Yeah? Tell That to Squirtle: The Fallacy of “Screen Time”

Recently, the American Heart Association release an “statement” decrying the dangers of screen time. The report, according to USA Today, said screen time can lead to sedentary behavior increasing the odds that kids can grow up obese. The statement says among other things,
Although the mechanisms linking screen time to obesity are not entirely clear, there are real concerns that screens influence eating behaviors, possibly because children ‘tune out’ and don’t notice when they are full when eating in front of a screen.. (USA News & World Today, August 8, 2018)
Most people won’t dive deeper than the article and it’s quote, which is problematic in itself. “Although the mechanisms linking screen time to obesity are not entirely clear,” is really a way of saying what “this is a correlative statement, which is very different than causality.” If you are unfamiliar with the vast difference between the two, this is a great video to explain it. Come back when you’re done.

The problem with these studies, once they get amplified, is that they fuel the ongoing panic we have with emerging technologies. Once again, here’s my reminder list:

1. Doing any activity for more than several hours in a row is unhealthy, with the exceptions of sleep and meditation.

2. Not all “screens” are equal, have identical lighting and spectrums, and therefore identical impact on sleep.

3. Research shows that using your eyes at night stimulates the areas of your brain that arouse you. So reading, looking at your aquarium, crosswords, and even knitting will also hinder the onset of sleep if you use your vision.

4. Whether in a scientific journal or Trump’s “400 lb guy in a basement,” can we please stop fat-shaming people? Not every heavy body type is the same, nor is obesity a moral issue. Why not focus on teaching your children to be kind, critically thinking and funny humans than focusing on their bodies so much?

In fact, I can make a very different correlation, based on my experience with PokemonGo. This summer I increased my gameplay of this screen-based smartphone app quite a bit. To date I have walked over 150 miles catching Pokemon. I also have lost 5 lbs. My experience would predispose me to conclude that increasing this screen time has actually decreased the sedentary nature of my lifestyle, and lowered my weight. Of course, the fact that I spend half of my time in a rural community with friends who like to hike in the summer doesn’t hurt either, but that’s correlation for you.

While I’m at it, since folks are so concerned with the public health of our children here are some pro-active suggestions based on other possible correlations:

  • Stop fat-shaming kids so they seek escaping reality so much.
  • Fund schools better and test them less so things like recess are longer than 15 minutes.
  • Institute better gun control so children and their families aren’t afraid to go outside and get shot.
  • Decrease stigma of trans youth so they can safely explore gender in ways other than just an avatar of a different gender.
  • Make playgrounds and athletic teams universally accessible so that kids can play and engage regardless of physical differences.

You want to connect some dots, there, I got you started. Now stop going for the low hanging fruit and blame something other than Nintendo.

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Can’t We All Just Game Along?

I had a powerful reminder about the prosocial nature of video games this week, and it was nowhere near a console screen. I was on my way home and ran into a Dunkin’ Donuts, in a town I’d never been to before and was unfamiliar with. I ended up waiting in a rather lengthy line and was a bit grumpy. I happened to be wearing a T-Shirt which said this:

I hadn’t worn it for ages, and had forgotten in fact I was wearing it until the cashier called out to me, “I love your shirt.” Cue the endorphins.

“Thank you,” I said, and smiled (which thanks to state bound learning probably cued my body to produce even more endorphins.)  Waiting in the line seemed much more pleasant by this point. I ordered my coffee and sandwich and while waiting for them received another compliment from a customer walking by.

The third person to compliment me was a man in his 40s, scruffy and in jeans and t-shirt. “I love that game,” he said. “I haven’t played it in a while though.”

By now I was in a mood that allowed me to initiate conversations, so I asked “What are you playing nowadays.”

He proceeded to tell me that his 14 year-old daughter had gotten him into Fortnite. She had enjoyed it initially for the crafting, he said, because she really enjoyed Minecraft; but now that they were playing together she was enjoying the combat as well. His face lit up as he recounted how much fun they were having together. I told him about a study that had been done by Brigham Young that indicated increased levels of protective factors against depression. He smiled at that, and we both went on our way.

