Digital Mental Health in the Era of Techlash: Towards Humane Health Technology

Note to readers: This is a long-ish read (closer to 15 rather than 5 minutes)

As someone who studies mental health, I rarely stop to ask myself about its definition. Yet, definition is increasingly at the front of my mind when I think about the field of digital mental health.

I know all the modern textbook definitions, but find myself drawn to a definition that was put forward over 60 years ago by Erich Fromm in his book The Sane Society. One of the founders of what would come to be known as Humanistic Psychology, Fromm wrote “Mental health is characterized by the ability to love and to create, ….by a sense of identity based on one’s experience of self as the subject and agent of one’s powers, [and] by the grasp of reality inside and outside of ourselves, that is, by the development of objectivity and reason.”

I love this definition because of its focus on what seems to me to really make us human: loving, creating, and having a desire for knowledge. The field of digital mental health is moving forward at a breakneck speed without considering the basic question of how it might promote – or disrupt – these building blocks of a sane and humane society and of our individual mental health within it. Moreover, it is developing in a world of obsessive social media use, mobile phone addiction, fake news, digital data insecurity, internet trolls, and the Uber-fication of human service industries, all of which serve a single, primary objective of absolute efficiency – getting what we want as quickly and easily as possible at all times.

Here I highlight key challenges we face in creating humane and effective health technology in a toxic digital ecosystem, lay out a four-point road map, and, as a case study, describe the development of a micro-intervention app for stress- and anxiety-reduction I developed called Personal Zen.

The Promise of Digital Mental Health

The potential payoffs of digital mental health are of crucial importance now. We are facing an ever-growing mental health epidemic in the US and around the world. Over half of us will be diagnosed with a mental health disorder in our lifetime. And our kids are struggling. Approximately one in every 4–5 youth in the U.S. meets criteria for a mental disorder with severe impairment, and the vast majority of mental health disorders in adults first emerge in childhood and adolescence.

The particular promise of computerized and mobile interventions are that they can, if done properly, radically increase the availability and accessibility of empirically-validated treatments, while reducing cost and stigma.

The Toxic Digital Ecosystem and Techlash

We’re used to believing, with true tech-enthusiasm, that if only we can “disrupt” current healthcare delivery systems, we can solve all our problems. But we now realize with growing certainty that what the digital ecosystem truly excels at is making money for technology companies and pushing us towards ever-greater efficiency. It does this so well because it is precisely and purposefully designed to grab our attention, addict us, and keep us glued to our screens: This is the basis of the attention and surveillance economies. The result of this design focus is that digital technology exhausts us, distracts us, and detracts from our ability to do other things.

Awareness of this has caused the pendulum to swing the other way, and we’ve entered an era of “tech-lash” with growing outcry about mobile phone addiction, negative effects of social media on youth mental health, data security, the spread of fake news, unethical business practices, and the list goes on. We are angry at Silicon Valley because these powerful companies created ubiquitous products and put profit so far above our well-being, that it’s unclear what to do about it.

Such is the degree of techlash now that even scientists are seeing causation in correlation before solid facts are established. In 2017, researchers, usually a circumspect bunch, went so far as to suggest in the popular media that smartphones have psychologically destroyed a generation of youth, citing among other findings that during the period following the birth of the iPhone about 10 years ago, we have seen a doubling of suicide rates and increases in depression and anxiety across vast segments of society.

In its annual survey of students, the American College Health Association found a significant increase — to 62 percent in 2016 from 50 percent in 2011 — of undergraduates reporting “overwhelming anxiety” in the previous year. Surveys that look at experiences related to anxiety are also telling. In 1985, the Higher Education Research Institute at U.C.L.A. began asking incoming college freshmen if they “felt overwhelmed by all I had to do” during the previous year. In 1985, 18 percent said they did. By 2010, that number had increased to 29 percent. Last year, it surged to 41 percent. These are alarming statistics, but is this enough evidence that smartphones are causing these problems?

I believe not. I have come to doubt conventional wisdom that smartphones or social media are a unique cause of anxiety, depression, or suicide; instead, I see them as a factor among many. By primarily “blaming the machines” we obscure the impact of other factors of equal or perhaps greater importance, and lose opportunities to deeply examine a range of factors and how they might work together with digital technology to contribute to the suffering of youth and adults.

