The Internet & Real Relationships

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

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

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

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

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

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

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

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

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

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

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

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

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

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Bringing Emerging Technology into the Clinical Process: Implications for Engagement and Treatment

If you have ever wondered how to begin attending to, listening for, and asking questions about a patient’s use of technology, this video might give you some ideas.  In it my colleague Lesa Fichte, LMSW, University at Buffalo School of Social Work, and I, discuss the role of technology, people’s relationship with technology, and how to integrate it into the treatment process by listening, inquiring, and learning.

 

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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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The Changing Landscape of Social Work

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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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Automation

papertowel-dispenser

Recently I was washing my hands in a public restroom.  The paper towel dispenser was one of those that automatically dispense.  There was a towel ready to be pulled off; you took it, and the dispenser automatically pushed another towel out for the next user.

I was in the middle of taking my fourth towel when I realized that my hands were long-since dry and that I was taking the towels continuously because the dispenser was offering them to me.

Technology offers itself to us, but technology doesn’t decide whether or not we should use it.  That is and always has been a human decision.  We can forget that, or ignore it, but we do so at our peril.

If the towel dispenser was one of the motion detected sort, the above story would never have happened to me, because I would have always had to exercise my agency to get it going.  Ironically that was what the Greeks meant when they first used the term automatos or αὐτόματος:  It came from , autos (self) and méntis (thought) and meant “self-moving, moving of oneself, self-acting, spontaneous” according to Wiktionary.  It wasn’t until the late 1940s when the term automation became more widely used, by General Motors in reference to their new Automation Department.

Although my towel story might be funny to some (it was to me,) it has some serious implications when we think about social media and digital literacy, in particular for our children.  Let’s take this example:

status updates

One of things that has created a confusion of tongues in social media is the fact that we are bombarded with opportunities to share regardless of what the implication might be if we do.  The Facebook status update box is a great example:  As someone I know once said, “they gave us the box, but they didn’t tell us what to with it.”

What is your status update? Is it how you are feeling?  What you are eating?  What you are doing/thinking/talking about?  If the box tells you to write something in it, do you have to?  If you are not feeling happy, sad or tired, do you leave it blank.  And what if you aren’t grateful for something right now?  The status update can be seen as akin to the towel dispenser:  pushing out prompts for you to think or communicate a certain way, but not telling you how or even that you have the choice to refrain from doing so as well.

In the 21st century, to educate our children and adolescents about personal responsibility and agency is to educate them in digital literacy.  This is the responsibility of adults who themselves were raised in a culture that never trained them how to deal with the increasing automation of society or the way social media has changed our brain, sense of self and the social milieu.

It may not come as a surprise that I have strong opinions about this, and they come in a large part from my training as a clinical social worker.  I believe that social workers have a responsibility to help their clients achieve and improve their digital literacy.  In general if you are a mental health provider I think it is your job to do this.  We are tasked with helping the human being in the social environment, and technology is part of the social environment for the majority of the population we serve.  If you do not know how to use Facebook then you are insufficiently educated to work with families and children in the 21st century.  If you are unaware of geotagging and the risk it poses to domestic violence victims seeking safety from their perpetrators you are putting your clients in jeopardy.  If you are an LGBT-affirmative therapist and you don’t know about Grindr you won’t be effective.  If you are a psychotherapist and you don’t ask about your patients’ use of social media you are missing out on a significant part of their daily interactions, behaviors, thoughts and feelings.

Chances are that if you are reading this blog you are not one of my colleagues who is completely averse to technology, so I hope that you’ll pass on some of this info to your colleagues who are.  To the best of my knowledge there are only two graduate courses that teach social workers about the impact of technology on our clients, and I’m teaching them.  This will have to change if we are to remain relevant to the populations we serve.

Technology is offering itself to our clients every day in hundred of ways.  It is up to us to remind them to pause and remember that they have agency.  If we don’t, then we are the ones who have become the machine.

