administrators will consider doing this differently. I have started offering custom educational offerings on Healthy Boundaries in the Digital Age, and you can find out more about it here.  I’m still doing my other presentations as well.

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Mindfulness, Minecraft & The I Ching

Video Games can be a form of mindfulness meditation, both playing and watching them. The Grokcraft Staff take you on a meditative creative session as we begin to build our I Ching Sculpture Park.  Watch, listen, and enjoy..

 

For more info on joining the Grokcraft project, go to http://grokcraft.com .  We are launching Grokcraft with an introductory subscription of $9.99 a month, & subscribers who join now will be locked in at that rate for as long as they are subscribed.  If any of this appeals to you, please check out our new site at http://grokcraft.com & please spread the word to anyone you think might find this resource useful!

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A New Startup Focusing on Minecraft & Social Emotional Learning

2015-12-15_17.20.01

Happy New Year, Gentle Reader!

I wanted to let you know about a new startup project that launches this month that you may find of interest called Grokcraft.

Grokcraft is a Minecraft server, learning lab, & community where parents, kids & professionals engage in playful collaborative social-emotional learning (SEL.) All our members are vetted & for youth require parent permission to participate.  Our counselors are available to mentor youth in SEL.  Our youth group, Grok Corps, will be open to those who want to be trained in conflict resolution & online moderation.  Our vision is that kids will not avoid conflicts as much as learn to resolve them when they arise.  We believe that in free play, children & adults can learn mindfulness, empathy & other social skills in a playful environment.  You can read more about this in our Manifesto.  With both adult and youth groups approaching with complementary educational needs & abilities in SEL & tech skills, there are constant opportunities for collaboration embedded in (most importantly!) fun.

Grokcraft is an educational rather than therapeutic milieu.  Based on the educateur model, professionals are encouraged to refer clients who would benefit from play-based social emotional learning.  Some examples of people who might refer:

  • A psychotherapist who has a patient needing to improve mindfulness, relational skills or empathy training beyond the clinical hour
  • A speech & language therapist who wants to provide a student with more opportunities for social pragmatic skills acquisition
  • A special educator who with students who need more opportunities to learn & practice SEL
  • A parent or professional who wants a child in their care to have a Minecraft community that is safe & supportive & vets each member personally

At the same time, Grokcraft provides a high-touch learning environment for adult educators & clinicians to learn how to use Minecraft in their work.  Monthly seminars for educators, in-game coaching & instruction are available to give professionals a fun way to learn & practice 21st-century game play & add it to their professional repertoire.  Some examples of professionals who may benefit:

  • A psychotherapist who wants clinical training in online play therapy techniques from experts
  • A speech & language therapist who wants a place to provide social pragmatics groups
  • A special educator who wants a secure place to have virtual field trips/project-based learning
  • A parent who wants parent guidance around digital literacy & SEL
  •  All of the above who want a peer community where they can exchange ideas & develop community that is not technophobic

We are launching Grokcraft with an introductory subscription of $9.99 a month, & subscribers who join now will be locked in at that rate for as long as they are subscribed.  If any of this appeals to you, please check out our new site at http://grokcraft.com & please spread the word to anyone you think might find this resource useful!

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Heroes

 

Extra Life Boo & Wow

This post is more personal than some, but then at some time in many of our lives cancer gets personal.  As many of you know, I have a companion and co-therapist named Boo.  For the past 12 years Miss Boo has worked with me to help in therapy.  We have worked with hundreds of children, adolescents and adults in settings ranging from special needs classrooms, alternative schools and outpatient settings.  And for the past decade we have been working together in my private practice.

This past Spring Boo developed a form of cancer known as osteosarcoma, which is a form of cancer where the tumor grows in the bone.  In her case, Boo began limping and we discovered that she had it in her front right leg.  What followed was a series of scary tests and decisions.  The recommended treatment for this in dogs is amputation of the limb and a course of chemo.  I was worried about this on so many levels:  I didn’t want to lose my friend, I didn’t want her to be in pain, and how was I doing to explain this to my patients?  You can’t just have a dog show up one week with one less leg and be all blank screen about it.  Some people suggested I retire her, but so many people come to me with ruptures in attachment, people who just walked out on them or were taken from them, that that didn’t make sense either.  Nope, we were going to do this honestly and mindfully.  If Boo could show up for such a challenging treatment, I could show up for her and we could show up for our patients.

Over the next few weeks I let people know what was going on if they wanted to know, to the extent they wanted to know.  While she was recovering from surgery I let people know that as well.  And when Boo came back to work, well that was a powerful week.  Cancer changes your body, but the self persists.  Boo had a visible change, there was a scar.  Some people approached petting her, some didn’t.  Boo accepted all of them.  Some people were reluctant to talk at first, imagining their problems were nothing compared to cancer or losing a leg, but we explored and put those concerns in perspective.  We all had work to do, and we did it.

Time passed, and chemo ended.  This is the result:

Each year, I take part in Extra Life, a worldwide celebration of the social impact of gamers of all kinds from video games to board games and tabletop RPG’s! Since 2010, Extra Life has raised more than $14 million to help children’s hospitals provide critical treatments and healthcare services, pediatric medical equipment, research and charitible care.  Your donation is tax-deductible and ALL PROCEEDS go to help kids nationwide and locally at my awesome colleagues at Boston Children’s Hospital.

This year, on November 7th, I’ll be playing World of Warcraft with a special avatar in honor of Boo.  (Of course I’ll be taking breaks every 45 minutes to keep my health ans stamina in good shape.)  If you want to join our team, Miss Boo’s Battalion, you can do that too!*  You don’t have to play WoW, you can play Minecraft, Dark Souls, Candy Crush, my colleague Jane McGonigal’s Superbetter, Zombies Run!, anything.  You can play Tabletop games like D&D or Pathfinder.  You don’t have to go 24 hours straight, any amount of time, anything you raise, helps.  Sharing the post helps too–you never know who might decide to donate or get their game on.

Miss Boo is my hero, and if you are living with cancer in your life you are my hero too.  Whether you are battling it yourself, defeating it, thriving after it, supporting someone who is, celebrating a win or grieving a loss, you are a hero.  On Saturday, November 7th, why not be a hero too?

*Past and present patients are asked to refrain to protect their privacy, but can always get involved with Extra Life on their own here.

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Better Living Through Minecraft

2015-02-21_11.14.25

Last month I had the opportunity to talk at SXSW 2015 about how the video game Minecraft has a lot to teach us about mindfulness.  Video games often get a bad rap with mental health folks, but I try to change that thinking by pointing out that playing video games can actually be a form of concentration meditation, albeit one that does not jibe with many people’s traditional concepts of such (focus on your breathing, focus on the candle, focus on..erm, Mario?)  If you want to hear more, the Audio is here:

https://soundcloud.com/michael-langlois-6/better-living-through-minecraft-audio-version

If you want to see the visuals from the Prezi, feel free to do so here:

If you enjoy it, please feel free to share, and if you want me to come talk to you and your colleagues drop me a note.

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The Lava Expert

lava cave

“Sometimes it is the people no one imagines anything of who do the things that no one can imagine.”  –The Imitation Game

Shortly before I fell into the lava I began a conversation with an eleven year old girl, we’ll call her Sal.  This was a while back, on a Minecraft server I play on from time to time.  My name when I play Minecraft has the word “therapist” in it, and Sal had noticed this.

“Hey, are you really a therapist?” Sal asked via our server text chat.

“Yes I am.”  I typed back.  I had been mining obsidian and using a river to cool the lava so I could chip away at it with my diamond pickaxe.  In the time it took to type my reply, I managed to fall into the river and get washed into the lava.  I watched myself go up in flames, and with me most of my loot.  There is always a chance though, when one falls into lava this way, that some of one’s loot can be thrown clear.  So upon respawning I quickly made my way back to the scene of my demise as we continued our conversation.

“Oops, burned up,” Sal said, as the server had announced just that when I fell in the lava.  “Are you the kind of therapist that talks to kids about their problems?”

“Kids and adults both, yes.”

“My mother wants me to see a therapist,” Sal said.

“Why?” asked another one of the kids on the server.

“She says I have problems with friends,” Sal said.  By this point I had returned to the lava pool.  There was no loot that had survived.

“Sal,” I said.  “Everyone needs help with their problems from time to time.  That’s why there are 7 billion people on the planet, to help each other out.”

For some reason that made quite an impact with the other players.  “Wow, you must be an expert!!” one typed.  I’m not sure how he’d come to that conclusion.

“I’m certainly not an expert on lava,” I replied, and fortunately the conversation went back to the business of mining after some sympathetic emoticons.

I have no problem talking with kids about therapy, or being a psychotherapist.  If I did, I certainly wouldn’t have the word in my userid.  And it wasn’t even that I was “off duty.”  I’ve had many conversations in chats over the years and heard a range of problems.  In part I was a little protective of Sal’s right to privacy, although experience has again shown me that kids are often less hung up on therapy than adults, and in many ways are often more trusting of psychotherapy than adults are.  Mostly the reason I wanted us all to get back to playing was that I had caught myself sounding “educational.”

*  *  *  *  *

In play if there is any such thing as an expert it is certainly not the therapist, or adults in general.  Virginia Axline, knew this.  In her book Play Therapy she writes, “Non-directive therapy is based upon the assumption that the individual has within himself…  the ability to solve his own problems satisfactorily.”  (Axline, 1947)  My trainees are often as surprised to find that I am friend to both psychodynamic and solution-focused theories as I am to find that they have been taught the two have irreconcilable differences.

As I see it, my job is often to be a unique experience in the lives of patients.  “It is a unique experience,” Axline writes, “for a child to find adult suggestions, mandates, rebukes, restraints, criticisms, disapprovals, support, intrusions gone.” (Axline, 1947)  And by the time people come to us as adolescents or adults, those suggestions, mandates, rebukes, restraints, criticisms, disapprovals, etc. have become internalized.  By adulthood, many of us feel as if we lack expertise in anything, except perhaps screwing our lives up.

Education has increasingly played a hand in this.  We do not teach so that our students learn to think independently and feel resourcefully.  Instead we teach them to think like someone else.  Critical thinking and exploration become supplanted by the sense that education has to give us something tangible in a materialistic sense:  A good grade; a profitable job; published ideas or maybe if we really drink the Koolaid admiration from other academics.

One thing that is so enjoyable about Minecraft for many is its’ open sandbox environment.  There is an endgame you can play if you want, but there are also myriad variations of play you can do instead.  Sal and millions of other children and adults can range freely through such open and creative spaces without “experts.”  Education certainly can happen there, but often in a lightly curated if not autodidactive way.  People have created versions of Westeros, Middle-Earth, Panem or their own creations.  There are PvP versions where conflict and combat, stealth and griefing hold sway; fantasy realms where people can role-play.  It is a topsy-turvy world where children can have the most wisdom, and we adult experts can trip and fall into lava.

*  *  *  *  *

In a world obsessed with measuring outcomes, psychotherapy can have a rough time of it.  If Sal ever goes to therapy, she will have to be labeled as ill somehow if her mother wants insurance to help pay for it.  Notes will have to be written, treatment plans planned, goals and objectives filed away so bean-counters can determine that Sal should get 14 beans-worth of help.  It’s hard for me to get too angry at the bean-counters though, over the past 25 years I’ve met a few of them and they don’t seem too happy either.

Education fares little better, with things like the Common Core which tells us what should be taught; standardized testing which masquerades as achievement; and trigger warnings which are supposed to warn students of upsetting content as if they somehow were entitled to get through the mind-altering experience of learning without ever being upset.

It takes bravery to stand up to this.  To let the individual chart their own course, make their own mistakes, draw on their own core.  For the therapist and educator it takes bravery to get out of the way, to radically reflect the developing self.  I do believe that each one of us needs help throughout our lives; but that help needs to be asked for lest we run the risk of telling others what to do and implying they aren’t up to the task of living their own lives.

*  *  *  *  *

Many therapists, social workers, and teachers I have met chose to become members of those professions at least in part as an expression of admiration for their own therapists, social workers and teachers.  They had no interest in falling into the lava ever again, so they started focusing on helping other people out.  It’s a thankless job if you are going to go through it secretly hoping to be thanked.  I’m not sure I’ve ever had someone I work with refer to me as an “expert” unless they were being facetious about some blunder I’d just made.  And I’ve made many.  As an apotheosis, being a psychotherapist or academic is rather anticlimactic, not because the work is devoid of meaning or value, but rather because if we truly place such people on a divine pedestal it needs a steady stream of troubled people to hold it steady.

Perhaps an alternative for therapists, social workers, educators and our ilk is to think of ourselves as “lava experts.”  We have some acquaintance with falling into pits, being consumed by intense feelings, losing all our, erm, loot.  These are human experiences.  This is not a secret to anyone, and I doubt most people would put their trust in someone who knows nothing of failure, obsession, overwhelm or grief.

What’s more is we’ve fallen into lava, often the same pit again and again!  We know something of the repetition compulsion.  We have let our yearning for whatever we think we need lead us to risky or self-defeating behaviors.  We can talk to people about their problems, because we are people who have problems ourselves.  We’ve been burned.  Minecraft miners know mining deep is risky:  We know what we’re doing even up to that moment our bones ignite.

Rather than being an expert on a pedestal, accept that you will tumble into fire, again and again, looking outside of yourself for what is precious.  Straight A’s, that book you published, six or seven figures–There’s a little Gollum in all of us.  It’s what makes us forget mindfulness, build empires, win arguments or wars.  No one was ever oppressed by play, only the lack of imagination that comes from the absence of it.

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Using Gaming & Gamification in Clinical Practice

What does “gamification” mean, and what is its relevance to mental health practice?  In this video of a conversation I had at University at Buffalo with Charles Syms, I take a stab at answering those questions.  This is just a start, and hopefully by the end of the video you can begin to see how applying principles of game design could be therapeutic for people dealing with issues ranging from trauma to executive functioning challenges to substance abuse and beyond.

 

 

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Gamer-Affirmative Practice: Today’s Play Therapy

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The importance of play is universal, and in many ways the nature of play is timeless.  That said, there is a lot to learn about video games as 21st-century play, especially if you are a play therapist.  Adding 21st-century forms of play to your repertoire can be daunting.  With so many naysayers in the mental health profession, avoidance of learning the new takes the form of contempt prior to investigation.  With video games being low-hanging fruit for political arguments ranging from gun control to teen bullying, many social workers, psychologists and counselors give in to the media hype and spend far more time demonizing or ignoring this form of play than they do understanding it.

Recently my colleagues at the University at Buffalo made it a point to take a gamer-affirmative stance and offer a beginning piece of continuing education on integrating video games as play therapy in the form of a podcast.  In it my friend, colleague, and yes, fellow video game player Anthony Guzman and I have a beginning conversation about just that.  Have a listen:

inSocialWork® Episode 144 – Michael Langlois: Gamer-Affirmative Practice: Today’s Play Therapy

 

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Bringing Emerging Technology into the Clinical Process: Implications for Engagement and Treatment

If you have ever wondered how to begin attending to, listening for, and asking questions about a patient’s use of technology, this video might give you some ideas.  In it my colleague Lesa Fichte, LMSW, University at Buffalo School of Social Work, and I, discuss the role of technology, people’s relationship with technology, and how to integrate it into the treatment process by listening, inquiring, and learning.

 

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The Relationship Between Emerging Technology & Psychodynamic Theory

Often when I present, people are surprised that I teach on both emerging technologies such as social media and video games, and classic psychodynamic theories.  Although it may initially seem counterintuitive, especially to classically trained psychotherapists and social workers, I see a strong connection between the two.  Here is the first in a series of posts featuring work I am doing with the University at Buffalo, in which Charles Syms and I discuss the relationship between the two.

 

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Works, Life and Marshmallows: Iterative Design

marshmallow

They say the journey of a thousand miles begins with a single marshmallow.  Ok, I say that, and more specifically I am talking about your life, job or relationship rather than a journey.  I am coming back to my practice from a brief sabbatical, and have been noticing that while many things are going to stay the same, a few are changing as well.  I’ll get back to the marshmallow in a minute.

One thing I learned on my sabbatical is that I definitely want to continue my therapy practice.  As I said to some friends on Facebook this week, “You know, I’m kind of grateful that I get to challenge the self-hatred of others for a living.”  As a clinical social worker and psychotherapist I get paid to do that.  One thing I also decided on my leave was to withdraw from the last managed care insurance panel I was on.  It made no sense to continue to decrease the time I could be seeing people due to paperwork and bureaucratic hassles, and it made no financial sense to have a waiting list of people who are willing to pay my full fee and also deserve treatment just so I could work at half my rate.  I have always built pro bono or sliding scale slots into my practice because I have a commitment to serving a diverse population, so why was I doing that and letting an insurance company slide the remaining hours of my week?

Part of the answer to this and most “why-have-I-been-doing-this-this-way-when-it-doesn’t-work-in-my-favor?” questions is fear. Most of us are afraid of change.  Whether we are staying in an abusive relationship, having difficulty getting sober, flunking out of college or missing days at work, most of us have moments when we see what we are doing to ourselves and ask the above question.  And then we often resume whatever the pattern is, leaving an interesting question unanswered and instead turning it into self-recrimination, which is really just evasion.  Another part of the answer is that we often act is if we only get one shot at answering the question of life satisfaction.  Here comes the marshmallow.

Invented by Peter Skillman of Palm, Inc. and popularized by Tom Wujec of Autodesk, the Marshmallow Challenge may be familiar to some of you:  “It involves the task of constructing the highest possible free-standing structure with a marshmallow on top. The structure must be completed within 18-minutes using only 20 sticks of spaghetti, one yard of tape, and one yard of string.” (per Wikipedia)  You can call it an exercise, or play, but in either event the creators of the challenge have observed something very interesting about how different groups tend to approach it.  Children tend to make a first structure, stick the marshmallow on top, and then repeat the process over and over, refining it as they go.  Adults tend to engage in group discussions, arguments, power plays and plans to produce one structure built once to which the marshmallow is added.  In other words they tend to approach it derivatively rather than iteratively.

Iterative design is a method of creating a thing or addressing a problem by making a prototype (first attempt,) testing it, analyzing the prototype, and then refining it.  Rinse and repeat.  Iterative design isn’t good for everything: As parents know, often there is not time in the world for everything to get done in 18 minutes or before the school bus gets here.  But a life built on derivative design alone is destined for stagnation and rigidity.

Derivative design, as the name suggests, takes something from a pre-existing something-else, whether it be a rule, materials, social construction or interpretation of the something-else.  When you psychoanalyze a patient’s dream and interpret it as a manifestation of their Oedipus Complex, you are deriving your interpretation and their dream from the something-else of Freud, who in turn derived his Oedipal Conflict theory from the something-else of Greek mythology.  Derivative design can save time and effort in many important ways, by collapsing cultural memes and thinking and transmitting them forward through time from Sophocles to your office.  But as feminist thinkers and cultural critics have shown us, we might have arrived at a different “complex” if Audre Lord et al had been in on the prototyping of it.

Derivative thinking left unchecked can get you in a rut.  One of my most recent examples of this comes from The Little Prince, where he encounters the drunkard:
“- Why are you drinking? – the little prince asked.
– In order to forget – replied the drunkard.
– To forget what? – enquired the little prince, who was already feeling sorry for him.
– To forget that I am ashamed – the drunkard confessed, hanging his head.
– Ashamed of what? – asked the little prince who wanted to help him.
– Ashamed of drinking! – concluded the drunkard, withdrawing into total silence.
And the little prince went away, puzzled.
‘Grown-ups really are very, very odd’, he said to himself as he continued his journey.”

Everything derives from the previous thing, but in the end it sometimes gets us nowhere.

We all get in these difficult spirals.  A good therapist or supervisor can point them out to us and then encourage us to become iterative in our design:

  1. So what are you going to do this time?
  2. How did that work out?
  3. So what are you going to do differently?

Therapists starting their private practices also come to see me, often stuck in derivative thinking:

-I need my NPI number.
-Ok, why?
-To get on Medicare.
-Ok, because?
-So I can get on insurance panels.
-Ok, why?
-So I can get patients who will pay me so I can rent an office so I can have an address to register for my NPI.

If you are one of my consultees reading this rest assured I am NOT talking about you in particular:  I have had this conversation a hundred times with people.  We get indoctrinated into the world of managed care and get, well, managed.  In this case, I usually recommend the consultee start by imagining what kind of office space they want.  Answers have varied and included: Sunny, exposed beams, plants, yellow paint, toys, music system, waiting room with receptionist, friendly colleagues in suite, accessible to public transportation, elevator, warm colors, cool colors, and all sorts of other iterations.

Once you have a mental prototype you can either build or design your office, or find and rent it.  Again I tell folks to walk around the areas they want to work in, find buildings that look interesting to them, then walk inside and ask to speak with someone about seeing a unit.  Testing involves going to see several spaces.  Then they can analyze the results: Does the space look like it would become what they imagine it to be furnished? Are there things about their ideal that need to be discarded? Do they now realize that they could be even more wild in their expectations?

This is just one example of the ways that iterative design can open up possibilities.  But be warned, iterative design can be daunting for many of us raised in our current education system.  We have been trained to create one product presented in final form with the expectation that we will be graded on that product alone. Everything becomes about that one paper or exam, which is often more about regurgitation rather than innovation.

I have colleagues who take my breath away with the number of projects and ideas they are consistently throwing out there to see what happens:  It takes guts to do that.  I myself often am afraid that the Project Police are going to pop out and say, “What happened to your idea of a Minecraft group?  Shame on you for proposing it and not completing that project!  You are not allowed any more ideas until you show us you can carry that one out.”

Sound ridiculous? Of course it is, but does it sound familiar to you as well?  If it does, go out and buy yourself some spaghetti, tape and marshmallows:  The quality of your job, relationship and life may depend on it.

Interested in setting up a consult for your practice?  I have some openings come March.  Like this post? I can speak in person too, check out the Press Kit for Public Speaking info. And, for only $4.99 you can buy my book. You can also Subscribe to the Epic Newsletter!

No Matter How You Feel, You Still Failed

Game_Over

Psychotherapists are often people who prefer to deal with feelings in their workings with people.  Feelings are important, and being empathically attuned to how patients are feeling is equally important.  We are taught to explore the patient’s feelings, imagine ourselves into their lived experience, and validate that experience.

This is often where we become disconnected from other professionals we collaborate with, such as educators.  Be it Pre-K or graduate school, educators are charged with working with students to learn and grow as a whole person.  It’s not that they aren’t concerned with feelings, they just can’t get hung up on them to the exclusion of everything else.

To be fair, psychotherapy has a long history of taking a broader view on the individual as well.  A famous psychoanalyst, Winnicott, once responded to a patient of his who was expressing feelings of hopelessness by saying something to the effect of “sometimes when I am sitting with you I feel hopeless too, but I’m not going to let that get in the way of continuing to work with you.”