As the evidence comes in, how do we work in an arguably toxic digital ecosystem to ensure that – for adults and children – health technology heals rather than harms?

A Four-Point Road Map for Humane Digital Mental Health Technology

For health technology to be truly humane, it must meet these four criteria:

  1. Prioritize development of micro-interventions. An irony of digital mental health is that the well-honed attention economy techniques that keep people glued to screens will work against mental health promotion. Therefore, focus should be on creating micro-interventions that require as little screen time as possible. Micro-interventions are brief and frequent, easily fitting into a person’s routine at home or on-the-go. They are part of the broader spectrum of care, with low-intensity preventative or “gateway” treatments at one end and intensive stand-alone treatments on the other end. Development efforts in health technology should be focused now on the low-intensity end of the spectrum. Later, once a strong evidence base is built, resources should then be devoted across the spectrum to develop more intensive, resource-heavy and stand-alone treatments. Spectrum of careThis strategy is largely reversed in digital healthcare right now. Many companies are trying to digitize gold-standard treatments like cognitive behavioral therapy (CBT), which remains time-consuming and expensive. Moreover, it remains unclear whether CBT is effective in digital or telemedicine format. Making poorly-validated treatments widely available does not solve the mental healthcare crisis.

 

  1. Maximize high accessibility. Along with the development of brief, micro-interventions, digital mental health must be qualitatively more accessible than current treatment delivery systems – affordable, easy to access, used on-the-go, and engaging. Current psychological treatments are often time-consuming and expensive. Of the over 160 million Americans who will have mental health problems in their lifetime, 50% of us don’t seek any treatment with 44% of these untreated patients citing price as a barrier. Basic access is also highly limited – over 83 million Americans live in federally-designated Mental Health Professional Shortage Areas.

 

  1. Reduce stigma. The stigma of mental illness represents a significant barrier to mental healthcare access. Of the tens of millions of untreated Americans struggling with mental health, 10% cite the stigma of mental illness – and fearing others will find out – as a primary barrier. A benefit of digital and mobile mental health interventions is that when we access mental wellness tools on our devices, they become part of our enjoyable and daily digital lives, increasing the possibility of normalization. Developers can also aim to create interventions that are fun and engaging, rather than having the clinical and medical feel that might turn people away from seeking help in the first place.

 

  1. Make adaptive and personalized. The promise of machine learning, artificial intelligence, and big data for solving health problems are immense. The most sophisticated techniques for data generation and gathering have been used in the worlds of advertising and politics, but these emerging techniques have already made waves in terms of medical diagnosis and risk assessment. In mental health, the ability to dynamically evaluate a treatment target and personalize interventions accordingly are the future of mental healthcare. At this stage, few research-based mental health tools have built-in adaptive methods. This is among the most important areas in which academia and industry must come together, one that holds perhaps the greatest promise for true personalization of treatment.

Summary: Development of humane and effective digital mental health technology must optimize the accessibility and mobility of digital technology, shift focus towards brief, flexible, and personalized interventions, and reduce screen time in order to step off the attention economy treadmill.  This approach minimizes the harmful aspects of the digital ecosystem while capitalizing on its nimble, accessible, and stigma-reducing aspects.

Finding Personal Zen

I had the idea of humane health technology as a guiding principle when I created the app Personal Zen. Personal Zen is a stress- and anxiety-reduction exercise. The app embeds scientifically-based attention training techniques into an engaging and appealing format. Its scientific “active ingredient” is something called attention bias modification.

Attention biases are rigid and selective ways of paying attention to information in the world. Decades of research tell us that people who tend to be anxious or stressed detect negative information more quickly, and pay attention to it longer and intensely than people who are relatively less anxious and stressed.

This preference to pay attention to the negative is called the threat bias.  And here’s the kicker: The threat bias piggybacks on one of the triumphs of evolution – the ability to quickly and automatically notice danger, which in turn triggers us to fight or take flight to deal with the danger. But the threat bias highjacks and skews this evolutionary advantage. It acts as an unconscious information filter, an imbalance in what we pay attention to that makes us actually prefer and prioritize threat and negativity at the expense of the positive. When the threat bias becomes a rigid habit of looking at the world, it puts our fight/flight response on a hair trigger, and sky-rockets our feelings of stress and anxiety. We see monsters in the closet even when they’re not there.

