Social Justice & Technology Revisited


I have written before about how technology often makes life easier for a large number of the population while simultaneously disenfranchising others.  The good news is that this does not have to be the case.

The example I used in the past was the Starbucks App which allows customers to use, gain rewards for, and reload their account on their smartphone, while making it more cumbersome and difficult to tip baristas.  This again does not have to be an inevitability, but requires Starbucks to enhance the functionality of its App.

So I was pleased to discover (special thanks to my student Marissa for bringing this to my attention) this week that come Wednesday March 19th, Starbucks will be rolling out an update to their smartphone App which allows just that.  You can read more about it at Forbes here.  You will be able to download the update from places like iTunes, and include your tip easily.

While some may dismiss this as a first-world problem, I cannot emphasize how powerful a shift I consider this to be in terms of workers’ rights in the service sector.  I am convinced it comes in part as a result of advocacy by and for workers, and sets the bar higher and yet attainable for corporations to maximize their value to customers while not disenfranchising their employees.

How can you help advocate for social justice in the technology you use?  First, simply by mindful usage.  Take a few minutes today to open your smartphone and make note of the Apps you use most frequently.  Next, ask yourself, who, if anyone is disadvantaged by my using this App?  Just thinking about the connections can be a powerful mental exercise.  Notice how complicated it can get fairly quickly:  If I use Evernote frequently, I am less likely to write things down on paper, which may be good for the environment but may also disenfranchise industrial workers in paper mills.  Hold on, did I say that you had to stop using Evernote or lobby for paper mills?  No, I’m asking us to sit with the complexity of a problem here for a minute to see the larger systems at play.  Technology has always resulted in job loss for some even as it may provide workplace improvements or quality of life for others.  It’s when we don’t think about these things in a more complex way that we stop innovating social justice itself.

Part of what I’m trying to encourage us to see is that social justice, workers’ rights, unions, and any person or group committed to social justice needs to keep pace with innovation and in fact keep innovating themselves.  Technology always runs the risk of disenfranchising people, especially workers.  If the McCormick reaper in a few hours does the day’s job of three workers, what happens to those three workers?  We are still living in a capitalist society in the US, and it is unlikely that as technology improves and reduces the need for human workers that all of these people will be able to afford to turn their minds and lives to the pursuit of art and culture.  Everything isn’t always getting better for everyone in the current system, and we are seeing overcrowding in occupations ranging from factory to legal work.

If social justice advocates, and social workers are to continue to help the disenfranchised, they are going to need to keep pace with technological developments and continue to think innovatively about 21st century equity in complex and sustained ways.  And by the way, thinking, “the gap is just going to get wider, the social fabric is unraveling,” is not an example of innovative thinking, but defeatism that exempts us from the work of innovation.

This brings me back to my social work colleagues, and my continued urging for them to keep pace with emerging technologies, especially if you are touting the concept of social innovation.  Social innovation without leveraging emerging technology will ultimately lead to future disenfranchisement.  If you have a social innovation department in your social work program that doesn’t leverage technology you are not being socially innovative.  I certainly don’t have all the answers, but I know that the answer to social injustice will inevitably need to integrate emerging technology into it.

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Crusader Man(1)

Recently, and frequently, I have heard colleagues describe me as being on “a crusade” about video games and technology.  On no occasion has it been used in an attempt to speak positively about my work, but it did get me reflecting on crusades in general.

In many ways, the term Crusade has always been used with an air of critique and generalization.  The most famous “Crusade” in medieval Europe was actually never named that by the people living in it; the term crusader began to be used 400 years after the fact.  Some famous crusades, such as the Children’s Crusade, may actually never have happened.  Additionally, there were actually numerous Crusades spanning 200 years rather than just one long one and they had both positive and negative far-reaching impacts on the world.  They fostered both genocide and the arts, opened trade routes and disease vectors, and were in short as complex, violent, and impacting as most human endeavors.