We spend so much time debating the neurological impact of playing video games that we often lose sight of another dimension; that of talking about playing video games. Talking about arts and culture is a powerful social adhesive. It identifies commonalities, allows for compliments and increased levels of engagement with others, allows us to recall exciting moments and share them. All of these activities in turn facilitate attachment, and increase a sense of well-being on the neurological level. That was the best line I’ve waited in a ages!

We need to find a way to get that message to Salty Sally the Social Worker and Morose Martin the Mental Health Counselor, whose eyes grow dull at the mention of gaming when their patients bring it up. “How much time are you playing Candy Crush?” they say, in uninviting tones, and eye such T-shirts as a clear sign of video game addiction. The next patient, who comes in with a T-Shirt of Monet’s “Water Lilies,” will get a compliment on it and no such screening for an Impressionist Art Addiction. In fact, the WHO didn’t include Art Disorder this go round at all, unless you include the art form of the video game.

In this current political climate, where we are so polarized, I wonder how many bridges (Minecraft or other) might be built if we paused to ask strangers in line if they play any games? I imagine Republicans, Democrats and Independents alike play something.

If Teams Valor, Instinct, and Mystic can all get along together raiding in Pokemon Go, perhaps we can too..

 

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Taking Leaps: Fortnite, HIPAA & Psychotherapy

“You keep dying,” Sam* said. The annoyance in the 9 year old’s voice was palpable. I looked at my avatar lying face down on the screen. Another of the 100 players in the game, appearing as a brunette woman in sweats sporting a ponytail, was doing a victory dance with her rifle over me. Sam was nowhere to be seen on the screen, but I knew he was hiding somewhere in the game, and seething.

“You’re disappointed in me,” I said calmly. A moment of quiet.

“Yeah.”

“You were hoping I’d be better at this, as good as you or maybe better, and it’s frustrating.”

“Yeah… Can we try again?”

And so we tried again and again, and while we did I talked with Sam about the other adults who were disappointments to him, who kept leaving or letting him down. And I guessed that we were also talking about his frustration and disappointment in himself. And at the end of our appointment I promised I would practice Fortnite, the game we had been playing. We had turned on our webcams again so we could see each other to finish the session, so I could see that he brightened at this idea.

“Nice to see you again,” I said. He smiled faintly.

“You too.” His screen went dark.

As I reflect on the work I do with patients, meeting them where they are at, I am struck by the same issues, opportunities, and conversations that can happen in an online play therapy session. I only wish more of my colleagues would try it. What gets in the way? For some it is a dismissal of emerging technologies which masquerades a fear of trying something new. For others it is a worry about running afoul of HIPAA and being sued. If you are one of those people who wonders about how to integrate video games online into your therapy practice, read on.

 *  *  *  *  *

Quick, without Googling it; what does the “P” in HIPAA stand for?

If you are a psychotherapist or other health provider, you probably guessed “privacy.” At least that’s often the consensus when I ask this question at my talks. It would be understandable if this was your guess. You’d be wrong.

The correct answer is “portability,” the basic premise that individuals have the right to healthcare treatment that moves with them as they go through the vicissitudes of life and work. That is also where technology comes in– electronic health records, telemedicine, etc., are ways that technology increases portability by collapsing time and space so that the patient and the healthcare professional can get to work.

In therapy, that work traditional has happened in an office setting. And in the case of children and youth especially, that meant play therapy which was bounded by the space and time of a physical office. From Uno to Sandtrays to the infamous “Talking Feeling Doing Game,” we have often assumed that play therapy needs to be the games of our own childhoods. But 21st century play can, and I maintain should, include 21st century play. That’s where video games come in.

In the days of the Atari 2600, there was no worry about patient privacy, because the system was hooked up directly to a television that didn’t even need to be connected to cable. But nowadays with SmartTVs, PCs and PS4s, video games are often played online with many other people and seamlessly connected to voice chat. This can be a concern for the psychotherapist who is unfamiliar with newer technology, especially with games like Fortnite, which boast Battle Royales having as many as 100 players at a time in the same game instance.