But often in the past decade or two, feelings have held sway over everything.  Students don’t complete their assignments because they felt overwhelmed and still expect to pass the course.  Adults feel emotionally exhausted and miss work or are late to it.  Children feel angry at the injustice of chores and don’t do them but still want their allowance.

A criticism I often hear toward video games is that they encourage people to believe that they can always just reset, do over and have another shot.  But implicit in this criticism is the fact of something I feel video games actually do better than many of us sometimes:  They acknowledge the reality of failure.

When we play video games, we are failing 80% of the time.  Failing in the sense of Merriam Webster’s definitions including:

  • to not succeed : to end without success
  • to not do (something that you should do or are expected to do)
  • to fall short <failed in his duty>
  • to be or become absent or inadequate
  • to be unsuccessful

In video games the reality of this is driven home to us by a screenshot:

minecraft71

 

 

warcraft

 

 

pac man

 

You can feel any way you’d like about it, angry, sad, annoyed, blase, frustrated with a touch of determination.  But no matter how you feel you still failed.

In life outside games, many of us have a hard time accepting the reality principle when it comes to failing at something.  We think we can talk, think, or feel our way out of failing to meet expectations.  My own predilection is that of a thinker, which is probably why I became a psychodynamic psychotherapist and educator.  I often waste a lot of time trying to think (or argue) myself into a new reality, which just boils down to not accepting the reality principle.  I notice the same with patients, colleagues and students, who miss deadlines, avoid work, come late to class and then try their best to think or feel their way out of it.

The first class each semester I tell my students, who are studying to be social workers and psychotherapists, that the most frequent complaint I get as an instructor is “I feel put on the spot by him.”  I assure them that this is a valid feeling and actually reflects the reality that I will put each and every one of them on the spot.  I will ask them tough questions, I will point out that they are coming late to class, I will disagree with ideas that seem erroneous to me.  Because if they think it is ok to be late or avoid thinking through a problem or confrontation in class, how in the world will they ever be a decent psychotherapist or social worker?  If the single mother you are working with wants to know how to apply for WIC, and you say you feel put on the spot by her question, that is a valid feeling AND you are useless to her.  If your therapist was 15 minutes late every week I hope you’d fire him.  And when you are conducting a family session and someone discloses abuse it is unprofessional to say “I’m feeling overwhelmed and sad right now, can you ask somebody else to go next?”

These sort of disconnects doesn’t happen overnight.  It comes from years of being enabled by well-intentioned parents and yes, mental health providers who focus on feelings to the exclusion of cognition and behavior, and worse, try to ensure that their children grow to adulthood feeling a constant sense of success.  When I hear self psychology-oriented folks talk it is almost always about mirroring and idealizing, and never about optimal frustration.  And I suspect that this is because we have become so focused on feelings and success that we are preventing people from experiencing optimal frustration at all.

The novelist John Hersey has said “Learning starts with failure; the first failure is the beginning of education.”  We commence to learn because reality has shown us that we lack knowledge or understanding.  That’s the good news.  We’ve woken up!  In this light I regard video games as one of the most consistent learning tools available to us.  When that fail happens and that screen goes up you can try to persuade it to cut you some slack, flatter or bully it, weep pleadingly for it to change to a win, but no matter how you feel, you still failed.  And because that reality is so starkly there, and because the XBox or PS3/4 doesn’t get engaged in your drama, that feeling will eventually dissipate and you will either try again, or give up.

Because that is in a lot of ways the conflict we’re trying to avoid isn’t it?  We want to avoid looking reality square in the face and taking responsibility for what comes next.  We want to keep the feelings flowing, the drama going, and we are willing to take entire groups of people and systems with us.  If we are lucky they put their feet down, but more often then not they want to avoid conflict too, and the problem just continues.

So here’s a confession:  I have failed at things.  I have ended a task without success.  I have not done things I was expected to do.  I have fallen short, been inadequate and been unsuccessful at stuff.  And nobody took away my birthday.  I’m still around doing other things, often iterations of the previous failures, quite successfully.

If you are a parent or educator please take a lesson from video games.  Start saying “Game Over” to those in your care sometimes.  If they can try again great.  If they want to read up on some strategy guides or videos to learn how to do it better, awesome.  But please stop capitulating to their desire to escape reality on the illusory lifeboats of emotional expression, rationalization or verbal arguments.  As Mrs. Smeal says in “Benny and Joon,” “when a boat runs ashore, the sea has spoken.”  Reality testing is probably the most important ego function you can help someone develop, please don’t avoid opportunities to do so.

Nobody likes to experience failure, I know it feels awful.  But to move through it to new realizations can be very liberating, and in time become more easily bearable.  And I truly believe that success without past failures feels pretty hollow.  When I play through a video game from start to finish without a fail I don’t feel like a winner.  I feel cheated.

 

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Selfie Esteem

Nancy J. Smyth, PhD, Dean & Professor, University at Buffalo

Nancy J. Smyth, PhD, Dean & Professor, University at Buffalo

 

“Photographs do not explain, they acknowledge.” –Susan Sontag

Last month, the Oxford Dictionary made the word “selfie” not only an official word, but their word of the year for 2013.  Defining selfie as “a photograph that one has taken of oneself, typically one taken with a smartphone or webcam and uploaded to a social media website” the OD made explicit what has implicitly grown to be the norm of our world; a world of smartphones, self pics and social media.

Many psychotherapists and social workers have and will continue to decry this as another sign the the “narcissism” of our age.  Selfies have become synonymous with the millenials, the dumbing down of the populace by the internet, and sometimes even stretching to how Google is making us stupid.  My chosen profession has historically played fast and loose with calling people and cultures narcissistic.  Karen Horney coined the term “the neurotic personality of our time” in the 1930s, initially in part as a critique to the Freudian critique of Victorian modesty.  Kohut’s groundbreaking work on “tragic man,” and the healthy strands of narcissism in human life was co-opted within years by Lasch (1979) to describe the then-current “culture of narcissism.”  In short, even though narcissism has been a part of human being at least since Narcissus gazed into the water in Greco-Roman times, we continue to see it as perennially on the uprise.

 

Joanna Pappas, Epic MSW Student

Joanna Pappas, Epic MSW Student

 

This dovetails with each generation’s lament that the subsequent one has become more self-absorbed.  And yet, as Sontag points out, by making photography everyday, “everybody is a celebrity.”  Yep, that’s what we hate about the millennials, right?  They think everything is an accomplishment, their every act destined for greatness.  But as Sontag goes on to say, making everybody a celebrity is also making another interesting affirmation: “no person is more interesting than any other person.”

 

Jonathan Singer, Assistant Professor, Temple University

Jonathan Singer, Assistant Professor, Temple University

 

Why do many of us (therapists in particular) have a problem then with selfies?  Why do we see them as a “symptom” of the narcissism of the age?  Our job is to find the interesting in anyone, after all. We understand boredom as a countertransference response in many cases, our attempt to defend against some projection of the patient’s.  So why the hating on selfies?

I think Lewis Aron hits on the answer, or at least part of it, in his paper “The Patient’s Experience of the Analyst’s Subjectivity.”  In it he states the following:

 

I believe that people who are drawn to analysis as a profession have particularly strong conflicts regarding their desire to be known by another; that is, they have conflicts concerning intimacy.  In more traditional terms, these are narcissistic conflicts over voyeurism and exhibitionism.  Why else would anyone choose a profession in which one spends one’s life listening and looking into the lives of others while one remains relatively silent and hidden?

(Aron, A Meeting of Minds, 1996, p. 88)

 

In other words, I believe that many of my colleagues have such disdain for selfies because they secretly yearn to take and post them.  If you shuddered with revulsion just now, check yourself.  I certainly resemble that remark at times:  I struggled long with whether to post my own selfie here.  What might my analytically-minded colleagues think?  My patients, students, supervisees?  I concluded that the answers will vary, but in general the truth that I’m a human being is already out there.

 

Mike Langlois, PvZ Afficianado

Mike Langlois, PvZ Afficianado

 

Therapists like to give themselves airs, including an air of privacy in many instances.  We get hung up on issues of self-disclosure, when what the patient is often really looking for is a revelation that we have a subjectivity rather than disclosure of personal facts.  And as Aron points out, our patients often pick up on our feelings of resistance or discomfort, and tow the line.  One big problem with this though is that we don’t know what they aren’t telling us about because they didn’t tell us.  In the 60s and 70s there were very few LGBT issues voiced in therapy, and the naive conclusion was that this was because LGBT people and experiences were a minority, in society in general and one’s practice in specific.  Of course, nobody was asking patient’s if they were LGBT, and by not asking communicating their discomfort.

What has this got to do with selfies?  Well for one thing, I think that therapists are often similarly dismissive of technology, and convey this by not asking about it in general.  Over and over I hear the same thing when I present on video games–“none of my patients talk about them.”  When I suggest that they begin asking about them, many therapists have come back to me describing something akin to a dam bursting in the conversation of therapy.  But since we can’t prove a null hypothesis, let me offer another approach to selfies.

All photographs, selfie or otherwise, do not explain anything.  For example:

 

looting

 

People who take a selfie are not explaining themselves, they are acknowledging that they are worth being visible.  Unless you have never experienced any form of oppression this should be self-evident, but in case you grew up absolutely mirrored by a world who thought you were the right size, shape, color, gender, orientation and class I’ll explain:  Many of our patients have at least a sneaking suspicion that they are not people.  They look around the world and see others with the power and prestige and they compare that to the sense of emptiness and invisibility they feel.  Other people can go to parties, get married, work in the sciences, have children, buy houses, etc.  But they don’t see people like themselves prevailing in these areas.  As far as they knew, they were the only biracial kid in elementary school, adoptee in middle school, bisexual in high school, trans person in college, rape survivor at their workplace.

So if they feel that they’re worth a selfie, I join with them in celebrating themselves.

As their therapist I’d even have some questions:

  • What were you thinking and feeling that day you took this?
  • What do you hope this says about you?
  • What do you hope this hides about you?
  • Who have you shared this with?
  • What was their response?
  • What might this selfie tell us about who you are?
  • What might this selfie tell us about who you wish to be?
  • Where does that spark of belief that you are worth seeing reside?

In addition to exploring, patients may find it a useful intervention to keep links to certain selfies which evoke certain self-concept and affect states.  That way, if they need a shift in perspective or affect regulation they can access immediately a powerful visual reminder which says “This is possible for you.”

Human beings choose to represent themselves in a variety of ways, consciously and unconsciously.  They can be whimsical, professional, casual, friendly, provocative, erotic, aggressive, acerbic, delightful.  Are they projections of our idealized self?  Absolutely.  Are they revelatory of our actual self? Probably.  They explain nothing, acknowledge the person who takes them, and celebrate a great deal.  If there is a way you can communicate a willingness see your patient’s selfies you might be surprised at what opens up in the therapy for you both.

 

Melanie Sage, Assistant Professor, University of North Dakota

Melanie Sage, Assistant Professor, University of North Dakota

 

In other posts I have written about Huizinga’s concept of play.  Rather than as seeing selfies as the latest sign that we are going to hell in a narcissistic handbasket, what if we looked at the selfie as a form of play? Selfies invite us in to the play element in the other’s life, they are not “real” life but free and unbounded.  They allow each of us to transcend the ordinary for a moment in time, to celebrate the self, and share with a larger community as a form of infinite game.

It may beyond any of us to live up to the ideal that no one is less interesting than anyone else in our everyday, but seen in this light the selfie is a renunciation of the cynicism I sometimes see by the mental health professionals I meet.  We sometimes seem to privilege despair as somehow more meaningful and true than joy and celebration, but aren’t both essential parts of the human condition?  So if you are a psychotherapist or psychoeducator, heed my words:  The Depth Police aren’t going to come and take your license away, so go out and snap a selfie while everyone is looking.

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Evocation and Mindfulness: Or, How to Think Better

evocation

Like other art forms, video games can be both a mirror and a candle held up to our culture, at times reflecting it and at times revealing things about it.  Normally I direct my posts primarily at people: therapists, gamers, educators, parents.  But today I want to include the company that produces World of Warcraft as well.  We have a crisis regarding thinking, and although I don’t think WoW created it at all, it has reflected it in a recent game mechanic change.

I am referring to a change mages that happened recently, where the spell Evocation was replaced by Rune of Power.  For people not familiar with the game, here’s a simple explanation.  Mages cast spells, but spells require an energy called mana, which gets used up gradually as you cast spells.  How much mana you start with depends on your character’s intellect, and once you have used up your mana, you can’t cast any more spells until it is replenished.  To replenish it you can either wait and it will gradually return (not the greatest idea in combat,) or eat and drink (not possible while you are in combat.)  Or you could in the older days cast Evocation, which meant you stood in place as the spell was going, gain 15% of your total mana instantly and another 45% of your total mana over 6 sec.  Move or get attacked, and the spell broke.

This recently was replaced with Rune of Power, which places a rune on the ground, which lasts for 1 min. While standing within 5 yds of it, your mana regeneration is increased by 75% and your spell damage is increased by 15%.  You have to keep remembering to replace it every minute, but that’s not the problem.  It may even be an easier game mechanic, but that’s not the problem either.  My problem with it is how it reflects our dysfunctional attitude about thinking, and specifically our tendency to think of thinking as separate from doing something.

We live in a culture where people frequently worry about things, and in fact have ruminations that are intrusive.  Many people report feeling hijacked by their minds with worrying or intrusive thoughts.  And yet at the same time, few of us seem to mark our time and set it aside specifically for thinking.  We schedule appointments to do things, but thinking isn’t one of them.  We treat thinking, which is intangible, as if it can occur in the same space as doing other activities that are more observable and tangible.  And then we are surprised when our minds rebel and hijack our thinking with thoughts and feelings that come unbidden, when all along we have been failing to cultivate the practice of intentional, mindful thinking about things.

This is where I think Blizzard and Wow initially had it right with Evocation.  It was acknowledging an important truth, that Thinking IS doing something, and when done intentionally it occupies time and has benefits.  Sure you weren’t able to do other things while casting Evocation, but isn’t that the point?  In the real world, when you want to think deeply and seriously about something, you really do need to be intentional about it, and make a space in your day to do it.  Rune of power definitely embraces the multitasking model, which encourages you to set up a rune and then go about your other business while keeping half an eye on it to know when to refresh.  Multitasking is not inherently a bad thing, but there are times and places that intentional thinking may be more appropriate and less anxiety-provoking.

Part of helping patients learn to manage worrying is often to help them set up a specific time for worrying about things.  This “worry time” can be a placeholder in the day or week which the patient uses when an intrusive worry enters into their thinking: They can dismiss it by deciding to put that on the agenda for the scheduled worry time.  This is a way of training your mind to be intentional about what you choose to think about and when.  But implicit in this is the idea that training your mind to think about things intentionally is a learned skill.

You can apply this to many different aspects of your life and work.  If you are growing your private practice, when was the last time you set aside an hour to think deeply about your business plan or clinical focus.  I’m not talking about daydreaming here, I’m talking about sustained intentional thought.  Clinically, do you set aside supervision time to think deeply about patients?  As students do you take 15 minutes after each article to think specifically about the reading?  As parents, when was the last time you said to your co-parent, let’s make a time to think together about how our child is doing in life at home and school.  Classroom teachers, when was the last time you asked students to take 5 minutes and think quietly about the classroom topic?

Another challenge here is the confusion of tongues around the concept of thinking.  Self-help gurus often exhort us to stop thinking about things and JUST DO IT.  But I don’t think they are talking about intentional thinking, I think they are talking about reactive or intrusive thinking.  Procrastination is reactive thinking, worrying can be intrusive thinking.  Those are often roadblocks to success, but the form of thinking I have been referring to is perhaps better described as a form of concentration meditation.  Concentration meditation has come to be seen by many of us as concentrating on an image, or a candle, or chanting, or a revered object, but that is not necessarily the case, and in fact it is limiting.

What if your idea is the revered object?  What if your thought process about your work, child, patient, class is worthy of your undivided attention?  What if you were to schedule a specific time to think about a certain project?

If you are one of those detractors who say, “I just don’t have time to think,” I don’t buy it.  Thinking time is not a luxury item, although it may be a learned discipline to set aside a few minutes at a time to do it.  So please take a second and schedule a time on your calendar to think about an idea that is important to you.  Schedule a time to hold your random worries and thoughts and show up at that appointed time to seriously consider them.  I suspect this will free up more mental space and time than you may imagine.

And please Blizzard, bring back Evocation.  I miss it, and the important life lesson in mindfulness it has to teach us.

 

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Mental Health: Yes, There’s an App for That..

apps2

Nobody wants to be irrelevant, and many mental health practitioners want to try out new technologies like Apps, but how to choose?  Currently the App Store in iTunes makes available 835,440 different Apps, of which approximately 100,000 are categorized as lifestyle, medical or healthcare & fitness.  And Android users have just about as many to choose from according to AppBrain, which says there are a whopping 858870 as of today.  With so many to look at, how can a clinician keep current?  Hopefully we can help each other.

Instead of writing the occasional “Top 10 Post,” I’m setting up a site for you to visit and review different Apps.  I’ll review some too, and hopefully by crowd sourcing we can get a sense of what are some of the best.  I’ll need Android users to weigh in heavy, as I will be test-driving Apple products alone.

Why have I decided to do this?  Several reasons, the complicated one first:

1. Web 2.0 is interactive.  We forget that, even those of us who are trying to stay innovative.  We keep thinking we need to get on the podium and deliver lectures, information, content.  And to a degree that is true, but we can easily slide back to the old model of doing things.  That’s what you see in a lot of our well-intentioned “Top 10 App” posts and articles.  Recently I found myself trying to explain on several occasions why doing a lecture or post on the best Apps for Mental Health didn’t sit right with me.  Part of it was because Apps are put out there so fast, and then surpassed by other apps, that it becomes a bit like Project Runway:  “One day you’re in, the next day you’re out.”

I was getting trapped behind that podium again, until I realized that we don’t need another post about the top 10 mental health apps, we need an interactive platform.  I need to stop acting as if I’m the only one responsible for delivering content, and you need to break out of the mold of passive recipient of information.  I’m sure that many of my colleagues have some suggestions for apps that are great for their practice, and I’m hoping that you all share.  Go to the new site, check out some of the ones I mentioned, and then add your own reviews.  Email me some apps and I’ll try ’em and add them to the site.  Let’s create something much better than a top 10 post with an expiration date, let’s collaborate on a review site together.  Which brings me to:

2.  I want to change the world.  That is the reason I became a social worker, a therapist, and a public speaker.  I think ideas motivate actions, and actions can change the world. The more access people have to products that can improve their mental health, the better.  By creating a site dedicated solely to reviewing mental health applications, we can raise awareness about using emerging technologies for mental health, and help other people improve their lives.  Technology can help us, which brings me to:

3.  Technology can improve our mental health.  Yes, you heard it here.  Not, “we need to be concerned about the ethical problems with technology X,Y or Z.”  “Not, the internet is making us stupid,” or “video games are making people violent,” but rather an alternate vision:  Namely, that emerging technologies can allow more people more access to better mental health.  Let’s start sharing examples of the way technology does that.  There are Apps and other emerging technologies that can help people with Autism, Bipolar, Eating Disorders, Social Phobias, Anxiety, PTSD and many more mental health issues.  I can’t possibly catalog all those alone, so I’m hoping you’ll weigh in and let me know which Apps or tech have helped you with your own struggles.

Is this the new site, Mental Health App Reviews, a finished product?  Absolutely not.  What it will be depends largely on all of us.  This is how crowd sourcing can work.  This is how Web 2.0 can work.

If you want to contribute, just email me at mike@mikelanglois.com with the following:

  • App name
  • Screenshot if possible
  • Price
  • Link to App

and I’ll take it from there.  Please let me know if you are a mental health provider and or the product owner in the email as well.

You can also contribute by reviewing the Apps below that you use.  Be as detailed as possible, we’re counting on you!  And while you’re at it, follow us on Twitter @MHAppReviews

Innovation is Dangerous & Gaming Causes Asperger’s

GamerTherapist blog is on vacation and will return with new posts after Labor Day.  In the meantime, here is a reader favorite:

At its heart, diagnosis is about exerting control.  Clinicians want to get some sense of control in understanding a problem.  We link diagnosis to prognosis to control our expectations of how likely and how much we will see a change in the patient’s condition.  Insurance companies want to get a handle on how much to spend on who.  Schools want to control access to resources and organize their student body.  And with the current healthcare situation, the government is sure to use diagnosis as a major part of the criteria in determining who gets what kind of care.

Therapists and Educators do not like to think of ourselves as controlling people.  But we often inadvertently attempt to exert control over our patients and entire segments of the population, by defining something as a problem and then locating it squarely in the individual we are “helping.”

This week has been one of those weeks where I have heard from several different colleagues about workshops they are attending where the presenters are linking Asperger’s with Gaming Addiction:  Not in the sense of “Many people on the Autism Spectrum find success and motivation through the use of video games,” but rather in the sense of “excessive gaming is prevalent in the autistic spectrum community.”

This has always frustrated me, for several reasons, and I decided its time to elaborate on them again:

1. Correlation does not imply Causation.  Although this is basic statistics 101 stuff, therapists and educators continue to make this mistake over and over.  Lots of people with Asperger’s play video games, this is true.  This should not surprise us, because lots of people play video games!  97% of all adolescent boys and 94% of adolescent girls, according to the Pew Research Center.  But we love to make connections, and we love the idea that we are “in the know.”  I can’t tell you how many times when I worked in education and clinics I heard talk of people were “suspected” of having Asperger’s because they liked computers and did not make eye contact.  Really.  If a kiddo didn’t look at the teacher, and liked to spend time on the computer, a suggested diagnosis of Autism couldn’t be far behind.  We like to see patterns in life, even oversimplified ones.

2. Causation often DOES imply bias.  Have you ever stopped to wonder what causes “neurotypical” behavior?  Or what causes heterosexuality for that matter.  Probably not.  We usually try to look for the causation of things we are busily pathologizing in people.  We want everyone to fit within the realm of what the unspoken majority has determined as normal.  Our education system is still prone to be designed like a little factory.  We want to have our desks in rows, our seats assigned, and our tests standardized.  So if your sensory input is a little different, or your neurology atypical, you get “helped.”  Your behavior is labeled as inappropriate if it diverges, and you are taught that you do not have and need to learn social skills.

Educators, parents, therapists and partners of folks on the Austism Spectrum, please repeat this mantra 3 times:

It is not good social skills to tell someone they do not have good social skills.

By the same token, technology, and video games, are not bad or abnormal either.  Don’t you see that it is this consensual attitude that there is something “off” about kids with differences or gamers or geeks that silently telegraphs to school bullies that certain kids are targets?  Yet, when an adolescent has no friends and is bullied it is often considered understandable because they have “poor social skills and spend too much time on the computer.”  Of course, many of the same kids are successfully socializing online through these games, and are active members of guilds where the stuff they hear daily in school is not tolerated on guild chat.