 

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Saving Ideas

cave painting

Sometime, over 40,000 years ago, someone decided to put images of human hands on the cave pictured above.  It turned out to be a good idea.  This painting has given scientists information on life in the Upper Paleolithic, raised questions about the capacity of Neandrathal man to create art, and sparked debate about which species in the homo genus created it.  Other later cave paintings depict other ideas: Bulls, horses, rhinoceros, people.

I wasn’t there in the Paleotlithic but I doubt that the images we are seeing in caves were the first ones ever drawn.  I imagine that drawing images in sand and other less permanent media happened.  I suspect that the only reason we have cave paintings is because at some point somebody decided they wanted to be able to save their idea, to keep it longer or perhaps forever.

Every day, 7 billion of us have untold numbers of ideas.  So what makes a person decide that an idea is worth saving?  What makes us pause and make a note in our Evernote App or Moleskine journal?  What inspires us to make a video of our idea on YouTube or write a book?  We can’t always be sure that an idea is a “good” one or even what the criteria for a good idea is.  It usually comes down to belief.

In the past several centuries, the ability to save ideas was relegated to the few who were deemed skillful or divinely inspired.  Books were written in monasteries, then disseminated by printing presses, and as ideas became easier to save, more people saved them.  But, and this is very important, saving an idea doesn’t make it a good idea, just a saved one.  Somewhere along the line we began to get the notion that only a few select people were capable of having a good idea, because only a few select people were capable of saving them.  Even in the 21st century, many mental health professionals and educators cling to the notion that peer-reviewed work published in journals is the apex of quality.  If it is written, if it was saved by a select few it must be a good idea.  If you have any doubt of what I’m talking about just Google “DSM V.”

With each leap in human technology comes the power to save more ideas and then spread them.  People who talk about things going viral often forget that an idea has to be saved first, and that in essence something going viral is really a form of society saving an idea.  If anything, technology has improved the democratization of education and ideas.

This makes many of us who grew up in an earlier era nervous and frustrated.  We call the younger generation self-absorbed rather than democratizing.  We grumble, “what makes you think you should blog about your day, take photos of your food, post links to cute kitten videos?”  We may even take smug self-satisfaction that we aren’t contributing to the static.  I think that’s a bad idea, although it clearly has been saved from earlier times.

40,000 years from now, our ideas may take on meanings we never anticipated, like cave drawings.  Why were kittens so important to them?  In the long view I think we remember that people have to believe they have an good idea before they take the leap of faith to save it.  The citizens of the future may debate who saved kitten videos and why, but it will be taken as given that they must have been important to many of us.

What if everyone had the confidence to believe that they had an idea worth saving?  What if everyone had the willingness to believe that it just might be possible that their idea was brilliant?  Each semester I ask the students in my class to raise their hand if they think they can get an A- or higher in the class, and most do.  Then I ask them to raise their hand if they think they can come up with in an idea in this class that could change the world.  I’ve never had more than 3 hands go up.  That’s sad.

This is why I admire the millennials and older groups who take advantage of social media and put their ideas out there.  I doubt that they are all good ideas, but I celebrate the implicit faith it takes to save them.  Anyone, absolutely anyone at all, can have a good idea.  It may not get recognized or appreciated, but now more than ever it can get saved.  Saving an idea is an act of agency.  It is a political act.  Saving an idea is choosing to become just a bit more visible.  On the most basic level saving an idea is a celebration and affirmation of the self.  Think about that, and dare to jot down, draw, record or otherwise save one of your ideas today.  I just did and it feels great.  Then maybe you can even share it with someone else.

What makes a person decide an idea is worth saving?

You do.

 

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Want To Help Stop Youth Cyberbullying? Let Your Kids Raid More.

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The above title is misleading.  In fact it is as misleading as the term cyberbullying, which is an umbrella term used from experiences which range drastically.  “Cyberbullying” has been used to describe the humiliation of LGBT youth via video; the racial hatred of Sikhs on Reddit, the systematic harassment and suicide of a teenage girl by a neighboring peer’s mother; a hoax wherein a Facebooker pretended to be a woman’s missing (for 31 years); and the bad Yelp reviews of a restauranteur in AZ.

Wait, huh?

