stress

Streaming, Path of Exile & The Repetition Compulsion

June 11, 2019 by langloimsw Leave a Comment

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!

Find this post interesting? I can speak in person too: Click here for Public Speaking info & Press Kit. And, for only $4.99 you can buy my book. 🙂

Filed Under: Gamer Therapy Tagged With: addiction, adolescents, behavior change, education, Freud, game theory, gamers, games, gaming, path of exile, psychoanalysis, psychodynamic, psychology, psychotherapy, repetition compulsion, stress, technology, therapy, twitch, video games, Web 2.0

Can’t We All Just Game Along?

July 16, 2018 by langloimsw Leave a Comment

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..

Find this post interesting? I can speak in person too: Click here for Public Speaking info & Press Kit. And, for only $4.99 you can buy my book. 🙂

Filed Under: Gamer Therapy Tagged With: adolescents, behavior change, buddhism, candy crush, children, education, gamers, games, gaming, minecraft, play, pokemon, psychodynamic, psychotherapy, stress, technology, therapy, video games

Boundaries and Health in the Digital Age

January 10, 2018 by langloimsw Leave a Comment

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.

Filed Under: Gamer Therapy Tagged With: activism, adolescents, digital literacy, education, psychology, psychotherapy, social media, stress, technology, Web 2.0

The Internet & Real Relationships

January 11, 2015 by langloimsw 7 Comments

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.

Find this post interesting? I can speak in person too: Check out the Press Kit for Public Speaking info. And, for only $4.99 you can buy my book. You can also Subscribe to the Epic Newsletter!

Filed Under: Gamer Therapy Tagged With: attachment, behavior change, de chardin, digital literacy, education, facebook, lemons, LGBT, mindfulness, play, private practice, psychoanalysis, psychodynamic, psychology, psychotherapy, social justice, social media, stress, technology, therapy, Web 2.0

No Matter How You Feel, You Still Failed

January 14, 2014 by langloimsw 4 Comments

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:

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.

Like this post? I can speak in person too, check out the Press Kit for Public Speaking info. And, for only $4.99 you can buy my book. You can also Subscribe to the Epic Newsletter!

Filed Under: Gamer Therapy Tagged With: addiction, adolescents, behavior change, buddhism, building your business, children, digital literacy, education, ego psychology, failure, Freud, gamers, games, gaming, Kohut, mindfulness, minecraft, optimal frustration, play, private practice, psychoanalysis, psychodynamic, psychology, psychotherapy, reality testing, ROI, self psychology, social justice, social work, stress, technology, therapy, video games

Reality Testing & The 7 Billion Rule

December 20, 2013 by langloimsw 3 Comments

In this video, I discuss the ego function of reality testing, how it affects us, and ways to cope with distortions in it. This is also another example of how I use technology, in particular YouTube as a transitional object for patients, allowing them to continue to remember our work together without compromising any of their personal health information.

This will be the last post for 2013, have a good end of the year and I’ll see you sometime in late January!

Like this post? I can speak in person too, check out the Press Kit for Public Speaking info. And, for only $4.99 you can buy my book. You can also Subscribe to the Epic Newsletter!

Filed Under: Gamer Therapy Tagged With: adolescents, behavior change, children, cognitive distortions, distortions, education, ego, ego psychology, Freud, mindfulness, private practice, psychoanalysis, psychodynamic, psychology, psychotherapy, reality testing, social media, stress, technology, therapy, Web 2.0

Evocation and Mindfulness: Or, How to Think Better

October 16, 2013 by langloimsw 2 Comments

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

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

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

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

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

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

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

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

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

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

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

Like this post? I can speak in person too, check out the Press Kit for Public Speaking info. And, for only $4.99 you can buy my book. You can also Subscribe to the Epic Newsletter!

Filed Under: Gamer Therapy Tagged With: behavior change, building your business, digital literacy, education, game theory, gamers, games, gaming, mindfulness, private practice, psychoanalysis, psychodynamic, psychology, psychotherapy, ROI, stress, video games, World of Warcraft, wow

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

June 30, 2013 by langloimsw 1 Comment

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Like this post? I can speak in person too, check out the Press Kit for Public Speaking info. And, for only $4.99 you can buy my book. You can also Subscribe to the Epic Newsletter!