I have had some difficulty embracing the identity of crusader when used by colleagues, because it is often a passive aggressive dig at my work.  They can’t quite get away with calling me militant or intolerant in polite circles, but they do float out these ideas when considering my take on video games, technology and therapy “unbalanced” and “evangelical.”  Lately I have been reminded that it is not just me who has to deal with this–for some reason many mental health professionals tend to single out any one of us who gets too “passionate” about one element of the work.  I had a consultee recently begin to describe his practice vision, grow very excited and then check himself with me as if somehow that excitement was an unseemly thing in a therapist.  Here he was describing something that made him revolutionary and special, and that was somewhat suspect.

The mental health and education systems in the United States beat down many, patients and therapists, alike.  Rather than an expansive fount of creativity, the mind is seen as a widget traveling on a conveyor belt with hundreds of other widgets to be stamped with a DSM-V label or pathology so insurance companies will dole out money and providers dole out care.  I have overheard young clinicians spend hours talking with each other about what code to use and not once mention what it feels like to sit in the room with a patient or wonder what is going on in their inner world.  And when we do talk about mindfulness, we often talk about it in an over-scripted way that implies a specific time, place and type of activity that is “mindful,” rather than see that mindfulness is a stance we can take with any activity, including, yes, video games.

One of the reasons that social media is so powerful is that each of us experiences the feeling of being alone in life. It is this, our yearning for the imagined other, that makes social media so compelling. Whether we feel alone in our sadness, bewilderment, pride or confusion, we long to call out to the other. The parent wondering if she is doing a good enough job, the adolescent unnerved by the changes in his very body, the student who just aced her exam, the toddler who just fell and is looking up to his parent: Each of us at some time needs to call out to the imagined other to help us know how we are in the world, and help us realize ourselves.  So, yes, I am passionate and on several crusades, and since this is my blog I get to write about them.  They are varied in size and scope and sometimes tangentially connected.  Here are a few soundbites from the Crusade:

Video Games and Play Therapy.  I tell as many clinicians I can that if you want to do play therapy in the 21st century, start using 21st century play.

Video Games are Social Media, and Everyone is Playing.  The only reason you don’t have patients who tell you they game is because you don’t ask them.  Young, old, male, female, Xbox, smartphone, the overwhelming majority of people play something several times a week, often online and in highly social ways.

Let Smartphones and Laptops in Your Office.  If you want to meet your clients where they are at, let them show you their life in social media.  Bemoaning that Facebook is unraveling the fabric of society doesn’t change the reality that the majority of your patients use it.

Education Needs to Change.  We need to make more room for the quirky student, the adult distance learner, and the team player.  We are training people to work in the 20th Century, and then blaming them when they function poorly in the 21st.

Starting Your Own Business is Risky and Rewarding.  Therapists are often unwilling to spend any time or money to launch their own practice, and buy into what I call the “hazing” model:  Work long hours for low pay at your “main” job, sublet a tiny space, and when you’ve had enough lumps you too will get to have a private practice.

Not All Ideas are Great, But ANYONE Can Have a Great Idea.  Years of working with children and adults who learn differently has taught me that this is possible.  Anyone, regardless of race, class, orientation, learning ability, or past history is capable of having a great idea.  To rule someone out is a violence you do to their very humanity.  So stop it.

Look, we live in such an exciting and enriching time, and we could so much more with our lives if we could embrace more of that.  Sure it means change and fear, and yes, there are lots of obstacles.  We have a lot of work to do.  But let’s stop siloing down in our own little offices or classrooms regurgitating the same old APA-style blah blah, and let’s stop training future generations to be automatons of despair.  Let’s stop peer-reviewing everything and privileging those few who play the academic game with expertise.  Of course we don’t have to do away with everything in academia and health care but we can certainly make room for diversity, passion, and expansive thinking.  And if you can’t do that, the least you can do is not rain on the parades of those of us who are taking risks, the crusades we are on aren’t of the genocidal variety.

