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Gaming, Slacking, & Stigma
August 17, 2011 by 7 Comments
Any group that is stigmatized usually finds that they are the object of more than one stereotype. In fact, the stereotypes are often completely opposite in nature. Women are weak enough to be the “frail sex,” yet strong enough to be a “battle ax.” Blacks were considered lazy enough to require slavery to motivate them, yet motivated enough to steal away white women. Gays are either acting like “sissies” or always at the gym working out. The abstract contortions made to bind all these stereotypes into a web that seems to hang together contains many tensions of opposites. In short, stigma creates a lose/lose situation for whatever population is targeted.
I have recently tried to explain the connection between technology and class, a connection that has endured as far back as Greece in 400 BC. And I have often decried the pathologization of gaming as an addiction and gamers as “addicts.” The portrait I often see sketched is that of gamers as monomaniacal, sacrificing work, friends and their health because they can’t stop playing video games. These addicted personalities, the stereotype asserts, are online for hours playing without any regard for real life. Worse, I often hear gamers refer to themselves as “addicted” to video games, which is often a shorthand for and identification with the negativism they have picked up from popular culture and popular psychology. Even therapists who feign neutrality often convey this stereotype: When was the last time you asked someone how many hours they did something that you didn’t think was a problem.
But forever Scylla there’s a Charybdis, and gamer stereotypes are no exception. For people who are so obsessive and driven by addiction, gamers are also referred to as slackers. They’re never working hard enough at what really matters, rarely bathe, are morbidly obese and locked in a perpetual state of early adolescents. As slackers, gamers are purported to be lazy, unkempt, and always slouched over their keyboards. They have no interest in “real life,” which is the term we use to refer to anything we think is interesting. This stereotype presents the gamer as apathetic and avoidant of any work or investment. And one thing we know about stereotypes is that they can be internalized and lead to self-fulfilling negativism, and I’ve come to hear gamers refer to themselves as lazy slackers.
Here’s why I know this isn’t true.
It’s not just the survey PopCap did which showed 35% of executives surveyed played video games at work. Nor is it the fact that gamers have compiled the second largest compendium of online knowledge, WoWwiki, the first being Wikipedia. I know the reason why Gamers aren’t slackers is because as Nicole Lazzaro points out gamers are failing 80% of the time they are playing the game. That’s right, 80% of the time a gamer plays a video game they try, and fail, and try again. That is not the characteristic of a slacker. If anything, that’s a perfectionist.
Video games create experiences that can be challenging and frustrating, but engaging nevertheless. This hard fun would not be possible if gamers were truly lazy or apathetic. And the level of detail that many gamers pay attention to is staggering, whether it be leveling a profession to 525 in WoW, unlocking every achievement in Halo 3, or mapping out every detail of the EVE universe. This is not apathy, this is meticulousness.
One of the most ironic things about the slacker stereotype is that it has its roots in the US History of WWI when the word slacker was used to avoid the draft and avoid serving in the military. One hundred year later, video games have been embraced by the military, with research that shows gaming to be the 2nd most efficacious coping mechanism for psychosocial stressors during service in Afghanistan. Apparently if that’s slacking, it keeps you saner. The US Army has not bought into the slacker stereotype at least since 2008, when it invested $50 million to create and fund a video game unit for 5 years to help prepare soldiers for combat.
Working with gamers as a therapist requires its own cultural competency, and we need to be cautious about using the oversimplification that stereotyping allows. Just because someone is interested in something we aren’t doesn’t mean they are delusional. In fact we may be the ones slacking off if we aren’t trying to understand a video game beyond hours played.
And gamers have their own responsibility in this. We need to stop bandying about terms like addiction and slacker. And perhaps more importantly, gamers cannot and should not resign themselves to being misunderstood in treatment. If your therapist seems unable to discuss video games beyond hours played, encourage them to read Jane McGonigal’s work. Print out some of my posts for them. Let them know that games are an important part of your life and world and that they need to try to understand them in order to understand you. And if they refuse to do that, consider finding a gamer-affirmative therapist.
It wasn’t many years ago that therapists didn’t think they had any gay, lesbian, transgendered or bisexual patients because they never asked their patients if they were gay, lesbian, transgendered or bisexual. And worse, because therapists assumed they weren’t. This vicious cycle made learning how to best treat LGBT patients take much longer than it should have. This can only change through therapist education.