Filed Under: Gamer Therapy Tagged With: ADHD, adolescents, Asperger's, behavior change, children, digital literacy, education, gamers, games, gaming, minecraft, play, private practice, psychoanalysis, psychodynamic, psychology, psychotherapy, social justice, social media, special education, stress, technology, therapy, video games, Web 2.0, World of Warcraft

Nice Everything You Have There: Mindful Minecraft

March 13, 2013 by langloimsw 4 Comments

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

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

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

Filed Under: Gamer Therapy Tagged With: adolescents, avatar, behavior change, buddhism, children, creeper, digital literacy, education, game theory, gamers, games, gaming, mindfulness, minecraft, Minecraft Pocket Edition, play, private practice, psychoanalysis, psychodynamic, psychology, psychotherapy, social justice, social media, stress, sxsw, technology, therapy, video games, Web 2.0, Xbox

‘Tis The Season For Power Ups

December 3, 2012 by langloimsw 2 Comments

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

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

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

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

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

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

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

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

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

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

Now you’re ready for…

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

Last, but not least:

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

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

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

Filed Under: Gamer Therapy Tagged With: adolescents, behavior change, building your business, cbt, game theory, gamers, games, gaming, mindfulness, pac-man, private practice, psychoanalysis, psychodynamic, psychology, psychotherapy, social media, stress, video games, Web 2.0, winter

Bio Breaks

September 17, 2012 by langloimsw 1 Comment

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!

Filed Under: Gamer Therapy Tagged With: adolescents, behavior change, bio break, children, education, gamers, games, gaming, mental health parity, private practice, psychodynamic, psychology, psychotherapy, stress, technology, therapy, video games, World of Warcraft, wow

21st Century (Psycho)education

July 8, 2012 by langloimsw 2 Comments

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

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

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

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

1. Game Patches

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

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

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

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

2. Talent Trees

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

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

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

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

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

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!

Filed Under: Gamer Therapy Tagged With: adolescents, behavior change, children, dbt, education, gamers, gaming, play, private practice, psychoanalysis, psychodynamic, psychology, psychotherapy, social media, stress, technology, therapy, video games, Web 2.0, World of Warcraft

Optimism

April 21, 2012 by langloimsw 11 Comments

This week I had the opportunity to meet with a group of college students who are on academic probation. There were supposed to be over 20 in the class, and 10 showed up, 5 late. One of the the things I was struck by initially was how subdued they were, and I suppose I can’t blame them. The class they are in, on how to succeed in school, meets twice a week in different locations at the college, half the time in a basement computer lab even though they won’t be using the computers. If they don’t pass this class they are out of the school altogether. There was something discouraging about the whole setup.

When I asked them how many of them played video games, they all did. Most of them had played their favorite game as recently as this past week. And when I went through the room and asked each what they liked playing, I was taken by how for a moment their face would brighten and they’d smile, even make eye contact. Probably the most memorable moment for me came after I shared with them the statistic that 80% of the time we play a video game we are failing at it, and asked them to think with me about why we can tolerate failure so much in video games yet have so little tolerance of failure in other parts of our lives such as school. What was different with a video game?

One student, I’ll call him John, raised his hand and said, “I might win.”

What a sad commentary on what education can do to students who don’t fit a certain mold. Somewhere along the line, John and thousands like him have lost a sense of optimism, a sense that they even have a chance to win at life. And yet, throughout the one and a half hours I was with these students, every one of them participated, had really interesting comments, argued and engaged with me. The last holdout was a guy in the back row. I asked him what he had learned so far today about video games and our discussion.

He sunk a little into his seat, and said, “I’m drawing a blank.”

“Let’s take a minute,” I said, “and let’s assume optimism. Because you can add something to this discussion. I know you can. What have you learned in here today?”

Long pause.

And then he said, “self confidence.”

I should add, and did say to the class then, that we hadn’t even brought up that key concept to academic success yet. If he hadn’t have added it, we might not have ever gotten it into our discussion. Each of them had unique ideas, worthwhile ideas, not all of which we agreed with, but ideas nonetheless.