Videoconferencing programs and online therapy using video/audio chat have been around long enough to have specifications that adapt to HIPAA’s privacy requirements, largely because there is market force behind developing products that can be sold to the healthcare industry. Video games and their platforms, on the other hand, do not have a similar demand to give them an incentive to supply. Games like World of Warcraft, Platforms like STEAM, and streaming services like Twitch were designed for gamers, not therapists, and it is unlikely they will go through the technical and legal procedures to become HIPAA compliant anytime soon.

Some therapists have begun developing their own video games, which, like most therapy games are dismally boring. They are thinly veiled therapy interventions that are disguised as play, but lack any of the true qualities of play. True, they are more likely private; but they are also boring, and easily recognizable as “not playful” by patients. Mainstream games have broader appeal, critical user mass, and better graphics and gameplay in many cases, and are more immediately relevant to the patient’s life. But they are definitely not HIPAA-compliant. So what to do?

 *  *  *  *  *

My solution, which I’m sharing as an example that has not been reviewed by policy experts, lawyers or the like, has two parts:

  1. Due Diligence– Research the existing privacy settings and technologies to maximize benefit and minimize risk to patient privacy. So for example, I structure the “talk” part of therapy to happen over HIPAA-compliant software like Zoom or GoToMeeting. We start on that platform with video camera on, until we begin playing. Then we, turn off the camera to save on bandwidth and talk over this software, not the game. Previously, I will have sent the patient or their parent a snapshot of the settings of the game we are using with the voicechat disabled if possible. We also want to lower or turn off the game sound so we can hear each other. So in the case of Fortnite, the settings would look like this:

 

2. Limited HIPAA Waiver- This is the part most therapists overlook as even being a possibility. You can ask patients to sign a release waiving in a limited capacity their HIPAA rights in order to use noncompliant technology. It is entirely voluntary and I’ve yet to have a patient decline. I use a informed consent form that I developed that looks like this:

 

These are examples of how to engage with online technologies in a clinical way that is thoughtful yet forward-moving.

 *  *  *  *  *

Whether you love Freud or hate him, most experts agree that he was one of the fathers of modern psychiatry. He was also an early adopter. He based his hydraulic model of the drives on steam technology of his era. His concept of the “mental apparatus” was likewise integrated from the advances in mechanics and his formulation of ego defenses such as projection occurred simultaneously with the Lumiere brothers’ creation and screenings of motion pictures. Regulatory concerns aside, therapists can be early adopters. Doing so would probably help our patients no end, and definitely cut down on my waitlist.

* “Sam” is based on several patients whose identifying information has been disguised to protect patient privacy.

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The Crisis Behind Crises

So far in 2018 alone, I have worked nationwide with the aftermath of one homicide/suicide in a video game server community; one threat issued over another; and 3 new requests for consultations from clinicians on how to improve their work with families and individuals related to online technology. Schools are now fielding multiple incidents of threatening language in chat rooms that get brought to their attention, and not necessarily handling them well. Multiple arraignments in district courts are pending because someone expressed violent language on gaming servers that was deemed threatening. Youth are ending up on probation for this.

I know, you’re probably thinking that I’m about to blame the technology, the erosion of family values, the rise of violence or some other social ill. I’m not. As I reflect over several of these cases, the common symptom I see is not mental illness or family dysfunction, but a crisis in digital literacy.

What all of these cases have in common is that before they got to the emergent stage, there were several opportunities for kids to solve their own problems; for educators to teach; for parents to engage or for therapists to help; if they’d seen the opportunities and had some education in digital literacy. Too often we see the end result of our dismissing or demonizing tech use. “Just leave the server, or Facebook,” we say, unintentionally further isolating kids. “You need to stop playing so many video games,” we opine, citing sketchy research to take away the one thing a person may experience some competency doing.

