http://youtu.be/pWQIbIkOVtY
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Psychotherapy Meets the 21st Century
http://youtu.be/pWQIbIkOVtY
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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?
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!
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.
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!
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.
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!
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!
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!
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!
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!
This is the first 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 1919 Freud wrote and published an article on “The Uncanny.” In it he described the concept of the uncanny as a specific type of fear something both strange and familiar. It is worth noting that the article begins with an investigation into aesthetics, something that was not usually done in the medical literature of Freud’s time. But Freud realized that there was something particularly aesthetic about the uncanny. It is an anxiety that both draws on the aesthetic, and from a distance also acquires an aesthetic quality itself. In fact, it could be argued that a whole genre of fiction, such as Lovecraft, embodies the aesthetic of the uncanny.
In German, the uncanny is unheimlich, which translates literally to the “unhomely” or “unhomelike.” Here homely has a double meaning. First homely is the quality of domesticity, the warm hearth of the house, down comforters, a cheery cottage coziness, etc. Second, heimlich refers to concealment, contained within the house’s domestic sphere, hidden from the public eyes of outside society.
Seen in this light, the uncanny or unheimlich is both alien and a revelation or an exposure. Freud quotes Schelling as saying that ‘“Unheimlich” is the name for everything that ought to have remained … secret and hidden but has come to light..’” Is it any wonder that Freud took up exploration of this concept, with all of its allusions to the unconscious, anxiety, and societal repression?
Freud also talks about the element of repetition in the uncanny, such as arriving at certain places we’ve been to before, or noticing the number 62 appearing throughout the day in a variety of places. This element of repetition gives rise to the sense that there is a pattern that we may not be aware of, which in turn makes the world suddenly seem both stranger and more imbued with meaning.
Freud goes on to discuss something gamers will be very familiar with, mana, although he discusses it from outside the framework of fantasy as a form of magical thinking that attributes powers to the neurotic overvaluation of their thought processes and their impact on reality. But the game world is within the realm of fantasy. Within that world, what Freud refers to as “the Apparent death and the re-animation of the dead” are fairly commonplace. The game world returns us in many ways to the animistic state of being, characterized by “the prompt fulfilment of wishes, with secret injurious powers and with the return of the dead.”
The uncanny also figures largely in the philosophy of Martin Heidegger, and is connected to the idea of man’s “throwness” into the world. Human beings want to feel at home in the world, but when they encounter the uncanny they experience themselves as thrown into it and apart from it. For Heidegger the unheimlich eradicates our sense of Being-at-home-in-the-World, but as it does so it reveals something about the World to us.
For Heidegger the World is also revealed to us (and we are revealed as well) by that which is ready-to-hand, something that has a meaning that connects us to the world. An example is a hammer, which we experience as imbued with meaning and value and inextricably linked to human being. We don’t think about the hammer, in fact the only time we are really conscious of it is when it isn’t working. A similar example is your car, if you reflect on it you will probably notice that you only really pay attention to your car as a concept when it isn’t working.
As opposed to ready-to-hand, present-at-hand refers to an uninvested, detached way of looking at something, one that takes us out of any sort of meaningful relationship. Its meaning may be unclear and unconnected with human being at all. If I ask you what you’d like to do with that round green and red thing, you’ll be confused. But if you see it as an apple, things will become much clearer. It probably isn’t a coincidence, by the way, that most depictions of Adam and Eve in the Garden of Eden show the fruit as an apple. Before the Fall, everything is ready-to-hand and imbued with meaning. Afterwards, in our thrown state, things become less clear, and more uncanny. Paradise has been lost.
Ninety years after Freud wrote “The Uncanny,” Markus “Notch” Persson created the game Minecraft. Minecraft is a sandbox type of video game, meaning that the world generated can be permanently changed by the player. Creativity and survival is the goal, and there is no way to “win” the game. The premise of the game is that your character is thrown into a vast world designed with 8-bit graphics (think early Nintendo) with only your bare hands. The game has a day and night cycle, and at night zombies, skeletons, and other monsters come out and will attack you if you are exposed.
Everything in the game world can be destroyed and broken down into elements that can be crafted if you have the right ingredients. At first you have fewer options, because destroying a tree with your hands takes more time than if you had an axe. But slowly you gather materials so that you can build things that in turn allow you to build more things, so that you can hopefully build a shelter before night falls.