Let’s do a little experiment:  How about I forbid you to go to your book discussion group, poker night, or psychoanalytic institute.  Instead, you need to spend all of your time with the people at work who annoy you, gossip about you and make your life miserable.  Sorry, but it is for your own good.  You need to learn to get along with them, because they are a part of your real life.  You can’t hide in rooms with other weirdos who like talking about things that never happened or happened a long time ago; or hide in rooms with other people that like to spend hours holding little colored pieces of cardboard, sort them, and exchange them with each other for money; or hide in rooms where people interpret dreams and talk about “the family romance.”

I’m sure you get my point.  We have forgotten how little personal power human beings have before they turn 18.  So even if playing video games was a sign of Asperger’s, we need to reconsider our idea that there is something “wrong” with neuro-atypical behaviors.  There isn’t.

A lot of the work I have done with adults on the spectrum has been to help them debrief the trauma of the first 20 years of their lives.  I’ve had several conversations where we’ve realized that they are afraid to ask me or anyone questions about how to do things, because they worried that asking the question was inappropriate or showed poor social skills.  Is that really what you want our children to learn in school and in treatment?  That it is not ok to ask questions?  What a recipe for a life of loneliness and fear!

If you aren’t convinced, please check out this list of famous people with ASD.  They include Actors (Daryl Hannah,) bankers, composers, rock stars, a royal prince and the creator of Pokemon.  Not really surprising when you think about innovation.

3.  Innovation is Dangerous.  Innovation, like art, requires you to want things to be different than the way they are.  Those are the kids that don’t like to do math “that way,” or are seen as weird.  These are the “oversensitive” ones.  These are the ones who spend a lot of time in fantasy, imagining a world that is different.  These are the people I want to have over for hot chocolate and talk to, frankly.

But in our world, innovation is dangerous.  There are unspoken social contracts that support normalcy and bureaucracy (have you been following Congress lately?)  And there are hundreds of our colleagues who are “experts” in trying to get us all marching in lockstep, even if that means killing a different drummer.  When people try to innovate, they are mocked, fired from their jobs, beaten up, put down and ignored.  It takes a great deal of courage to innovate.  The status quo is not neutral, it actively tries to grind those who are different down.

People who are fans of technology, nowadays that means internet and computing, have always been suspect, and treated as different or out of touch with reality.  They spend “too much time on the computer,” we think, until they discover the next cool thing, or crack a code that will help fight HIV.  Only after society sees the value of what they did do they get any slack.

Stop counting the hours your kid is playing video games and start asking them what they are playing and what they like about it.  Stop focusing exclusively on the “poor social skills” of the vulnerable kids and start paying attention to bullies, whether they be playground bullies or experts.  Stop worrying about what causes autism and start worrying about how to make the world a better place for people with it.

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Dopey About Dopamine: Video Games, Drugs, & Addiction

Last week I was speaking to a colleague whose partner is a gamer. She was telling me about their visit to his mother. During the visit my colleague was speaking to his mother about how much he still enjoys playing video games. His mother expressed how concerned she had been about his playing when he was young. “It could have been worse though,” she’d said, “at least he wasn’t into drugs.”

This comparison is reminiscent of the homophobic one where the tolerant person says, “I don’t mind if you’re gay, as long as you don’t come home with a goat.” The “distinction” made actually implies that the two things are comparable. But in fact they are not.

Our culture uses the word addiction pretty frequently and casually. And gamers and opponents of gaming alike use it in reference to playing video games. Frequently we hear the comments “gaming is like a drug,” or “video games are addictive,” or “I’m addicted to Halo 3.” What muddies the waters further are the dozens of articles that talk about “proof” that video games are addictive, that they cause real changes in the brain, changes just like drugs.

We live in a positivistic age, where something is “real” if it can be shown to be biological in nature. I could argue that biology is only one way of looking at the world, but for a change I thought I’d encourage us to take a look at the idea of gaming as addictive from the point of view of biology, specifically dopamine levels in the brain.

Dopamine levels are associated with the reward center of the brain, and the heightened sense of pleasure that characterizes rewarding experiences. When we experience something pleasurable, our dopamine levels increase. It’s nature’s way of reinforcing behaviors that are often necessary for survival.

One of the frequent pieces of evidence to support video game addiction is studies like this one by Koepp et al, which was done in 1998. It monitored changes in dopamine levels from subjects who were playing a video game. The study noted that dopamine levels increased during game play “at least twofold.” Since then literature reviews and articles with an anti-gaming bias frequently and rightly state that video games can cause dopamine levels to “double” or significantly increase.

They’re absolutely right, video games have been shown to increase dopamine levels by 100% (aka doubling.)

Just like studies have shown that food and sex increase dopamine levels:

This graph shows that eating food often doubles the level of dopamine in the brain, ranging from a spike of 50% to a spike of 100% an hour after eating. Sex is even more noticeable, in that it increases dopamine levels in the brain by 200%.

So, yes, playing video games increases dopamine levels in your brain, just like eating and having sex do, albeit less. But just because something changes your dopamine levels doesn’t mean it is addictive. In fact, we’d be in big trouble if we never had increases in our dopamine levels. Why eat or reproduce when it is just as pleasurable to lie on the rock and bask in the sun?

But here’s the other thing that gets lost in the spin. Not all dopamine level increases are created equal. Let’s take a look at another chart, from the Meth Inside-Out Public Media Service Kit:

This is a case where a picture is worth a thousand words. When we read that something “doubles” it certainly sounds intense, or severe. But an increase of 100% seems rather paltry compare to 350% (cocaine) or 1200% (Meth)!

One last chart for you, again from the NIDA. This one shows the dopamine increases (the pink line) in amphetamine, cocaine, nicotine and morphine:

Of all of these, the drug morphine comes closest to a relatively “low” increase of 100%.

So my point here is twofold:

1. Lots of things, not all or most of them drugs, increase the levels of dopamine.

2. Drugs have a much more marked, sudden, and intense increase in dopamine level increase compared to video games.

Does this mean that people can’t have problem usage of video games? No. But what it does mean, in my opinion, is that we have to stop treating behaviors as if they were controlled substances. Playing video games, watching television, eating, and having sex are behaviors that can all be problematic in certain times and certain contexts. But they are not the same as ingesting drugs, they don’t cause the same level of chemical change in the brain.

And we need to acknowledge that there is a confusion of tongues where the word addiction is involved. Using it in a clinical sense is different than in a lay sense– saying “I’m hooked on meth” is not the same as saying “I’m hooked on phonics.” Therapists and gamers alike need to be more mindful of what they are saying and meaning when they say they are addicted to video games. Do they mean it is a psychological illness, a medical phenomenon? Do they mean they can’t get enough of them, or that they like them a whole lot? Do they mean it is a problem in their life, or are they parroting what someone else has said to them?

I don’t want to oversimplify addiction by reducing it to dopamine level increase. Even in the above discussion I have oversimplified these pieces of “data.” There are several factors, such as time after drug, that we didn’t compare. And there are several other changes in brain chemistry that contribute to rewarding behavior and where it goes awry. I just want to show an example of how research can be cited and misused to distort things. The study we started out with simply found that we can measure changes in brain chemistry which occur when we do certain activities. It was not designed or intended to be proof that video games are dangerous or addictive.

Saying that something changes your brain chemistry shouldn’t become the new morality. Lots of things change your brain chemistry. But as Loretta Laroche says, “a wet towel on the bed is not the same as a mugging.” We need to keep it complicated and not throw words around like “addiction” and “drug” because we want people to take us seriously or agree with us. That isn’t scientific inquiry. That’s hysteria.

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Breaking Eggs and Holding Your Fire: Some Thoughts on Skills Acquisition

cod-sniper

Not too long ago, I was learning how to fire a sniper rifle in Call of Duty. It wasn’t going very well. I kept firing (which you do by holding down the right-hand trigger) and missing. Or I would use the scope, which you do by holding down the left-hand trigger; and then try to find my target so slowly that I’d get shot long before seeing it. To make thing more complicated, my patient Gordon** was trying to teach me the difference between “hardscoping” which meant to press and hold down the left trigger, and “quickscoping” which was more like a quick tap and release of the scope.

The key to success, I was told, was to locate the target, quickscope it for a second to take aim, and then fire. The source of my failure was that I’d see the target and not bother to scope at all, and just fire. At first I didn’t even know I was doing that. I thought the scope was going up, and it was, but it was going up a split second after I was firing and not before.  After several fumbled attempts Gordon said, “you have to not fire and learn to push the scope first instead.”  I suddenly realized that he was teaching me about impulse control.

Because many parents and therapists are reluctant to play video games, in particular first-person-shooters, they only tend to see them from outside the experience.  What they learn from seeing that way is that FPS are full of violence, mayhem, blood and noise.  Is it any wonder then that they grow concerned about aggression and the graphic nature of the game?  It’s all that is really available to them unless there is a strong plot line and they stick around for that.

But as someone who has been playing video games for years I can tell you things are different from within the experience.  And one of the most counterintuitive things I can tell you from my experience is this: First Person Shooters can help you learn impulse control.  It takes a lot more impulse control to not fire at a target the second you see it.  It takes a lot more impulse control to wait and scope.  And because all of these microdecisions and actions take place within the player’s mind and the game experience, outside observers see violence and aggression alone and overlook the small acts of impulse control the player has to exert over and over again.

Any therapist who has worked with adolescents, people with ADHD, personality disorders and a host of other patient types understands the importance of learning impulse control. That act of mindfulness, that ability to create a moment’s space between the situation and the patient’s reaction to it is necessary to help people do everything from their homework to suicide prevention.  In addition, there is always a body-based aspect to impulse control, however brief or small, and so to create that space is to forge a new and wider relationship between mind and body.

All of this was going on as we were playing Xbox. Over and over again, I was developing, practicing impulse control from behind that virtual sniper rifle.  Again and again I was trying to recalibrate my bodily reflexes and sensations to a new mental model.  Don’t fire.  When my kill score began to rise, it wasn’t because my aim had gotten better, it was because my impulse control had.

Meanwhile, for the past two weeks I have been practicing making omeletes.

In particular, I have been learning how to make an omelette roulée of the kind Julia Childs makes below (you can skip to 3:30 if you want to go right to the pan.)

This type of omelette requires the ability to quickly (in 20-30 seconds) tilt and jerk the pan towards you multiple times, and then tilting the pan even more to flip it.  Doing this over the highest heat the movement needs to be quick and reflexive or you end up tossing a scrambled eggy mess onto the burner.  I can’t tell you how tense that moment is when the butter is ready and you know that once you pour in the egg mixture there is no going back.  To jerk the pan sharply towards you at a tilt seems so counterintuitive, and this is an act of dexterity, meaning that your body is very involved.

In a way an omelette roulée requires impulse control just like Call of Duty in order to learn how to not push the pan but pull it toward you first.  But just as importantly, making this omelette requires the ability to take risks.  It can be scary to make a mess, what happens if the eggs fly into the gas flame?!

Let me tell you, because I now know what happens:  You turn off the flame, wait a minute and wipe off the messy burner.  And then you try again.

Adolescents, all people really, need to master both of these skills of impulse control and risk-taking.  To do so means widening the space in your mind between situation and action, but not let that space become a gaping chasm impossible to cross.  Learning impulse control also happens within experience, not in a special pocket universe somewhere apart from it.  Learning risk-taking requires the same.  And at their core they are bodily experiences, which may be what Freud meant when he said that the ego was first and foremost a body ego.

When I worked in special education settings, I was often called on to restrain children in crisis.  Afterwards we would usually do a postvention: “What was happening?” “How could you do things differently next time?”  We were looking at their experience from the outside, constructing a little pocket universe with words, as if we understood what had been going on in the experience, in the body and psyche of the child.  I doubt these post-mortems taught impulse control.

I wonder what might have happened if we had risked throwing some eggs on the fire and encouraged the kids to play first person shooters or other video games.  If my theory is right, then we would have been cooking.

**Not his real name. Name, age, gender and other identifying information have been altered to preserve confidentiality.

Mike is on vacation until September, which means that he has started talking in the third person at the end of blog posts.  It also means that the next new post will be next month.  He’ll repost an old fave or book excerpt to tide you over in the meantime.

 

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“Can I Kill You Again Today?”: The Psychoanalysis of Player Modes

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In 1947, Virginia Axline published the first edition of what  was to become a seminal work in the field it was named for, Play Therapy.  In her book she championed the concept of non-directive play, the form of play therapy where the therapist takes in some ways a very Rogerian approach of reflecting rather than directing the play either overtly or subtly.

This is easier said than done, as I learned when I started using it as an intern.  I recall watching a youngster play and describe a family in a horrible car accident.  My first comment was, “are they all right?” covertly signalling to the child that I was anxious in the presence of such violence and the possibility of death.  The child reassured me that the family was okay, and I am convinced that I had essentially ruined that session’s treatment.  Fortunately I was lucky to have an amazing supervisor, Linda Storey (great name for a therapist too!) who helped me to learn how to truly be non-directive.  Over the next year and since I have greeted tornadoes, murder, floods, monster attacks, plane crashes, burning buildings and other disasters with “what happens next?”

Non-directive play therapy is still at it’s heart a two-part invention between the therapist and the patient.  However, unlike some other forms of treatment, it requires the therapist to be able to tolerate a lot of violence and anxiety.  Trying to direct children away from their aggressive fantasies and desires is often rooted in the therapist’s own anxiety about them.  Let’s face it, for many of us death and destruction are scary things.  It isn’t just a rookie mistake to ask the child to make the story turn out “okay,” and yet I think it has never been more urgent for therapists to be able to tolerate violent fantasy and encourage it to unfold in the play.

21st Century Play

Virginia Axline never had to contend with Call of Duty Special Ops, Modern Warfare or Battlefield 3.  What was different about 20th Century play therapy was that the games in the consulting room usually resembled the ones from the child’s everyday life at home or school.  The therapists therefore knew how to play them, and didn’t necessarily need to learn them as they went.  But now we are in the 21st century, where the therapy office often has games from our childhoods rather than those of our patients, and they are very different.

If you are a therapist and never intend to learn to play video games and play them with your patients, you should probably stop reading here; the post won’t be useful to you and I’ll probably annoy you.  But if you don’t plan on using video games with your young patients I hope you’ll consider stopping doing play therapy with children as well.  Certainly stop calling yourself a non-directive play therapist, because you’ve already directed the child’s play away from their familiar games and away from this century.  I actually hope, though, that you will lean into the places that scare you and try to meet your patients where they are at in their play, and for 97% of boys and 94% of girls that means video games.

Video games like Call of Duty and Minecraft are both very useful in both diagnosis and treatment of patients, as I hope to demonstrate by focusing just on one aspect here, that of player modes.  Most video games have a range of player modes, and what the patient chooses can say a lot about their attachment styles, selfobject needs, and object relations.

Solo Play is OK

Like other forms of play, sometimes patients want to play alone, and have me bear witness to their exploits.  They may do so out of initial mistrust, or a yearning for mirroring.  Solo play is looked down on by some therapists, who often think kids using “the computer” are austitic and/or “stuck” in parallel play.  I’d refer you to Winnicott, who taught us that it is a developmental achievement to be alone in the presence of another.  (I’d also refer you to my colleague and therapist Brian R. King who has a lot to say about a strengths-based approach to people on the autistic spectrum, on which he includes himself.)

The Many Reasons to Collaborate.

Some patients want to play with me on the same team in first person shooter games.  The reasons for this can vary.  Some patients want to protect me from their aggression because they are afraid I’ll be scared of it like parents, teachers and other adults may have been.  Other patients want to be on the same team because they want  to have a merger with an idealized parent imago to feel more powerful and able to take on the game.  Still other patients, seen in their daily lives as oppositional or violent, want to play on the same team so they can revive me and have me experience them as nurturing and a force for good in the world.

Some patients  want to have their competition framed by overall collaboration, meaning that they want to get the most or final “kills” but remain on the same team.  Some patients secretly yearn to play on a different team, and may need to “accidentally” change the settings to put us on opposing teams and passively want the game to continue.

Let’s Bring On A World of Hurt.

On the other hand, there are a lot of reasons patients want to compete.  They may want to see if I can stand their aggression and/or desire to win without being annihilated.  They may want to express their sadism by tormenting me for my lack of skill, or alternately project their yearnings for recognition by praising me when I kill them.  They may want to see how I manage my frustration when playing, and interpret that frustration as investment in the game and therefore my relationship with them.  They may be watching very carefully to see how I act when I win or lose.  Do I gloat when I win?  Do I make excuses when I lose?  How might these behaviors be understood by children and adolescents who often feel like they are chronically losing and behind their peers in the game of education?

More questions arise:  Does the patient ask me what mode I want to play or simply decide on one?  Do they modulate their anxiety by playing a combat mode but expressing the desire to stay away from the zombie mode?  By allowing them to do that am I helping them to learn that sometimes life is about choosing the lesser of two anxieties rather than avoiding anxiety altogether?

Multiplayer and Uninvited Guests

In terms of settings, there is some direction on my part, which is part of maintaining the therapeutic frame.  I make it a requirement that we play either locally or in a private game.  And of course this sometimes go wrong, with a random player joining us.

What to do then?  What if we are on an extremely high level and just terminating the game will do more harm than good?  In that case I make sure we are on mute and the our conversation can’t be heard by the added player, and then things get even more interesting in the therapeutic conversation:  Does the patient have any feelings about the new player’s arrival?  What do they imagine the usertag “NavySeal69” means anyway?  Do we help them when they are down or try to ignore them?  How do we feel if they are ignoring us?  Do we team up against them?

Minecraft and the Repetition Compulsion.

I could probably write a whole post or paper on this, but for know let’s talk about creative mode and griefing.  In Minecraft you and other players can build things alone or together.  Other players can also “grief” you, meaning cause you grief by destroying your structures and setting you back after a lot of hard work.   What does it mean when a patient griefs my building, apologizing and promising not to grief it if I rebuild, then griefs it over and over again?  What may be being reenacted here?  Are there adults in the patient’s life who tear her/him down again and again?  When does one give up on any hope for honesty or compassion from the other?  What sort of object are they inviting me to become to them; angry, patient, gullible, limit-setting, mistrustful?

I have used the term child or adolescent here, but exploring the gameplay of adults when they describe it to me is often useful as well.  I often encourage my adult students or gamer readers to do a little self-analysis on their play-style?  What does your preferred mode of moving through video games say about you?  What questions does it invite you to explore?

The goal here is not to give you an explicit case presentation or analysis of one hypothetical patient or game.  Rather, it is to provide you with a Whitman’s Sampler of practice and theory nuggets to give you a taste of the richness you are missing if you don’t play video games with your patients, especially if you are a psychodynamic therapist.  There is a lot that “happens next” if you engage with your patients in 21st century play that has themes you may find familiar:  How do I live in a world that can be hostile to me?  Why should I trust you to be any different?  Will my badness destroy or repulse you?  Will you hurt me if I am vulnerable?  These and dozens of other fascinating and relevant themes emerge in a way that never did for me when I forced kids to endure 45 minutes of the Talking, Feeling, Doing Game.  And what’s more you don’t have to remember to take the “What Do You Think About a Girl Who Sometimes Plays with or Rubs Her Vagina When She’s Alone?” card out of the deck.

I’m not THAT non-directive.  🙂

 

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Saving Ideas

cave painting

Sometime, over 40,000 years ago, someone decided to put images of human hands on the cave pictured above.  It turned out to be a good idea.  This painting has given scientists information on life in the Upper Paleolithic, raised questions about the capacity of Neandrathal man to create art, and sparked debate about which species in the homo genus created it.  Other later cave paintings depict other ideas: Bulls, horses, rhinoceros, people.

I wasn’t there in the Paleotlithic but I doubt that the images we are seeing in caves were the first ones ever drawn.  I imagine that drawing images in sand and other less permanent media happened.  I suspect that the only reason we have cave paintings is because at some point somebody decided they wanted to be able to save their idea, to keep it longer or perhaps forever.

Every day, 7 billion of us have untold numbers of ideas.  So what makes a person decide that an idea is worth saving?  What makes us pause and make a note in our Evernote App or Moleskine journal?  What inspires us to make a video of our idea on YouTube or write a book?  We can’t always be sure that an idea is a “good” one or even what the criteria for a good idea is.  It usually comes down to belief.

In the past several centuries, the ability to save ideas was relegated to the few who were deemed skillful or divinely inspired.  Books were written in monasteries, then disseminated by printing presses, and as ideas became easier to save, more people saved them.  But, and this is very important, saving an idea doesn’t make it a good idea, just a saved one.  Somewhere along the line we began to get the notion that only a few select people were capable of having a good idea, because only a few select people were capable of saving them.  Even in the 21st century, many mental health professionals and educators cling to the notion that peer-reviewed work published in journals is the apex of quality.  If it is written, if it was saved by a select few it must be a good idea.  If you have any doubt of what I’m talking about just Google “DSM V.”

With each leap in human technology comes the power to save more ideas and then spread them.  People who talk about things going viral often forget that an idea has to be saved first, and that in essence something going viral is really a form of society saving an idea.  If anything, technology has improved the democratization of education and ideas.

This makes many of us who grew up in an earlier era nervous and frustrated.  We call the younger generation self-absorbed rather than democratizing.  We grumble, “what makes you think you should blog about your day, take photos of your food, post links to cute kitten videos?”  We may even take smug self-satisfaction that we aren’t contributing to the static.  I think that’s a bad idea, although it clearly has been saved from earlier times.

40,000 years from now, our ideas may take on meanings we never anticipated, like cave drawings.  Why were kittens so important to them?  In the long view I think we remember that people have to believe they have an good idea before they take the leap of faith to save it.  The citizens of the future may debate who saved kitten videos and why, but it will be taken as given that they must have been important to many of us.

What if everyone had the confidence to believe that they had an idea worth saving?  What if everyone had the willingness to believe that it just might be possible that their idea was brilliant?  Each semester I ask the students in my class to raise their hand if they think they can get an A- or higher in the class, and most do.  Then I ask them to raise their hand if they think they can come up with in an idea in this class that could change the world.  I’ve never had more than 3 hands go up.  That’s sad.

This is why I admire the millennials and older groups who take advantage of social media and put their ideas out there.  I doubt that they are all good ideas, but I celebrate the implicit faith it takes to save them.  Anyone, absolutely anyone at all, can have a good idea.  It may not get recognized or appreciated, but now more than ever it can get saved.  Saving an idea is an act of agency.  It is a political act.  Saving an idea is choosing to become just a bit more visible.  On the most basic level saving an idea is a celebration and affirmation of the self.  Think about that, and dare to jot down, draw, record or otherwise save one of your ideas today.  I just did and it feels great.  Then maybe you can even share it with someone else.

What makes a person decide an idea is worth saving?

You do.