As a therapist and educator who has worked for the past twenty-five years with emerging technologies in mental health, I have been helping schools, clinics and workplaces identify vulnerabilities before, during and after crises. I assure you that before is the most useful and least utilized. I’m hoping you and your administrators will consider doing this differently. I have started offering custom educational offerings on Healthy Boundaries in the Digital Age, and you can find out more about it here.  I’m still doing my other presentations as well.

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Mindfulness, Minecraft & The I Ching

Video Games can be a form of mindfulness meditation, both playing and watching them. The Grokcraft Staff take you on a meditative creative session as we begin to build our I Ching Sculpture Park.  Watch, listen, and enjoy..

 

For more info on joining the Grokcraft project, go to http://grokcraft.com .  We are launching Grokcraft with an introductory subscription of $9.99 a month, & subscribers who join now will be locked in at that rate for as long as they are subscribed.  If any of this appeals to you, please check out our new site at http://grokcraft.com & please spread the word to anyone you think might find this resource useful!

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Heroes

 

Extra Life Boo & Wow

This post is more personal than some, but then at some time in many of our lives cancer gets personal.  As many of you know, I have a companion and co-therapist named Boo.  For the past 12 years Miss Boo has worked with me to help in therapy.  We have worked with hundreds of children, adolescents and adults in settings ranging from special needs classrooms, alternative schools and outpatient settings.  And for the past decade we have been working together in my private practice.

This past Spring Boo developed a form of cancer known as osteosarcoma, which is a form of cancer where the tumor grows in the bone.  In her case, Boo began limping and we discovered that she had it in her front right leg.  What followed was a series of scary tests and decisions.  The recommended treatment for this in dogs is amputation of the limb and a course of chemo.  I was worried about this on so many levels:  I didn’t want to lose my friend, I didn’t want her to be in pain, and how was I doing to explain this to my patients?  You can’t just have a dog show up one week with one less leg and be all blank screen about it.  Some people suggested I retire her, but so many people come to me with ruptures in attachment, people who just walked out on them or were taken from them, that that didn’t make sense either.  Nope, we were going to do this honestly and mindfully.  If Boo could show up for such a challenging treatment, I could show up for her and we could show up for our patients.

Over the next few weeks I let people know what was going on if they wanted to know, to the extent they wanted to know.  While she was recovering from surgery I let people know that as well.  And when Boo came back to work, well that was a powerful week.  Cancer changes your body, but the self persists.  Boo had a visible change, there was a scar.  Some people approached petting her, some didn’t.  Boo accepted all of them.  Some people were reluctant to talk at first, imagining their problems were nothing compared to cancer or losing a leg, but we explored and put those concerns in perspective.  We all had work to do, and we did it.

Time passed, and chemo ended.  This is the result:

Each year, I take part in Extra Life, a worldwide celebration of the social impact of gamers of all kinds from video games to board games and tabletop RPG’s! Since 2010, Extra Life has raised more than $14 million to help children’s hospitals provide critical treatments and healthcare services, pediatric medical equipment, research and charitible care.  Your donation is tax-deductible and ALL PROCEEDS go to help kids nationwide and locally at my awesome colleagues at Boston Children’s Hospital.

This year, on November 7th, I’ll be playing World of Warcraft with a special avatar in honor of Boo.  (Of course I’ll be taking breaks every 45 minutes to keep my health ans stamina in good shape.)  If you want to join our team, Miss Boo’s Battalion, you can do that too!*  You don’t have to play WoW, you can play Minecraft, Dark Souls, Candy Crush, my colleague Jane McGonigal’s Superbetter, Zombies Run!, anything.  You can play Tabletop games like D&D or Pathfinder.  You don’t have to go 24 hours straight, any amount of time, anything you raise, helps.  Sharing the post helps too–you never know who might decide to donate or get their game on.

Miss Boo is my hero, and if you are living with cancer in your life you are my hero too.  Whether you are battling it yourself, defeating it, thriving after it, supporting someone who is, celebrating a win or grieving a loss, you are a hero.  On Saturday, November 7th, why not be a hero too?