We need to stop trivializing video games in life and in treatment. We need to stop rushing to peg gamers as addicts or slackers, and try to listen to them. Because I am convinced that it is within the content of the video game’s meaning that we may best understand the gamer, and how they play the game may hold the key to how they can resolve their difficulties elsewhere.
Technology, Video Games & Class
August 6, 2011 by 5 Comments
Some 500 years after the Greeks began using the alphabet they’d adopted from the Phoenicians, Socrates expressed his concern and disdain for the new technology of writing:
“for this discovery of yours will create forgetfulness in the learners’ souls, because they will not use their memories; they will trust to the external written characters and not remember of themselves… they will be hearers of many things and will have learned nothing; they will appear to be omniscient and will generally know nothing; they will be tiresome company, having the show of wisdom without the reality.” –Socrates in Phaedrus
Fortunately for us, Plato disagreed with Socrates, at least to the point where he wrote down the dialogues which have endured to the present.
Aristotle, who was probably a teenager when Phaedrus was written, describes in his Nicomachean Ethics several different concepts of thought including episteme, techne, and phronesis. Episteme referred to knowledge that is rational, eternal and certain. Phronesis is ethical thought. And techne is usually translated as “craft” or “craftsmanship.” Techne was considered the realm of the Mechanical Arts by the ancient Greeks, as opposed to the Liberal Arts. As such it was the realm of the common worker of the lower classes, while episteme was the pursuit of the free man of the upper class. This perhaps is why Socrates was so concerned about writing: The common worker would not have the time to engage in dialogues with learned teachers, and his understanding of philosophy could go awry. The Liberal Arts clearly involved having free time to talk and listen to teachers.
I elaborated on all this to help make the point that technology has always been about class.
Anything kinesthetic, or hands on, was associated with techne, and the lower class occupations of masonry, carpentry, and back in ancient Greece, medicine. Working with ones hands was not then, or is it now, considered one of the characteristics of the upper class. Gentleman don’t work with their hands.
This attitude persists, albeit more subtly to this day. We see it in our educational system: Students who don’t score high on IQ tests are often tracked to vocational tech schools. Students are often discouraged from using the technology of calculators because they need to “learn” how to solve the problem. What distinguishes us as adults in math is our ability to count in our heads, not with our hands. We see it in work in the difference between blue and white collar jobs. And we see it in our attitude of technology.
Therapists often view technology in general, and video games in particular with a thinly veiled disdain. Technology has been accused of ruining relationships, causing addictions, destroying our neurology, and fostering escapism. We pathologize people playing video games in a way that is reminiscent of the novel in the 19th century, when solitary reading was considered a dangerous pastime for women, leading to languishment and insanity. The gamer has become the hysteric of the 21st century: out of touch with reality, immature, lazy and troubled.
Anything that smacks of being technological and kinesthetic is also seen as at best a necessary evil in therapy. Using the phone to call insurance companies, filling out paperwork are examples of the work we therapists often feel takes away from our time to do “what matters.” Emails, Facebook and Twitter are unnecessary and probably a liability issue. In fact the majority of our workshops on technology aren’t actually about techne but Phronesis, i.e., the “ethical” use of technology. And when our patients try to talk with us about technology, they are often rebuffed or pathologized (“How many hours are you spending on the internet, anyway?”)
With our adolescent patients, the assumptions are even more dire: It’s less than face to face contact. It’s too complicated to understand. It’s too boring to listen to teens about. It gets in the way of “real” relationships. It distracts teens from therapy, and listening to adults in general. Its for kids with Aspergers Syndrome / who have poor social skills. And heaven forbid they meet people they talk to online, they’ll be killed.
It is a dangerous assumption to leave unexamined, the linking of different forms of thought to class. We have seen how it has played out in race, gender, and sexual orientation. And it is being played out today in our disdain and suspicion of all things technical and the people who use those things. Just listen at your local office or agency to the way people talk about the “IT guy” and you’ll hear it.
Although class issues remain in play, techne and technology inevitably become integrated into our society. Imagine for example that you go to the local Apple store, only 600 years ago:
Skeptical customer: “I’ve begun seeing more and more of these “pencils” around, but they don’t seem very useful to me.”