I don’t like being the recipient of these sorts of microaggressions, but I am so grateful that I have things I care passionately about.  My life of the mind and soul is so important to me, and ultimately it is not for me to decide whether my ideas are great or my crusade is just.  You can call me a crusader, but as Maya Angelou said,

my description cannot
fit your tongue, for
I have a certain way of being in this world

What about you?  What crusade are you on?  What makes you passionate?  Who is the next right person to talk about it with?


Interested in setting up a consult for your practice?  I have some openings come March.  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!

Works, Life and Marshmallows: Iterative Design


They say the journey of a thousand miles begins with a single marshmallow.  Ok, I say that, and more specifically I am talking about your life, job or relationship rather than a journey.  I am coming back to my practice from a brief sabbatical, and have been noticing that while many things are going to stay the same, a few are changing as well.  I’ll get back to the marshmallow in a minute.

One thing I learned on my sabbatical is that I definitely want to continue my therapy practice.  As I said to some friends on Facebook this week, “You know, I’m kind of grateful that I get to challenge the self-hatred of others for a living.”  As a clinical social worker and psychotherapist I get paid to do that.  One thing I also decided on my leave was to withdraw from the last managed care insurance panel I was on.  It made no sense to continue to decrease the time I could be seeing people due to paperwork and bureaucratic hassles, and it made no financial sense to have a waiting list of people who are willing to pay my full fee and also deserve treatment just so I could work at half my rate.  I have always built pro bono or sliding scale slots into my practice because I have a commitment to serving a diverse population, so why was I doing that and letting an insurance company slide the remaining hours of my week?

Part of the answer to this and most “why-have-I-been-doing-this-this-way-when-it-doesn’t-work-in-my-favor?” questions is fear. Most of us are afraid of change.  Whether we are staying in an abusive relationship, having difficulty getting sober, flunking out of college or missing days at work, most of us have moments when we see what we are doing to ourselves and ask the above question.  And then we often resume whatever the pattern is, leaving an interesting question unanswered and instead turning it into self-recrimination, which is really just evasion.  Another part of the answer is that we often act is if we only get one shot at answering the question of life satisfaction.  Here comes the marshmallow.

Invented by Peter Skillman of Palm, Inc. and popularized by Tom Wujec of Autodesk, the Marshmallow Challenge may be familiar to some of you:  “It involves the task of constructing the highest possible free-standing structure with a marshmallow on top. The structure must be completed within 18-minutes using only 20 sticks of spaghetti, one yard of tape, and one yard of string.” (per Wikipedia)  You can call it an exercise, or play, but in either event the creators of the challenge have observed something very interesting about how different groups tend to approach it.  Children tend to make a first structure, stick the marshmallow on top, and then repeat the process over and over, refining it as they go.  Adults tend to engage in group discussions, arguments, power plays and plans to produce one structure built once to which the marshmallow is added.  In other words they tend to approach it derivatively rather than iteratively.

Iterative design is a method of creating a thing or addressing a problem by making a prototype (first attempt,) testing it, analyzing the prototype, and then refining it.  Rinse and repeat.  Iterative design isn’t good for everything: As parents know, often there is not time in the world for everything to get done in 18 minutes or before the school bus gets here.  But a life built on derivative design alone is destined for stagnation and rigidity.

Derivative design, as the name suggests, takes something from a pre-existing something-else, whether it be a rule, materials, social construction or interpretation of the something-else.  When you psychoanalyze a patient’s dream and interpret it as a manifestation of their Oedipus Complex, you are deriving your interpretation and their dream from the something-else of Freud, who in turn derived his Oedipal Conflict theory from the something-else of Greek mythology.  Derivative design can save time and effort in many important ways, by collapsing cultural memes and thinking and transmitting them forward through time from Sophocles to your office.  But as feminist thinkers and cultural critics have shown us, we might have arrived at a different “complex” if Audre Lord et al had been in on the prototyping of it.