It takes optimism to risk answering a question in class, start a business, go to therapy, or play a video game. Without optimism we won’t risk trying and failing, and without trying and failing there can be no innovation.

Take a second and think about the world around us. Is it perfect in every way, or would you like some things to change? If you think it is perfect we’re done here.

But if you think that the world can be a better place, for people and all sentient beings, then you’re thinking something needs to change. Maybe you think racism needs to change. Maybe you think poverty and starvation needs to change. Maybe you need to be a better parent or partner, or learn more about something in school. Maybe you want a better job, or want to create a work of art. Maybe you want to better understand what it all means and how to fit in? Maybe you want your daughter to have a better life with more respect, maybe you want your son to have a better future. Maybe you want a war, all war, to stop.

Nothing gets better without change, and risk of failure. But to risk failure we need to think we can win. To fail and try again we need to think we could win this time. Optimism improves resilience and changes our body, according to dozens of studies done by Seligman and other positive psychologists. And optimism can create a more conducive learning environment.

Optimism, in my opinion is not simple delusion, or a brain defect, as some would say. Yes, we might fail, but let’s not let that get in the way of making an effort. Yes there is a lot of suffering and injustice in the world. We’d better get busy.

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.

Filed Under: Gamer Therapy Tagged With: adolescents, behavior change, buddhism, building your business, children, education, failure, gamers, gaming, hope, optimism, positive psychology, psychodynamic, psychology, psychotherapy, resilience, seligman, social justice, stress, video games

But Not Your Thoughts: Social Media & Children

March 14, 2012 by langloimsw Leave a Comment

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.

Filed Under: Gamer Therapy Tagged With: adolescents, children, education, facebook, mental health parity, online identity, privacy, psychodynamic, psychology, psychotherapy, social media, stress, twitter, Web 2.0

Occam’s Oyster

December 7, 2011 by langloimsw 2 Comments

The oyster has an amazing evolutionary trick. When a microscopic particle of something or other gets into its soft tissue, it creates over time layer upon layer of nacre, a substance which creates a pearl. What began as an irritant can go on to become a very valuable object.

You are not an oyster.

If something irritates you, you don’t always need to be stuck with it. And although I am a big fan of the cognitive reframe, to use it all the time overlooks that you can often resolve whatever is irritating you by removing it.

Case in point, for the past several years I have used a billing service. They’re great, but there has been something about the process of my patient intakes that irritates me. I have patients fill out an intake form, which they bring in to me. At the same time the billing office has a face sheet they use as well, but they need some information that is not on the face sheet but is on my intake form.

So for the past several years the patient will download my form off the site, fill it out and bring it in to me. I then have to scan the form and fax it to my billing office. To make things more complicated I have several computers and a scanner at home as well as an iPad. You’d think this would make things easy, but I can not seem to get them all to talk to each other the right way to scan something and email it in under 30 minutes. One laptop doesn’t get recognized by the wireless network. The iPad can scan the form but not email it. This has been going on for years, and I had grown accustomed to the irritation as I tried putting on layer after layer of “solutions.” I’d put off scanning the forms until my office asked me for them, which made their work harder, and payments from insurance choppy.

Then it hit me that I am not an oyster. Whenever this irritation came up I had been so focused on trying to make things go more easily, that I had never really taken a few minutes to think about how to make this problem go away. The answer in this case was simple. Instead of having my patients email the form to me, my introductory email to them can instruct them to email or fax it to the office directly. They need regular access to it, and I don’t. They have all of my other administrative paperwork which they keep all safe and secure, so it is actually far easier to have them keep it since they are doing all the billing. I rarely use that initial paperwork, and I’ll always know where it is.

I offer this as a nuts and bolts example of how your therapy practice needs to be evaluated periodically. The whole craziness above is a vestige of when I was doing all of my billing, and something I now realize I was not ready to let go of. And so I just got used to the irritant, ignored it, and hoped it would go away or become less irritating.

