Every technology reveals the hand that shaped it.  The technology of the 21st Century is no exception:  Social Media has proliferated because human beings are inherently social creatures, even when that sociability takes on different forms.  And the explosion of access to information was detonated by our own curiosity.

For better or for worse (usually worse) our ability to engineer and zeal to use technology usually outstrips our ability to behave well with it, and in a large part I believe that this is what spurs on our refinement of it.  Listservs are a great example:  They allowed amazing access to online community through emails and postings, and they elevated the concept of “flame war” in comments to a new level.  Eventually, email and bulletin boards were insufficient to allow us to be sociable, and Web 2.0, with its emphasis on interactivity and real-time community was born.

And then Facebook, MySpace, Friendster and other social network platforms quickly outstripped the listserv and bulletin board.  The emphasis became on finding and connecting with old friends, acquiring new ones, and maintaining a steady if sometimes awkward flow of real-time announcements, status updates and feedback to them.  The online world expanded exponentially, and in fact that interactivity and information became overwhleming.

Which brings us to Google+.

For those of you who have not had the pleasure, Google+ is a new social networking platform (and in many ways much more than that) which has brought a new level of functionality to online social media.  Although it is still in beta, the number of people participating in the largest usability test in the history of the world is growing by leaps and bounds.  If your patients have not mentioned it, it is only a matter of time before they do, and that alone should be a good reason to learn to use it.  But in fact, Google+ has already begun to show me how valuable it may be in actual treatment.

So today I want to introduce you to two of the core concepts of Google+, Streams and Circles, and show you how each of these may present you and your patients with an arena to talk about psychological concerns and skills in therapy.

Circles

The Google+ system of circles is as powerful as it is flexible.  Whereas on Facebook you really had only one big group of people called your Friends, Google allows you to create and label various circles, such as “Friends,” “Colleagues,” and “Family.”

The interface let’s you drag the name and image of different people located on the top to one or more of the circles below.  When you mouse over the circle it expands to give you an idea of who you have put in it.  And if you drag a person to the grey and white circle on the far left, you can create a new circle, one which you label yourself.  For example, I have a circle for “Minions.”  I’ve always wanted minions.

This graphic representation of the way we can and often do categorize people in our life may allow our patients to visualize the decisions and boundaries they struggle with in real life.  This can be especially useful with patients on the autistic spectrum.  We can begin by empathizing with them when we upload our 1000 email contacts, and discover that we now have an overwhelming 1,000 individuals to make sense of.  Who goes where?  Is everyone a friend?  Can we put people in more than one circle?  Decide to take them out of one and into another, like say out of “acquaintance” and into “friend”?  What sort of circles might we want to create that Google+ didn’t give us?

People with Aspergers often have exceptional spatial reasoning, and can find mapping out relationships very helpful.  Now they have a dynamic way to do this, and a visual representation of how unruly and confusing social relationships can be.  Even though we can use this only as a powerful metaphor and coneptual tool, we could go even further.  Inviting a patient to bring in their laptop and taking a look at Google+ could be a helpful intervention.  We could help them explore and decide how to set up their own personal boundaries and affectional investment.

Or imagine for a second you are working on emotional regulation issues with a patient.  You can encourage them to create circles like “love them,” “Push my buttons,” “scary,” “feel sad,” and help them take a snapshot of their life at any given time to see who they want to put in each circle.  Do some people go in more than one circle of affect?  Do they notice that they are taking people in and out of circles frequently, or never?

Or imagine working with social phobia, and trying to help the patient brainstorm what activities they might want to try to invite someone to.  They can create circles like “Go to movies,” “Have dinner,” “Learn more about them,” and other options for various levels and types of engagement, and then they can sort people into those.  And all of a sudden they also have a visual list of who they can call when they are trying to socialize.