Pencil salesman: “Oh not true, they are very useful indeed. Combined with this “paper” they become a powerful storage system. You can write your ideas down on the paper, and it will store it for later use. And you can expand your paper and store even more ideas.”
Skeptical: “But isn’t that a privacy risk? If I write something with this pencil, can’t it be lost and read by others?”
Pencil Salesman: “Well, yes, but you can always store the paper securely..”
Skeptical: “But even so, what if I write down something on paper and want to unwrite it later.”
Pencil Salesman: “Our developers have anticipated that! See down here, this part of the pencil is an “eraser.” Just swipe the eraser across the markings and they’ll disappear.”
Skeptical: “I dunno, I don’t have a lot of writing to do.”
Pencil Salesman: “Well, everyone has different needs, that’s why this pencil comes with several Applications. You can use the pencil to draw pictures. You can use it to do mathematics. Or you can compose poetry. Or you can play games with it alone or with your children. Whatever you want to do, there’s an App for that.”
Nobody would seriously imagine that they need to be convinced of the usefulness of the technology of the pencil. Nor would they suggest that if you write a threatening note to someone that it was because the pencil was bad. But today we seem to be at an earlier phase of development with computers, smartphones and tablets. And much of this fear and suspicion, I would suggest, involves class.
Technology has become more complex through time, but our attitudes about it are still generally simplistic. And right in the middle of this terrain we have the video game. It’s one thing to have to use technology for our work, but to actually enjoy using it? That’s strange and suspect. And so people talk about how much time others are “wasting” on Facebook, or playing World of Warcraft, downloading music to their iPod, or surfing the net. I know people who are actually ashamed that they spend time trying to figure out a new technology like Google+, and we have a word for these people, geeks. Although the term geek has begun to be reclaimed by many, it’s important to remember that the word comes from the English and German dialects to mean fool or freak.
We need to be open to learning about our patients, and with gamers especially, about their technology. To do this we need to understand how gamers, and geeks, are part of a marginalized population. To practice gamer-affirmative therapy one needs to be culturally competent, and I believe that part of this competence is understanding the stigmatizing connection between technology and class.
To be gamer-affirmative, I believe therapists need to get technical, that is, “hands on.” Every time I do a consult or a workshop I tell therapists that there are dozens of free trials of the different games their patients play, and encourage them to spend some time playing them. I consistently get resistance on this, usually a version of the comment “I don’t have time to play video games.” Really? Over half of all adults play video games, and 4 out of 5 young adults do. If they can find the time to play while holding down a job and having meaningful relationships, so can you.When email first came out, many people decried it saying that it was going to be impossible to use it because there wasn’t enough time in the day. And yet, we’ve managed somehow to make time. “I don’t have time to play video games” is usually a gussied-up version of “I have better things to do with my time than play video games.”
But too often people have bought into the stereotype of gamers as unemployed, unmarried, and unfit. This is the same form of projection and splitting that our society has used to “other” people in terms of race (lazy Mexicans,) gender (weaker sex,) sexual orientation (promiscuous bisexuals,) and class (poor white trash.)
Very often I hear therapists protest that they like technology, that it has “its place” in our lives. This sense of having and knowing one’s place is inextricably bound to issues of class and status. Technology doesn’t have its place, technology is everywhere. It is a vital part of human being, ever evolving, responding to us, shaping and being shaped by us. In therapy, we need to unlearn our privileging of one group over another if we are to truly understand our patients. When we demure and say, “oh I don’t know anything about video games or Facebook,” we are being more haughty than contrite. The fact that we act as though using or talking about technology is unnecessary is our class bias at work in our profession.
Being A Noob
June 11, 2011 by 1 Comment
Over the past few months I have taken some time off from playing World of Warcraft to try a new MMO called Rift. Rift takes place in a different world from WoW, the world of Telara. It has a different storyline and although the user interface is pretty much a duplicate of WoW’s, there are many many other differences as well. I have been playing WoW for several years, and had progressed my character to level 85, the highest you can get as of now. In those several years I have been a member of three guilds, leveled 6 professions, and spent countless hours researching the internet on strategies, spell rotations, and boss strategies. I’ve traveled the length and breadth of Azeroth and Outland, and completed hundreds of quests and achievements.
And now I’m a noob again.