We therapists take more irritation for granted than is necessary in our business. We each have a different version of layering on the nacre. One of mine is constantly adding new gadgets and trying to find ways to make work easier, rather than making it go away entirely. I used to spend hours learning the intricacies of a billing software and calling insurance companies, and then I realized I wanted to get rid of the irritation. I researched different services, and finally decided on one which cost a little more, but did a lot more for me. Now I give them 9% of my fee, and in return they keep me credentialed with the insurances I take, send out statements, answer questions from patients and submit all my claims electronically to insurances. Not only do they trap more of my revenue because they can focus on it with more expertise than I, they save me valuable time.

I didn’t value my time as much when I started out, and I am glad I changed that, because I know I wouldn’t have had the time or energy to write a regular blog, do speaking engagements, or write my book this year if I had been chewing on all that paperwork.

So why does it often take us so long to fix systemic problems like this in our practices, or our lives for that matter? I would suggest that the answer is that we don’t value thinking.

I know, sounds crazy on the surface, therapists don’t value thinking? Thinking and thinking about thinking is a big part of our profession. But when was the last time you allotted yourself time specifically to think on something. By that I mean dedicated time where you think through something single-mindedly, not answering emails, talking on the phone, watching television, etc. Most people I coach can’t remember the last time they did that, in fact our coaching appointments are often the closest they come to it.

You don’t have to schedule a specific “thinking time” in your day, although you can certainly do that if it works for you. But in the case above I didn’t do that. Instead I noticed I was getting irritated for the umpteenth time and said to myself, “Ok, stop EVERYTHING, how can I make this irritation go away?” Within a relatively short time of dedicated thinking I identified what the system was, what the problem was, and what the new system would need to be to make the form nightmare go away. Not get less irritating, not more tolerable, but gone.

Look, I’m not saying that everything in life that irritates you can be removed, or even that that would be a good thing. I’m just saying don’t settle for mitigating damage before you’ve tried making the problem disappear. Ask yourself, “am I layering nacre over and over? Is that the best I can strive for?”

Then ask yourself, “am I making time to think, and am I thinking about the things I want to think about when I do?” Sure there are lots of times when you run a business that you’ll need to think about stuff you’d rather not think about; but if that’s how you’re spending the majority of your time then maybe you’re running the wrong business.

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.

Filed Under: Gamer Therapy Tagged With: behavior change, building your business, insurance, managed care, mindfulness, private practice, psychoanalysis, psychodynamic, psychology, psychotherapy, ROI, stress

What Google+ Could Mean For Therapy

July 25, 2011 by langloimsw 14 Comments

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

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

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

Which brings us to Google+.

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

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

Circles

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

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

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

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

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

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

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

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

Streams

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

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

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

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

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

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

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

Filed Under: Business Tagged With: addiction, adolescents, behavior change, building your business, Google+, mindfulness, private practice, psychoanalysis, psychodynamic, psychology, psychotherapy, stress, therapy, Web 2.0

Epic Mickey and Frittering

May 13, 2011 by langloimsw 1 Comment

The last week I have had a blast playing Epic Mickey; two blasts actually. In the game you’re Mickey Mouse, and your primary tool is an enchanted paintbrush, which sprays two different substances with very different effects. The first is a magical blue paint, which can make invisible things real, and make an enemy in the game turn blue and become a friend. The second is a magical green paint thinner, which can make real things invisible, and thin an enemy into nothing.

There are good reasons to do both of these things, but the unnecessary obstacle in the game is that there is a limited amount of paint and thinner, and so if you use too much too quickly, you have to wait until a cooldown replenishes it, or until you find a power-up. Power-ups, in case you aren’t familiar, are items in the game you can come across that replenish your health, and in the case of Epic Mickey, your paint supply.

The game is a Wii game, and so the motion controller is how you aim the paintbrush to paint or thin. And when I started playing it quickly became apparent that I was going to have to get better at aiming if I wanted to accomplish anything before running out of paint/thinner.

Epic Mickey teaches therapists, gamers, and anyone else who wants to learn through video games some important lessons about living life and frittering away your resources. The game has very simple mechanics, but life often has more complicated ones. Fortunately, this video game can help serve as a meditation on mindfulness and achieving goals.