*Past and present patients are asked to refrain to protect their privacy, but can always get involved with Extra Life on their own here.

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Better Living Through Minecraft

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Last month I had the opportunity to talk at SXSW 2015 about how the video game Minecraft has a lot to teach us about mindfulness.  Video games often get a bad rap with mental health folks, but I try to change that thinking by pointing out that playing video games can actually be a form of concentration meditation, albeit one that does not jibe with many people’s traditional concepts of such (focus on your breathing, focus on the candle, focus on..erm, Mario?)  If you want to hear more, the Audio is here:

https://soundcloud.com/michael-langlois-6/better-living-through-minecraft-audio-version

If you want to see the visuals from the Prezi, feel free to do so here:

If you enjoy it, please feel free to share, and if you want me to come talk to you and your colleagues drop me a note.

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The Internet & Real Relationships

IMG_1994

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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The Lava Expert

lava cave

“Sometimes it is the people no one imagines anything of who do the things that no one can imagine.”  –The Imitation Game

Shortly before I fell into the lava I began a conversation with an eleven year old girl, we’ll call her Sal.  This was a while back, on a Minecraft server I play on from time to time.  My name when I play Minecraft has the word “therapist” in it, and Sal had noticed this.

“Hey, are you really a therapist?” Sal asked via our server text chat.

“Yes I am.”  I typed back.  I had been mining obsidian and using a river to cool the lava so I could chip away at it with my diamond pickaxe.  In the time it took to type my reply, I managed to fall into the river and get washed into the lava.  I watched myself go up in flames, and with me most of my loot.  There is always a chance though, when one falls into lava this way, that some of one’s loot can be thrown clear.  So upon respawning I quickly made my way back to the scene of my demise as we continued our conversation.

“Oops, burned up,” Sal said, as the server had announced just that when I fell in the lava.  “Are you the kind of therapist that talks to kids about their problems?”

“Kids and adults both, yes.”

“My mother wants me to see a therapist,” Sal said.

“Why?” asked another one of the kids on the server.

“She says I have problems with friends,” Sal said.  By this point I had returned to the lava pool.  There was no loot that had survived.

“Sal,” I said.  “Everyone needs help with their problems from time to time.  That’s why there are 7 billion people on the planet, to help each other out.”

For some reason that made quite an impact with the other players.  “Wow, you must be an expert!!” one typed.  I’m not sure how he’d come to that conclusion.

“I’m certainly not an expert on lava,” I replied, and fortunately the conversation went back to the business of mining after some sympathetic emoticons.

I have no problem talking with kids about therapy, or being a psychotherapist.  If I did, I certainly wouldn’t have the word in my userid.  And it wasn’t even that I was “off duty.”  I’ve had many conversations in chats over the years and heard a range of problems.  In part I was a little protective of Sal’s right to privacy, although experience has again shown me that kids are often less hung up on therapy than adults, and in many ways are often more trusting of psychotherapy than adults are.  Mostly the reason I wanted us all to get back to playing was that I had caught myself sounding “educational.”

*  *  *  *  *

In play if there is any such thing as an expert it is certainly not the therapist, or adults in general.  Virginia Axline, knew this.  In her book Play Therapy she writes, “Non-directive therapy is based upon the assumption that the individual has within himself…  the ability to solve his own problems satisfactorily.”  (Axline, 1947)  My trainees are often as surprised to find that I am friend to both psychodynamic and solution-focused theories as I am to find that they have been taught the two have irreconcilable differences.

As I see it, my job is often to be a unique experience in the lives of patients.  “It is a unique experience,” Axline writes, “for a child to find adult suggestions, mandates, rebukes, restraints, criticisms, disapprovals, support, intrusions gone.” (Axline, 1947)  And by the time people come to us as adolescents or adults, those suggestions, mandates, rebukes, restraints, criticisms, disapprovals, etc. have become internalized.  By adulthood, many of us feel as if we lack expertise in anything, except perhaps screwing our lives up.