In Telara I’m just out of the training zone, and level 13. I have no idea where I am, and most of the map is still an undiscovered blank screen. I don’t have more then 20 points in any profession and I’m not in a guild. I’m reading new material and trying to figure out what sort of place Telara is, why the sky is constantly ripping apart as rifts from some other dimension open up and rain down monsters on me and any other players in the area at the time. I keep running the wrong way into mobs of villains many levels higher than me and dying. Lots and lots of dying. And lots and lots of running back from graveyards as a ghost trying to find my body.
Good times.
For those of you who don’t know this, being a “noob” is a term for being a newbie, a newcomer unfamiliar with game mechanics and the lay of the land. It can be a very frustrating experience. The first time I was a noob, in WoW, I had no idea how much I was learning as I was learning it. There was such a steady progression that I didn’t realize how much experience and skill I had amassed with the game until I switched over to a new game. Now it is like I have lost all of that experience and skill, and I can feel overwhelmed. I am nowhere near Rift’s “endgame,” and everything is new and weird. So why not just go back to playing WoW?
First off, I have a little faith. As I stumble through being a noob in Rift, I can remember feeling similarly clueless at the beginning of my time playing WoW. I know that I am learning a great deal, more than I can even tell, and that this sense of being overwhelmed will pass. Also, I am enjoying the heightened sense of discovery, stumbling into the city of Meridian for the first time, having chats with other noobs as we form public groups and down elites.
The last time I was on, my mage was teamed with a warlock and a warrior, and we took on an elite without a healer. We gave it all we got, and then the warrior was down and the warlock was getting attacked. As the warlock fell, and the boss approached me with only 5% of its health left I kept spamming shadow bolts at it until it got to me. Just as it killed me I set off one more bolt that killed it. We closed the Rift, resurrected ourselves, collected the loot, and I felt the same level of thrill and achievement as when I first started playing WoW.
Every gamer was once a noob. Every gamer you see in your therapy practice was once thrown into a strange unfamiliar world knowing no one, with only the clothes on her or his back and a few silver in their satchel. Those men and women in your office who have been deemed failures at school or work by parents or coworkers has tried and failed and tried again hundreds of times. They have wandered around lost in a dangerous world knowing no one, and struck up conversations with other wanderers. They’ve banded together with others to defeat powerful adversaries, worked diligently to perfect professions and skills, and you’ve known nothing about it, because you didn’t ask. Instead therapists often focus on how many hours a person plays, pathologizes gaming as an addiction, or dismisses it as a silly hobby with no clinical or real-life value.
(How many of us approach our patients’ dreams that way? How many of us ask, “how many hours a night do you dream?” or consider them to have a dreaming addiction? When was the last time you dismissed dreaming as a valueless, silly hobby.)
Being a noob takes courage, and stamina. We therapists know this deep down. Most of us gravitated to our profession because we wanted to help the vulnerable, the bewildered and the confused grow into the strong, wise and whole people our patients become. We help them map out their inner world, strengthen their coping skills through trial and error and retrial. We encourage them as they level their professions at work or school, build guilds of peers and loved ones to raid life with, and face whatever monsters they have to to heal from trauma. Let’s recognize the game mechanics in what we do, and learn from the game mechanics in what they do.
Last but not least, let’s talk business.
In the 21st century, many therapists are seeing a game change in our profession. The way we practice therapy and help our patients is changing in many ways. We can use Google to help them find the closest AA meeting, Skype with them when they are away on business in Hong Kong, email them DBT worksheets or set up mindfulness reminders for our groups on Twitter. Even if we avoid using these technologies with our patients, they are trying to talk to us about bullying via Facebook, sexting on their iPhones, or falling in love in Second Life or World of Warcraft. In the 21st century, technology is no longer negotiable, it is embedded in virtually all treatment issues one way or another. And so therapists are noobs once more. This doesn’t mean that we can’t still practice psychotherapy the way we always have. But do you think that that should be our prime goal, to do things the way we always have?
When I first advertised on Google, I paid .10 a click. Nowadays colleagues in my area are paying upwards of 6$ a click to be visible. Having a Google ad or website is now pretty common. Between changes in social media and healthcare, many of my colleagues and the therapists I consult with are finding that the game has changed again, and they feel frustrated and bewildered like they haven’t in years. They’ve become noobs again.