Derivative thinking left unchecked can get you in a rut.  One of my most recent examples of this comes from The Little Prince, where he encounters the drunkard:
“- Why are you drinking? – the little prince asked.
– In order to forget – replied the drunkard.
– To forget what? – enquired the little prince, who was already feeling sorry for him.
– To forget that I am ashamed – the drunkard confessed, hanging his head.
– Ashamed of what? – asked the little prince who wanted to help him.
– Ashamed of drinking! – concluded the drunkard, withdrawing into total silence.
And the little prince went away, puzzled.
‘Grown-ups really are very, very odd’, he said to himself as he continued his journey.”

Everything derives from the previous thing, but in the end it sometimes gets us nowhere.

We all get in these difficult spirals.  A good therapist or supervisor can point them out to us and then encourage us to become iterative in our design:

  1. So what are you going to do this time?
  2. How did that work out?
  3. So what are you going to do differently?

Therapists starting their private practices also come to see me, often stuck in derivative thinking:

-I need my NPI number.
-Ok, why?
-To get on Medicare.
-Ok, because?
-So I can get on insurance panels.
-Ok, why?
-So I can get patients who will pay me so I can rent an office so I can have an address to register for my NPI.

If you are one of my consultees reading this rest assured I am NOT talking about you in particular:  I have had this conversation a hundred times with people.  We get indoctrinated into the world of managed care and get, well, managed.  In this case, I usually recommend the consultee start by imagining what kind of office space they want.  Answers have varied and included: Sunny, exposed beams, plants, yellow paint, toys, music system, waiting room with receptionist, friendly colleagues in suite, accessible to public transportation, elevator, warm colors, cool colors, and all sorts of other iterations.

Once you have a mental prototype you can either build or design your office, or find and rent it.  Again I tell folks to walk around the areas they want to work in, find buildings that look interesting to them, then walk inside and ask to speak with someone about seeing a unit.  Testing involves going to see several spaces.  Then they can analyze the results: Does the space look like it would become what they imagine it to be furnished? Are there things about their ideal that need to be discarded? Do they now realize that they could be even more wild in their expectations?

This is just one example of the ways that iterative design can open up possibilities.  But be warned, iterative design can be daunting for many of us raised in our current education system.  We have been trained to create one product presented in final form with the expectation that we will be graded on that product alone. Everything becomes about that one paper or exam, which is often more about regurgitation rather than innovation.

I have colleagues who take my breath away with the number of projects and ideas they are consistently throwing out there to see what happens:  It takes guts to do that.  I myself often am afraid that the Project Police are going to pop out and say, “What happened to your idea of a Minecraft group?  Shame on you for proposing it and not completing that project!  You are not allowed any more ideas until you show us you can carry that one out.”

Sound ridiculous? Of course it is, but does it sound familiar to you as well?  If it does, go out and buy yourself some spaghetti, tape and marshmallows:  The quality of your job, relationship and life may depend on it.

Interested in setting up a consult for your practice?  I have some openings come March.  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!

No Matter How You Feel, You Still Failed


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:







pac man


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

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

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

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

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

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

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

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

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


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Reality Testing & The 7 Billion Rule

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!


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Obama, Selfies, Projections & Death

In this video Mike Langlois, LICSW gives an analysis of what the furor around President Obama’s selfie at Mandela’s funeral could say, not about him, but us.



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Selfie Esteem

Nancy J. Smyth, PhD, Dean & Professor, University at Buffalo

Nancy J. Smyth, PhD, Dean & Professor, University at Buffalo


“Photographs do not explain, they acknowledge.” –Susan Sontag

Last month, the Oxford Dictionary made the word “selfie” not only an official word, but their word of the year for 2013.  Defining selfie as “a photograph that one has taken of oneself, typically one taken with a smartphone or webcam and uploaded to a social media website” the OD made explicit what has implicitly grown to be the norm of our world; a world of smartphones, self pics and social media.

