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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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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Boundaries and Health in the Digital Age

2017 saw an historic rise in women and men coming forward to speak out against sexual assault and harassment. Whether it was the #MeToo movement, news outlets, or Time’s naming the “Silence Breakers” Person of the Year, our society has felt a seismic shift in how we understand sexual misconduct.

A common misperception is that sexual harassment occurs in person between two people. In fact, boundary transgressions of this kind happen frequently between adolescents and adults who exclusively work with them “virtually.” Technologies such as social media, texting, video games and geosocial apps have allowed for greater connection and amplification in our lives. At the same time, with greater connection come new personal boundaries for both educators and the adolescents in their care.

Educators and counselors now find themselves inundated with daily examples and dilemmas: What do I do when a student brings me a nude text they received? When I overhear a YouTube video that is sexist or homophobic, how do I respond? Meanwhile, youth are trying to sort out unwanted attention on Facebook, demeaning chat while gaming, and humiliation on Snapchat resulting in school avoidance.

The possibility of turning technology off is no longer an option. Now we need to begin to recalibrate our thinking and teaching in light of it. Part of digital literacy and social emotional learning is the ways that we create and maintain respectful boundaries in learning communities. “Boundaries and Health in the Digital Age” is a project I’ve started to do just that.

I have worked with youth and their families for 25 years, and gained an understanding of them and the technologies they use. Through a combination of presentation and discussion tailored to your needs, I can provide education and support around a topic which is both charged and urgently needed. Far from being anti-technology, I’m helping agencies and learning communities appreciate and understand the power of the digital world to amplify harm AND healing. Talking, and more importantly, listening to youth, we CAN help them create and maintain healthy boundaries both online and in person.

As a Teaching Associate in Psychiatry at Harvard Medical School, I consult and educate on the topics of adolescence, technology and mental health. If you are interested in having me come work with you, email mike@mikelanglois.com for more information. If you want more information before you do that, check out my Public Speaking page for videos and reviews.

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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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

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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 Internet & Real Relationships


Today I was slicing some lemons for shish kabobs and so not surprisingly I began to think about social media, attachment and what constitutes an authentic relationship.

Authenticity was a key term when I was becoming a therapist in the mid nineties, and society in general.  Today, most people I have spoken to in the mental health profession would say our happiness in part depends on having authentic relationships with others.  Setting aside for a moment that we often talk about “authenticity” as if there is one monolithic thing that “everyone knows” it is, this belief in the connection between authentic relationships and happiness often gives psychotherapists, social workers and educators their moral imperative to discourage use of technology.  That’s where the lemons come in.

Ten years ago, I met my friend Jackie Dotson on the bulletin boards of Psychology Today.  These bulletin boards were designed for clinicians to have an online forum where they could discuss a range of issues, make referrals, and share ideas.  They were also a place where early-adopting clinicians stumbled and experimented, behaved badly, gossiped and misspoke, as we tried to make sense of emerging technologies.  I remember heated online conversations about whether the forums were private and “safe,” where people were startled to consider that anyone could cut and paste your confidential posts anywhere on the web.  People were emboldened or perhaps I should say “emoboldened” by the relative anonymity on the forum to say things that could be breathtaking in both their vulnerability and/or sadism.  It was the Wild West of mental health on the web.

My interactions with Jackie were few and far between when she and I were both active there.  It wasn’t until I moved on from the forums to spending more time on Facebook that I think we really began socializing more.  Perhaps it was because FB allowed for a flow of text and images, more seamless interaction, and chat.  Whatever the reason, over the past few years my life has intersected with Jackie more and more.  We have several mutual acquaintances from the PT forums, and a mutual friend with whom I went to college with.  I’m glad I friended her.

From 3,000 miles away, Jackie has crept into my online and emotional life with the secret code of affinity that could only be shared via social media.  We share a love of bone marrow as evidenced by our food pics, and she has forced me to rethink my stance in social media workshops I do where I used to announce to my audience, “Nobody wants to see your food.”  Our dark wit and banter is present more days than not in my FB feeds, I’ve even taken more of an interest in my local sports teams so I can insult hers.  In return she pretends to be a bigot on LGBT issues to bait me.  Although I’ve never told her explicitly, she has reassured me when I worried about how my picture looks online, and comforted me when my city suffered a terrorist attack.

And then last year she started sending me lemons.  Real lemons.

Jackie lives in CA, and has at least one prolific lemon tree.  Last year she offered to mail a box of them to anyone of her friends on Facebook for the price of shipping.  I jumped at the chance.  They arrived within days and were enjoyed by my family immensely.  So immensely, that when Jackie began posting pictures of budding trees this year, I grew quite impatient for them.  They arrived two weeks ago, and for the past two Sundays I have used them for cooking.  As I write this, there are chicken kabobs marinating in lemon and thyme for tonight.

Jackie and I have never sat down together for a heart to heart or face to face conversation, but we carry our connection to each other throughout our day with our smartphones.  In the decade that we have been in each others’ orbits, I suspect we have each known deep sadnesses that we haven’t spoken of to each other.  Yet I am convinced that if I ever chose to reach out to her that way it would be okay and vice verse.  Not all intimacy needs to be acted on.

That said, for two Sundays, as I have chopped and squeezed fresh lemons, I have thought of Jackie and smiled.  I have imagined her and our conversations as I move through my kitchen, while my brain alters levels of different neurochemicals and changes my affective state in ways that are real and comforting to me.

The stubborn adherence to imagining that technological use inherently diminishes our authenticity has been eroding the mental health field’s relationship with the people we work with for decades now.  Friends and colleagues of mine in the tech industry are consistently amazed that I still need to educate and advocate with my peers about this.  Our profession continues to act as if relationship mediated by emerging technologies is one step removed from other relationships, less authentic because we use our bodies in different ways to achieve connection with each other.  I wonder if our dogs feel that we are less authentic because we have replaced smelling butts with eye contact and uttering sounds all the time?

I jest, in part because I doubt our companion animals feels as fearful of becoming irrelevant as many of my colleagues do.  I think this fear is only justified to the extent that we are dogmatic about what constitute authenticity for everyone.  Pierre Teilhard de Chardin once said:

Love is the only force which can make things one without destroying them. … Some day, after mastering the winds, the waves, the tides and gravity, we shall harness.. the energies of love, and then, for the second time in the history of the world, man will have discovered fire.

I do not think it is the role of the therapist to be the arbiter of truth in what makes intimacy or authentic relationships.  Our role is to help our patients explore their capacity and harness their energies for love in ways that may go beyond the imagination our own experience affords us.  It is not for us to give them fire as gods would, but to help them make themselves whole without destroying them.

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