Being a noob isn’t bad, although it can be uncomfortable. But what I’ve learned from fellow gamers is that being a noob can be fun as well. The key is to keep your sense of humor, and not take having to learn new things as an insult. I sometimes hear colleagues express outrage at having to do things differently to grow their business, and heaven forbid they spend money on coaching or business planning or consulting with someone who has more expertise than they do! The subtext is “How dare I be treated this way?!”
Change isn’t meant to single out and insult you, lighten up. Of course you should be learning new things, and leveling up. Have a little faith that you are learning even though it feels clumsy. We keep trying to get to this “secure” place where we’ll never need to stretch or do something different, and it just doesn’t exist. We need to cultivate what my colleague Chris Willard refers to in his book of the same title as our “Child’s Mind.”
In other words, we need to embrace being a noob.
Do Your Dailies
March 28, 2011 by 10 Comments
UVN4UFFHFPND
Epic Therapists do their dailies. And if you’re not a therapist, but a gamer or someone else who wants to have a better life, this post may be useful to you also.
At a recent workshop, I began by showing a slide with our “Epic Agenda.” And the first question I got from a therapist was a great one, one that staggered me:
“What does Epic mean?”
Gamers among you may be chuckling now, but try to answer that question, and try to remember back to a time when you didn’t know the difference between green and purple gear. Back then you didn’t know what Epic meant either. So let me offer us a working definition of Epic:
Epic means “the most super amazing over the top of all time.” An Epic Win would be the most super amazing over the top win of all time. An Epic Fail would be the most super amazing over the top fail of all time. Epic is big, Epic is superlative, the most super dooper in history.
We don’t talk about ourselves in epic language much. We tend to think of it as arrogant, unrealistic, and asking to be taken down a peg. The idea of being Epic anything makes us self-conscious, with a lower-case s. And yet, I think it is time we change that.
All over the world you people are being Epic. Right now in Japan, every one of those people is Epic. The people surviving a disaster of multiple phases and historic proportions are Epic. I doubt that any of my readers would argue that. Every person helping those survivors is Epic. Even as we speak the people of Japan are pulling off what will be seen in years to come as one of the biggest Epic Wins in their history. (By the way, if you want to support their Epic Win, go to the Red Cross and take 5 mins to donate. There’s also a great definition of psychosocial support there for you therapist types.)
But you don’t have to be at the epicenter of a disaster to be Epic. Gamers know that there are several ways to get that Epic gear. Sure, one of the ways to do that is to down that boss on heroic mode. But there is another way to get that gear and become Epic: Do your dailies.
Dailies, in WoW, are daily quests that you do to gain XP, gold, or points towards buying Epic gear. And it takes a long time to earn those points. But each day, the game server resets, and you get to run these daily quests again. One of the first things an experienced gamer will tell a “noob” who wants to get better gear is, “Do your dailies.”
Back to you therapists: Epic therapists do their dailies. The most successful therapists I know show up for those mundane tasks every day. They return phone calls every day, respond to emails every day, step back to consider the state of their practice every day. Epic therapists read about their craft regularly. Epic therapists learn about what their patients are talking about regularly. Epic therapists reach out and connect with their colleagues regularly, and Epic therapists take risks to make their business visible regularly.
Last Friday I met a dozen Epic therapists who came to my workshop. They spent time and money to learn about online gaming and gamers. I can’t tell you how moved I was to see these colleagues spend 3.5 hours with me learning how to better understand gamers. They were willing to step beyond the model of addiction and see gaming as a culture they needed to become more competent with. They decided not to dismiss video games as trivial or uninteresting and as a result will be able to meet their patients “where they’re at” more than ever. Less than 50 therapists across the world have ever spent 3.5 hours on a workshop to understand gaming, so these folks are truly Epic!
Am I suggesting you all enroll in my workshop to become Epic? Hardly. But I am suggesting that you do your dailies and when you’re feeling down about your practice, keep doing them. I have noticed that the people who tend to be naysayers in our profession tend to be people who don’t want to take risks or invest extra time on a daily basis. They are hoping for a quick fix or solution, one book or secret that will tell them how to succeed. I think there are a lot of books out there that may help, but I think the secret to becoming an Epic Therapist may just be to do your dailies.