Many psychotherapists and social workers have and will continue to decry this as another sign the the “narcissism” of our age.  Selfies have become synonymous with the millenials, the dumbing down of the populace by the internet, and sometimes even stretching to how Google is making us stupid.  My chosen profession has historically played fast and loose with calling people and cultures narcissistic.  Karen Horney coined the term “the neurotic personality of our time” in the 1930s, initially in part as a critique to the Freudian critique of Victorian modesty.  Kohut’s groundbreaking work on “tragic man,” and the healthy strands of narcissism in human life was co-opted within years by Lasch (1979) to describe the then-current “culture of narcissism.”  In short, even though narcissism has been a part of human being at least since Narcissus gazed into the water in Greco-Roman times, we continue to see it as perennially on the uprise.


Joanna Pappas, Epic MSW Student

Joanna Pappas, Epic MSW Student


This dovetails with each generation’s lament that the subsequent one has become more self-absorbed.  And yet, as Sontag points out, by making photography everyday, “everybody is a celebrity.”  Yep, that’s what we hate about the millennials, right?  They think everything is an accomplishment, their every act destined for greatness.  But as Sontag goes on to say, making everybody a celebrity is also making another interesting affirmation: “no person is more interesting than any other person.”


Jonathan Singer, Assistant Professor, Temple University

Jonathan Singer, Assistant Professor, Temple University


Why do many of us (therapists in particular) have a problem then with selfies?  Why do we see them as a “symptom” of the narcissism of the age?  Our job is to find the interesting in anyone, after all. We understand boredom as a countertransference response in many cases, our attempt to defend against some projection of the patient’s.  So why the hating on selfies?

I think Lewis Aron hits on the answer, or at least part of it, in his paper “The Patient’s Experience of the Analyst’s Subjectivity.”  In it he states the following:


I believe that people who are drawn to analysis as a profession have particularly strong conflicts regarding their desire to be known by another; that is, they have conflicts concerning intimacy.  In more traditional terms, these are narcissistic conflicts over voyeurism and exhibitionism.  Why else would anyone choose a profession in which one spends one’s life listening and looking into the lives of others while one remains relatively silent and hidden?

(Aron, A Meeting of Minds, 1996, p. 88)


In other words, I believe that many of my colleagues have such disdain for selfies because they secretly yearn to take and post them.  If you shuddered with revulsion just now, check yourself.  I certainly resemble that remark at times:  I struggled long with whether to post my own selfie here.  What might my analytically-minded colleagues think?  My patients, students, supervisees?  I concluded that the answers will vary, but in general the truth that I’m a human being is already out there.


Mike Langlois, PvZ Afficianado

Mike Langlois, PvZ Afficianado


Therapists like to give themselves airs, including an air of privacy in many instances.  We get hung up on issues of self-disclosure, when what the patient is often really looking for is a revelation that we have a subjectivity rather than disclosure of personal facts.  And as Aron points out, our patients often pick up on our feelings of resistance or discomfort, and tow the line.  One big problem with this though is that we don’t know what they aren’t telling us about because they didn’t tell us.  In the 60s and 70s there were very few LGBT issues voiced in therapy, and the naive conclusion was that this was because LGBT people and experiences were a minority, in society in general and one’s practice in specific.  Of course, nobody was asking patient’s if they were LGBT, and by not asking communicating their discomfort.

What has this got to do with selfies?  Well for one thing, I think that therapists are often similarly dismissive of technology, and convey this by not asking about it in general.  Over and over I hear the same thing when I present on video games–“none of my patients talk about them.”  When I suggest that they begin asking about them, many therapists have come back to me describing something akin to a dam bursting in the conversation of therapy.  But since we can’t prove a null hypothesis, let me offer another approach to selfies.

All photographs, selfie or otherwise, do not explain anything.  For example:




People who take a selfie are not explaining themselves, they are acknowledging that they are worth being visible.  Unless you have never experienced any form of oppression this should be self-evident, but in case you grew up absolutely mirrored by a world who thought you were the right size, shape, color, gender, orientation and class I’ll explain:  Many of our patients have at least a sneaking suspicion that they are not people.  They look around the world and see others with the power and prestige and they compare that to the sense of emptiness and invisibility they feel.  Other people can go to parties, get married, work in the sciences, have children, buy houses, etc.  But they don’t see people like themselves prevailing in these areas.  As far as they knew, they were the only biracial kid in elementary school, adoptee in middle school, bisexual in high school, trans person in college, rape survivor at their workplace.