Education has increasingly played a hand in this.  We do not teach so that our students learn to think independently and feel resourcefully.  Instead we teach them to think like someone else.  Critical thinking and exploration become supplanted by the sense that education has to give us something tangible in a materialistic sense:  A good grade; a profitable job; published ideas or maybe if we really drink the Koolaid admiration from other academics.

One thing that is so enjoyable about Minecraft for many is its’ open sandbox environment.  There is an endgame you can play if you want, but there are also myriad variations of play you can do instead.  Sal and millions of other children and adults can range freely through such open and creative spaces without “experts.”  Education certainly can happen there, but often in a lightly curated if not autodidactive way.  People have created versions of Westeros, Middle-Earth, Panem or their own creations.  There are PvP versions where conflict and combat, stealth and griefing hold sway; fantasy realms where people can role-play.  It is a topsy-turvy world where children can have the most wisdom, and we adult experts can trip and fall into lava.

*  *  *  *  *

In a world obsessed with measuring outcomes, psychotherapy can have a rough time of it.  If Sal ever goes to therapy, she will have to be labeled as ill somehow if her mother wants insurance to help pay for it.  Notes will have to be written, treatment plans planned, goals and objectives filed away so bean-counters can determine that Sal should get 14 beans-worth of help.  It’s hard for me to get too angry at the bean-counters though, over the past 25 years I’ve met a few of them and they don’t seem too happy either.

Education fares little better, with things like the Common Core which tells us what should be taught; standardized testing which masquerades as achievement; and trigger warnings which are supposed to warn students of upsetting content as if they somehow were entitled to get through the mind-altering experience of learning without ever being upset.

It takes bravery to stand up to this.  To let the individual chart their own course, make their own mistakes, draw on their own core.  For the therapist and educator it takes bravery to get out of the way, to radically reflect the developing self.  I do believe that each one of us needs help throughout our lives; but that help needs to be asked for lest we run the risk of telling others what to do and implying they aren’t up to the task of living their own lives.

*  *  *  *  *

Many therapists, social workers, and teachers I have met chose to become members of those professions at least in part as an expression of admiration for their own therapists, social workers and teachers.  They had no interest in falling into the lava ever again, so they started focusing on helping other people out.  It’s a thankless job if you are going to go through it secretly hoping to be thanked.  I’m not sure I’ve ever had someone I work with refer to me as an “expert” unless they were being facetious about some blunder I’d just made.  And I’ve made many.  As an apotheosis, being a psychotherapist or academic is rather anticlimactic, not because the work is devoid of meaning or value, but rather because if we truly place such people on a divine pedestal it needs a steady stream of troubled people to hold it steady.

Perhaps an alternative for therapists, social workers, educators and our ilk is to think of ourselves as “lava experts.”  We have some acquaintance with falling into pits, being consumed by intense feelings, losing all our, erm, loot.  These are human experiences.  This is not a secret to anyone, and I doubt most people would put their trust in someone who knows nothing of failure, obsession, overwhelm or grief.

What’s more is we’ve fallen into lava, often the same pit again and again!  We know something of the repetition compulsion.  We have let our yearning for whatever we think we need lead us to risky or self-defeating behaviors.  We can talk to people about their problems, because we are people who have problems ourselves.  We’ve been burned.  Minecraft miners know mining deep is risky:  We know what we’re doing even up to that moment our bones ignite.

Rather than being an expert on a pedestal, accept that you will tumble into fire, again and again, looking outside of yourself for what is precious.  Straight A’s, that book you published, six or seven figures–There’s a little Gollum in all of us.  It’s what makes us forget mindfulness, build empires, win arguments or wars.  No one was ever oppressed by play, only the lack of imagination that comes from the absence of it.

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Using Gaming & Gamification in Clinical Practice

What does “gamification” mean, and what is its relevance to mental health practice?  In this video of a conversation I had at University at Buffalo with Charles Syms, I take a stab at answering those questions.  This is just a start, and hopefully by the end of the video you can begin to see how applying principles of game design could be therapeutic for people dealing with issues ranging from trauma to executive functioning challenges to substance abuse and beyond.

 

 

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