My point, exactly:  All of the things described above are different in scope, intentionality, form of media used, duration, and impact.  We need to keep this complicated.  This is not to take away from the horrific acts that people  have perpetuated with social media, or excuse them.  Rather I think we need to help kids and their parents find more nuanced ways to make sense of the way newer technologies are impacting us.

Social media amplifies ideas, feelings, and conflicts.  It often dysregulates family systems.   Growing up, many family members didn’t need to learn the level of digital literacy that today’s world requires.  Parents may be tempted to put their children in a lengthy or permanent internet lockdown.  I hear the threats, or read them, all the time:  No screens.  You’re unplugged.  She’s grounded from Facebook.

Please don’t do that.

I’ve worked with a number of young adults who have had the experiences of being on the receiving end of hatred, stalking, harassment and intrusion delivered via the internet.  And thank goodness that their parents didn’t unplug them as kids.  Because they stayed online they got to:

  • learn how to ignore haters
  • see/hear others stand up for them in a social media setting
  • come to the defense of a peer themselves
  • increase their ability to meet verbal aggression with cognition
  • make the hundreds of microdecisions about whether to “fight this battle”
  • seek out support from other peers
  • form strong online communities and followings that helped them cope with and marginalize the aggressors

More and more, online technologies are becoming a prevalent form of communication, and to take away access is to remove the hearing and voice of youth.  To do this is disempowerment, not protection.

I’ve said before that parents need to take an engaged approach with kids in order to be there to help kids understand and process the conflicts that are communicated through and amplified by social media.  But this time I want to go further, and suggest that one way to help kids achieve digital literacy in terms of social skills is to let them play more multiplayer video games.

Many of you probably saw that coming, but for those of you who didn’t, let me explain.  21st century video games are themselves a powerful form of social media.  Multiplayer games allow individuals to band together as guilds, raids, platoons and other groups to achieve higher endgame goals.  Collaboration is built into them as part of the fun and as necessary to meet the challenges.

There are exceptions to this, but it has been my experience that people don’t begin systematic personal attacks on each other when they are in the middle of downing Onyxia.  They are too busy joining forces to win.  I am convinced that much hatred we see in the developed world is there in large part because of boredom and apathy.  Games provide an alternative form of engagement to hatin’

Look, I’m not saying that people playing games never say sexist things, swear, or utter homophobic comments.  But I can say that I have heard more people, adults and children, stand up to hatred in World of Warcraft than I ever have in the 2 decades I worked in public school settings.  I’ve seen racism confronted numerous times in guild chat, seen rules for civility created and enforced over and over, always citing a variation of  the same reason:  “We’re all here to have fun, so please keep the climate conducive to that.”

Video games provide powerful interactive arenas for diverse groups of people to collaborate or compete strategically.  They capture our interest with a different sort of drama than the sort that we see our youth struggle with in other settings.  In fact, for many individuals video games provide a welcome respite from the drama that occurs in those other settings.

Social media does indeed amplify nastiness, harassment and hatred.  It also amplifies kindness, hope, generosity and cooperation.  If we don’t lean into social media with our kids, they’ll never know how to use it to amplify goodness in the world.  Worse yet, if we cut them off from connecting with the world online we’ll deprive them of the necessary opportunities to recognize and choose between good and evil.

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What To Do When Your Therapist Turns Into A Kitten

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I have been working with patients online for about 6 years, and even now I have some interesting surprises in the work.  Recently I was meeting online with one of my long-term patients for their regular session.  I use my laptop but have a better web camera and monitor hooked up to it.  The bigger monitor allows me to see the patient’s image, but also keep an eye on my image so I can see what the patient is seeing.  The laptop monitor stays dark, and the laptop’s built-in webcam goes unused, at least most of the time.  But this particular day the laptop webcam decided to switch on 15 minutes into the appointment, and hijacked the webcam I was using.  So from what my patient could see, one minute I was there listening empathically, and the next minute I had disappeared.

Those of you who enjoy object relations theory should be enjoying this story by now.  Wait, it gets better.