 

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Bad Object Rising: How We Learn to Hate Our Educated Selves

Recently I had the opportunity to work with a great set of educators in a daylong seminar.  One of the things I do with teachers when I present is have them play Minecraft.  In this case I started off by giving a general presentation that ended with a story of auto-didactism in an Ethiopian village, where 20 children who had never seen the printed word were given tablets and taught themselves to read.  I did this in part to frame the pedagogy for what came next:  I had them turn on Minecraft and spend 30 minutes exploring the game without any instruction other than getting them networked.

The responses were as varied as the instructors, but one response fascinated me in particular.  Midway into the 30 minutes, one teacher stopped playing the game and started checking her email.  Later, when we returned to our group to have a discussion about the thoughts and feelings that came up around game play, this same teacher spoke up.  We were discussing the idea of playfulness in learning when she said , “you know, I hear a lot about games and learning, and making learning fun; but sometimes learning isn’t fun and you have to do it anyway.  Sometimes you just have to suck it up and do the work.”

“I’m not saying that I disagree with you entirely,”  I said.  “But then how do we account for your giving up on Minecraft and starting to check your email?”

She looked a little surprised, and after a moment’s reflection said, “fair enough.”

I use this example because these are educators who are extremely dedicated to teaching their students, and very academically educated themselves.  Academia has this way, though, of seeping into your mind and convincing you that academics and education are one and the same.  They’re not.

I worked in the field of Special Education for more than a decade from the inside of it, and one of the things I came to believe is that there are no unteachable students.  That is the good news and the bad news.  Bad news because if a student was truly unteachable, they wouldn’t learn from us that they are dumb or bad if they don’t demonstrate the academic achievement we expect.  I remember the youth I worked with calling each other “SPED monkeys” as an insult; clearly they learned that from somewhere and someone.  They had learned to hate themselves as a bad object, in object relations terms, or to project that badness onto other students.  They learned this from the adults around them, from the microaggressions of hatred they experienced every day:  By hate I’ll go with Merriam as close enough, “intense hostility and aversion usually deriving from fear, anger, or sense of injury.”

We tend to mistakenly equate hatred with rage and physical violence, but I suggest that this is because we want to set hatred itself up as hated by and other from ourselves; surely we never behave that way.  But hatred is not always garbed in extremis.  Hatred appears every day to students who don’t fit the academic mold.  Hatred yells “speak English!” to the 6 year olds getting off the bus chatting in Spanish.  Hatred shakes its head barely (but nevertheless) perceptibly before moving on to the next student when the first has fallen silent in their struggle.  Hatred identifies the problem student in the class and bears down on her, saying proudly, “I don’t coddle my students.”  And Hatred shrugs his shoulders when the student has been absent for 3 weeks, and waits for them to be dropped from the rolls.

I’m not sure how I came to see this, because I was one of the privileged academically.  I got straight A’s, achieved academic awards and scholarships that lifted me into an upperclass world and peer group.  I wrote papers seemingly without effort, read for pleasure, and was excited to get 3 more years of graduate school.  And I have had the opportunity to become an educator and an academic myself, having taught college and graduate students.  I could have stayed quiet and siloed in my area of expertise, but work with differently-abled learners taught me something different.  It taught me that people learn to dislike education, shortly after academia learns to dislike them.

Perhaps one of the best literary portrayals of  adult hatred of divergent thinkers comes from the movie Matilda:

“Listen, you little wise acre. I’m smart, you’re dumb; I’m big, you’re little; I’m right, you’re wrong. And there’s nothing you can do about it.”

Nowadays I teach in a much different way than I did early on, before I flipped my classrooms and facilitated guided learning experiences rather than encourage people to memorize me and ideas that I had memorized from others.  And I struggle with this new approach, because I enjoy it so much I feel guilty.  You see, I have internalized the bad object too.  Even with my good grades I internalized it.  And any time I start to depart from the traditional mold of the educated self, I experience a moment of blindness, then a stony silence that seems to say, “you’re being lazy, you should make them a powerpoint and prepare a lecture.”  Yet, if my evaluations on the whole and student and colleague testimonies have truth to them, I am a “good” educator.  So let’s say I am a “good” educator, and if I as a good educator struggle with this, we shouldn’t assume that people that struggle with these issues are “bad” educators.

In fact, when it comes to emerging technologies like social media and video games, educators often try to avoid them, if not because they are fun and suspect, then because educators risk experiencing themselves as the bad object: Who wants to experience themselves as hopelessly dumb, clumsy or lazy when they can experience themselves as the bountiful and perfectly cited fount of all wisdom?  Truth is, both are distorted images of the educated self.

Don’t forget that educators themselves experience tons of societal hatred.  For them it often comes in the guise of curriculum requirements or linking their performance to outcomes on standardized testing.  Hatred comes in the low salaries and the perception that people doing intellectual or emotional labor aren’t really working.  All of this helps educators to internalize a bad object which feels shaming and awful; is it any wonder that we sometimes unconsciously try to get that bad object away from ourselves and locate it in the student?

The good news as I said before is that we are all teachable.  We can learn to make conscious and make sense of the internalized bad object representations.  We can see that thinking of people in terms of smart or dumb is a form of splitting.

And yes, there’s a lot we can do about it.

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10 Nonviolent Video Games

Sometimes mental health providers, parents and educators get so caught up in the debate about video games and violence that we imagine all video games have violent content.  They don’t.

So when I am feeling proactive (like now) I point out that there are dozens of nonviolent video games.  In this case, I’ll give you a rundown of some of my favorites available on smartphones and/or tablets.  You may ask, “Mike, how do you find all of these games?”  I find them for free in several places, and you can too!  One place in the real world is a certain coffee chain we all know and love which often has App of the Day cards to try for free.  Another good source of freebies is App Gratis.  App Gratis has 1-2 daily deals on free apps for iPhone, iPad, and Android.  The app itself is free, so download it as soon as you are ready to go bargain hunting.

Without further ado, here are some games I’m enjoying lately:

 

1. Puzzlejuice

 puzzlejuice

Ok, so the tag line is violent:  Puzzlejuice is billed as a game “that will punch your brain in the face.”  But there’s no punching or violence beyond that blurb.  Puzzlejuice combines the spatial skills of Tetris with the wordplay of Scrabble.  You rotate blocks to line up 3 or more blocks of one color, which turns them into letters.  Spell words with the letters by dragging your finger across them and the blocks disappear.  Sound simple?  Please come back and comment on this post once you’ve tried it, heh.

 

2. Circadia

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Circadia is all about timing and pace.  The graphics are simple enough, where you try to tap expanding rings in order to time their intersection with a dot and other rings.  But this game is all about impulse control, patience and learning from your mistakes.  Different colors and musical tones indicate different speeds of ring expansion, and once you are through the tutorial you find yourself timing 3 or more rings, dots that move, and increasingly complicated sequences.

 

3. Denki Blocks!

 denki

This is a perennial favorite of mine.  Move blocks with the swipe of your finger to connect all of the same color, avoiding obstacles that will get you stuck.  Add to that timer challenges, special shapes and bonus mystery rounds and you have a simple, playful puzzle game that will challenge you for hours.

 

4. Ticket To Ride

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Based on the German-style board/card game, you can now play TTR on your smartphone or tablet.   TTR combines strategy, planning and blocking other players as they race to build train routes connecting different cities in the US, Europe or “Legendary Asia.”  Play against the computer or online with other players, and if you’re feeling social, the built in chat feature allows you to chat with other players between turns.

 

5. Hundreds

hundreds

Who would have thought a black and white (ok, and gray and red) game could be so beautiful and elegant?  The website explains the basic premise of the game, but just dive right into the tutorial like I did and see what it’s like to learn a game from within it.  Did I mention how beautiful it is?  🙂  Minimalists take note..

 

6. Tilt World

tilt world

Playful, but with a strong ecological message, this offering from game designer and thought leader Nicole Lazzaro makes use of the smartphone or tablet’s accelerometer to make Flip the tadpole help fight the Blight that has affected Shady Glen by eating carbon and planting seeds.  The game is tied to a real world impact:  For each milestone of player points in the world, more trees get planted in Madagascar.  More than 10,000 trees have been planted to date, and players can see a real-world impact calculator here.

 

7. Carcassonne

carcasonne3

Based on the classic tile game, Carcassonne is a game of building medieval towns, castles and monasteries.  Build your cities, place your Meeples, and try to get the most points by the end of the game.  Best part, you can share points with other players, so the game is about strategic alliances as well as blocking another player’s move.  Play by yourself or on networked multiplayer.  Note to therapists:  The basic game can usually be played in the 10 minutes between sessions, just sayin’..

 

8. Osmos

osmos

If you like your games with ambience and an organic dreamlike quality, try this one out.  In Osmos you play a single cell Mote who jets around and absorbs smaller motes to become the biggest cell on the block.  But be careful, because the jet propelling you is made by expelling your own matter, so the farther you go the smaller you get!  This game emphasizes patience and planning over speedy acquisition.  Accompanied by some great electronic music.

 

9. Flower Chain

flower chain

I disagree with the developer Joybean describing this as  “a beautiful game for girls,” and exhort you to play this game regardless of gender!  Tap on one of the small floating buds to cause a flower to burst open, touch a nearby bud and start a chain reaction.  Easy when the early levels only require you to hit 2-3 flowers, but when you have to get a chain reaction of 50, choose where and when you tap carefully!

 

10. Nintai 2

nintaii2

The Japanese term “nintaii” means “patience, perseverance, or endurance,” and you’ll need it to get through all 100 levels of this puzzle.  Flip a rectangular block through a 3-D platform landscape to get to the end of the maze.  Each level is accompanied by trippy music and seemingly random titles like “Joy,” “Bravery,” and “Wealth.”  This game has a high “Huh?” factor, but is a compelling experience and best of all, non-violent.

Versions of these games range from free to $9.99 for most smartphones and tablets, and nothing is shot or slashed, not even watermelon (sorry, Fruit Ninja.)  Many of these games emphasize one or more social and cognitive skills, from cooperation to word-building to problem solving and impulse control.  But don’t let that discourage you–have fun!

Have a favorite non-violent game?  Let us know below!

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Empathy (Re)Training

 

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Last night I was mining Gold Omber in the asteroid belt near Erindur VI, and I can’t begin to tell you what an accomplishment that was. (This post is not just about spaceships, but about pacifists, Ethiopia and education, so non-gaming educators and therapists keep reading.)  OK, let me tell you why it was an accomplishment.  I am talking about playing the MMO EVE Online, which involves piloting spaceships across vast amounts of space in order to mine, trade, build or pirate among other things.  In essence, your spaceship is your character, with the ship’s parts being the equivalent of your armor and weapons in games like World of Warcraft.  But you can only build or use these parts as your pilot acquires skills, ranging from engineering to planetology to cybernetics, so in that way the player’s pilot is the character in the game.  But at the start of the game you’re told that the pilot is actually a clone (this becomes important later on) and as someone was explaining to me last night the whole cloning thing has its own complications once you start using implants to modify individual clones, which you can only do after you’ve trained the skill of Cybernetics.  And why all that is important is because once you use implants you can learn skills more quickly.

If you think that is confusing, try learning how to use the sprawling user interface or UI, which one of my friends says “was made by demons who hate people, hate their hopes and dreams. Know that you are playing with toys made by demons for their amusement and tread lightly.”  Another way of putting it is that you have keep trying to remember what window you opened in the game to do what, and often have multiple windows open simultaneously in order to figure out what you’re doing or buying or training.  There is a robot tutorial program in the game that helps somewhat, but the whole thing is very frustrating and intriguing for the first several hours of game play.  During this time I was ganked repeatedly, lost lots of loot and ore I had mined, as well as a nice spaceship or two.  So to get to the point where I had learned enough skills to be able to warp halfway across the galaxy, lock onto an asteroid, orbit and mine it while defending myself from marauders was extremely exciting.  I was only able to do this because my above-mentioned friend had given me a much bigger and safer ship than I had started out with, as well as lots of instructions on how to do things; and because I was chatting with people in the game who offered great tips.  Of course one of those people then clicked on my profile in chat to then locate me and gank me again (bye-bye nice ship,) but the knowledge is mine to keep.

By now you may be asking “what has any of this got to do with psychotherapy, social work or education?” so I’ll explain.  I had tried EVE months ago, and given up after about a week of on and off attempts, but this past month I have begun teaching an online course for college educators and MSWs about integrating technology into psychotherapy and education.  One of the required exercises in the course is for the students to get a trial account of World of Warcraft and level a character to 20.  There has been a lot of good-natured reluctance and resistance to doing this, in this class and others:  I have been asked to justify this course material in a way I have never had to justify other learning materials to students.   This included several objecting to playing the game because of violent content prior to playing it much or at all.  It’s as if people were not initially able to perceive the course material of World of Warcraft as being in the same oeuvre as required readings or videos.  It is one thing to bring up in your English literature class that you found the violence in “Ivanhoe” or the sex in “The Monk” objectionable after reading it, but I’ve not heard of cases where students have refused to read these books for class based on those objections.  So I was curious, what made video games so different in people’s minds?

Things became easier for several folks after I set up times to meet them in the game world, and help them learn and play through the first few quests.  As I chatted with them and tried to explain the basic game mechanics I realized that I had learned to take for granted certain knowledge and skills, such as running, jumping, and clicking on characters to speak with them.  I started to suspect that the resistance to playing these games was perhaps connected to the tremendous amount of learning that was having to go on in order to even begin to play the game.  In literacy education circles we would call this  learning pre-readiness skills.  Being thrown into a learning environment in front of peers and your instructor was unsettling, immediate, and potentially embarrassing.  And I think being educators may have actually made this even harder.  Education in the dominant paradigm of the 20th and 21st century seeks to create literary critics and professors as the ultimate outcome of education, according to Ken Robinson.  So here are a group of people who have excelled at reading and writing suddenly being asked to learn and develop an entirely new and different skill set within the framework of a college course:  Of course they were frustrated.

So I started playing EVE again not just to have fun, but to have a little refresher course in empathy.  I have leveled to 90 in WoW, so I know how to do things there, and had begun to forget how frustrating and bewildering learning new games can be.  In EVE I have been clueless and failing repeatedly, and getting in touch with how frustrating that learning curve can be.  I have also been re-experiencing how thrilling it is the first time I make a connection between too concepts or actions in the game:  When I realized that there was a difference between my “Assets” and my “Inventory” I wanted to shout it from the rooftops.  I have begun to see and help my students reflect on similar “learning rushes” when they get them as well.  They are now , in short, rocking the house in Azeroth.

We forget how thrilling and confusing it can be to learn sometimes, especially to the large population on the planet that doesn’t necessarily want to be a college professor or psychotherapist.  We forget that our patients and students are asked to master these frustrations and resistances every day with little notice or credit.

There is a village in Ethiopia, where 20 children were given Xoom tablet computers last year.  The researchers/founders of One Laptop Per Child dropped them off in boxes to these children, who had never learned to read or write.  They were offered no instruction and the only restriction placed on the tablet was to disable the camera.  Within minutes the children had opened the box and learned how to turn the computers on; within weeks they were learning their ABCs and writing; and within months they had learned how to hack into the tablet and turn the camera back on, all without teachers.  This story inspires and terrifies many.  It is inspiring in that it tells the story of what children can learn if they are allowed to be experimental and playful.  It is terrifying because if all this was done without a teacher to lecture or a therapist to raise self-esteem, it raises the question “do we still need them?”

Having played EVE, and taught academics in World of Warcraft, let me assure you that the world still needs teachers and therapists.  But the world needs us to begin to learn how to teach and help in a different way.  If EVE had nothing but online tutorials I would have probably struggled more and given up.  I needed to remain social and related to ask for help, listen to tips, and get the occasional leg up.  We need to retrain ourselves in empathic attunement by going to the places that scare or frustrate us, even if those places are video games.  The relationship is still important; to inspire, encourage and enjoy when learning happens in its myriad forms.  But we need to remember that there are many literacies and that not all human beings aspire to teach an infinitely recurring scholasticism to others.  We need to remember how embarrassing it can be to “not get it,” and how the people we work with every day are heroic that they can continue to show up to live and be educated in a system that humiliates them.

What’s exciting and promising, though, is this simple fact:  Learning is happening everywhere, all the time!  Whether it’s a village in Ethiopia, Elwynn Forest in Azeroth, or in orbit around Erindur VI; learning is happening.  Across worlds real and imagined, rich and poor, learning IS happening.

And we get to keep all the knowledge we find.

 

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Want To Help Stop Youth Cyberbullying? Let Your Kids Raid More.

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The above title is misleading.  In fact it is as misleading as the term cyberbullying, which is an umbrella term used from experiences which range drastically.  “Cyberbullying” has been used to describe the humiliation of LGBT youth via video; the racial hatred of Sikhs on Reddit, the systematic harassment and suicide of a teenage girl by a neighboring peer’s mother; a hoax wherein a Facebooker pretended to be a woman’s missing (for 31 years); and the bad Yelp reviews of a restauranteur in AZ.

Wait, huh?

My point, exactly:  All of the things described above are different in scope, intentionality, form of media used, duration, and impact.  We need to keep this complicated.  This is not to take away from the horrific acts that people  have perpetuated with social media, or excuse them.  Rather I think we need to help kids and their parents find more nuanced ways to make sense of the way newer technologies are impacting us.

Social media amplifies ideas, feelings, and conflicts.  It often dysregulates family systems.   Growing up, many family members didn’t need to learn the level of digital literacy that today’s world requires.  Parents may be tempted to put their children in a lengthy or permanent internet lockdown.  I hear the threats, or read them, all the time:  No screens.  You’re unplugged.  She’s grounded from Facebook.

Please don’t do that.

I’ve worked with a number of young adults who have had the experiences of being on the receiving end of hatred, stalking, harassment and intrusion delivered via the internet.  And thank goodness that their parents didn’t unplug them as kids.  Because they stayed online they got to:

  • learn how to ignore haters
  • see/hear others stand up for them in a social media setting
  • come to the defense of a peer themselves
  • increase their ability to meet verbal aggression with cognition
  • make the hundreds of microdecisions about whether to “fight this battle”
  • seek out support from other peers
  • form strong online communities and followings that helped them cope with and marginalize the aggressors

More and more, online technologies are becoming a prevalent form of communication, and to take away access is to remove the hearing and voice of youth.  To do this is disempowerment, not protection.

I’ve said before that parents need to take an engaged approach with kids in order to be there to help kids understand and process the conflicts that are communicated through and amplified by social media.  But this time I want to go further, and suggest that one way to help kids achieve digital literacy in terms of social skills is to let them play more multiplayer video games.

Many of you probably saw that coming, but for those of you who didn’t, let me explain.  21st century video games are themselves a powerful form of social media.  Multiplayer games allow individuals to band together as guilds, raids, platoons and other groups to achieve higher endgame goals.  Collaboration is built into them as part of the fun and as necessary to meet the challenges.

There are exceptions to this, but it has been my experience that people don’t begin systematic personal attacks on each other when they are in the middle of downing Onyxia.  They are too busy joining forces to win.  I am convinced that much hatred we see in the developed world is there in large part because of boredom and apathy.  Games provide an alternative form of engagement to hatin’

Look, I’m not saying that people playing games never say sexist things, swear, or utter homophobic comments.  But I can say that I have heard more people, adults and children, stand up to hatred in World of Warcraft than I ever have in the 2 decades I worked in public school settings.  I’ve seen racism confronted numerous times in guild chat, seen rules for civility created and enforced over and over, always citing a variation of  the same reason:  “We’re all here to have fun, so please keep the climate conducive to that.”

Video games provide powerful interactive arenas for diverse groups of people to collaborate or compete strategically.  They capture our interest with a different sort of drama than the sort that we see our youth struggle with in other settings.  In fact, for many individuals video games provide a welcome respite from the drama that occurs in those other settings.

Social media does indeed amplify nastiness, harassment and hatred.  It also amplifies kindness, hope, generosity and cooperation.  If we don’t lean into social media with our kids, they’ll never know how to use it to amplify goodness in the world.  Worse yet, if we cut them off from connecting with the world online we’ll deprive them of the necessary opportunities to recognize and choose between good and evil.

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Skyrim Family Values

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In psychotherapy we have grown to have a narrow definition of what it means to prescribe something.  Most of us think of prescription in terms of medication, however if we take this definition, you’ll see why I often prescribe video games:

pre·scribe

/priˈskrīb/
Verb
  1. (of a medical practitioner) Advise and authorize the use of (a medicine or treatment) for someone, esp. in writing.
  2. Recommend (a substance or action) as something beneficial.

(Google, Transmitted from http://bit.ly/XyztcE, 2013)

I have mentioned before my assertion that video games are among other things models of the world, that must both resemble and be distinct from the world to be effective.  Sometimes they are models that present dystopian worlds, and other times they model how things could be if we set aside some of our differences.

The game The Elder Scrolls V: Skyrim is such a game, and one I recommend that therapists who work with a diverse range of families familiarize themselves with.  Like other prescriptions it does have some effects that need to be considered carefully before recommending it to patients.  It is rated M by the ERSB, which is characterized as  “MATURE: Content is generally suitable for ages 17 and up. May contain intense violence, blood and gore, sexual content and/or strong language.”  For parents who are very concerned with violence in video games, this one has a range of it:  Set in a quasi-Nordic society, it contains the brutality one would expect there, including a decapitation in the first 10 minutes of the game’s opening.

So what on earth am I thinking in recommending it?

Last week the U.S. and the Supreme Court engaged in public deliberation on Proposition 8 in CA, the repeal of DOMA, and the question of what makes a marriage, and by extension, a family.  As the debate unfolded, the statistics reported indicated that the court of public opinion had already reached a majority about the subject.  The Washington Post reported that 58% of Americans favored gay marriage, the highest percentage of our citizens yet.  And in the Supreme Court, Justice Kennedy raised this:

He was alluding to children of parents in same-sex relationships, some of whom are biological offspring, but a substantial number of others who are adopted.  Adopted children often experience marginalization by virtue of their adoptive status, which can in itself be stigmatizing in a world which often give genetics primacy over nurturance.  But the child who is adopted by same-sex parents often faces a double whammy in a world where their family system goes unrecognized if not persecuted.

I’d like to think that at least part of the change in public opinion on gay marriage and families is due to Skyrim.  The video game from its inception has allowed for quest lines that culminate in your proposal, wedding, and marriage to a partner who can either be the same or different sex.  If your character is female and you ask another female character to get married, your experience is one of acceptance.  Later you get married in a ceremony celebrated and witnessed by several people in your community.  Still later you set up house together, and have the experience so many of us have craved, coming home to someone who loves you after a hard days work (or dragon-slaying as the case may be.)  As of last July, 10 million copies of the game had been sold worldwide, so it is not unreasonable to imagine that a large number of these found their way into the homes and minds of U.S. gamers.  So let’s not give Will and Grace all the credit.

When working with patients from adoptive and/or same-sex families, Skyrim can be a valuable resource in providing a model of a world where adoption and gay marriage are accepted and treated with little fanfare as part of life.  Families can use the game as a launch pad for discussion about what makes a family.  Perhaps more importantly, kids, adolescents and adults can enjoy hours of gameplay in a world that celebrates marriage diversity and the family of adoption.  It’s by no means a perfect world, but the benefits of such a video game may outweigh the concerns about gore.  I can tell you that what I hear discussed eagerly by players is not how cool the gore is, but rather how neat it is to be able to be adopted or marry who you want.