So if they feel that they’re worth a selfie, I join with them in celebrating themselves.

As their therapist I’d even have some questions:

  • What were you thinking and feeling that day you took this?
  • What do you hope this says about you?
  • What do you hope this hides about you?
  • Who have you shared this with?
  • What was their response?
  • What might this selfie tell us about who you are?
  • What might this selfie tell us about who you wish to be?
  • Where does that spark of belief that you are worth seeing reside?

In addition to exploring, patients may find it a useful intervention to keep links to certain selfies which evoke certain self-concept and affect states.  That way, if they need a shift in perspective or affect regulation they can access immediately a powerful visual reminder which says “This is possible for you.”

Human beings choose to represent themselves in a variety of ways, consciously and unconsciously.  They can be whimsical, professional, casual, friendly, provocative, erotic, aggressive, acerbic, delightful.  Are they projections of our idealized self?  Absolutely.  Are they revelatory of our actual self? Probably.  They explain nothing, acknowledge the person who takes them, and celebrate a great deal.  If there is a way you can communicate a willingness see your patient’s selfies you might be surprised at what opens up in the therapy for you both.


Melanie Sage, Assistant Professor, University of North Dakota

Melanie Sage, Assistant Professor, University of North Dakota


In other posts I have written about Huizinga’s concept of play.  Rather than as seeing selfies as the latest sign that we are going to hell in a narcissistic handbasket, what if we looked at the selfie as a form of play? Selfies invite us in to the play element in the other’s life, they are not “real” life but free and unbounded.  They allow each of us to transcend the ordinary for a moment in time, to celebrate the self, and share with a larger community as a form of infinite game.

It may beyond any of us to live up to the ideal that no one is less interesting than anyone else in our everyday, but seen in this light the selfie is a renunciation of the cynicism I sometimes see by the mental health professionals I meet.  We sometimes seem to privilege despair as somehow more meaningful and true than joy and celebration, but aren’t both essential parts of the human condition?  So if you are a psychotherapist or psychoeducator, heed my words:  The Depth Police aren’t going to come and take your license away, so go out and snap a selfie while everyone is looking.

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The Changing Landscape of Social Work


Recently I had the great opportunity to be a scholar-in-residence at The University at Buffalo’s School of Social Work.  For three days I met with students, faculty and staff to speak about emerging technologies ranging from Twitter to video games.  During one morning, Dean Nancy Smyth and I sat down for a series of informal discussions around various topics, and the University was kind enough to let me share these videos with you.  If you want to learn more about how I can come to your institution to do the same thing, please contact me.

How to Use Social Media and Technology to Develop a Personal Learning Network:


If I Don’t Use Social Media and Technology in Social Work Practice What Am I Missing?



Social Work is Changing:  Integrating Social Media and Technology Into Social Work Practice



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First Thoughts on Snapchat


Because my vision for my work is to help integrate emerging technologies with clinical social work and psychotherapy, I don’t have the luxury of relying on moral panic for my information when a new social media arrives. Actually, I’m a bit late to the game with Snapchat, which has been around since September 2011. But I take comfort that I am in the fastest growing user demographic for it, namely people in their 40s.

I am fortunate to have a cohort of clinicians, educators and early adopters in my personal learning network.  Folks such as Nancy Smyth and Jonathan Singer, who are also committed to approaching technology with an NCPTI (No Contempt Prior To Investigation) attitude.  So this week I invited them to partake in a foray into Snapchat with a few other friends and clinicians.