As I was explaining to my patient why I’d disappeared, I was trying to turn off the laptop’s built-in webcam.  Instead I turned on a special program the laptop has that replaces the screen with the image of a kitten, the one seen above in fact.  Suddenly I was not invisible, but a kitten.  Better yet, the kitten was lip synching and moving its mouth when I spoke.  Fortunately this wasn’t happening at a particularly delicate moment in the therapy, and we both had a good laugh at it.  I apologized to my patient and said, “you know, I studied a lot of things at grad school, but they never taught me what I’m supposed to do if I turn into a kitten when I’m with a patient.”

Many psychotherapists have the sort of relationship with technology that resembles the folks they treat with Borderline Personality Disorder:  They alternately overidealize and devalue tech, often in the same breath.  “Skype” will be the way we salvage our dwindling practices, we’ll be able to reach people all over the planet, make our own hours and go completely self-pay because most insurance doesn’t cover it.  It will be wonderful.  That’s the overidealizing part, the devaluing part is more subtle.

Because I do a growing amount of therapy and supervision online, I often get requests for a consultation session to help therapists who want to do online therapy and “need my help getting on Skype.”  At this point I try to explain that Skype is not HIPAA-compliant, and that there is more to it that getting a webcam, but here’s where the devaluing of technology comes in.  It’s as if some folks think that the only thing one needs to know in order to be an online therapist is how to download a program and turn on the camera.

Most therapists who decide to get Basic EMDR training wouldn’t bat an eye at needing to go through two weekend trainings and a minimum of 20 didactic and 20 hours of supervised practice in order to be certified.  And yet many therapists don’t consider that working online and with emerging technologies requires more than learning how to flick a switch.  It’s sort of the way people often treat the IT guy at the workplace:  With one breath we describe ourselves to him as “clueless” about technology; and yet we really want him to stay in that basement office until we need him to come up and fix our email.

Graduate programs teach us next to nothing about how to use technology in our practice, except perhaps to warn us to avoid it at all costs.  Think about it.  Do you know what to do if you disappear in the middle of talking with a patient?  Do you know what to do if you turn into a talking kitten?  More importantly do you know how to prevent yourself from turning into a talking kitten, or turn yourself back from one if you do?  And perhaps most importantly, do you know how to help patients anticipate the glitches with virtual therapy, process the unique empathic failures that can arise, and create a good-enough holding environment online?

People like my colleagues DeeAnna Merz-Nagel and Kate Anthony founded the Online Therapy Institute for just this reason.  They offer dozens of different 5 hour courses on various technologies, from video conferencing to text chat to conducting therapy in virtual realities like Second Life.  The takeaway here is that there is a lot more to learn about online therapy than downloading Skype.

Look, I am not trying to discourage people from doing online therapy, in fact the opposite.  I know that it can be a very effective treatment modality, and easily accessed by a growing global population.  I’m not even trying to get you to sign up for consultation with OTI or me or anyone in particular.  The point I am trying to make is that it is an additional skill set that needs to be learned and integrated into your clinical repertoire.

Psychotherapists don’t just buy chairs and a couch and start talking.  EMDR isn’t just wiggling your fingers in traumatized people’s eyes. Both take time, case supervision and specialized training.

Online therapy, and integrating social technologies into your therapy practice is no different.

 

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One Bostonian’s Thoughts On Social Media

 MA Cambridge Charles River view of Boston

 

How does one begin to carry on with one’s life and work when the tide of history overwhelms a society?  This week I have had numerous conversations with colleagues about the myriad and often conflicting ideas and feelings we have been asked to hold alongside each other.  Initially I had been asked by one supervisee if I was going to write about the bombings in Boston, and my immediate response to him was, “No.”  I have seen too many colleagues either consciously or unconsciously use their social media to self-promote during times of tragedy.  Although I am a believer in the importance of self-promotion in building one’s business, this is not the time.

Hundreds of people in my Twitter feed and online seem to agree.  From therapist to marketing types, people noticed when your automatic Tweets continued unabated as the events of this week were unfolding.  And whether they were individual or enterprise level businesses, the response was pretty much the same, “turn it off.”