Think about how often parents wish their children could understand them better.  Now  your child has the opportunity to imagine themselves choosing a child as they were chosen.  Imagine a LGBTQ adolescent being able to experience choosing to marry who they want regardless of sex.  And imagine a straight person seeing that they aren’t always what “normal” has to look like.  Not medication, but a powerful prescription for what often ails our patients, and our nation.

And then, as I was preparing to write this post, I was bitten by a vampire.

Another common occurrence in the world of Skyrim is encountering a vampire.  In my case, without choosing to, I had been bitten, and within a few days of game play, people in Skyrim began to notice.  At first the shopkeepers would tell me I looked pale.  A day or so later I was told by the guards that I had a hungry look in my eye.  Finally, when my vampirism was no longer concealable everyone turned hostile.  I couldn’t enter any city, including my hometown without being attacked, both verbally and physically.  No matter that I hadn’t hurt anyone yet, I was forced to sneak around everywhere.  I felt frustrated and victimized.  It was a powerful lesson in ostracism.

I wish I could assign Skyrim to every one of my social work students studying diversity and racism.  The game provides a model of a world which provides you with the experience of tremendous acceptance and empowerment, as well as hatred and stigma.  It also shows us models of love and families which we have yet to embrace sufficiently in the United States of America.

There are  38 children in Skyrim who could be parented by a same-sex couple, in CA there are some 40,000 who have been.  In our nation as a whole an estimated 65,000 adopted children are being raised by same-sex parents.  We risk raising a portion of these, our future population, to feel ashamed, marginalized and flawed.

We can do better.

 

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Epic Supervision Fail

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This past week social work colleagues Ericka Kimball and JaeRan Kim had an article published in Social Work entitled: “Virtual Boundaries:  Ethical Considerations for Use of Social Media in Social Work.”  It’s a good article, and more importantly it’s a nice start.  The article discusses if, when and how to use social media ethically.  The authors don’t purport to have a solution to every potential problem that social media poses clinicians, but they have some good suggestions.

I have mixed feelings about the constant yoking of “technology” to “ethics” in our profession.  (In general, not specifically the article above.) It always seems to imply that social media and ethical problems go hand-in-hand.  No other ethics issue, even patient abuse by psychotherapists, gets as much play in our current professional development course offerings, and the irony is that there is evidence to support the much higher prevalence of the latter than the former.  It seems the only way the majority of psychotherapists can get curious about social media is if somebody scares them with the idea of ethical or legal violations.

Is there an ethical dimension to integrating technology into psychotherapy?  Absolutely.  It’s just not the only dimension.  And the problem with always focusing on ethics is it often encourages fear-mongering and contempt prior to investigation.  Part of the problem is that most of the people talking about ethics and technology in clinical practice have little to no experience with the technology side of things.  And as a result, they can’t engage us with ideas and brainstorming, but instead often adopt the fall-back of “you need to be careful.”

The result is that many clinicians get understandably scared:  You told me something is dangerous, and that the only solution is to be careful.  So seasoned clinicians often adopt what I call the “just say no” attitude.  Firewalls go up.  Patients can’t be emailed.  Agencies adopt no-Facebook policies, and in general evoke an air of monasticism.  I have even heard cases where clinicians are told they need to renounce having personal social media.  Though Shalt Not Tweet.

Into this  “just say no” milieu come our trainees.  Many of them are digital natives, and have been wired for technology in a way we digital immigrants may never be.  In many cases they are more digitally literate than we are.  They come into their supervision sessions with questions about cell phones in the office, suicide posts on Facebook, and being followed by patients on Twitter.

And they get “just say no.”

So let’s get real a sec here.

The Pew Internet Research Group states that roughly two-thirds of North Americans are on Facebook.  It, along with other social media, has become a primary source of communication and shaper of culture for our society.  This means that a majority of our trainees and their patients are probably using it.  We can’t just say no.  We can’t just say, “be careful out there.”  Our trainees look to us for supervision, and understanding social media and technology is part of 21st century clinical work.

I can’t tell you how many times I have heard horror stories in my classes about how supervisors fail their students this way.  And I get emails detailing, for example,  how a young clinician tried to bring up the positive impact of social media to a supervisor: “I thought her head was going to implode.”

Psychotherapy has a past history of using innovations in technologies to enhance our work, and our theoretical models.  Freud used the newer technologies of hydraulics to explain drive theory.  Similarly, advances in thermodynamic technology helped pave the way for family systems theory.  By now, many of the principles and parallels of those technologies have become so commonplace in our lives and understanding that we don’t even connect them with being familiar with technology.

Historically technology creates a period of suspicion and confusion before integration into culture.  A favorite example of mine is this:

indexAC

Prior to the Gutenberg printing press, books were a much rarer technology.  In the 8th Century, approximately 12,000 books were published in all of Western Europe; by the 18th century that number had risen to 1 billion.  As this technology became cheaper and more easily accessible, literacy rose.  But this was also a time when things got overwhelming.  When you had a handful of books read by a handful of people, the knowledge in them was much easier to locate.  But when the number of books and readers increased, there was an overwhelming amount of information to remember and locate.  The book index was the technology we came up with to solve that problem, but we needed to experience the technology as problematic before a solution was necessary.

Today we take indices, books and literacy largely for granted.  We know how they work, we aren’t afraid of them.  If anyone wanted to hold a workshop on the “Ethical Considerations of Printing” they’d be hard-pressed (heh) to get anyone to attend.

So now we find ourselves faced with a new technology, one as revolutionary in many ways as the printing press.  Only this time we are the generations that need to get used to it and confused by it.  And it’s risky and scary, because we don’t fully understand its implications yet.  But just as we wouldn’t have wanted our ancestors to forbid us to read and write, we need to let our trainees learn how to use the newer technology of social media in our lives and work.  And to do that, we need to learn it too.

This takes time, and it takes someone with expertise to teach you.  So before you hire a consultant, keynote speaker, or workshop presenter to talk about social media or technology in general, ask yourself, and them, these questions:

1. What do you plan to teach me beyond ethics about technology?

2.What strategies can you help me and my agency deploy besides be careful or “Just say no.”

3.What if any experience do you have with technology? Do you use social media? Professionally? Personally?

Just asking potential consultants those 3 questions could save you or your professional organization a lot of money down the line, as well as make the difference between helping you embrace innovation or stagnation.

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Continuing Education From Pax East

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For those of you who may not know, Pax East is a yearly convention here in Boston celebrating all things video game. This year I was so fortunate to have the opportunity to present there on “Rethinking Gaming Addiction.” If you are interested in seeing what the presentation was about, you can view the Prezi here:

 

 

For those with the stamina, you can find a video of the presentation here:

 

 

And if you want to just listen to it in MP3 form, you can do so here:

 

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Nice Everything You Have There: Mindful Minecraft

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Did you know that Minecraft has a lot to teach us about how we pay attention to, get distracted from, and cope with things? Embedded in the design and the lore of the game are nuggets of philosophy, neuroscience, and psychology. From work/life balance to physical and mental health to the meaning of life Minecraft has something to teach us.

That’s why I decided to present on mindfulness and Minecraft this year at SXSW.  If you were there, thanks for coming, but if you weren’t fret not, for David Smith of Austin, TX was kind enough to videotape the event on his iPhone.  David, thanks for your stamina!  The video is broken into 5 parts, and I’ll include the prezi for you to play with as well:

 

 

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Twenty-Three Apps for the 21st Century Therapist

apps

 

Mobile applications have a lot to offer therapists.  Whether you are looking for games to play with patients, productivity or billing tools, or something to help you research, there’s an app for that.  Many supervisees, students and consultees have asked me lately what apps I recommend, so I thought it was about time I gave you a list sampling those I find most helpful and fun.  Many are cheap or free, and available for the iPad, iPhone and Android:

1. GoToMeeting

Planning on doing online therapy?  Gotomeeting has desktop and app versions of videoconferencing software, which is HIPAA-compliant.  The app version allows you to attend meetings, but the meeting needs to be initiated from the desktop version.  I use this program for the majority of my online sessions with patients and supervisees.

2. IbisMail

If you are juggling multiple roles or a portfolio career, or simply want better therapeutic boundaries, this is the email program for you.  Installed on your iPad or iPhone, this program allows you to set up automatic filters, so you can sort through junk mail.  But it also allows you to set up folders for patient emails, so that you can have them all in one place.  Then it is up to you to decide when you review your patient communications, rather than have everything coming through one inbox.  Supports multiple email accounts.

3. Flipboard

If you are wanting to add value to your twitter followers or consultees, this is a great app.  It provides a slick intuitive interface on your mobile device that pulls in stories from feeds you set, from you Facebook account to the Harvard Business Review blog.  When you find something you want to share, the app allows seamless sharing on a variety of social media platforms.  In a few minutes you can browse and share selected readings and keep up to date on current interests.

4. Bamboo Paper

This app allows you to write notes on your iPad.  It is great for note-taking during evaluations, and allows you to send these notes to Evernote as a .pdf or email yourself a copy.  NOTE: Doing this is not HIPAA-compliant if you have distinguishing identifying information in the note, so I recommend you refrain from using the cloud-based features if you have any concerns about patient privacy.  If you are using it for workshops or other personal uses, however, no worries.  And if you keep the notes local to your password-protected device, it can be a great tool.

5. Evernote

I was hesitant to add Evernote due to the recent hack they experienced, but their quick and effective response to this have actually made me more confident that this cloud-based note-taking device is still useful.  It is NOT HIPAA-compliant, so I don’t use it for patient notes ever.  That said, it is great for dictating notes about workshops, blog ideas, snapping pictures of things for study aids, and a myriad of other useful tasks.  The notes synch up between every device you have them on, so you’re always up to date.

6. iAnnotate

One of my favorites.  iAnnotate allows you to mark up .pdf files on your mobile device.  If you need to sign off on a document someone emails or faxes you, no more scanning, printing, scanning again stuff.  And if you are a student or researcher this is a must-have, as it supports highlighting and annotating research articles.  Synchs with Mendeley and Dropbox so you can store your research library with notes online.

7. 1Password

How can you make your mobile device more secure and use your web-browser more safely?  This may be the answer for you.  1Password installs on your mobile or desktop, and allows you to save and generate extremely long and secure passwords.  The level of encryption can be adjusted for the most cautious of password protectors.  This program also synchs over the cloud so that you always have the up-to-date passwords on all of your devices.  Even more convenient, it can bookmark your sign-in pages.  All of this is secured by double-password protection on your iPhone.  Stop using the same lame password for everything and start generating unique hard-to-crack ones for true HIPAA-compliance.

8. Mendeley

One part social network, one part research library,  Mendeley allows you to store research articles and annotations online and on your device.  It allows you to network with other colleagues to see what they are researching, share articles, and store all of your articles in one place.  Often it can even pull up the bibliographic entry from the web just by reading the .pdf metatag.  Geeky research goodness!

9. PayPal

This is one option for billing patients and paying vendors that is good to have.  You can invoice by email, transfer money to your bank account, and keep track of online payments on the website.  The app works well in a pinch if you aren’t ready to swipe cradit cards in your office.  NOTE, each transaction has a small fee.

10. Prezi

I’d love to see more therapists using this one.  This presentation software allows you to create dynamic visual presentations on your computer or mobile device.  You could use it to convert boring DBT worksheets to a dynamic online presentation.  Prezi supports importation from powerpoint, and provides free online hosting of your prezis as well as tons of templates and tutorials.  If you do public speaking, upload some of your prezis on your LinkedIn profile to give potential clients a vivid sense of your work.  You can see a sample here, but bear in mind that it would make more sense if I was there giving the talk.  🙂

11. DCU

I haven’t been to a bank in over 2 years, and this app is the reason why.  Digital Credit Union’s Mobile Branch PC, allows me to deposit checks from patients via my iphone.  Just login, scan the checks, and in 10 minutes you’ve done your deposits for the week.  Meanwhile, the online interface allows you to keep track of your spending easily and export to Excel or accounting software if you need to.  Great for tax season!

12. Dropbox

Dropbox is a great and free way to store non-private information on the cloud.  The app allows you to email items easily, so I use it to email intake instructions to patients, press kits to people inquiring about keynotes, and a number of other items.  I also keep all my DBT worksheets on it so that they can be sent quickly and easily to patients should they be feeling in need of extra support between sessions but not acute enough to warrant hospitalization.

13. TED

This app allows you to stay inspired and experience innovation daily, by beaming TED talks to your mobile device from the offical TED site.  You can favorite, search, and share your favorite ones, or hit “Inspire me” for random ideas.  As I wrote this, I was listening to Amanda Palmer speak on “The art of asking.”  This app can allow you access to ideas outside of the filtered professional bubble with therapists often get ourselves stuck in.

14. Line2

Want a second phone line on your iPhone?  This app allows you to have one.  You can port your practice number to it, and stop carrying two cell phones.  At $9.95 a month you can have unlimited US/Canada calling, at $14.95 a month you get a toll-free number and virtual fax.

15. CardMunch

Tired of keeping all those business cards from a shoebox?  CardMunch allows you to snap photos of a colleague’s business card and convert it to a digital one which it stores in your contacts.  Synchs with LinkedIn.

16. Micromedex

Keeping up-to-date on medications is pretty daunting, but this app, with frequent updates, helps you keep track od a medication, its Black Box warnings, contraindications, drug interactions, adverse effects, alternate names, standard dosages and more.

And now for some games!

17. Plants Vs. Zombies

This game is great for helping patients who want to learn about strategy and pacing.  Choose a certain number of plant types to plant in order to stop the zombies from overrunning your backyard.

18. Zombies, Run!

Continuing my zombie kick, this game is better than any pedometer I’ve ever used.  The more you walk or run, the further you progress in this game of fleeing zombies.  Go on multiple missions, play with friends, and even train for a 5K.

19. Kingdom Rush

This game is a classic tower defense game, which helps patients learn to make choices, control impulse spending as part of a winning strategy, and work on pacing, problem-solving and a host of other cognitive abilities.

20. Minecraft Pocket Edition

This mobile app version of Minecraft is a great way to connect with a patient’s gaming, and the app allows you to play together on a wireless LAN, so you can fight for survival or create an amazing construction right from your office together.

21. Flower Chain

This is a completely nonviolent game that focuses on setting up a chain reaction of flower blooms in order to complete each level.  Great eye candy, and a fun game for clearing the mind after a difficult session.

22. Trainyard

This puzzle game requires you to plan out and design multiple railroad tracks.  The trick is to set them up and pace them so that they all meet their goals without running into each other.  Great prompt for talking with adolescents about how they can learn to negotiate peer relationships in the same way, or learn to compromise with adults in order to get along with them.

23. Lavalanche

This puzzle game is reminiscent of Jenga, in that you have to dismantle a tower without letting the Tiki Idol fall into lava.  Another great one for executive function capacity-building around sequencing, planning and problem-solving.

So there you go, give some of these a try and let me know what you think.  Have a favorite app that you want to share?  Please feel free to comment and include the link.

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Live At The Cooney Center: “Improving Our Aim: A Psychotherapist’s Take On Video Games & Violence”

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Learn More About Rethinking Video Games & Addiction Here!

 

In the midst of several projects, including the upcoming 2013 SXSW presentation, but wanted to give you a post in the meantime.  Here is the presentation on rethinking gaming addiction I did there last year.

[gigya ]

This can give you an idea of:

  1. The power of Prezi, even in its’ most stripped down version
  2. The visuals that accompanied the presentation you can listen to if you go here
  3. What my approach to technology and psychology is
  4. What my style is as a public speaker

Enjoy, and I will be posting again with bigger news soon!

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4 Tips For Dealing With Video Game Violence For Parents

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Whenever there is an upsurge in moral panic around violence in the media, the focus becomes more polarizing than pragmatic.  Despite the overwhelming research (such as these articles) that shows weak if any links between video games and violence, media pundits whip up mental health providers and the parents they work with into a frenzy.  Feelings such as a passionate urge to protect children and adolescents are often to intense to be suspended to look at data.  In the midst of all this, moderate and practical ways to address the graphic content of some video games are overlooked in favor of heated philosophical debates.  So for those of you who are parents and/or work with them, here are a few tips and links on how to handle violence in video games:

1. Set console parental controls.  You can set your game consoles to only play games of a certain rating.  If you haven’t done so and are complaining about violence in video games, take some action here.  Here are the how-tos:

XBox Parental Controls

Playstation Parental Controls (Video from CNET

Wii Parental Controls

These are password-protected, and will allow you to set the ratings limits, which brings us to:

2. Know your ratings.  Although I have mixed feelings about the Entertainment Software Rating Board, it’s what we’ve got.  But the ESRB is only as useful if you familiarize yourself with it.  This means not only looking at what each rating means, but using the other resources they have, including mobile tools, setting controls, family discussion guides and other tips for safety.  The message here is that there is more to understanding and moderating access to your child’s gameplay than a rating system, including discussion of in-game content.

3. Make use of graphical content filters.  Many parents, educators and therapists don’t know that a growing number of games have options that can be set to filter out violent graphics, profanity, and alter the experience of game content to a more family-friendly level.  If your child wants a video game, have searching online to see if the game has a GCF be part of the process.  Not only will you be teaching them about consumer choice, but digital literacy as well.  Here are some popular games that have GCFs:

Call of Duty Black Ops 2

Gears of War 3

World of Warcraft

4. MOST IMPORTANT TIP: Parenting has no “settings.”  Parents and educators often want some expert to rely on–don’t try to “park it” that way.  Most games can be rented before you buy them from services like GameFly so you can test drive them.  That’s right, I’m suggesting you play the games yourself so you can make a personally informed decision.  At the very least you should be watching your child play them some of the time, not to be nosy, but because part of your role as a parent is to take an interest in their world.  If you can spend 2 hours going to their Little League game, you can spend an hour watching (if not playing) Borderlands 2.

If you’re an educator or therapist, you’re not off the hook either.  🙂 If you are going to offer opinions on video games and their content, make sure you are playing them.  Chances are you don’t say things like “reading Dickens is dangerous for young minds” if you have never read any of his work.  If you did, you’d probably be out at a book burning rather than reading this blog.  By the same token, don’t presume to opine about video games if you have done nothing to educate yourselves about them.  And please note that asking children about them is a place to start, but by no means sufficient for educating yourself.  If you are a play therapist, please start including 21st century play materials like video games in your repertoire.  And be sure to provide parents with the resources they need to help them make sense of this stuff, such as the resources this post gives you.

Look anyone can have an opinion on video games and violence, but we need practical processes to help people be informed consumers.  This is one parenting issue that has practical, doable options, and is rated “O” for “Ongoing…”

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Epic Every Day: What Video Games and the Millenials Can Teach Us If We Let Them

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The term millennial refers to the generation following mine, Generation X, who were born between the early 80s and 2001.  There certainly may be some differences in the millennial cohort in terms of race and social class, but in my experience working in both urban and suburban settings, technology use is not one of them.  In fact, technology has probably exacerbated some of the traits millennials are known and often criticized for.  Social media has made expression more democratic and amplified, and millennials cite self-expression as extremely important.  Growing up with the internet has also placed them in the same social and informational spheres as their parents more than previous generations, making them more civic-minded than rebellious, and having different, some would say overly dependent, attachments to their parents.

Common complaints about millennials include that they are entitled, tethered to their parents, unable to tolerate longterm goals, averse to sustained effort and require a constant stream of praise for the most minimal pieces of work.  The other side of this coin is worth noting, too:  Higher sense of self-expression has led to millennials’ higher acceptance of diversity in others; they are more comfortable with switching jobs or organizations they work with and working outside the box in general.  Yes, they may also have a higher tendency to blame external rather than internal things for their problems, but having come to self-awareness post-9/11, can we really blame them?

In my work, I often encounter children, adolescents and young adults who are failing in school for a variety of reasons.  These “millennials” avoid attending, and often the blame is placed on excessive video game use.  They are seen to be escaping from reality, and although I can understand this perspective, it also puzzles me in some ways.  Video games would in many ways seem to me to be going from the frying pan into the fire:  They are rife with failure; in fact the statistic Jane McGonigal gives us is that people are failing 85% of the time in playing video games.  MMOs often require even more collaboration, sharing and critical thinking between individuals than classrooms in any given 30 minute period.

Millennials are often criticized as post-academic workers as well, for having less job loyalty, a need for constant feedback, and expecting that feedback to be praise.  In more affluent school districts I often heard their parents described as helicopter parents, who would email school minutes after receiving the report card to begin to debate the grades and exert pressure on educators to change them.  This has led to such grade inflation in my experience that my graduate school students are hurt and insulted when they get a B+ on a paper, sometimes to the point of tears.  I can’t remember a class I had in college where I wasn’t listening to a lecture, millennials are constantly asking for more small group work.  I’ve even had a call on occasion from a parent about their child’s performance.  Did I mention that I taught in graduate school?

From the above criticisms you’d think I was down on millennials, and you’d be dead wrong.  Because I think for the most part the millennials are happy, tolerant, and more likely to help others voluntarily than other generations, and the Pew Research on them bears this out.  And I think that a major reason for this is that they play video games.

The video games of today and the past decade have morphed from Pong and Space Invaders to Halo and World of Warcraft.  They have set up myriad game worlds where survival and thriving requires critical thinking, social collaboration, and lots of trial and error for mastery.  These games have also been played by over 90% of the millennial population, and I would suggest that the result is that millennials have been conditioned to be more collaborative, expect feedback to be quick and positive, and be more connected to others through technology.

Then we send them to school,  and it is frustrating for a majority of them, a majority of teachers, and a majority of parents.  Rather than encourage them to be “lifelong learners,” education as it is currently structured aims to produce a very narrow form of educated person, one that Sir Ken Robinson describes in his TED talk as an “academic professor.”  In addition, we all start to become impatient with millennials to adopt our own often individualistic notions of what adulthood is.  They need to stand on their own two feet, work without constant reassurance, and memorize things that they could just as easily Google.  All to get into the right college, and all to get a good job.

We criticize the millennials’ work ethic for many of the same reasons:  They won’t take individual responsibility for projects, they have trouble working independently, and they expect an award merely for being present.  They need to take things more seriously and get their nose to the grindstone, no one has time to hold their hand anymore.  These are all complaints I have heard levied against adolescents and young adults in my work, and the implicit message is that it is time to grow up.

One of the greatest things we can learn from millennials is something that I think they learned from video games, and that is how to destigmatize, and even enjoy, failure.  The epitome of this for me is the Heron’ The Greatest Spelling Bee Fail/Epic Win of All Time—which was posted on YouTube originally by the millennial who flubbed it.  This ability to have a sense of observing ego and humor about oneself is something many of us in psychotherapy work with our patients for years to achieve, and yet as a generation millennials seem to have grasped it more easily.