And if you’re one of my gamer readers, this applies to you too. You can be Epic out of the game as well as in it. That same stamina it takes to do your Baradin Hold dailies can be applied to your life outside of Azeroth. Getting up a half hour earlier so that you can get to work without feeling anxious is doing your dailies. Doing every bit of your homework is doing your dailies. Listening to your parents and doing your chores are doing your dailies. Telling your partner that you love them is doing your dailies. Spending an hour in meditation, in therapy or at an AA meeting are examples of doing your dailies. Sometimes these dailies will seem easy and quick. Sometimes they will seem a grind. No matter.
Do your dailies.
UVN4UFFHFPND
What I Learned at Pax East.
March 12, 2011 by 4 Comments
For those of you who aren’t in the know, Pax East is a 3 day event founded by Penny Arcade a great website for online comics and other fun stuff. Pax East takes place in Boston, and this is it’s 2nd year. It is a huge convention which had approximately 70,000 video, tabletop and PC gamers. Last year I went to Pax East because I had finally decided I needed to take gaming and gamer-affirmative therapy seriously as part of my growing practice. I had always thought video games were fun, but it was only over the past 10 years that I had come to see that they could be life-changing.
I had discovered firsthand how World of Warcraft, Mario, and Zelda had helped me recover from a terrible job loss and re-evaluate what I wanted my work and life to be like. I had met dozens of gamers in-game and out who were recovering from various life struggles through gaming. I met soldiers stationed in Iraq who were gaming to keep their morale up or stay in touch with their families. I met LGBT people who had come out and found community for the first time in a Warcraft guild. I met people who had fought off isolation in other countries by raiding with loved ones at home. Still more had survived a divorce, discovered a way to rebuild confidence when they’d lost the ability to walk, or taken the first steps to socializing when their autism had stigmatized them and all seemed lost.
I also began to meet a growing number of young men and women who were refusing to be labeled as addicted or abnormal by virtue of their gaming experience. And I began to wonder what it would be like if as a therapist I came out as a gamer and helped people begin to take video games seriously.
At the same time I began to realize that I needed to take my career more seriously, because I had decided to start a full-time private practice. I had had a part-time practice for over a decade, but it always felt like a hobby. And so when I began to float the idea to family and colleagues I was amazed by their response.
They took me seriously.
Anyone who has launched a business can probably identify to some extent. You spend a lot of time wishing, and then daring, and when you finally decide to tell others you find that they have a far easier time taking you seriously than you do yourself. It was as if the company I’d helped built, my education and my CV were all fluff in my head.
If I had a hard time imagining myself as a independent businessman and a full-time private practice therapist, you can imagine how hard it was to imagine being a successful therapist who specialized in video games, virtual worlds and social media. Sure I could justify playing video games with children I worked with, but a gamer-affirmative therapist? This was a harder row to hoe. I had people thinking I meant online gambling and referred gamblers to me. I had colleagues who pretended Facebook didn’t exist and glazed over when I told them about the social media company I had helped develop. And most often I had this response.
“Oh, I don’t know anything about video games.”
This from colleagues who were throwing out the term gaming addiction willy-nilly. So I knew that I had a couple of choices, keep quiet or begin working with gamers and educating psychotherapists about what video games actually are, and what they can do for us. And I decided that if I was to really try to educate people on video games and doing therapy with gamers, I’d have to take myself seriously. And that is where Pax East and Blizzcon came in.
Where better to meet gamers than in those places? And what better form of continuing education for me than to see what is happening in the gaming world? This was part of the work I wanted to do, and the only thing holding me back from engaging in it seriously was that I felt guilty for having fun. From graduate school and continuing education I had learned that education was serious and not necessarily fun. But when I took the plunge I found that the money I spent on travel and the conferences was totally worthwhile, and the people I met were really interested in my work. This is something my colleague Susan Giurleo wrote about recently regarding another such convention that she is going to, SXSW.
I’ve learned a lot in the past two years. Last year at Pax East I didn’t have nearly as much fun as I did this year, because I felt like I needed to be there every minute and take everything seriously. This year I went Friday and picked a few things I wanted to do, like attend Jane McGonigal‘s keynote speech. And I took fun more seriously and learned more. I got a sneak peek and play of the Nintendo 3DS. I got to watch the amazing new XBox Kinect game Child of Eden. I walked around all day with a Plants Vs. Zombies traffic cone on my head. I participated in the largest massively multiplayer thumb-wrestling match in world history! And all around me I saw happy and energized people playing and socializing with strangers.