Lesson 1: Paint Vs. Thinner

When approaching a problem, relationship, or business, it isn’t always immediately apparent whether to add paint or thinner. Do we need to add more stuff or clear some off our plate? Will additional effort reveal opportunities that were invisible moments ago? Do we need to process more with our partner, or less? Perhaps we need to simplify, reduce or focus our practice niche? Maybe we need to remove an obstacle, rather than spray creativity all over the place. One of my favorite paint thinners in real life is Occam’s Razor, which has been often interpreted as “the simplest explanation is most likely the correct one.” Or to put it more like it was originally intended, we should try to avoid any unnecessary pluralities, and tend towards the simpler theories or applications. Sounds like thinner to me, who would have thought Mickey Mouse to be a Scholastic thinker?

And to make things more complicated, Epic Mickey shows us how if we can’t make up our minds we will go back and forth between paint and thinner, undoing anything we may have started and wasting time and effort. So whether we decide we need to add something or take something away, we need to commit to a course of action, or we’ll be confusing dithering with effort. In Epic Mickey so far, I have found that many problems can be solved in a variety of ways, some using paint, some using thinner. I suspect life is like that too.

Lesson 2: Keep an Eye on Your Power Reserves

In the game, you always have to keep an eye on your paint and thinner meters to make sure you pace yourself and don’t run out. They will replenish automatically over time, but slowly. In my business I can attest that this is also true. I usually have a couple of irons in the fire, but I have learned to pace myself. I remember a few years back I was seeing 25 patients a week, supervising three interns and therapists, teaching two classes, taking another, sitting on 2 commissions and trying to write. I had to learn the painful lesson that I was doing a subpar job of every one of these because I wasn’t prioritizing, and perhaps more importantly, I wasn’t allowing time for replenishing myself. Nowadays, I try to pace myself and make time to do fun stuff, like running at least once a week, playing some games, spending time with my family chilling or getting a massage, eat regularly and get enough sleep. Not only are these things rejuvenating, but if I can resist multitasking they block off time so I don’t get exhausted and put out subpar work.

Are you keeping an eye on your reserves? And more importantly, are you willing to give up a few things so that you can devote more time to living life and having fun so you have the energy to do others? I certainly didn’t want to give up any of the activities I was doing, I liked doing them all, just not all at once. Often I hear colleagues say “I just don’t have enough time to simplify and relax,” as if it is a luxury rather than a choice. Sure giving up a couple of things is going to discombobulate you, especially if you’ve learned to pride yourself on being busy. But you won’t run out of paint as often.

Lesson 3: Keep an Eye Out for Power-Ups

In Epic Mickey, time isn’t the only way to replenish, there are treasure chests with power-ups. When I recently defeated the Clock Tower Boss, the way I did it was to keep an eye out for power ups, and sometimes pass up what seemed a perfect shot to get a power-up. In the long run, keeping an eye out for the things that power you, your relationship or your work up will be worth foregoing the perfect shot. This is especially true in relationships: It can be very hard for us to resist zinging that perfect shot, but backing away and taking time to do something replenishing will usually make things turn out more harmoniously!

What are your Power-Ups? Is it a massage, a walk in a botanical garden, meditation, playing Super Mario or spending time with your kids? It’s your responsibility to figure out what these are, make a little time for them regularly, and do them even when you aren’t feeling totally depleted. Pay attention to what happens when you do certain things, eat a certain way, or take something else into your being. Do you double in size and power? Become able to hurl fireballs? Defeat previously impossible monsters? If so, chances are whatever you just took in is a power-up.

Lesson 4: Focus stops Frittering

Last, the more targeted you are in what you’re trying to do, the less wasted energy and resources you’ll have. In life, like in Epic Mickey, you often need to aim for something. Sure, sometimes random efforts yield surprising results. When it does, huzzah, but that’s no excuse for not trying to be focused. Mindfulness is in a large part about focusing your mind and body on something, letting distractions drift by. Use the Force Luke–if you don’t you will probably find yourself feeling depleted, frustrated, and confused as to why.

Yes, focusing means giving up on something else. Frittering means giving up on everything while deluding yourself you haven’t. Parents who become obsessed with quality time rather than choosing a game night are frittering. Saying you want a committed marriage while you’re out every night drinking beer with the buddies is frittering. Complaining about managed care and lower fees rather than marketing your business or helping a forward-thinking candidate is frittering. And there are a thousand other ways that all of us confuse dithering with effort. So pick something and try to focus on it single-mindedly. At least that’s what works for Epic Mickey, and can an 83 year-old mouse who can still defeat monsters and jump over chasms be all wrong? I think not.