Part of my work with gamers is often to explore this paradox:  Why is it fun or okay to fail in video games so much, and so intolerable in work or school?  Sure, part of it is that play is a magic circle according to Huizinga, which is marked apart from real life.  But games impact the same brain, the same emotions that exists inside and out of that circle.  And if that is the case, there must be some transferable skills.  We work on how to destigmatize failure

Innovation requires lots of trial and error, and lots of failures.  As educator Lucas Gillispie said at a recent education conference in Second Life, it makes little sense to penalize so harshly when students get 69%.  Rather than see it as having acquired more than half the knowledge assessed, we make it a source of embarrassment and usually require they repeat the entire exercise, class, or grade.  Millennials have grown up with a split view of failure.  On the one hand, video games have helped them understand that failure can be fun, even if you’re failing 85% of the time.  On the other, they are put in educational environments where the A is everything, and the goal of learning is to get high marks rather than enjoy the creativity and critical thinking.   In fact, A’s are so limiting!  Why not focus on a high score which can always be improved upon in school?  If the best you can do is an A, then you have to resort to accumulating the most A’s possible, which is less intrinsically rewarding and dynamic.

Many detractors will say that millennials need to get with the existing program, that what I am suggesting is dumbing down a curriculum, or that I am being too Pollyanna and that some jobs just aren’t capable of being fun.  But for over a decade companies like IBM have found success modeling work environments on MMOs, and schools which institute dance classes notice higher math scores. And the solution to our economic and occupational troubles may not be the return of a “work ethic” or more job, but the creation of new types of schools and jobs, work we can’t even imagine yet because it hasn’t been innovated or invented.  Can you imagine some 14th century youth telling his farmer dad, “I don’t want to work on the farm.  I’d like to create and use something that applies pressure and ink to paper to make reading and writing something we can all do.”

It probably isn’t a coincidence that the word “epic” has become ubiquitous over the past several years, with so many millennials and others playing video games like World of Warcraft.  And it has come under fire by many of my colleagues, who maintain that in a culture where everything is Epic, nothing truly is.  I’m not saying that everything is Epic, but I am saying that there can be some Epic every day.  It’s what they call teachable moments, flow, success, even the Epic fail that we can laugh off with colleagues before redoubling our efforts to nail it next time.  What we’re really learning here is how to tolerate frustration.

Millennials know that “epic” is a superlative, they’re not devaluing the currency of that word.  If anything, I think that this is a sign that Buddhist thinking is becoming more integrated into the 21st century:  It is Epic that we are here alive in this moment, that we want and fear so much, and the struggles that ensure from those things. There are a lot of levels left to unlock and problems to be vanquished in the world, and we need to cultivate optimism and positive psychology at school and in the workplace, not stomp on it.

Millennials often have that sense that there can be some Epic every day.  Video games offer worlds where there can be some Epic every day, too.  Let’s start noticing it.

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Happy New Year!

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As we start the New Year I wanted to share a quote I think applies to you:

“Talent hits a target no one else can hit; Genius hits a target no one else can see.”

— Arthur Schopenhauer

Going into the New Year, entertain the possibility that you are a genius.  Whether you are a gamer playing first-person shooters, a therapist trying to build your private practice, an educator trying to reach students, or someone trying to live a good life, ask yourself:  What are the targets you can see that other people can’t?

Don’t expect praise, people will think you are crazy for shooting into thin air.  You may be bullied, insulted or ignored, but remember you are not alone.  Find that person or group who believes in you even though they can’t see your target.  Those are true people of faith in your life.

Does this mean you’ll be coasting?  Nope.  It takes practice allowing yourself to look for things invisible to most.  It takes constant effort to hone your talent.

If you play Minecraft, think of 2013 as your new sandbox.  2013 is loaded with things you’ve not discovered yet.  Any rock could conceal diamonds or ore.  You will encounter creepers when you least expect them, lose things and have setbacks.  But you can opt for multiplayer, and build in community.  All of the materials are there for you.  You may think you are starting with nothing, but you always have the tools to build tools.

If you keep at it you can change the world.

Whether you are a regular visitor or a loyal follower of this blog, thank you.  In case you missed them, below are the 5 most popular posts from this year:

 

Dopey About Dopamine: Video Games, Drugs, & Addiction

Epic Mickey and Frittering

Gamer Therapy

How to Get Taken Seriously as a Mental Health Professional

Skyrim, Stealing & Sadism

 

Like this post?  I can rant in person too, check out the Press Kit for Public Speaking info?  And, for only $2.99 you can buy my book.  You can also  Subscribe to the Epic Newsletter!

Angry Birds, Advent, & the 12 Links of Christmas

You may be familiar with Angry Birds, one of the most popular smartphone games in the world. But did you know that they have a holiday season edition? They cover several world holidays, but by far my favorite is the Christmas version, which comes out early each December.

The reason I like it so much is that it is basically an Advent calendar. For those of you who aren’t familiar with them, advent calendars are holiday calendars used to help celebrate the anticipation of Christmas. There are usually 24 little doors or windows in the calendar, and each night you open one of the doors as you get closer to the 25th. Behind the door may be a picture, small piece of chocolate, part of a story, or something else.

Angry Birds Seasons allows you to play one game level per day leading up until Christmas. Whether you whiz through it or play for 2 hours, the next day’s level is locked until midnight. You’ll see a countdown page if you try to move forward, but that’s it.

Many spiritual traditions emphasize the celebration of small patient acts. Hanukkah uses the nightly lighting of the menorah and exchange of small gifts for 8 nights. Diwali has 6 nights of celebration in its festival of lights, and there are many more. And now we have the more secular tradition of Angry Birds.

I want to celebrate with you the idea of waiting and enjoying small things. I think we can enjoy anticipation, see the value in the smallest of gifts. And that those gifts can be as powerful as they are small.

So whatever your particular holiday tradition is, or isn’t, I hope you’ll accept this gift from me to you. I call them the Twelve Links of Christmas, but you can call them whatever you want. They’re hyperlinks (sorry Zelda fans) to 12 different activities and ideas. Some of them are video games you can try, others are gift ideas, some are videos of change. All of them engage you in some activity involving social justice.

Don’t open them all at once! Each day from now until the 25th, click on one link and try it out.

The Twelve Links

1. Darfur is Dying: Refugee Game for Change Play this game to learn more about the genocide in the Darfur region. One of my students played the game for 45 minutes before realizing that she had now spent more time learning about Darfur in one sitting than the totality of her life before.
2. Eli Pariser TED Talk: Beware online “filter bubbles” In this TED Talk, Eli Pariser helps us see how we are in danger of having our experiences and information filtered by emerging technologies, and warns us of the potential consequence of such searches mediating and filtering our understanding of the world.
3. True Colors It’s been two years since this performance was belted out by the LA Gay Men’s Chorus, but it is as moving as ever. Sung to the world, but also to every LGBT youth feeling isolated and hopeless, this resounding cry of comfort and encouragement is perhaps best summed up in the powerful vocals at 3:50: “So don’t be afraid..”
4. Foldit: Science Game for Health Learn about and play the game that contributed to HIV research in 10 days of gaming in ways that computer models had been trying to do for years. Foldit uses a video game to fold proteins, which aids in the search for cures of health issues such as Cancer and AIDS. Within minutes, anyone can begin playing the game and help!
5. Tropes Vs. Women #3: The Smurfette Principal This is one video from Anita Sarkeesian’s series, which offers a feminist perspective on the limited and limiting ways women are portrayed in popular culture. Anita’s more recent exploration of sexism and these tropes in video games sparked a hateful backlash from some, and may just have ushered in a new era of discussion and self-critique as gamers and game developers supported Sarkeesian and have begun working to make the days of such hate numbered.
6. Papo and Yo If you still have any doubt that video games can be both art and social commentary, this powerful trailer may convince you otherwise. This PS3 game offers a powerful exploration of childhood abuse, ethnicity, poverty and the power of the imagination to solve the puzzle trauma inflicts on the oppressed.
7. Ken Robinson Says Schools Kill Creativity Check out this TED talk, not just for its commentary on education in general, but as a meditation on how we could rethink learning disabilities, autism, and other differences in the human learning process.
8. Ethos and Seniors Flash Mob for Elder Abuse Awareness Day This year, senior citizens in my very own Massachusetts dropped into the local supermarket for a flash mob to raise awareness on elder abuse. Their choice of song was apt, and even a bit chilling. Check out the video and see if you can notice how many stereotypes of elders it helps debunk.
9. Heifer.org : Rethinking Gift-giving A perennial favorite of mine, the mission of Heifer is simple: “To work with communities to end hunger and poverty and care for the Earth.” This website will show you the way you can change the world this holiday season by giving a gift of sustainable food and agriculture to indigenous peoples all over the world. Much nicer than another soap on a rope.
10. I Am: Trans People Speak A brave and bold use of social media, this project is affiliated with the Massachusetts Transgender Political Coalition in partnership with the Gay & Lesbian Alliance Against Defamation. It seeks to raise awareness about diversity within transgender communities, as well as empower individuals to create positive change in the media representations of trans people.
11. Food Force 2 Look, you’re on Facebook anyway, why not spend some time learning a bit about sustainability, community organizing and world hunger? This game, sponsored by the United Nations World Food Program, seeks to raise both awareness and money to solve real world food shortages. Since it is a video game on a social media platform, perhaps you can invite your friends to play too!
12. Give An Hour: Psychotherapists Supporting Veterans Got a spare 50 hours? Of course not. Okay, how about 10 minutes to check this video out. In it my colleague Barbara Van Dahlen discusses how she founded Give An Hour, an organization that connects returning veterans with psychotherapists who have volunteered to donate an hour a week of free therapy. After you listen to some of the soldier’s stories, you may find yourself inspired to make room for that hour a week in your practice. I have since 2006, and I recommend it highly.

If you’ve checked out the link before, maybe there is someone important to you you could send it to? Maybe you haven’t shared it with your child? Maybe someone else who you know will be alone for the holidays, or someone you’ve been meaning to reconnect with and can’t quite figure out how to do it?

I hope you find these links as rewarding and enriching as I have. Please accept them as my thank you for reading the blog this year. Please take them as an invitation to change the world. Because that is what social justice is, isn’t it?

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‘Tis The Season For Power Ups

This time of year is for many of us a time of stress and reflection.  The days get shorter and much of the time it seems as if we are wandering around in darkness waiting for things to change.  We may be pursued by haunting images of past relationships and mistakes we have made.  We may feel like we are doing things over and over the same way expecting different results.  We may become painfully aware of our repetition compulsion even as we charge around trying to get something to fill us up.  We may dread the end and fear death.

You all know I’m talking about Pac-Man, right?

No, seriously, by now everyone on the planet, gamer or not, must know that Pac-Man is not just a fun video game but a compelling spiritual meditation.  First off, Pac-Man is walking a labyrinth over and over, focusing on his path, how mindful is that?  And then there are the ghosts, don’t even get me started on them.  They pursue him constantly, like the specter of death or the ruminating thought that can’t be shaken.  They are constantly somewhere on the board with him, yet Pac-Man is essentially alone in the world.

This would all be pretty depressing if it weren’t for the power-ups.  Traditionally there are four of them, in the form of larger blinking white dots in the corners of the maze.  You probably recall the drill:  Pac-Man runs away from the ghosts until he finally eats one of those power-ups.  And then everything changes.  The ghosts turn blue and run away from him, and he can eat them for more points.  Yep, turns out Pac-Man applies good old Buddhist principles to the whole situation:  He faces his fears, and moves toward them.  As Pema Chodron would say, Pac-Man goes to the places that scare him and leans into the sharp points.

Ok, so back to you and your life, or your business or your family or your health, whatever situation or ghostly thoughts are running around the maze in your head.  Let’s do some Pac-meditation on them:

1. Who’s chasing you?  Take a moment to stop rushing around and ask yourself what are you worrying about?  Are you legitimately busy or being hectic?  Remind yourself that in this present moment, the people, places or things you may be avoiding are probably not really there in front of you. If you aren’t physically moving, then remind yourself of that with a breath or two. If you feel like you are moving and you really aren’t, gently remind your mind of that.  And if you are moving, try moving like you are walking a labyrinth not running around a maze: purposefully, single mindedly.  Mindfulness is the difference between a maze and a labyrinth.

2. Don’t let the bouncing fruit distract you.  This time of year especially it is easy to get thrown off course because you can become fixated on one goal: The perfect gift, the perfect holiday dinner, the New Year’s resolution to change X,Y, or Z.  Much of it is hype or a collective hysteria.  Look again, there isn’t one special dazzling fruit (or pretzel) that you have to have to win.  Nope, it’s just ordinary time, the present moment stretching out before you like a string of yummy pellets.  Enjoy those quiet unassuming moments where everything is calm and sufficient.

3. Know your ghosts.  Take a few minutes now to get to know your four ghosts.  This doesn’t need to be all psychoanalytic.  Just try to list off 1-4 things that are most pressing to worry about.  The ghosts often have less scary identities than you may suspect:

Those are the traditional names, but now let’s have you take your ghosts and put your names on them.  For example they could be:

Try to limit the ghosts to four–Remember, this isn’t Space Invaders.  What are the most pressing urgent concerns?  The goal is to get them down and begin to do what Michael White referred to as “externalizing the problem.”

Now you’re ready for…

4. Identify your power-ups.  What are those things that help you feel more powerful, more effective?  Some people identify a song that powers them up to go to the gym.  A favorite quote can be your power-up.  In my office I have one of those Staples Easy Buttons which some people find useful.  My own personal power-up is an Iced Venti Americano at Starbucks.  Sometimes power-ups are specific to the particular ghost you are dealing with, sometimes one power-up works for many different ones.  This is not a new concept, people have been using talismans for years.  Object relations folks would probably call power-ups “transitional objects.”

Last, but not least:

5. Use your power-ups.  This is not as easy as it sounds.  People often forget they have power-ups even after they have identified them.  You need to make sure your power-up is ready at hand.  If yours is an Easy button, you need to keep it at your workspace in plain view.  If it is fresh orange juice you need to make sure there is some in the fridge.  If it is a song it needs to be downloaded on all your gadgets.  If prayer or meditation is your power-up put the cushion on the floor in front of your bedroom doorway.  Enlist your partner or family members to remind you that you have these power-ups.  Then use them no matter how silly it feels, no matter how hopeless you feel.  Just. Use. Them.

This isn’t the only time of year you can use power-ups, but it is definitely a good time to start.  Not because it is the holiday season, but because it is the present.  Right now you are awake, so you can reflect and take action.  The only person stopping you from logging off and figuring out your ghosts and power-ups is you: Game on!

Like this post? There’s more where that came from, for only $2.99 you can buy my book. I can rant in person too, check out the Press Kit for Public Speaking info.  Subscribe to the Epic Newsletter!

 

Avatars & The Curated Self

If I ever meet James Cameron, I hope I will remember to ask him if it was a coincidence that he chose to the make the aliens blue.  His movie, Avatar, garnered 3 Academy Awards for it’s epic tale of humanity’s encounter with the Na’Vi, largely through the creation of avatars, body forms that humans beam their consciousness into so they can mingle and fraternize with the locals.

The concept of the avatar comes originally from Hinduism, and refers to the concept of a God or Supreme Being deliberately descending to earth in a manifest form.  One of the most popular gods for doing this is Vishnu, also blue.  The concept of avatar in  Hinduism is more complicated than this, but the piece of it that pertains to this post is the general concept of the attempt of a supreme being to incarnate part of itself to enter the world.  There is an inherent diminution or derivative quality to it.

If you are more familiar with video games than Hinduism, you are probably more familiar with the concept of an avatar meaning the graphical representation of the player’s character in the game.  When we play Pac-Man, our avatar manifests in the video game as a little yellow circle with a mouth that races around gobbling dots.  Over the decades games and graphics have become capable of more sophisticated avatars ranging from the Viking-like Nords of Skyrim to the soldiers of Call Of Duty.  As these video game worlds proliferate, players descend into them with avatars of many shapes, sizes and species.  Some games, like Eve Online, allow you to customize the features of your avatar extensively; others allow you to pick from a limited number.  We are always diminished by the process of taking on an avatar.  Even if the powers an avatar has in the video game world are immense, it is derivative of the complexity of being human.

What is interesting is that most of us use avatars every day online, we just never realize it.  Video games are just one form of social media, and avatars abound in all of them.  The graphic may be as simple as our picture next to a blog post or comment, or a video on Youtube.  But in the 21st century most of us are digital citizens and use one form of avatar or another.  Some people in the world will only ever know us through our avatar in a video game or Second Life.  And yet we know something of each other.

I think more and more of us are becoming aware of the connection between the avatar and the curated self, the aspects of our psychological self we choose to represent online.  The curated self is the part of ourselves we have some ability to shape, by what we disclose, what graphics we choose, and how we respond to others.  Like an avatar, the curated self at its best is deliberate.  I say at its best, because although the curated self is in our care, we can also be careless with it.

Recently I posted a video of myself on my YouTube channel entitled “Should Therapists & Social Workers Post Videos Of Themselves On YouTube?”  In making the video I chose to wear a bike helmet, and by the end of the post was using the bike helmet as an example of the risks we take when we opt to attempt innovation of our curated self.  The video was designed to inspire critical discussion and thinking, and it did just that.  In some groups where it appeared people described the video and points it was illustrating as “brilliant.”  Other groups interpreted it as an instructional video on how to advertise your therapy practice and lambasted it.  There was a myriad of responses, and I’m sure even more from people who opted not to comment on it.  I received a number of likes of it, and a number of dislikes.

What I think is important and instructional here was how people began to comment through their avatars as if they were addressing the whole person I am rather than an avatar.  And they made incorrect assumptions ranging from my age to my motives.  The bike helmet and my posture on the video became the target for some incredible nastiness disguised as constructive criticism.  From the safety of their own avatars they hurled some invectives at who they thought I was and what they thought I was doing in front of an audience of other avatars who alternately joined in, were silent, emailed me privately to offer words of support, or publicly commented on what they saw.  The irony to me was that people began to demonstrate all of the roles we encounter in “cyberbullying,” which was part of what the video also touched on.  In a perhaps not surpising parallel process, we got to see and play out the sorts of dynamics that our patients and children experience all the time.

We need to remember that every avatar is a derivative of the person.  It is connected enough that we have attachments and responses to it.  We can feel proud or ashamed, hurt or healed through our avatars.  In fact, research from Nick Yee on “The Proteus Effect” has shown that playing a game with a powerful avatar for 90 seconds can give the player increased self-confidence that persists for up to 6 hours.  It stands to reason that if someone experiences their avatar as weak or socially unacceptable for a brief time there may be lasting effects as well.  Behind the guy in a bike helmet is someone else.  He may be a faculty member at Harvard, a sensitive fellow, a father, a student, a man who just lost his partner, a person with a criminal record, or any, all or none of these.  But he is always more than the derivative of his avatar.  We need to practice being mindful of this and model it as we train others to be digital citizens.  It is counterproductive to sound off on cyberbullying to our children or grandchildren, when they can Google us online and see us doing it ourselves.

We also need to help our patients, their families, and colleagues understand the active role we need to take in curating ourselves online.  We need to understand what may happen when we put certain things out there.  For therapists this includes the dilemma of putting out a curated self that resembles what kind of work you would do, while not disclosing or conveying more than you want the world to know.  The example I always use with students and consultees is how I talk about my family but never who they are in particular.  This is deliberate, because it is no big disclosure that I have a family, everyone on the planet has one of sorts with the possible exception of Dolly the cloned sheep.  But beyond that I curate a private self, and let folks project what they may.  If we put out comments describing patients or coleagues as “screwed up,” we are also curating ourself, I suggest poorly.  We need to be mindful that most groups we participate online in are open and searchable.  Many of my colleagues became therapists at least in part because they didn’t want to be known and thought the best defense was a good offense (“We’re here to talk about you, not me.”)  They’re used to sharing the gallows humor with the team, and think the same applies to online.  I’m with Rilke on this one:  “for here there is no place/that does not see you. You must change your life.”

To paraphrase Wittgenstein, “our self is everything that is the case,”  not just one avatar, blog, string of emails or video; not even the composite of all of them.  Nor is our curated self everything that is the case.  We’re more than our Facebook likes or our Twitter following.  Human beings are so much more, much more wondrous and tragic than the curated self.  We descend into the Internet and are diminished, but do bring some deliberate part of ourselves along.  We will only ever know hints and glimmers of ourselves and each other online.  As for the rest:

“Whereof one cannot speak, thereof one must be silent.” –Wittgenstein

 

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On The Importance Of Feeling Useless

Recently I was being trounced in a game of Call Of Duty 3:  Modern Warfare 3.  Not only was I having a difficult time understanding the lingo and mechanics of the game, the controls for this first person shooter were bewildering to me.  I found myself staring down at the controller more than at the screen.  Why couldn’t I remember what the A button did? Over the course of the week, I was also informed that Halo 4, Assassin’s Creed, and Paper Mario: Sticker Star are also here or on the horizon.

I wasn’t sure when I was going to find the time to try all of these.  I was already behind.  Skyrim had new DLC, Minecraft had different updates for both PC and the XBox 360 versions, and the Secret World and Guild Wars 2 had both been preempted by the latest World of Warcraft : Mists of Pandaria expansion.  And what about Salem?  I had gotten a beta key for that, didn’t that make me obligated to try a little more?  And I won’t even go into the iPad and iPhone games, but Baldur’s Gate was just 3 weeks away…

I write all this because I have found that readers and colleagues often assume that because gaming is an area of clinical practice and focus of mine, that I am up on all of the latest games.  If you have been imagining that I always know what every MMO gamer is talking about, or can jive with adolescents about the finer points of COD: MW3 (Call of Duty: Modern Warfare 3) and how it differs from Max Payne, you are in for a rude awakening.

I can relate to every therapist who has sat with a patient and said no repeatedly to “Do you know about” questions involving video games.  I can relate to every colleague with thumbs of lead who plays with (against) their patients on XBox.  I too struggle against the countertransference urge to display my “hipness.”  And boy am I tempted sometimes to throw up my hands and say I am so over the latest thing.

But I don’t throw up my hands because I recognize that it is a defense against feeling useless.  Who wants to feel slow, clumsy, behind the times?  Feeling useless coincides with feeling powerless, devoid of meaning or hope, and isolation.  For me, that feeling of uselessness is touching the water’s bottom:  It’s where I kick off.  Uselessness is almost always the feeling that precedes determination for me and the moment when I am closest to getting going again.  Here are just a few reasons why feeling useless can be important:

1.  Feeling useless reminds me of how my patients often feel.  Regardless of age, gender or walk of life, I have sat with people who experience feelings of utter uselessness.  Most kids feel useless in school at one point or another.  Adults tend to embrace amnesia when it comes to remembering how dumb education can make you feel before you feel smart.  They have forgotten what it was like to be called last for the kickball team, or draw and erase and draw until your paper ripped.  And the population of Baby Boomers can feel useless as they sense the impatiences of their younger colleagues in the workplace:  You talk too slow, drive too slow, and why don’t you just retire?  Meanwhile, younger adults send out resume after resume and spend more hours in sweatpants as they feel that they and their education are both useless.  Parents send their children off to college and experience the empty nest, or send them off to war and experience a more terrifying version of uselessness.  We need to remember how it feels to be useless if we are going to stay empathically attuned to our patients.