Last example, working with trauma and/or substance abuse.  Circles can be created for “Triggers me,” “Can call when I want a drink,” “My supports,” “self-care partners,” etc.  Then populate each with the people in their life, so they have a ready-made resource for when they are in crisis.  It also can be very illuminating to share and explore this in therapy, allowing you to make comments like, “what do you make of the fact that most of the people in your family circle are also in your triggers one, but not in the support one?  What do you think you could do about that?”

So these are just a few quick examples of how you can use the Circle concept of Google+ to understand your patients better, help them understand themselves better, and use social media to intervene in a variety of situations.

Streams

In Google+ circles go hand in hand with your Stream or Streams.  A stream is a stream of comments, updates, links to information, invitations, photos, video and other media, posted by people in your circles.  It is probably important to note here that similar to Twitter, you can invite people into your circle without their permission, but that doesn’t mean they will invite you back.  And you can set each circle to have different levels of access to your posts.  In other words, circles and streams together allow you to learn and set boundaries.  Here’s what a Stream can look like:

This is only the fraction of the incoming Stream, which gives you a sense of how multimedia, interactive, and possibly uninteresting some of it could be sometimes.  Much like Twitter, or like life.  If we had to pay attention to everyone all the time in the same way, we would become very fatigued.  Like our patients with ADHD, we would be overwhelmed despite our best attempts to understand at times.  Again, we can use this technology that our patients may be familiar with to begin to deepen our empathic attunement with them.  But it gets even more interesting.

If you look at the upper left-hand corner under Stream, you will see a list of your circles, in this case family, friends, acquaintances, etc.  Now if you click on any of those circles, the Stream changes.  Specifically, it changes to list only the posts from the people in any given circle clicked.  This synergy between circles and streams highlights not only the importance of privacy, but that focussing our attention is inherently a social as well as cognitive function.

Imagine working with an adolescent and reviewing their streams together.  What sorts of media, comments, and concerns are streaming through their lives at any given moment?  And what is the consequence of having 500 “friends” in their friend circle?  Do they feel intimate or able to attend to all of these friends?  Or are there some times that they may be more interested in attending to some friends than others?  If so, why?  Might it be time to start to rethink what it means to be a friend?  Is it ok to select who they attend to at certain times?  Do they really find the content they get from A interesting?  And if it is consistently uninteresting, does that say anything about their relationship?  Sorting through Streams to make sense of their world quickly becomes a talk about sorting through their values and their relationships.

For a second example, let’s return to the patient with ADHD.  Perhaps they could create circles for “School,” “Fun,” “Work,” “Family,” and sort people that way.  That way when they are doing work for school they can focus only on the Stream for the School Circle, which may contain links to papers, classmate comments, or lecture recordings from their professor.  If that stream starts to have too many other types of posts, maybe that is an indicator that someone is in the wrong circle, or that they need to only be in the “Fun” one until that paper is done.  Remember the circles are easily adjusted back and forth, so this is neither difficult or permanent to do.  But these types of decisions and focussing techniques may be crucial to staying on task.  (For those of you who might be ready to suggest that they not need to follow any Streams when they are studying, I encourage you to take a look with them at how much academic content and collaborative learning is done online before you rush to judgment.  It’s not always just “playing on the computer” now.)

Other ways that you can use Streams to help your patients therapeutically may come to mind if you reflect on the names of their circles.  Do they really want to follow the Stream of posts from their “Pushes My Buttons Circle?”  Maybe they’d rather tune into a steady Stream from their “Supports” circle instead?  And what might happen if they created a circle for “Intimates” that only contained people that touched them in deeply meaningful ways?  Could they still enjoy their “Friends” Stream, but switch to a “Skeleton Crew” one when they are needing to simplify their social life?

We make these decisions all the time, we just aren’t always conscious or overt about it.  And if we don’t make those decisions, we often suffer for it by overextending or stressing ourselves.  We need to have boundaries and filters.  We need to be able to focus and set limits and values.  These needs have begun to be more clearly revealed by the technology of Google+.  Knowing about that technology may improve our ability to treat our patients.