Filed Under: Gamer Therapy Tagged With: behavior change, building your business, disney, epic mickey, game theory, gamers, gaming, managed care, mindfulness, nintendo, occam's razor, private practice, psychology, psychotherapy, stress, video games, Web 2.0, wii

Is your Practice Busy or Hectic?

December 10, 2010 by langloimsw 5 Comments

This time of year the reply I often get from colleagues when I ask how their business is going is “Busy!” This is often said with shortness of breath, decreased blinking, and other physiological signs of anxiety. At the college I teach at, I often see my fellow faculty members commiserating with each other about how busy they are there. I think lots of us are busy, but I think it is time to re-evaluate if we are really busy, or hectic.

The way I differentiate between busy and hectic is simple: ROI and organization. When I am busy, I have most of my clinical hours filled, am up to date on my billing, know which week I am teaching on the syllabus, and returning phone calls or emails within 24 hours. I am also eating and sleeping well. That’s “busy.” When I am “hectic” I am thinking “oh my god I have too many patients to see;” forget to do my billing (or avoid it;) unfocussed when I get ready to teach; and start “saving” (read sitting on/avoiding) voicemails and emails. I also feel more of a pull to commiserate, to tell people how “busy” I am. For me, talking about how busy I am when I could be doing something more productive is usually a sign that I am hectic, not busy.

Once you have started to feel more stress in your practice, pause immediately and ask yourself if this is a prod from your psyche to take care of yourself. Have you done that? Good, if the answer is you haven’t, and that you don’t have time to because you are too busy, you’re being hectic.

Now knock it off.

Really, I am suggesting it is that simple. Other than an opportunity to review for self-care there is NO ROI on being hectic. You won’t get more patients, you’ll get less. You won’t have more time by worrying or commiserating, you’ll have less. You may derive a sense of self-importance from how crazy things are, but you aren’t really impressing anyone, including if you are honest, yourself. So put down the cross, we need the wood.

Here’s a suggested checklist if you are still unsure whether you are being “busy” or “hectic:”

I miss appointments or double-book
I haven’t eaten today
I am avoiding the phone and email
I have complained to 2 or more people that I am busy
I feel like I am working too much, and making less than I usually do
I am behind on billing patients
I have open times for patients but can’t find the time to schedule intakes
I hate my office
I’m feeling cranky and dissatisfied with my clinical work
I can’t remember the last time I had a non-therapy conversation with a friend, or if I can it was over 24 hours ago
I feel a sense of dread when I think about work

You may notice that some of these can also be signs of burnout: This is not a coincidence. I firmly believe that if you don’t learn to distinguish between being hectic and busy, your business will fail. It will fail because you burn out, and or because you sabotage your income streams to the point where you have to close up shop and go work for someone else. And if you do that, you can guarantee they’ll help you learn the difference between busy and hectic the hard way.

So this weekend, take 15 minutes to sit and reflect, is my practice busy or just hectic? And if you don’t think you have 15 minutes to do that this weekend, you already have your answer. 🙂

Filed Under: Business Tagged With: building your business, mindfulness, private practice, ROI, stress

Autumn

October 8, 2007 by langloimsw Leave a Comment

Autumn has rolled around, and yet, I have had to modify my practice of the old New England tradition of complaining about the weather. The warm and sunny days have been great for apple picking and walks, but at last my inner cranky Yankee managed to put my finger on my discontent with the climate. It happened when I heard yet another meteorologist cheerfully remarking on our “record-breaking highs,” our “unseasonably warm weather.” I try not to get political in these blogs, but I have to point out that these changes fit Shakespeare’s quote, “Ill blows the wind that profits nobody.” We are benefitting from a global warming trend that is no longer surprising or joyful, so let’s encourage the media to stop spinning it that way, shall we? I have begun meta-complaining about the weather—how’s that for Yankee ingenuity?