Personal Zen is designed to retrain our attention to disengage from the negative in flexible ways so that we can better benefit from positive information all around us. This creates a stronger attention filter favoring the positive. As a micro-intervention, it was designed to be used briefly and on-the-go, so it can fit into anyone’s daily routine.

Findings suggest that this technique loosens the vicious cycle of stress and anxiety, immediately reducing distress as well as laying the groundwork for positive change. We’ve published three clinical trials of Personal Zen showing that even with short-term use, Personal Zen can reduce stress and anxiety. We’ve recently focused on the potential benefits of Personal Zen for a group of people in particular need of easy-to-access stress-reduction tools that can fit into their busy lives – pregnant women – and found that using Personal Zen for about 30 minutes a week for a month reduced the stress hormone cortisol. While much more work needs to be done, I believe that with this approach, we’re on the right track.

The Future is Now

The field of digital mental health is skyrocketing at a time when there are compelling arguments to reduce screen time. Humane digital mental healthcare must navigate this contradiction while taking the best that digital technology has to offer to actively promote the essence of mental health in us all: the ability to love and create, to have an empowered sense of self, and to embrace objectivity and reason. It’s up to us all, researchers, developers, and healthcare professionals, to get this right.

Blast from the Past: The Game Doesn’t Care: Why the Gamification of Mental Health Isn’t Working (Yet)

This post is from 5 years ago, July, 2013. I believe we’re all still thinking about and struggling with these same issues today! 

Games that are not games. There is a serious barrier to the effective gamification of mental health. This barrier is that the games we psychologists and health professionals are coming up with are not fun. In fact, they are totally uncool, border on the condescending, and wouldn’t motivate anyone to play for more than 30 seconds. This is the case even though the bar is set quite low because these “games” address things that people really want, like boosting our intelligence and memory, reducing depression and stress, quitting smoking, … fill in the blank. boring gameI’ve been fascinated with this disconnect between Psychology’s view and real-world acceptability. This disconnect is plaguing other fields as well, such as in the development of “serious games” for education. In this larger context, I’ve been working on the development of an app that takes a scientifically proven approach to reducing stress and anxiety, and embeds the “active ingredient” of this intervention into a game that is fun – fun enough, we hope, for someone to want to play for much more than 30 seconds.

Fun versus health goals. In the midst of  this ongoing development process, I had the pleasure of speaking with Nick Fortugno, co-founder of the game design company Playmatics. In addition to creating really fun games, like Diner Dash, he has created games to promote positive social change and is one of the visionary and forward-thinking advocates for the idea that serious games can and should be fun. So, he has a deep understanding of the barriers facing the gamification of mental health. As we were talking about these barriers, Nick said something that really got me thinking. He said, when we design games for education or health, we have to remember that “the game doesn’t care” about whether we’re making progress towards our goal. In other words, a game isn’t fun because it meets some criterion that we, the developers, have for success – like boosting our ability to remember, reducing symptoms of anxiety, or losing 5 pounds. A game is fun because it creates an aesthetic experience and facilitates game play that we want to come back to again and again. Therefore, I would argue that a “serious” goal embedded in a truly fun game is reached as a by-product of the fun.

The need for backward engineering. I think I am accurate in saying that very few people, myself included, who are trying to create serious games for wellness think like this – i.e., like a game designer – about the process of gamification. From what I can tell, game designers think very deeply about the experience they want the game to promote, and then they work through the pragmatics of the game play that will facilitate this experience. This backward engineering from the point of view of the aesthetic/experiential goal to the pragmatics of the game is the opposite of what psychologists do when they think about gamification. Instead, we have parallel streams of development in which (a) we know that our “game” (read scientific protocol) is truly boring, and (b) we have to somehow decrease the snore factor. We think: “Hm, here is my very rigid experimental protocol/computerized intervention. I must overlay this protocol with some cute little animated guys, perhaps with a fun back-story (wizards? aliens?) and then make sure users get points when they conform to the requirements of the protocol.” Sounds thrilling, huh? So fun? Exactly the recipe for the next Dots? Right…. So, we have a lot to learn from game designers, and I believe that crucial to the future of the endeavor of gamifying mental health is partnering with people who know how to create fun and understand the process of game design.