2. To recognize that you are feeling useless is to begin to wake up.  At least it can be, because the sense of being useless is completely irrational.  There is nobody, not one person on the planet who has nothing to give of themselves.  There is no such thing as a useless person, it is a cognitive distortion.  And the minute we recognize that distortion we can begin to use our observing ego to ask ourselves “who is this who is telling me I am useless?”  Whoever it is, the media, a parent, an old tape running in our head, or all of the above, it is just wrong.  And that’s ok, because we’ve been wrong before, and now that we know it we can begin to gently guide our thinking back to a more rational place.  If this sounds like meditation, that’s probably because it is.

3.  To feel useless is only a feeling.  Sure feelings are important, and a powerful part of human experience.  But they are only one part of human experience.  Thinking and behavior are two other parts.  We can use feeling useless to motivate ourselves.  We can use it as a barometer for our overall mental health.  We can also use it as a defense to stay stuck, or to attempt to elicit pity from others.  There are all sorts of ways we can use a feeling, and they aren’t all necessarily, well, useful.  Or we can just sit still for a bit, because being just a feeling, feeling useless will float by and be replaced by another feeling, and another and another…

So if you are a therapist, and you notice yourself feeling useless, you are one step closer to coming to your senses.  You can become more mindful of how unpleasant the feeling is, and mindful of how your patient may feel when they experience it.  You can remember it is only a feeling, and become curious about it and why it is coming up.  And you can consciously decide how to use it or cope with it, rather than unconsciously act out in response to it.

To return to my video game example, here’s how I used it.  I noticed the feeling and said to myself, “That’s how my patients experience themselves sometimes.”  From there I went on to think, “That’s how the therapists I consult with about technology experience themselves sometimes.”  Interesting information, and it helped me pause a moment more.  And when I sat with it more it occurred to me that there was some symbolic content that had come up in a session recently that I’d overlooked.  And then it occurred to me to write this blog, and as I wrote the first paragraph I remembered how video games are a form of social media, and how my friend Susan Giurleo often reminds me that we don’t need to be on every single platform of it to be technically savvy.  From that stream of consciousness, and more importantly, from my feeling of uselessness, came this post.  And I have no doubt that at least a few of my colleagues will find it useful, which totally debunks the useless Mike theory.

What about you?  What has elicited a feeling of uselessness for you lately?  What is that feeling about, and what are you going to do with it?

 

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Taking An Interest

 

This week I was at the dentist, and the appointment probably took twice as long as it was supposed to.  This was because as I was waiting in the dentist chair, I was playing Denki Blocks on my iPhone when the assstant came in.  She found the game interesting, and confessed to me that she didn’t know how to download games on her new iPhone.  And as I was explaining how to do that, the dentist came in and he talked about how his children weren’t allowed to play games on the iPhone because they discouraged socializing.  So then of course I explained that there was research that suggested very differently.  He listened quietly and I said, “maybe I shouldn’t be arguing with someone who is about to put a drill in my mouth.”

“No, no,” he said.  “It’s just that I’m thinking about what you said, and I haven’t thought about it that way before.”  All three of us had an ongoing conversation between all the stages of filling a cavitiy, about smartphones, digital literacy, gaming.  And at the end of it I noted how clearly this is a topic for our times if all of us can be talking and listening intently about it for such a long period of time.

In college, one of my creative writing teachers once said, “What interests you is interesting.”  I think there is a lot of truth in this in general, and specifically when it comes to psychotherapy and running a business.  I feel extremely fortunate to be in a portfolio career that allows me to pursue my interests and take an interest in the psyche and society.  Not everybody has an easy or clear path to this in our society.  Some self-help gurus make it sound like all you need is a burning interest to become the happy and successful, which is absolutely not true.  There are millions of talented people out there that start off with less privilege and opportunity, and more stressors due to race, gender, poverty, or living in an ableist culture.  But what I do think my professor was on to was the idea that often what interests you can be a strong motivator to yourself and exciting to others.

A supervisee and I recently were discussing the possible meanings and messages that could be conveyed in leaving a voicemail for a patient.  After discussing this for 30 minutes, I interjected by saying, “Can I just take a step back and point out what a weird profession we’re in that we can spend so much time talking about this?”  We both laughed at this, and it was true, but the time had gone by so fast because we were mutually interested in the subject.

Enthusiasm, in its original meaning, was taken from the Greek enthousiasmos, which came from enthousiazein, to be possessed from within by a spirit or god.  That sense of a powerful force from within that can fill one with energy and ideas and lose track of time is at work in all of the stories above.  It is not the only ingredient to having a successful business, but I believe it is an essential one.  We need to be able to geek out about what we do, to go on at length about it.  Hopefully we can do so in an engaging way, but we need to be able to lose a bit of self-consciousness to be able to focus properly on our patients, our work, and our business.

Frequently I consult with therapists who come to me because they want to grow their practice.  A few of them say that, but what they really mean is that they want to make more money and work less.  That is not in itself a bad thing, but for some it is an attempt at compromise.  For they have grown tired or disinterested in what they are doing.  They feel trapped in their work, not interested in it.  They are afraid that they are too old to change, or don’t have anything else they can do.  Some dream about a time they’ll retire and write a novel.  But for now they are consigned to sit silently and voicelessly in their office.  They grow bored and resentful of their patients, who if they are lucky, escape.  This vicious cycle can go on for years.

The same holds for supervision.  I have heard from a lot of supervisees about supervisions where it’s all about the paperwork, or the liability, or the billable hours.  I’ve heard supervisors lament how they don’t have time to focus on talking about the dynamics of therapies, as if that was “extra” stuff!  My experience is that these comments are voiced midway or at the end of a progression towards burnout.  First the supervisor feels overwhelmed by the “musts” of paperwork and filing 51As, and then the supervision shifts to only being about those.  Next, the supervision gets defined as merely being about that, so that the supervisee sees the supervisor rushing down the hall or on the phone, pausing to ask, “Anything we need to talk about?”  If there is no crisis the student feels pressured and becomes trained to say no, there isn’t.  And now that supervision is only about crises and paperwork, it becomes something everyone wants to avoid because it is boring, lifeless.  There is no enthusiasm.

I would suggest this is ultimately a setup for malpractice.  Supervisees trust supervisors who seem interested in them.  Over and over I have heard that supervisees have a hard time connecting or trusting supervisors who are “just business,” or cheerleaders.  Yes, supervisees don’t want a supervisor who lets them talk for an hour and then says, “sounds like you handled that well.”  This bears saying, because sometimes we unconsciously or consciously try to substitute affirmation for engagement and interest.  If you’re a supervisor, don’t do it, because your supervisees can smell it a mile away.  If you’re vacant, they know it.  If you are filled with the spirit of interest, they know that as well.

I’ve had colleagues tell me how clever I am to have found the niche I have, which drives me crazy frankly.  I didn’t choose to focus on technology, gaming and social media in therapy because I saw a vacuum.  I was just lucky that there was one.  I chose these areas of specialty because I am a total geek about them.  I could play or talk about video games for hours.  I can’t talk about Twitter or Google+ without getting animated.  I see their influence everywhere, read vociferously about them on my “free” time.  I wrote a book about it which I charge $2.99 for.  When asked to teach a class on clinical practice I declined, and said, “No, but I’ll write a syllabus and teach a class for social work and technology.”  Any of you who have taught at the graduate level know that teaching from a pre-existing syllabus is easier and less time-consuming than writing and proposing a pilot course.  But I was enthusiastic about the topic, which fueled my work ethic.  And this has set up a virtuous cycle, where I get more recommendations for reading or TED Talks than I can handle, and referrals to work with those patients.

I’d be lying if I said I didn’t hope someday to become famous or rich, but it is more likely that I will make a decent living and have a modest reputation.  Because as I said there are thousands, no millions of people out there who have talents and interests to share with the world.  I’m just grateful I got lucky enough to be one of the ones who got the chance to do it.

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The New Achievement Gap

 

Last night while watching the political debate, I was struck by how Mitt Romney tried to reassure the nation that his Medicare plan would not affect current retirees.  This is not an anti-Romney, or even political post, because I have heard other politicians, both Democratic and Republican, often use this reassurance when pitching a policy.  This won’t effect you, they say, only future generations.

Only future generations?  Is it possible that people really care that little about people outside our own little 80-year life span bubble?

Actually this post is going to be about education, how proud I am of my students, and how worried I am about the social work and mental health professions.

This year, Boston College made a step into the future of social work when they allowed me to propose and teach the first graduate social work class on Social Work Practice and Technology.  It was a leap of faith for the faculty and administration, and one not lost on me.  A few weeks into the class I bumped into a colleague who sat on the committee to approve the course.  She asked how the class is going, and when I updated her she said, “honestly, when we were reading your syllabus we didn’t understand half of what you were talking about, but I said ‘let Langlois teach it, if anyone can do it he can.'”

Very flattering, but more importantly an example of a social work program taking a leap of faith into educating 21st century social workers.  Are you paying attention, Deans of other social work schools?

But although I am proud of BC and myself for this, I’m even more proud of the students and how they are doing in our class!  They’re starting blogs and commenting on each others, researching and test driving smartphone Apps for possible clinical benefit, and venturing into a class which will be conducted today in World of Warcraft.  In our discussions they are raising thoughtful comments and challenging my technophilia as much as their technophobia.

At the same time, I am being reminded of the mistake older clinicians often make when we assume that all “young people” know how to use technology.  This is an impossibly blanket and uniform statement to make about the diverse group of social work students today.  Many grad students have avoided smartphones, dislike Twitter, and think of blogging as solo and literary rather than multimedia and interactive.  But the speed at which they are learning and innovating is impressive!

So here is the new Achievement Gap, or Achievement Gaps as I see them:

1. The Gap between current students and continuing education.

This class was filled up on its first run, which contrasts sharply with workshops I often try to do with colleagues for professional development. Too many older clinicians are thinking they can still “opt out” of learning about things like social media, video games, and internet technologies.  They’re the Romneys of the social work world, reassuring themselves that technology changes will not effect their business or the quality of the work they do.  And perhaps just as bad, they are leaving it to the younger generation to learn on their own.

This achievement gap is troubling for many reasons, which brings me to:

2. The Gap between knowing how to use technology technically and how to use it clinically and ethically.

Even if we were to overlook the ageism in the assumption that “young folks know all about the new technologies,” it simply is not true.  Young people, and technology itself, are too diverse for that.  Not all grad students have had the same access to technology, the same aptitude or interest, or time to keep up with the proliferation of new technologies.  And even if they did, there is a vast difference between knowing how to use Twitter mechanically and how (or if) to use it as a clinician.

For learning how to be a clinician our students have always looked to our faculty and supervisors for direction.  From what I have heard over the past several years, the response students get to technology-related questions is usually dismissal or fear.  This is reflected in our profession’s consistent focus on technology as an ethical issue rather than as a modality for treatment.  Technology workshops pay lip service to how technology can provide us with new and exciting innovations, but then skip over how to actually do that and focus on the ethical concerns.  Our profession has bought into the moral panic around the internet by making it into solely an ethical topic almost all the time.

In the search of graduate school curricula, I found only one course on the graduate level that addressed technology, perhaps not surprisingly at UT Austin.  The focus however was much more on IT for informatics and case management than clincial social work.

According to the Council for Social Work Education‘s latest report, there are over 213 MSW programs in the US.  Of those reporting information, the indication is that 85,290 full-time and 26,129 part-time social work students are enrolled currently.  That’s 111,419 students.  Of these students, 20 will graduate this year with advanced clinical training on utilizing online technologies and social media.

That’s an Achievement Gap.  That’s scary.

Look, no one is saying that grad schools and agencies, faculty and supervisors, are in an easy position.  We are being called on to teach future professionals knowledge that we often don’t have a sufficient grasp on ourselves.  But that’s a call to action, not a call to resigning that knowledge to be the responsibility of some future generation, or worse the students who pay us thousands of dollars to prepare them for social work in the 21st Century.  This is an epic fail, and one I hope graduate schools remedy quickly.

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Contributing

 
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Bio Breaks

 

If you’re a therapist looking to join a group of innovative colleagues for supervision, you may want to take advantage of this.  Like this post? There’s more where that came from, for only $2.99 you can buy my book. I can rant in person too, check out the Press Kit for Public Speaking info.  Subscribe to the Epic Newsletter!

What Back to School Could Mean

This past week, over 70 million students from Pre-K to PhD went back to school in the United States.  Of those, an estimated 1 million students are homeless, an all-time high.  And this past week, many of us went back to school ourselves to teach these folks.  Maybe you have a adjunct position, or maybe you are supervising an intern, or maybe you are a school counselor or work at a university health service.

It has never seemed more urgent to me then now that we help people get the educations they desire and work toward.  Our country has been struggling immensely over the past several years with fiscal crashes, growing gaps between the upper, middle and working classes, and the sense of hopelessness and pessimism that accompany them.  When 1 million children are homeless in one of the 10 richest countries in the world, there is a lot of change needed.

Education should be fueled by optimism even though it always begins in failure.  By that I mean that we start off by not knowing stuff, and hoping to change that.  If we all knew how to read, write and think critically innately, we’d never need to go to school.  We begin not-knowing, but, and this is what is amazing, hard-wired to learn things.  We are wired to attach to caregivers, acquire language, and make meaning of the world.  And we all have the ability to have ideas.

Recently there has been a lot of useful commentary on how we need to get better at failing, in order to be able to innovate.  That is true, and it is only half the story.  To be able to innovate, we need to be willing to risk and tolerate failure, true.  But just as importantly, we need to allow for the possibility that we could contribute something important and transformative to the world as well.

Recently I was talking with a group of my graduate students, and I asked them to be honest with me and raise their hand if they thought they could get an A in my class.  I was heartened to see that 3/4 of class raised their hands.  Then I said, “Now raise your hand if you believe that you could have an idea in this class that could change the world.”

One student raised their hand.  It was a poignant moment for me, and I suspect many of them.

What has happened to our educational system and values that we teach people to expect they can get an A, but not come up with an idea that can change the world?

I do not fault the students at ALL for this, because I think they have been taught this pessimism by our system.  SATs and standardized tests are the ways we grant access to more educational privilege in the U.S., but numbers don’t allow for the reality that everyone has the ability to ideate, to come up with a new thought that could change the world in small and large ways.  And students are given or not given financial support based on numbers, which at best only indicate potential, the potential in many ways to know what has already been known, rather than the ability to discover the unknown.  These numbers become a driving concern to parents and children, to teachers and students 0f all ages.

Many of the students you are working with are starting the year feeling defeated already.  I remember a talk I gave a while back to students on academic probation at a community college, in the last chance class they had to pass in order to continue.  Every one of them played and enjoyed some sort of video game, and I asked them why they were willing to try and fail repeatedly with video games when they were having such reluctance to try and fail at school?

One student raised his hand and answered, “because with a video game, I might win.”

What a damning indictment of the educational environment we are shaping people’s hearts and minds in.  And yet, by the end of that class every one of the students had spoken, had put forth an idea of their own which brought us as a group further.

Recently, I have been playing a new MMO called Guild Wars 2 and I am finding it very timely for the back to school season.  Although I have played WoW for years and have leveled characters up to 85 there, suddenly I find myself thrown into a new world.  There is a completely unexplored map, a new economy to master, the game mechanics and character classes just different enough to make my keyboard skills rusty.  I didn’t have a clue what was going on until I hit level 5 or 6, when suddenly I began to “get it.”  The big question I have for you is, what kept me going to level 5?

I suspect the answer is that video games like GW2 create an optimistic world, where the possibility of success and creating something new is a distinct one.  I kept trying in places where I got stuck because I knew both that failure was a possibility but so was success.  I also had the opportunity to play the beta version, where we were always being asked by the game designers for our impressions and ideas.  Many of these ideas have been incorporated into the later iterations of games like GW2, WoW, and Minecraft.  These ideas have literally changed the worlds of these games.

What if we looked at our classrooms and studies more like a beta test?  What if we allowed for the possibility that each of us, any of us, could have an idea that changes the world?  What kind of learning and character building would that environment produce?

I highly doubt that if aliens were to visit our planet thousands of years from now that they would be impressed with anyone’s GPA.  I doubt that they’d sift through the ashes of a civilization to see its test results.  They might note the high levels of anxiety and rhetoric in the 21st century speeches on education reform though.

If you are a student reading this I hope you will take this to heart:  I believe that you are capable of coming up with an idea that could change the world.  If you are a teacher I hope you’ll fight to keep your classroom a laboratory of innovation or a beta test rather than crank out widgets of standardized educational achievement.  If you are a therapist I hope you will help support your patients and their families to maintain a sense of their capability and optimism.  If you are a parent I hope you will remember that your children’s willingness to take risks and find interests in the world may not always match your own or the status quo and that that is a good thing.

Someone, many someones, somewhere, many somewheres out there, a world-changing idea is about to happen.  Let’s not miss it.

 

If you’re a therapist looking to join a group of innovative colleagues for supervision, you may want to take advantage of this.  Like this post? There’s more where that came from, for only $2.99 you can buy my book. I can rant in person too, check out the Press Kit for Public Speaking info.  Subscribe to the Epic Newsletter!

Minecraft & The Uncanny, Part 2

This is the second of a two part series on Minecraft.  Up until now you could only read it if you bought my book, but I am posting it here to give you a sense of what the book is like.  You can buy it here.  More importantly, I’m hoping you will find the topic interesting enough to vote for my presentation proposal on Minecraft & Mindfulness for SXSW this year.  You can do that here.

In Minecraft, nothing is present-at-hand, at least initially, until you realize that the ground you are running on or the mountain you are climbing aren’t just that, they are materials.  You can dig up stone to make a furnace, then bake bricks out of clay, build a house and so on.  The world gradually becomes ready-to-hand.

There is no avoiding the sense of throwness when you begin playing Minecraft.  It comes with very few directions, although there is plenty of info on the web to be had.  The downloadable beta allows you to play single and multi-player, with the single being a good way to practice the basic mechanics.  The multiplayer version opens up a whole new vista.

The multiplayer game is hosted on individual servers all over the world, some of which you can log into for free, others for a small fee.  Once logged in, the virtual world is a huge massively multiplayer sandbox, which can be a very social experience.  The cooperative building in some of these worlds is incredible.  My first journey to a server in France threw me into a world which included a vast underground city beneath a dome of molten lava.  Players are allowed to explore the world, and at a certain distance from their neighbors mine, farm and build.  Like Second Life, you can port to various places on the server, and encounter anything ranging from a Waterslide Park to a model of Hyrule, all built out of the game materials by the players.

Once in the multiplayer world, the social element of the game can become compelling.  People on chat are offering to sell gold ingots, suits of armor they crafted, or tracts of land they have developed, for both in-game and out of game monies.  You can have as much or as little to do with that as you like, and you can teleport to far-off corners of the map if you want to build and play in undeveloped lands.

In its simple mechanics, Minecraft allows us to glimpse the uncanny experience that I would suggest all video games have.  Video games are a unique art form in that they are both interactive and aesthetic by nature.  In fact they are far more stimulating and less anergic than watching television, and stimulate more regions of the brain.

Video games allow us to experience our throwness in a new world, and the animistic state of being inherent in the uncanny. We are never completely at home in the world of the game, although the game may become more familiar over time (or not, in the case of the indie game Limbo.)  We are always just visiting, strangers in a strange land.  But within the game world, mana and magic are also real, and our thoughts and strategies can quickly and permanently change the world.

Psychotherapy is in many ways, another sandbox game.  There really is no way to win in it.  The office becomes a setting for a potential space that can be shaped and altered by the patient and something new created.  Psychotherapy is also an uncanny space, one that resembles the world outside the office and yet does not.  It is a place for “everything that ought to have remained … secret and hidden but has come to light.”  Within that space, the patient experiences hauntings by ghostly relationships from the past, encounters the internal monsters of the drives, and explores the wishes behind their secret injurious powers.  Unexplored and avoided, these have calcified into symptoms, and the anxious, exciting, process of therapy helps the patient break down that calcification for a more flexible psyche.

Any child or gamer knows that play is a serious and dangerous business.  There is always the risk of annihilation, and no place worth going to doesn’t have its hazards.  But there are great treasures to be found in the game.  Further, the emotional and intellectual changes encountered within the game can then be taken out of it into the daily life of the gamer.  This is one of the reasons that video games are so compelling.  Why else would people spend hours making houses out of pixel bricks?

Both psychotherapy and video games create very real thought and feeling states in people, and that is part of their curative power.  In this book I hope I have shown that they can restore a sense of purpose and achievement that our patients have lost.  I have discussed how they can help people stay connected with others over great distances in times of duress, help us feel the sense of achievement necessary to learn and change behaviors, and explore aspects of their personalities that may be less easily seen or developed in their daily lives.  I have also explored how we can use the experience and metaphors from video games with patients to help them understand ego defenses, communication patterns and strategies that impact their relationships, and apply game mechanics to their lives to change them.  I have tried to discuss the stigmatization of gamers and technology in terms of diversity, in particular social class.  Finally, I hope I have shown how therapists can apply the principles from video games and gamification to impact both their clinical work and business skills.

All of this pales in comparison to doing the actual work, and by this I mean two things.  The first and most obvious one is the practice of psychotherapy.  Theory is a necessary but insufficient precursor to clinical practice and healing.  The second piece of actual work will be for the therapist to begin playing some video games.  Reading is not the same as doing, and it is only by entering the uncanny and enriching world of the video game that therapists can hope to truly understand them.  Never has play been more important in our work, and never has understanding video games been more urgent in healing the world.  To do so we need to rethink our attitudes and reconsider our biases towards gaming and technology.

It’s time to reset.

Gamer Therapist is on vacation, so we’ll see you in two weeks!  In the meantime, please vote for our minecraft panel at SXSW!

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Post to a Young Therapist

I’m a big believer in twofers.  When you run your own business, twofers are essential.  So when I get several emails about a topic I try to craft a post in response.  Recently I have been getting emails from many therapists or therapists in training who want advice on how to pursue a career as a gamer therapist.  Many of them grew up playing video games and have a lot more comfort and familiarity with them than their therapists who have been around for a bit.

Take Claire for example, who has graciously allowed me to share an excerpt from her email to me:

For most of my life, both video games and service to others have been passions of mine. I’ve recently been working at a game company in XYZ, and have been immersed in the gaming culture more than ever. The more I see it (and experience it first-hand) the more I see a need for therapists who can address the issues so many gamers face as a result of their passion.