For those of you who aren’t familiar with Snapchat (and for those of you who say, “isn’t that about teen sexting?” you aren’t familiar with Snapchat,) Snapchat is a photo messaging application that allows you to take photos and share them with members of your Snapchat social network.  The photos are temporary; once a person views them for 1-10 seconds they disappear forever.  There is an option to keep them on a feed called your “Story” for 24 hours, but after that they too are gone forever.  Viewing them on your smartphone requires keeping your thumb touching a spot on the screen, and when you lift it the photo is gone, forever if the seconds run out before you touch again.

In reality the photos may be stored on the servers for up to a month if they are not viewed, but the initial viewing starts a countdown to deletion and impermanence.  Technically there are possible workarounds, such as taking a screenshot on your iPhone, which I managed to do at least once successfully with only 5 secs and some thumb dexterity.

Snapchat has become synonymous with teen sexting in the popular media, there is not a lot of research specifically on it.  My preliminary look showed that one study mentioning photo images, which tended to conflate teen sexting with grooming for pedophilia.  Pew Information that predates Snapchat by 2 years shows that a minority of teens 12-17 were sending (4%) or receiving (15%) “sexual” photos, and that 1:3 ratio itself is worthy of wondering about.  The number goes up at 17 with 8% sending and 30% receiving them. That said, another study by Mitchell et al (2012) found a lower number of students reported receiving sexual images at 2.5%  Even more significant was how that percentage dropped to 1% when the definition of images was reduced to sexually explicit as defined by showing naked body parts.  The 1:3 receive/send ratio remained the same, but once the research drilled down to specifics about the images, a clear minority of teens emerged.

Every teenager is important, but 1-4% of a population is not an epidemic.  In terms of how many kids may be using snapchat, it is hard to tell.  Anecdotally the media tells stories of kids who believe “90% of my class uses it,” and yet the data I’ve seen on comparable products such as Twitter or Instagram is much lower than that, with 26% of youth in 2012 using Twitter and 11% using Instagram, per Pew.

Back to Snapchat.  So far the my impressions have been these:

1. Snapchat may actually encourage privacy relative to other platforms.  The fact that adolescents are using Snapchat, with its fleeting images and transient nature may indicate their growing interest in digital privacy.  Future surveys need to specifically ask the question “Do you take screenshots when you get a Snap so you can keep it?” to see if teens are doing just that.  An equally important question is “Do you know you can do that?”  Here’s why:

2. Teens may mistakenly think that the images are more permanent than they actually are.  We often assume youth are more sophisticated in technology use than adults, but even if that is true, it means that we have limited ability to ask them the specific questions to understand their understanding of it.  If we discover that a majority of children understand they can work around the temporary nature of Snapchat, yet don’t do that, does that indicate a heightened interest in personal privacy and respect for the privacy of others?  Does it indicate a lack of premeditation when viewing a picture? Does it indicate something else?

3. Snapchat makes adults anxious.  I base this on the number of folks I chatted with trying to enroll in my experiment who joked about whether we would engage in sexting or not.  Answer: No, we won’t.

4. Snapchat has potential to change the way we converse.  As I exchanged photos I realized that the real fun was in snapping the photo to “reply” to the friend’s photo.  If I just snapped pictures and sent them the conversation tended to peter out.  Captions allowed me to frame the picture with humor and engage.  Or you can refrain from captioning and see how strong the image is in its ability to convey meaning.  My favorite to date was when Nancy Smyth sent me a Snap of her latest Starbucks Refresher, and I replied with mine as if to say “This is all your fault.”  I’ll be curious to see if that is how she interpreted to image.

5. Snapchat seems to encourage whimsy and humor amongst my cohort.  Perhaps it is because we are not in the throes of adolescence, but the images we have sent are more latency age from a psychodynamic point of view.  They have included:

  • A leaf
  • A book by Julian Barnes
  • A Do Not Enter Sign (in response to the book by Julian Barnes)
  • Several beverages
  • A glowing ghost
  • Someone sporting a V for Vendetta masque
  • A screenshot of Call of Duty: Ghosts
  • Flowers
  • One child, presumably an offspring.
  • 2 Cat pictures with veterinary injuries circled and labeled

What has been emerging is a playful portrait of everyday lives, curated surely, but informative and engaging nonetheless.  Are these trivial images? Maybe, but I prefer to think that human engagement that is playful is meaningful regardless of how trivial it may seem, and I’d encourage skeptics to try Snapchat out a bit rather than adhere to the CPTI model.

