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No Matter How You Feel, You Still Failed

January 14, 2014 by 4 Comments

Game_Over

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

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

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

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

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

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

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

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

minecraft71

 

 

warcraft

 

 

pac man

 

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

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

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

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

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

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

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

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

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

 

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

July 28, 2013 by 2 Comments

2057142-shepards

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

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

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

21st Century Play

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

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

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

Solo Play is OK

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

The Many Reasons to Collaborate.

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

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

Let’s Bring On A World of Hurt.

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

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

Multiplayer and Uninvited Guests

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

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

Minecraft and the Repetition Compulsion.

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

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

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

I’m not THAT non-directive.  🙂

 

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Digital Citizenship and the Forward Edge Transference

April 28, 2012 by 11 Comments

Recently I had an opportunity to visit a school for a daylong workshop, where I got to meet with the kids during the day, and their parents at night.  I love it when this happens because I can then ask the children what they struggle most about with their parents regarding technology.  So during the course of the morning I asked over 425 5th, 6th, and 7th graders what I should help their parent understand about technology.  I got lots of great answers from them all, and my favorite one came when one 7th grader raised his hand and said, “can you please explain to my parents that multiplayer video games have no save?”

There are several reasons why that request is actually brilliant, but the one I want to focus on is how this statement, and a person’s frustration at being asked to log off in the midst of a multiplayer video game may be a forward edge transference.

The term “forward edge transference” comes from Marian Elson’s work in self-psychology.  She has described the forward edge transference as being akin to what Kohut was talking with his interns about when he described leading edge transference.  Forward edge transferences, according to Tolpin, are tendrils of psychological growth in the patient, often hard to see, if not completely overlooked, by the therapist because they don’t look like growth.  Often we consider “psychological growth” as in the eye of the beholder, whether it be therapist, parent, teacher or someone else other than the patient.  One of the example’s Tolpin uses is that of a patient who cuts to be able to “feel,” and to bleed.  The forward edge transference there in Tolpin’s estimation, is the self’s still healthy yearning for kinship, to “bleed like everyone else.”

I use this example because it very powerfully demonstrates how even an easily pathologized concern such as cutting, could indicate a tendril of healthy growth, easily overlooked.  The behavior forward edge transference travels concealed within is glaringly “obvious” to us, and because of that forward edge transferences may be misunderstood, and the striving for psychological health get stymied.

So what does this have to do with Massively Multiplayer Online Games?

As I mention in my book MMOs are a form of social media, and collaborative play, where the player is often cooperating with a group of others in a raid or guild to achieve something that could not be accomplished individually.  Whether it be downing a dragon in World of Warcraft, unlocking guild achievements, or building a city overnight in Minecraft, the player is part of a larger group.  They matter to the larger group.

Embedded in the comment “multiplayer has no save” is the forward transference for a sense of kinship, and more specifically the dawning of a concept of being a digital citizen.  Here is an adolescent saying that they understand their behavior has an impact on others, that they want to collaborate online, and that they feel responsible to the larger group.  Saying in fact what all the adults around them have been trumpeting for over a decade of their lives in most cases.

A digital citizen is defined in Wikipedia as “a person utilizing information technology (IT) in order to engage in society, politics, and government participation.”  To be a digital citizen requires “extensive skills, knowledge, and access of using the internet through computers, mobile phones, and web-ready devices to interact…”  And the elements of digital citizenship per digitalcitizenship.net include:

  • Digital Access:full electronic participation in society.
  • Digital Commerce:electronic buying and selling of goods.
  • Digital Communication:  electronic exchange of information.
  • Digital Literacy:process of teaching and learning about technology and the use of technology.
  • Digital Etiquette: electronic standards of conduct or procedure.
  • Digital Law:electronic responsibility for actions and deeds
  • Digital Rights & Responsibilities: those freedoms extended to everyone in a digital world.
  • Digital Health & Wellness:physical and psychological well-being in a digital technology world.
  • Digital Security (self-protection):electronic precautions to guarantee safety.

Here’s the rub:  If you look at those elements, many of the adults charged with caring for and educating the young aren’t necessarily competent digital citizens themselves.  I can tell you for a fact that I have participated over the past decade with professionals and peers on listservs and bulletin boards, and have seen appalling standards for conduct and procedure.  It rivals anything I’ve seen adolescents do to each other.