And I agree, now is not the time to self-promote one’s business or market, which ironically leaves those of us with social media back at where Web 2.0 all began.  Not for marketing, but for community.

So what I did want to discuss today I sincerely hope will be heard as sharing thoughts and feelings across the range of you all, who reading this are to some extent part of my community.  And why I want to discuss the topic of social media today is to offer some ideas to keep in mind as we go through the next piece of our history together.

Social media collapses time and space.  As I listened from my locked down house simultaneously to Twitter, the police scanner via Broadcastify, Facebook and other platforms, I heard firsthand how information and misinformation could spread far more quickly than it could have on 9/11.  Social media use and technology in general played a huge part in the ability to share, identify and ultimately capture one suspect.  It also hindered investigation at times by creating chatter that looped back to law enforcement in ways that were more confusing than helpful.

As someone who lives 2 miles from the explosions, a mile from where Patrol Officer Collier was killed, and far too close to the 7-11 and site of the carjacking, the week and especially last 48 hours were horrifying, confusing and anxiety-provoking for me.  But social media allowed me to reach out to friends, family, and colleagues, collapsing space in a way that brought a lot of comfort and support.  I can’t say enough about the gratitude I felt that the ping of Facebook and Twitter were heard consistently amidst the constant sirens and other sudden noises that hypervigilance brings.

Social media helped me express more pride as a Bostonian and New Englander could have ever imagined, as memes like this one popped up on and were shared by me on Facebook:

keep-wicked-calm-and-carry-the-hell-on

 

For those of you who aren’t locals, this pretty much summarizes how we people in the Hub of the Universe are, and how we dealt with things this week.

Unfortunately, social media also collapsed the space between MA and Arkansas, when we were subjected to this Tweet:

nate-bell-tweet

As enraging as this post was, social media allowed many of us in Boston to respond to this, including yours truly, with our Bostonian blunt arguments and a dash of humor thrown in:

nate comment

Social Media allowed thousands of people to respond alongside me, causing Bell to say to the Associated Press, “I really didn’t think about it going to Boston and was generally expressing my personal view of how I would have felt in that situation myself.”

This is one thing I hope we all can keep in mind over the next days and weeks, that we can remember the power of social media to collapse space and time and reach and impact a global and thus diverse audience.  Such a collapse can help bring comfort or quicken the pace of misinformation; bring a city together or divide a nation.

Social media amplifies feelings and emotions.  I hope colleagues can keep this in mind as we continue forward through the next days and weeks.  Social media can amplify love and community, and it can amplify hatred and racism.  It can amplify hysteria or reasonable thinking.  Social media can amplify comfort and applause, and it can amplify grief and vicarious trauma.

Please think before you tweet, post or share.  Ask yourself what you are shouting into the village square, what you are bringing to the conversation.  If you think you have something important to say, say it.  When in doubt, refrain.  Turn off your autobots advertising your wares or workshops for a bit.  And above all please remember that you are speaking to people you may not even imagine, whose experience of what has been happening ranges from the loss of an intellectual argument to the loss of a limb to the loss of a loved one.

How does one begin to carry on with one’s life and work when the tide of history overwhelms a society?  I’d like to suggest the answer is, carefully, thoughtfully, humbly and compassionately.

Epic Supervision Fail

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This past week social work colleagues Ericka Kimball and JaeRan Kim had an article published in Social Work entitled: “Virtual Boundaries:  Ethical Considerations for Use of Social Media in Social Work.”  It’s a good article, and more importantly it’s a nice start.  The article discusses if, when and how to use social media ethically.  The authors don’t purport to have a solution to every potential problem that social media poses clinicians, but they have some good suggestions.

I have mixed feelings about the constant yoking of “technology” to “ethics” in our profession.  (In general, not specifically the article above.) It always seems to imply that social media and ethical problems go hand-in-hand.  No other ethics issue, even patient abuse by psychotherapists, gets as much play in our current professional development course offerings, and the irony is that there is evidence to support the much higher prevalence of the latter than the former.  It seems the only way the majority of psychotherapists can get curious about social media is if somebody scares them with the idea of ethical or legal violations.