Before today, I had no idea if anyone had pioneered this field of study, of if there was even a place for it. And then I found you. A quick perusal of your website tells me that you and I are very much aligned in our beliefs about how games affect us, and why they matter. Seeing that you have crafted this job for yourself inspires me to look further into the possibility of knitting together these passions of mine.

Note the use of the word “passion” here.  I hear from these younger folks how their interest and curiosity around video games and technology in general is met with skepticism and often hostility.  Supervisors turn into lawyers before their very eyes and begin every conversation about technology with the words “HIPAA” and “liability.”  The only question asked in the exploration of patient’s video game is “how many hours are they on the computer?”

Part of the problem with this disconnect is that many up and coming therapists become inadvertently ashamed of the fact that they are gamers themselves.  The implicit or explicit pathologizing of video games and tech use shapes the behavior and expectations about whether discussing gaming, or even using it as an intervention, stops before it begins.

Those of us who have been in the field for a while can often become set in our ways.  We can act as if education and the workplace haven’t changed much since we started our practice.  Insulated in our office and routine, we stick with the phone, maybe email, and play therapy games that have changed little since the 70s.  With this stance we are not prepared to work with patients in the 21st century, let alone supervise 21st century trainees.

If you are training to be a therapist, here’s what I recommend if you want to be a gamer therapist:

1. Start from Within

Repeat after me, “It is okay to experience excitement and enjoyment when I am working with patients.”  Somewhere along the line our graduate programs have begun to give you the message that you are supposed to be an evidence-based automaton with little emotional investment in treatment.  I have had students who have heard dozens of times in their training ideas like “emotional detachment,” and “inappropriate boundaries;” yet not once has anyone talked to them about feeling excited and enjoyment in their sessions.  Even trainees doing play therapy express guilt or fear about getting “caught up” in the play.  You’d think we were supposed to spend our entire careers with dull, depressing people!  Allowing for a range of emotional experience with patients means the whole range, including excitement and fun.  So if you are going to be a gamer therapist, start building your capacity to enjoy yourself in sessions.

2.  Create A Gamer-Affirmative Environment

Did you know that research has suggested that 1 out of 4 comic book readers are age 65 or older?  Yet how many offices have comic books for their adult patients alongside People and Time?  The same is true for video games.  Geeking up your office and waiting room sends the message that you don’t equate video games or technology with “toys.”  In my waiting room I don’t have comic books currently, but I do have Wired magazine and titles devoted to video games.  Many conversations have begun as a result.  I also have a Deathwing statue and other game-related memorabilia.  Recently someone saw a Post-It I had with the word Katamari on it.  I had made a note of the game to remind myself to check it out.  That Post-It was all it took to begin a very excited and meaningful conversation about the game (which has a free App, by the way.)  The smallest changes to your office can convey that you are interested.

3. Try (and I mean play) lots of different video games

This is the fun part, usually.  I have the major game platforms and am always trying one or two new games a week.  If a patient mentions a game in a session, I make a note to try it ASAP if I haven’t already.  Sometimes this requires discipline, because like most people I don’t like every sort of game.  But each game I test out helps me understand the patient better.

4. Have video games in your office

I have always had handheld video game consoles in my office, but in addition I have an XBox 360 as well.  I don’t think you can be doing contemporary play therapy well without it.

5. Disclose that you play video games

The fact that you have game consoles probably implies this a bit, but let’s be explicit. Regardless of age, 64% of Americans play video games, and the percentage is much higher under 40.  So if you have played video games, disclose that you have.  If you have a supervisor who sees that disclosure as more akin to “I smoked pot as a teen” than “Yes, I saw Star Wars” run away.  Video games are an art form not a controlled substance, and there is a big difference between those two conversations.

6. That said, be on the lookout for countertransference.

Whether you like or hate, play or avoid, video games, you need to be mindful of the reasons why and when you talk about aspects of it.  If your patient is telling you that they managed to fish up the giant sea turtle in WoW, it is an empathic failure to say, “Yeah I got that last week, isn’t it cool,” rather than to reflect to them what that says about their persistence and discipline.  Note any feelings of competition you have (or don’t have) and wonder about it.

7. Get good supervision, even if you have to pay for it privately.

One of the downsides of licensure having a (in MA) 2 year post-graduate supervision requirement before you get your independent license is that it inadvertently sends the message to fledgling clinicians that after two years you don’t need it any more.  That is not true.  I encourage new therapists to consider ongoing supervision of some sort to be a business expense to build right into your practice.  I had the opportunity to have weekly supervision for free at my workplace for 12 years.  That sort of job benefit has gone the way of the milkman in many places today.  This means you’ll need to buy some.

If you buy private supervision, remember that it is a different experience from your earlier or agency experiences with it.  This is not your boss, you are hiring them.  Hiring people means interviewing them, and screening them for fit.  If they are technophobic they are not going to be a good fit for a gamer therapist, so it is important to let them know your pro-technology and gaming stance from the beginning.

If you are interested in participating in a small group supervision experience, you may want to check out the Supervision Package I’ll be offering this fall.  You can find out more about it here.

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Tower Defense & Executive Functioning

Some of the most important tasks the human brain performs are known as the executive functions.  According to the National Center for Learning Disabilities, executive function is “a set of mental processes that helps connect past experience with present action. People use it to perform activities such as planning, organizing, strategizing, paying attention to and remembering details, and managing time and space.”  As such, the executive functions are crucial to the learning process over the life cycle.

Like many phenomenon in mental health, executive functions were focused on initially in regards to populations that had some deficits in them.  With the advent and prevalence of the diagnosis of ADHD, as well as the study of learning and learning disabilities, educators and therapists began to become familiar with a concept that had previously been of most interest to neuroscientists. We still tend to think of executive functioning from a pathology-based approach, only paying attention to how they work when they don’t work.

The truth is everyone has executive functions, which are a combination of nature and nurture, and can develop well into adulthood.  They can also deteriorate for a variety of reasons, from traumatic brain injury to Alzheimer’s disease.  And there is a body of research which suggests that mental and physical exercise can help maintain, if not improve our executive functions as we age.  Not surprisingly, as the Baby Boomers age, interest and research grows in this area.  At both ends of the life cycle, our focus on the executive functions are widening beyond pathology to the optimal environments for human learning.  How might we get better at planning, attending, strategizing, and managing time and space?

My suggestion:  Start playing more tower defense games.

Tower defense is a particular genre of video games, one which in general focuses on on preventing the progress of an enemy army across a map.  This is done by the use of towers which have varying abilities, costs to build, and points earned from downing enemies.  You don’t necessarily need to have towers in the game:  Plants Vs. Zombies for example is an example of a tower defense game where the plants are the equivalent of towers, with special abilities used to defend against the march of those pesky undead across the lawn.

More recently I have been fascinated with one of the latest iterations of tower defense games on the iPad, Kingdom Rush.  You start out with a variety of maps and coins for building.  You can use one of 4 basic tower types.  There are barracks which have soldiers who can fight and slow down the invaders.  There are artillery towers which drop bobs for an area wide (AOE) damage.  There are marksman towers which target individuals and fire arrows or guns.  Finally, there are magician towers with wizards firing spells of various types.

Each invading monster has different strengths and vulnerabilities, which are discovered by trying out different towers and noting their effects.  As the invading army is always moving forward in waves, the time element requires you to plan which towers to build first, where to place them, and what upgrades to focus on.  To do this requires a tremendous amount of strategy, organization and time management.  You also need to make decisions, including how long to delay gratification.  The more powerful towers require you to save up many more coins to buy them.  Upgrades that you can select from a talent tree add another layer of choice and complexity.

In short, to succeed in Kingdom Rush you need to have good executive functions.  It isn’t enough to have good hand/eye coordination or reaction time.  You need to be able to learn from your past experiences, and often switch strategies midway through the game.  You need to recall which towers are best for different situations and monsters.  There is a map to be managed in space and a marching army and builders to manage in time.  You need to recognize both immediate feedback and notice trends.  And there are multiple towers and units to keep track of.

The more I play Kingdom Rush, the more struck I am by how many if not all of my executive functions are required to succeed.  I can see where using this game could be both a useful assessment tool and intervention for deficits in EF.  It also has reminded me how necessary executive functions are in terms of managing money as well.  The ability to recall prices, to budget and pace spending, and set up investments that accrue value over time–all these economic experiences are embodied in the game.

Speaking of economy, you can try this game for free if you have a computer in your office or classroom here.  And you can buy it for a whopping $2.99 for your iPad.  Check it out, and see if you agree that it might be a fun, feedback rich way to challenge your executive functions.

 

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21st Century (Psycho)education

Whether you’re a psychotherapist, an educator or a parent, sooner or later you will be involved in the facilitation of growth through learning.  The bad news is that most of us were educated in the 20th century, when education was largely modeled on the 19th century.  The view of literacy then was narrower, standardized and often monolithic.  The good news is that technology today can help us invigorate learning as never before, often by using the mechanics or design of video games and social media.

Before we press on, it is time to choose your own adventure!  I encourage you to ask yourself and answer this question: Is education inevitably like a daily spoonful of cod liver oil?  That is, do I believe that it is something that is routine, unavoidably unpleasant the people need to just suck it up and deal with?

If you answered yes, click here to stop reading this post and go to Mordor, where you can play a free MUD with other denizens of gloom and doom.

If you answered no, read on to find some examples of how simple game mechanics can revolutionize a curriculum.

1. Game Patches

Game patches are supplementary, downloadable game content that patches into existing games to either fix bugs or introduce new content into existing games.  One example was the famous Burning Crusade from World of Warcraft, which added another world of play, new races to create characters as, flying, and many new quests to challenge players.  More recently, Minecraft added patches to include jungles (1.2,) fixed multiple crashes (1.2.4,) and made cats more impatient and eager to sit on things (1.2.5.)  Much of the patch content comes from user experience comments, and players often know and eagerly await for patches for weeks in advance of their arrival.

Introducing content into classroom settings can benefit from this approach.  First off, polling students during subject matter about what aspects of what they are learning would they like to know more about?  What ways can learning or behavioral problems be debugged?  For example, elementary school teachers can hype up the class before rolling out Grade 3.5, at the halfway mark of the year, and include in this patch a total restructure of seating plans, allowing new class configurations and addressing problems in a way that starts to be both expected and exciting.

In terms of curriculum, from kindergarten to college, most educators have some lesson plan, and previewing content of upcoming lessons can generate interest and engagement.  This can range from creating a funny trailer on YouTube with teasers for the next lesson, to releasing hints about upcoming problems and subject matter.  This can include contests to name upcoming characters, for example the characters involved in mathematical word problems, or residents of new areas about to be unlocked and explored in geography.

In school-based and outpatient therapy groups, where is often a psychoeducation component, group leaders can initiate a countdown before patching new content or welcoming new group members into the group.  For process-oriented groups, members can be invited to debug and modify the design of the group to deal with challenges or conflicts in the group.  I remember a really interesting version of this that a colleague of mine went through in her internship.  We were at an outpatient mental health clinic, and although it was not languaged as a patch, her co-leader had her join the group for the first several weeks as a participant-observer.  She attended the first 4 groups without speaking, and as week five approached there was much discussion and projection from other members about what she would say when she finally spoke.  She was in essence the new content “patched” into the existing group, which introduced change, and new transference while maintaining some group stability and continuity.

2. Talent Trees

If we can just get beyond the tendency towards and linear thinking in curriculum, I am convinced that this intervention could be extremely effective.  First, for those of you who are unfamiliar with the idea of a talent tree, here’s an example:

 

In many games, players have some choices about how to specialize in the area of talents.  As they progress through levels, they acquire talent points to spend on unlocking different talents.  So if an educator can be flexible in the order of learning certain topics, students can choose to specialize in learning something first or second.  Let’s take Literature, would you like to be an Arcane Satirist, Epic Voyager, or specialize in Bloodmagic Murder.  If you want to progress through the first talent tree, you will need to read and complete assignments involving Gulliver’s Travels, the second, The Odyssey, and the third MacBeth.

If you are doing psychotherapy we already have a version of this, it’s called DBT.  In it people focus on unlocking talent points in the trees of mindfulness, interpersonal effectiveness, emotion regulation and distress tolerance.  Which does the patient feel that they would benefit from working on first?  Which do you recommend?  For adolescents especially, this can make the difference between engaging in treatment and just another boring worksheet.

Other ways to use talent trees effectively can include:  Helping gamer couples unlock skills to better communicate or improve their sex lives; helping parents focus on and prioritize specific behaviors to work on with their children; a template for an emergent adult’s first career search; and systematic desensitization of a phobia.

These are just two ways that we can use both the technology and concepts behind it effect change therapeutically and educationally.  Can you think of others?

 

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“On the Computer.”

You can often tell a lot about how people value (or don’t) something by a preposition.  It is very subtle, but I have come to find that “on” in particular is a problematic one.  People are on drugs, on parole, etc.

Often I hear parents or clinicians talk about how much time Janey spends “on” the computer, or on Xbox, Playstation, etc.  I also hear about how much time Eric is “on” Facebook, 4Chan, etc.  There is always a negative connotation to this.  I have never heard someone complain about how much time someone spends “on” the book, on the gym, on the dance, etc.

This may seem like a small detail, but why are the recent technologies, things that we are “on?”  Is it because the web and video games were seen as analagous to the phone and television in their early days?  I don’t think that is the whole story.  Maybe we view technology as still cold and alien so we don’t curl up “with” a video game like we would a good book.  I can’t quite put my finger on it, but there seems to be something perjorative about being on the computer or social media that just isn’t presented the same ways with the older more familiar literacies and arts in our culture.

But my biggest problem with this preposition is that it allows important clinical data to hide in plain site of the clinician: Our patient telling us that they are on the computer at night tells us next to nothing about what they are doing with it.  The same goes for Facebook or Tumblr.  When someone tells you in your office that they spent several hours on Facebook, do you ask them what they are doing on it?

These question matter, because as technology has become more advanced and mainstream the computer can be used to access many things: information, play, sexual excitement, art, all these and more are a mere mouse-click away.  And when we are told someone is on the computer, I’d suggest we are only one question away from a panoramic window into their conscious and unconscious life.

So to with Facebook.  In 2012 being on Facebook can mean any or all of these: reading, status updating, letter-writing, IMing, game-playing, listening to music, political activism, remembering a birthday, seeing photos of grandchildren, searching content, RSVPing to a party, planning a party, and yes, even having a party.  Many relational things are happening on social media, real connections are beginning, middling and ending on it as you read this.

One good check for you is to pause and ask yourself what you think they are doing on Facebook.  I am often amazed at how disinterested therapists appear to be about that.  I have heard things at workshops like, “I don’t want to have anything to do with Facebook.”  End of subject.  Well, the statistics are accurate, more than half of the people in the US are “on” Facebook.  And I personally think when  half the population is involved in something, we can’t afford to be disinterested in it.  At best this dismissal of a patient’s interest is an empathic failure, at worst it is dangerous.

I believe more and more that we have an ethical duty to educate ourselves about social media sufficiently so that we can help our patients and our society move towards universal digital literacy.  We need to be able to help parents understand privacy settings, as well as challenge them not to think parenting has a privacy setting they can “park” their responsibility on.  We need to help schools help kids learn how to communicate online even as we educate them that cyberbullying is different than traditional bullying, and in fact often more indicative of a moral panic about technology rather than an “epidemic.”  We need to help extend our support of the individual’s reality testing to the online world, or as Howard Rheingold says, help them develop their “crap detector.”

Additionally, we need to become more nuanced in our understanding of what can be done or experienced “on” the computer, in order to understand how to keep psychology and social work relevant.  We need to include video games in play therapy, use Pinterest for DBT skills building, YouTube to provide transitional objects or guided imagery.  These do not have to dilute traditional psychotherapy, but our reluctance to use them does.  As a psychodynamic practitioner I note how we are falling behind our more behaviorally-oriented colleagues in using technology.  Technology has always had its place in psychoanalytic theory, as metaphor, analogy, and the technology of literacy to help us make sense of human experience.  Technology aids and abets the ego defenses, creates another arena for object relations to play out, and provides selfobject functions.

We are not just “on” the computer or Facebook, our relationship with them and their’s with us is much more complicated than that.  If by on we are talking about position, we’ve got the position all wrong.  “On” implies perching on top of something, like a precipice.  We are within experiences of the computer and social media, the plunge has been taken and we are swimming in it.  Now we need to begin to figure out what that means.

 

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Unplanned Obsolescence: Rethinking Play Therapy

Recently I ordered a copy of Call Of Duty: Modern Warfare 3, which I plan to try this week.  As I have mentioned in a previous post, I am not easily interested by first-person shooters, but as a gamer-affirmative therapist I can’t let my low interest get in the way of educating myself.

I once calculated that by a conservative estimate I had played approximately 27,000 games of Uno in my decade working in a public school as a clinical social worker.  I drove around with a ton of board games and a sand tray as well.  I had learned the value of play therapy at the first placement I ever had as an intern, from Winnicott’s squiggle game to the infamous Talking, Feeling, Doing Game.  This is all a roundabout way of establishing my “street cred” for valuing play therapy.

Back then, I would go home from work, and many times play Legend of Zelda: Majora’s Mask on the Nintendo 64.  My roommate at the time liked to hang out with me while I played and we chatted about life, education (he was a teacher) and politics.  He also liked to imitate the fairy guide in the game, and would often cry out, “Listen!” and offer a couple of tips.

In all those years, it never occurred to me that I could have played those games at school if I’d had an office (and some years I did) or that there was a disconnect between what I was doing with the students (card playing) and what they were talking about (Nintendo, XBox, Playstation.)  I could hold a conversation with them about these things because I played them in my spare time, but the idea of playing them with my students didn’t register as, well, therapeutic.

I am not alone in this.  Many if not most play therapists are not inclined to play video games with their patients, and it is time to rethink this.  When 97% of the boys and 94% of the girls we work with play video games, it is no longer an outlier.  But there are a few fallacies which I think get in the way of play therapists integrating play therapy into the 21st century.

One I hear frequently is that video games don’t require imagination, or offer projections to explore.  But I think this is contempt prior to investigation for the most part.  The proliferation of video games is itself the best evidence that there is imagination going into each generation of games, which are produced by imaginative people who must have been able to develop their imagination in part through video games.  And we don’t start each session making our children build their own dolls and dollhouse from scratch.  We use available tools that do to an extent always structure and limit the imagination.  For example, why does the dollhouse have a pointy roof and two floors?  This is limiting, and in fact didn’t represent 90% of the urban population I worked with at all.  And few play therapists would avoid using Elmo puppets on the grounds that it limits the imagination of the child, even though Elmo is clearly an icon of popular culture.

In fact, play has often had its inception in the popular culture of the time.  We may take chess for granted now, but when it came into being it was a reflection of a medieval monarchy, with kings, queens, and bishops.  Yet play therapists often fall prey to nostalgia, if not luddism, and maintain that there are certain games and play that are relational and therapeutic, and others, usually the modern ones, are not.

This brings me to what I suspect is another reason we resist using video games in play therapy, which is the therapist’s fear of being incompetent or failing at the unfamiliar.  Years of training in a traditional educational model have taught us to silo down in our area of “expertise” as soon as we can.  We “major” in psychology or social work, go to graduate school for advanced specialization, and basically get to a point where we can work in a routine and structured environment.  For years we get in the habit of certain forms of play therapy: Candy Land, Chutes and Ladders, cards, chess, dollhouses and telephones.  These are easy and portable, but more importantly perhaps, we know how to play them, so we can not be “distracted” by the game, or lose by design if we want to build the kids self-esteem, and otherwise feel in control of the play situation.

It’s time we work through this resistance.  People can and do have conversations while they play video games, and video games are in themselves social media.  There are plenty of metaphors to explore in and after video gameplay.  Angry Birds is rife with themes of anger, different abilities, and protecting the innocent and defenseless.  Call of Duty can give rise to expression of competition, drives, and the hunger for destruction or cooperation.  And a recent (to me) favorite, Demon Souls, is a tone poem on isolation, yearning to connect, and persistence in the face of despair.

I’m sure I’ll get comments arguing that video games are inherently violent as well.  To which I would respond, just like Battleship and the card game War are inherently violent.  We have become insulated to the violence in them, and it may not have the graphic sophistication of video games.  But the next time you play Battleship ask yourself what you think happened to all the people on the battleships that sunk?  The game doesn’t come with little lifeboats, you’re drowning people.  Play therapy does not avoid violence in its expression.

Virginia Axline, one of the founders of modern play therapy, had 8 guiding principles for play therapists:

  1. The therapist must develop a warm, friendly relationship with the child, in which good rapport is established as soon as possible.
  2. The therapist accepts the child exactly as he is.
  3. The therapist establishes a feeling of permissiveness in the relationship so that the child feels free to express his feelings completely.
  4. The therapist is alert to recognise the feelings the child is expressing and reflects those feelings back to him in such a manner that he gains insight into his behaviour.
  5. The therapist maintains a deep respect for the child’s ability to resolve his own problems if given an opportunity to do so. The responsibility to make choices and to institute changes is the child’s.
  6. The therapist does not attempt to direct the child’s actions or conversation in any manner. The child leads the way; the therapist follows.
  7. The therapist does not attempt to hurry the therapy along. It is a gradual process and is recognised as such by the therapist.
  8. The therapist establishes only those limitations that are necessary to anchor the therapy to the world of reality and to make the child aware of his responsibility in the relationship.

 

Nowhere in there does it say, the therapist sticks with the tried and true games s/he grew up with.  To my colleagues who are ready to decry the death of the imagination and lesser play of video games, I think Axline said it best:  “The child leads the way: the therapist follows.”

Following in the 21st century means having Gameboys and Playstations in our repertoire.  If we don’t keep learning and using technology in our play therapy, we may find ourselves in a state of unplanned obsolesence.  Am I saying we should stop playing Jenga and Uno?  No.  But if our patients are looking for video games amongst the chess sets and dollhouses, perhaps they are telling us something we need to pay attention to.  Just because we don’t know how to play a game doesn’t exempt us from learning it.  And what a gift it can be for an adolescent to experience themselves as more competent and talented by an adult!  So many of them come to us having been labeled as “failed learners,” and we have the potential to help them experience themselves as successful teachers, of us.

Those of us working in agencies and schools need to resist the temptation whenever possible to use the excuse of needing to be mobile or budgetary constraints.  Video games are now as portable as a Nintendo DS PSVita or Smartphone.  And the price of a video game system is not so prohibitive as to be a given.  The real reason we often don’t advocate for video games at the agency or school is our own bias that they are somehow less valuable as therapeutic play media.

I anticipate that this will meet with resounding criticisms from the “play-is-going-to-hell-in-a-hand-basket” crowd, but I’m really interested in hearing from colleagues who have managed to successfully integrate video games into their play therapy.  What are your success stories?  What have been some challenges you’ve had to overcome?  Do you schedule online play sessions?  How do you manage the noise in an office suite?  I’m really interested in your experiences.

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Harriet At Forty-Eight