I was reminded of the things I tell my supervisees all the time, that if you aren’t enjoying yourself in your work something is wrong. Because enjoying yourself helps you achieve a state of believing that success is possible. And that the people who settle for less in their work get less. Such optimism is crucial, because running your own business takes a lot of time and effort. I have never worked as hard at a job in my life, and I have never loved what I do as much as I do now.
(Un)Desperate Times, or Know Your Talent Trees
February 16, 2011 by 12 Comments
Recently I was given a referral for an evaluation, and upon some reflection I declined it. This is not something I am often in the habit of doing, but in this case the evaluation would have involved a clinical situation that did not fit with my integrity. So it got me thinking about the relationship between building your business and professional integrity.
The referral would definitely have been lucrative, and within my scope of experience and skill. And most of us these days certainly cannot afford to turn away business.
Or can we?
If I had taken this evaluation on, I would have most likely have been called on to testify about something that I was not entirely behind. This would have compromised my ability to be an expert witness. As I weighed the pros and cons I was quickly aware of my feeling of “halfheartedness” about the whole thing. And that was what clinched it for me. No patient deserves anything less than a wholehearted therapist as far as I am concerned. And I believe that when we catch ourselves trying to make something “fit” with our practice, we should probably stop right there.
Most of us were trained in clinics or hospital settings where we did not choose our patients. We were there to help everyone, and the idea of a good clinical fit was something we were usually reluctant to give voice to. Social workers in particular are often encouraged to be little mental health Statues of Liberty, treating any of the huddled masses that get sent our way. But no one of us is supposed to treat everyone in my opinion. And believe it or not, there are therapists who want to work with every segment of the population. I have met therapists who love working with borderline personality disorder. Others feel invigorated by working with substance abusers. There are people who really enjoy working with schizophrenia, like me. So in the long run, I think it is important to notice who you like working with, especially if you want to be in private practice.
Being clear on this is hard enough when we are starting or growing our practice. Turning down a referral can be terrifying and guilt-inducing. Somebody needs our help, we need to earn money, and we’re going to decline a referral? Sometimes, yes. Sometimes we need to hold a space open in our practice for a bit. And always the patient deserves a therapist who is 100% committed to the therapeutic relationship. So if we are lucky and have a good coach or supervisor we brave our fears and hold open the space for a while.
But later on in the development of a private practice, you may encounter a slightly different issue, what can be called an “embarrassment of riches.” The phone starts ringing with calls from potential patients, requests for court or special education evaluations, or maybe your old employer wants you to come back and do a workshop for your old agency. It can be tempting to overextend yourself, but I would suggest the following when this happens: Don’t just do something, sit there. Give yourself time to evaluate whether this opportunity is the best opportunity for you after the initial shine or honor of being asked has worn off a little. Because only you know your business plan, and which of the opportunities presenting themselves to you is the best one for furthering your practice.
The picture at the beginning of the blog is what World of Warcraft veterans will recognize as a talent tree. Each character class has three talent trees they can choose from to put their talent points into. The more talents points you put into one tree, the more access you have to higher powers and abilities of a certain kind. At the same time, since you have a finite amount of talent points, putting talent points deep into one tree makes it impossible to put them deep into another. So for example, if I am a mage, I can choose to put my talents in Fire, Frost, or Arcane trees. If I put most of them in fire, I won’t be as powerful when I need to use frost spells.
Sometimes newbie gamers decide to spread their talents across all three trees. They divide up the points and suddenly notice that they are at a high level but aren’t doing that well in the game. At some point someone will notice their talent trees are a mess, and explain to them the importance of specifying their talents. Sometimes therapists do the same thing: We try to be everything to everyone and learn to do a little of this and a little of that. This is often where the diabolical word “eclectic” comes up. We’re not frost mages OR fire mages, instead we’re hurling bolts of lukewarm water, and who needs that really?
If you have been building your practice for a while, you have probably noticed that your phone is starting to ring more, or your website is getting more hits, and this can be so exciting and intoxicating you’ll lose sight of your business plan. This week I had a day like that, where I got 2 referrals for psychotherapy, an extended evaluation, and invited to teach 2 classes! You bet that feels good (and overwhelming!)