The landscape of the world is randomly generated by the game, and remains saved if you are killed. Dig a hole in the ground and it will be there when you return from the dead and to the game. The graphics are not realistic, with the blocky edges of 8-bit design, which underscores the uncanny element of the world. The world is vast, and looks like the real world, and also doesn’t. Minecraft is not trying to trick you into thinking it looks like real life, in fact that is one of the things that makes it so immersive.
Part 2, next week.
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Many therapists looking to start or grow their private practice often wonder the same question when they are starting out: How do I get referrals? If you can tolerate a mild rant, I may have one answer for you.
Let’s look at this concern through a tried and true mental health paradigm. First, we take a symptom, and then we look at the underlying conflict that the symptom represents.
So what’s the symptom? That’s easy, head on over to LinkedIn and take a look at several profile pictures of colleagues. Go ahead, I’ll wait. What did you see? When I looked I saw some professional headshots, but more of the following:
If you want to generate referrals, this may be a problem. Some colleagues may have a different opinion or be too diplomatic to say this, but let me not mince words. If you don’t have a professional headshot it is doubtful I will refer to you. I don’t send people to waterfalls for psychotherapy. I suspect people wearing shades of paranoia or vampirism. I envy people who can ski much too much to ever want to help them grow their business. Cars in photos are either nicer than mine or too shabby, triggering too much judgment either way. And party-goers scare me. 😉
My experience as a consultant has been that these headshots are symptomatic of one of two scenarios:
1. You don’t take social media seriously. In this day and age, our potential patients want to see us before they see us. They often do their research by checking out our online presence. If you go on LinkedIn for example, you may find that several people viewed your profile this week. A picture is worth a thousand words. I have seen great head shots in black and white, or even avatars for online therapists, so it doesn’t have to be a standard color shot. But the way technology works now, whatever picture you choose will most likely attach to your emails, tweets, blog comments, posts, and feeds of all kinds. There are exceptions to this, like my colleague Social Jerk, who needs to maintain a tight hold on her anonymity to allow for her to create such creative and satiric posts about social work. But if you are not trying to be a satirist, but rather grow a therapy practice, this will not work for you. And if you’re on Twitter, please don’t be an egg. When I need to jettison followers to follow additional people, the eggs are often the first to go. Accept that social media is the point of professional first contact with your colleagues and customers. Take it seriously.
2. You don’t take yourself as a therapist and businessperson seriously. Anyone that has read this blog or chatted with me at a workshop can probably tell you that I am neither dour nor constantly serious. I certainly think there is a lot of room in our profession for humanity, play and creativity.
That said, we are in the business of providing treatment for serious concerns, working with people who have a range of predicaments. We assess for suicidality, psychosis and trauma. Your patients come to you with vulnerability and hope that you will help them create profound change, recovery and healing in their lives, maybe even help them stay alive. If you think that therapy is just two people in a room chatting, then by all means keep the beach picture.
To get a professional head shot requires investment of your time and money. It is a business expense. If you are unwilling to invest in a professional image to represent your business concern I suspect you are not ready to own and run a business. If you are unwilling to invest the time to look through your existing photographs and select one (if you have it) that presents a professional demeanor online then I suspect you are not ready to own and run a business.
Now I know that the term “professional” photo is vague and subjective. I am not saying that you need to be in a suit and tie. You can be a play therapist and have affect like my colleague Charlotte Reznik. But slapping up a blurry photo of you near a palm tree sends the message that you can’t be bothered to represent yourself or your brand. And in business we need to be concerned about our brands, even as therapists.
Look, I’m not saying these things to hurt your feelings. I really want you to succeed, and I know that there are a lot of people out there who need your help. That’s why I suggest that the photo is the symptom of an underlying issue, which is the difficulty to take either technology or your business seriously. If you have taken time and consulted with trusted colleagues and have come to the conclusion that “I want potential patients to see me as someone blurry whom they could go skiing with” is your brand, and that the head shot is a conscious and intentional image to brand yourself online than you have my blessing.
If not, get thee to a photographer.
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.
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.
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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.
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!
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