Is there an ethical dimension to integrating technology into psychotherapy?  Absolutely.  It’s just not the only dimension.  And the problem with always focusing on ethics is it often encourages fear-mongering and contempt prior to investigation.  Part of the problem is that most of the people talking about ethics and technology in clinical practice have little to no experience with the technology side of things.  And as a result, they can’t engage us with ideas and brainstorming, but instead often adopt the fall-back of “you need to be careful.”

The result is that many clinicians get understandably scared:  You told me something is dangerous, and that the only solution is to be careful.  So seasoned clinicians often adopt what I call the “just say no” attitude.  Firewalls go up.  Patients can’t be emailed.  Agencies adopt no-Facebook policies, and in general evoke an air of monasticism.  I have even heard cases where clinicians are told they need to renounce having personal social media.  Though Shalt Not Tweet.

Into this  “just say no” milieu come our trainees.  Many of them are digital natives, and have been wired for technology in a way we digital immigrants may never be.  In many cases they are more digitally literate than we are.  They come into their supervision sessions with questions about cell phones in the office, suicide posts on Facebook, and being followed by patients on Twitter.

And they get “just say no.”

So let’s get real a sec here.

The Pew Internet Research Group states that roughly two-thirds of North Americans are on Facebook.  It, along with other social media, has become a primary source of communication and shaper of culture for our society.  This means that a majority of our trainees and their patients are probably using it.  We can’t just say no.  We can’t just say, “be careful out there.”  Our trainees look to us for supervision, and understanding social media and technology is part of 21st century clinical work.

I can’t tell you how many times I have heard horror stories in my classes about how supervisors fail their students this way.  And I get emails detailing, for example,  how a young clinician tried to bring up the positive impact of social media to a supervisor: “I thought her head was going to implode.”

Psychotherapy has a past history of using innovations in technologies to enhance our work, and our theoretical models.  Freud used the newer technologies of hydraulics to explain drive theory.  Similarly, advances in thermodynamic technology helped pave the way for family systems theory.  By now, many of the principles and parallels of those technologies have become so commonplace in our lives and understanding that we don’t even connect them with being familiar with technology.

Historically technology creates a period of suspicion and confusion before integration into culture.  A favorite example of mine is this:

indexAC

Prior to the Gutenberg printing press, books were a much rarer technology.  In the 8th Century, approximately 12,000 books were published in all of Western Europe; by the 18th century that number had risen to 1 billion.  As this technology became cheaper and more easily accessible, literacy rose.  But this was also a time when things got overwhelming.  When you had a handful of books read by a handful of people, the knowledge in them was much easier to locate.  But when the number of books and readers increased, there was an overwhelming amount of information to remember and locate.  The book index was the technology we came up with to solve that problem, but we needed to experience the technology as problematic before a solution was necessary.

Today we take indices, books and literacy largely for granted.  We know how they work, we aren’t afraid of them.  If anyone wanted to hold a workshop on the “Ethical Considerations of Printing” they’d be hard-pressed (heh) to get anyone to attend.

So now we find ourselves faced with a new technology, one as revolutionary in many ways as the printing press.  Only this time we are the generations that need to get used to it and confused by it.  And it’s risky and scary, because we don’t fully understand its implications yet.  But just as we wouldn’t have wanted our ancestors to forbid us to read and write, we need to let our trainees learn how to use the newer technology of social media in our lives and work.  And to do that, we need to learn it too.

This takes time, and it takes someone with expertise to teach you.  So before you hire a consultant, keynote speaker, or workshop presenter to talk about social media or technology in general, ask yourself, and them, these questions:

1. What do you plan to teach me beyond ethics about technology?

2.What strategies can you help me and my agency deploy besides be careful or “Just say no.”

3.What if any experience do you have with technology? Do you use social media? Professionally? Personally?

Just asking potential consultants those 3 questions could save you or your professional organization a lot of money down the line, as well as make the difference between helping you embrace innovation or stagnation.

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