But I needed to spend my talent points wisely. If I load up on patients, I won’t have time to do my writing or workshops and ultimately develop passive revenue streams. What’s worse, the patients will get an overworked overtired therapist who is not wholehearted. If I teach two classes, I won’t have enough time to do something else, and if I take on an eval that has me interviewing, writing and expert witnessing, same thing. Time to refer back to my Tweaking 2011 plan. So everything went on hold for a day (remember, we’re running a private practice, not an ER: If something seems so emergent that it can’t wait a day, it may not be something to take on) and I ended up declining half of the embarrassment of riches, offered alternate referrals, and hopefully everyone will be the better for it.
Have you started to specify your talents yet? Have you chosen the talent tree you’ll put the majority of your points in? The secondary one that enhances the first? Does what type of work you accept clearly map to the business plan you’ve made for yourself? I’ve written before about being an Epic Therapist and this is one of the qualities that makes a therapist Epic: Epic therapists specify and hone their talents in one main area. And because they do that they can explain what kind of therapist they are at parties. And they can do solid work and reading in their area so the patient gets excellence. Excellence is what will keep your business afloat in the coming years, so spend your time and talents wisely!
Children, Mental Illness & Video Games
January 25, 2011 by 7 Comments
Photography by Mykl Roventine
I hesitated to use the above title, because I can imagine my gamer audience rolling their eyes already. Bear with me please, it’s not what you think.
A new study has come out reporting that children are using video games “pathologically,” and that this is a global problem. The study, summarized here, reported that out of a sample of 3,034 children, 9% of them could be considered “pathological” in their play, which the researchers found “some serious problems – including depression, anxiety, social phobias and lower school performance – seemed to be outcomes of their pathological play.” And so the media has already begun to hype this up as video games cause mental illness in children, as well as video game addiction is a problem.
So let’s think this through together.
First, there is the problem of cultural translation. The study was conducted in Singapore, and as one of the researchers acknowledges, “”In the US, we didn’t follow the kids across time, so we don’t know where that threshold is across each culture or if there is a certain amount that is too much.” And we also don’t know the cultural variables when we compare Singapore, a city-state, with other countries. Children in urban areas often play more video games due to the safety concerns of living in an urban area.
But more importantly, let me share with you some other statistics, more close to home. The National Institute for Mental Health as recently as last September released this information. Using a sample of over 10,000 teens ages 13-18, they found that over their lifetimes 20% of the children had “suffered from a mental disorder with symptoms severe enough to impair their daily lives.” An earlier study with over 3000 younger children found that 13% of the children met the criteria for one or more mental disorder. This figure, by the way is down from the Joint Commission on the Mental Health of Children, which in 1969 found that 13.6% of all children had “emotional disturbance.” So that’s long before Pong, people, and the statistics if anything have gone down with the advent of better treatment.
Let me share with you one more statistic, from the Pew Research Center which found in 2009 that 99% of boys and 94% of girls play video games. So yes, close to 100% of children in the U.S. play video games, and yes, somewhere between 13-20% of U.S. children have some mental health issue, but that’s because the statistic correlates to a pretty consistent percentage of the population over time predating video games entirely. And if the first study from Singapore were comparable, we could make the argument that kids in Singapore play more video games and have less mental health issues than kids in the U.S. So go Singapore!
If you think you game more than you’d like, feel free to change that, but don’t do it because someone in Singapore says you should.
But if I stopped my rant here, I think that would be doing a large percentage of the population a disservice, namely, those 26.2% of Americans who live with some form of mental illness. Haven’t we stigmatized these folks enough? The constant warcry of “video games are bad,” leans on the ableist stereotype that “mental illness is bad.” It’s not. Mental illness can be challenging, heartbreaking, costly and different from a societal norm, but it is not bad. It is a prevalent health condition, like other prevalent health conditions like, per the CDC statistics, p. 292, Diabetes (10.1%,)High Cholesterol (15.6%,) Hypertension (30.5%,) and Low Back Pain (25.6%.) Whether it be providing adequate health coverage and parity, or taking away the moral overtones, it’s time we stopped treating mental illness like it is something different than other health concerns.
Gamers and people with mental illness do have something in common: They are both marginalized and socially stigmatized by the larger population. So whether you play Super Mario or live with PTSD; whether you play WoW or keep challenging your Depression; whether you have ADHD, Asperger’s or a PS3, game on! There’s nothing bad about you all, any of you, no matter what the experts say.
UVN4UFFHFPND