The Postman Always Rings Twice

Although I like to encourage colleagues to take advantage of modern technology in our practice, I did want to pass on this article as a word of caution. If you use email through Yahoo or Google (gmail) your email content is searchable and may be “trawled” for content. It is an important reminder that your email is not just in your client’s and your computer, but also in the servers that each of you uses. Keep emails brief and nondescript. Having your client sign an informed consent around the internet is important, and will make sure you both understand what the limits and challenges of emails are. Many clients will want to continue to use email for scheduling, but spelling out the risks never hurts.

Racial Stress and Prenatal Care

A recent study from Joint Center for Political and Economic Studies’ Health Policy Institute took a look at 600 African-American women and the impact of racism on their health. The results indicate that reasons for their higher stress levels ranged from hearing white teachers’ comment on “those kids” to working longer hours to win acceptance from white co-workers. Looking at the stress disparities across racial lines is nothing new, but this study looks at what causes the stressor with an eye to race, and finds that “rich or poor, well-educated or barely literate, African-American women were still more likely than white women, first-generation, poor Hispanic immigrant women and foreign-born black women to have premature and low birth-weight babies… and that when foreign-born black women had been in the United States for a generation they showed the same infant mortality rates as American-born black women.” (Lu, 2007) This would indicate that addressing the psychosocial impacts of racism is an important part of prenatal care, and culturally competent practice.

Filed Under: Gamer Therapy Tagged With: prenatal care, security, stress

Research and Job Dissatisfaction

July 30, 2007 by langloimsw Leave a Comment

20 Years in GLBT Youth Research

The NASW website “Help Starts Here” recently published an article I wrote that you or your clients may find of interest. The article reviews selected literature from 2 decades of research on risk factors for gay, lesbian, bisexual and transgendered youth. It compares those earlier findings to the two most recent Youth Risk Behavior Surveys done in Massachusetts. Although the review of the literature is not exhaustive, it may be useful to clinicians and families.

Take This Job…

Some interesting news came out of the outplacement consulting firm Challenger, Gray & Christmas. They estimate that 25% of workers regret having taken a new job within their first year. For those of us who work with clients dealing with work dissatisfaction, this statistic may de-stigmatize it. It may also free them up to leave a job that providing them with the satisfaction and quality that work can and should bring.

Filed Under: Gamer Therapy Tagged With: stress, work

Spring Fever, Etc.

March 28, 2007 by langloimsw Leave a Comment

Recently the Archives of Pediatric and Adolescent Medicine published an article finding that children whose parents and families are experiencing stress tend to have more fevers and illness than other children. The article, summed up in Medical News Today goes on to state that stress increases children’s immune functioning. You may want to share this with your colleagues, as this time of year is particularly stressful for children and adolescents. Between academic demands, increased testing, and gearing up for the “last stretch” of school, some children may be physically and metaphorically overheating!

Support for Bipolar Adults

In case you are not aware of this local resource, you and your patients may benefit from the services of the Manic-Depressive and Depressive Association of Boston. While not a replacement for treatment, MDDA offers support and information for people with affective disorders, including support groups that meet at McLean. These groups are a useful part of partial hospitalization discharge planning, especially with the increasingly shortened lengths of stay allowed by many insurances.

Insurance Update

I am happy to report that I have added Tufts Navigator and HMO Blue/Managed Care Behavioral Health to the insurances I accept. I currently have availability most weekday mornings and afternoons, with a waiting list for evenings. Please feel free to forward this information to whomever you’d like. If you or your clients have any questions about the practice, the answers can be found on my site, www.mikelanglois.com . Thanks to those of you who have made referrals, they are always appreciated.

Filed Under: Gamer Therapy Tagged With: allergies, children, pediatrics, stress

Streaming, Path of Exile & The Repetition Compulsion

Can’t We All Just Game Along?

Evocation and Mindfulness: Or, How to Think Better

Bio Breaks

Occam’s Oyster

What Google+ Could Mean For Therapy

Epic Mickey and Frittering

Is your Practice Busy or Hectic?

Autumn

Research and Job Dissatisfaction

Spring Fever, Etc.

Mouse Over My Pic For A Secret Message..

Epic Tweets

Ye Olde Vault

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Mouse Over My Pic For A Secret Message..

Epic Tweets

Ye Olde Vault