We live in interesting times, when we are entrusted to educate youth about a technology when we often don’t know how to use socially and effectively ourselves.  We tell them not to interrupt, then answer our cell-phones in the middle of them telling us about their day.  We tell them to pay attention to us even as we’re checking our emails on the Blackberry.  We stalk them on Facebook to censor them in one browser window, and post embarrasing pictures and comments of them in another.  And we pull the plug on them while they’re playing an MMO even as we tell them that they’ve been inconsiderate of their younger sibling who wants a “turn.”

Part of the problem here is our neophyte digital citizenship.  People from older generations tend to think of video games as this:

when they’re actually more like this:

When was the last time you showed up at your daughter’s basketball game in the 3rd quarter and told her, “you’ve been on the court long enough, you’re coming home?”  And yet, we do this to kids online all the time, and foil their attempts to be team players and group contributors.

There’s a lot at stake here:  Multiplayer has no save.  10-30 people, often from all over the world have come together to try to overcome an obstacle.  When you pull the plug, you’re pulling it on all of them.  It is great that our kids know this and care about it!

Most of us have wanted to be a part of something bigger than ourselves, to create something together, even if it is just one moment or memory with others.  We need to look at video games without the Pong Goggles, and see it as a form of society and an opportunity for digital citizenship.

To recognize the forward edge of a transference is never an easy thing.  It is small, fragile, the newest shoot of growth.  In a sense, all of us on this planet are in the midst of such a tendril of growth when it comes to technology.  But the time when digital literacy was optional has passed, and we need to do a better job with the next generation of digital citizens than we are doing.

 

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Want a Private Practice in the 21st Century? Get a Thick Skin.

November 23, 2010 by 13 Comments

Photo courtesy of http://www.rhinos-irf.org/

Many therapists go into the psychotherapy field because we are sensitive to the feelings and behaviors of others.  In the clinical session, this is very important.  Even if you aren’t a Self Psychology-oriented treater, empathic attunement is crucial to understanding your patient and meeting them “where they’re at.”  People often come to therapy hoping for and expecting a corrective emotional experience, and usually that is an unspoken part of the therapy contract.  Patients desire to be understood and heard; therapists strive to understand and listen.  In this, sensitivity to what the other is communicating is key.

This is not always recognized by those outside our profession:  Many times when we are asked what we do, and when we reply that we are therapists, we hear, “Oh I could never do your job, I’m too sensitive.”  Yeah, I can do this job because I’m a really callous asshole.  I don’t ever say that in reply, usually I don’t mention I’m a therapist (if someone asks me what I do I usually leave it at, “I do interiors.”)

However, there is a place for insensitivity in owning a private practice, and that is what I want to talk about today.  Many of you are excited to begin practicing in a Web 2.0 environment.  You have your Twitter account, your professional Facebook presence, etc.  But are you psychologically ready for what comes next?

Recently I did a blog on Gamer-Affirmative therapy.  It got many positive responses that I don’t remember clearly, but one negative one of course stuck with me.  The colleague wrote on a bulletin board, “…it’s just a PR stunt. “Gay affirmative-Transgender affirmative- bla bla bla” Don’t use it…sounds stupid.”

Ouch.

I could get huffy, refer the person to my earlier blog on managing your online presence, but I’m not going to do that.

What’s more, if I have a thick skin, I can look at the comments more objectively, see if they are pointing out something of value to me, something about an idea or plan I hadn’t anticipated.  If they do, good deal!  If they don’t, can I let it bounce off and move on to the next one without ruminating about it too much?

If you are planning on venturing out here with your practice, are you prepared?  Can you take the good with the bad?  Can you shake off the hurtful comments?  Better yet, can you learn from them? Sure we’d like everyone to communicate on the web in a respectful, polite way.  They don’t.  Can you deal with this and move on?  If you find yourself scrolling down to that comment or email and reading it for the umpteenth time and you haven’t learned anything from it or calmed down, you are not dealing with it and moving on.

Last word, don’t rush this:  If you aren’t sure that your idea or practice focus is “ready for prime time,” who can you share it with that you trust will be more compassionate?

Oh, and if you want to donate to the International Rhino Foundation, click on the photo!  🙂

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