6. Snapchat could have potential for social work.  I’m thinking about how it could be used to contract for surveillance with runaways and their caregivers.  I’m thinking of how it could raise awareness on homelessness if we had people create “Stories” to be viewed temporarily what homelessness looks like.  I’m thinking how teen groups could use it to send each other encouragement between groups in the form of pictures of resilience, warmth or whimsy.  Remember, the title of today’s post is “First Thoughts” not “Best Practices.”  Now is the time for innovation and reflection, and I’m sure there are a number of ways we could utilize this platform to supplement the work we do with children if a few of us mental health types think for a few minutes beyond the “It’s about sexting!” line of thought.

Technology amplifies thoughts and feelings, and so it will be unsurprising to me if it amplifies sexual expression and flirtation in adolescents.  Our real problem with adolescents has always been that they have a sexuality to begin with, and a life that is diverging from the adults in their world.  Snapchat isn’t really the problem here.  Our larger problems are as always the proprietary sense of control we exert on adolescents, our anxiety about their sexuality, and our tendency to want to avoid those two emotional conflicts by finding a way to control the adolescents who trigger us.

But it may just be the case that our youth are starting to request and require more privacy from their technology, and if so that is a great thing.  The main danger I see is that they have been raised by a generation that often yearns to find a privacy setting to “park” their children on, rather than educate them about critical thinking and digital citizenship.  If teens don’t know the whole story about the settings on Snapchat and other platforms that’s a problem.  If they don’t learn how to be good digital citizens that’s a problem.  But if they don’t know because all we ever taught them was how to “park” their privacy settings or turn the App off, then we have failed them.  And that’s our problem.

By the way, if you are a parent and want to understand more about Snapchat and your child’s  safe use of it, Snapchat actually has a Guide for Parents

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Extra Life


Earlier this year, my co-therapist Boo had to have an emergency surgery at Mass Vet Referral Hospital.  She came through it with flying colors, but I was reminded of how important hospitals are every day, even though I may not use one every day.  And then on Marathon Monday, Boston citizens and the world received an painful reminder that hospitals are called on to do extraordinary things every day, often with not enough resources to do them.

This year, as in year’s past, Team Boo will be participating in Extra Life.  What is it?

“On an Autumn Saturday each year since 2008, tens of thousands of gamers have joined together to save the lives of local kids in a celebration of gaming culture that we call Extra Life.  From console games to tabletop RPG’s to even lawn sports, Extra Life gives people that love to play a chance to do what they love to save lives and make a difference.  To participate you need only sign up (free) and gather the support of your friends and family through tax-deductible donations to your local CMN Hospital.  Then on Saturday, November 2nd (or any day that works for you!) play any game(s) you want on any platform(s) that you want with anyone you want for as long as you want.”



As always, Team Boo will be gaming close to home, for Boston Children’s Hospital.  Each year, BCH has approximately 25,000 inpatient admissions each year and their outpatient clinics schedule 557,000 visits annually. Last year the hospital performed more than 26,500 surgical procedures and 158,700 radiological examinations.  That’s a lot of kids!

If you read this blog with any regularity you know that I believe that anyone can have a good idea and change the world.  Few people would argue that hospitals and a public infrastructure for health care are not good ideas.  But we live in a world where ideas alone won’t always save us, and Extra Life gives you and I an opportunity to raise awareness and money for that.

So please consider joining Team Boo as we game on tomorrow to raise money for Children’s Hospital in Boston, or the Children’s Health Network nationwide.  If you want to donate you can do that here.  And even if you can’t do either, please pass this post along to amplify the idea.  Because you never know when you or someone you love will need a hospital, but we do know that every day many kids do.

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