Pocket rituals. What would it be like if we created mental wellness tools, or even interventions for serious mental health problems, that were truly fun and that could become part of our array of habits and strategies for feeling better, reducing symptoms, performing more efficiently, or dealing with stress?  These games, if “snackable” would become our pocket rituals, our chill pills. We could take out our device for 5, 10, or 15 minutes and be empowered to bring about a targeted, appreciable positive impact. The barriers to use should be minimal, the experience intrinsically rewarding – that is, it feels good to play – as well as reinforcing because it helps us meet our health goals. I think many psychologists feel that this approach is not easily conducive to a rigorous scientific approach. But if we fail to find a way to do this – good science and giving people tools they want to use – then the whole endeavor is dead in the water.

Experiments in Subway Poetry

I think a lot about how our use of digital technology, social media, and mobile devices shapes how we feel, think, and behave; shapes our muscles and our memories. There is no doubt about the host of benefits afforded us by all of these technologies, but their costs are both obvious and hidden.

We know that sometimes we feel addicted to them. We know we devote an immense amount of time and attention to them. Although they should be working for us, we often feel that we are working for them. We may even feel more tired and stressed and discouraged after being on screens. Muscles tense, furrowed brows. No one feels free on screens.The cult of efficiency tells us that we can and must get more done.

We are learning more about the consciously addictive designs of these technologies, mobile devices in particular. They are meant to hook us in. We now have no doubt that our views and clicks, our “data”, are the basis of the attention and surveillance economy, a multi-multi-billion dollar behemoth of an industry. As a psychologist and neuroscience researcher, I think about states of mind and brain when we use these devices, mobile phones in particular.

So, in the great tradition of obsessive scientists throughout history, I have been conducting an experiment on myself. Instead of using my mobile device on my daily

poetry book
My poetry notebook

subway commute, I now take a little notebook, about the size and shape of a small mobile device, and write poetry.

Some of the poetry is about my personal experience of technology, but most is not. The goal of the experiment is to track my subjective experience and assess how my state of mind changes when I think in poetry, express ideas in verse, write with a pen instead of click, swipe, click, swipe. No goals. Free-flowing thoughts. Efficiency the last thing on my mind.

Here are the poems I’ve written so far. I’m still collecting data. I’ll report back later in the summer and post more poems as I go.

If anyone wishes to join me in this experiment, please do so! Post your poems in the comments and I’ll post them on the blog (attributing them to you, the author, of course).

The Subway Poems

by Tracy-Dennis-Tiwary

Show Instead of tell

I wake

I raise my hand

I reach

I press

I swipe

I talk to you and forget

What you said

Only half remember what I said

I wonder, in the flood, what is really worth saving

 

What happens when we suddenly start listening,

When we pay

Attention?

Liquid sound

Small conversations: “I’m here”; “I know what you want”

 

My husband holds the coffee cup

Shifting in its saucer

Zooming in on a screen

Except nothing like that

The opposite of a two-dimensional half-life

 

On the screen, our bodies shrink,

Contained in our headbox

Eyes and ears

Holding our breath

A laser pointer, robot madmen

Eyes created to gather information

Autistic ticket-taker

Punch! Punch! Check off, check off!

 

We have made ourselves into the image of small people

Stuck in the trees, no forest views though they cry, “disrupt!” “innovate!”

Victims who have become victors

Powerful like sad, awkward puppeteers

 

Kind

Are you my kind?

Two of a kind, a kind of wonder

Kind of this and kind of that

Kinship is a slippery slope

An avalanche of decency

One step forward and three…

A tango, a pas de deux

Eliminate the excess

Authentic core

“i carry your heart with me(i carry it in

my heart)”

Anywhere I go

I am in a land of others, of those who are not

Kin

 

Kinship being a slick and clever bird

Oil-slick and floundering

hydrodynamic

As little friction as possible

Same in skin, same in heart, same in bones

Same

Immense sameness

A tribe of potentiality

The tip of the spear

 

The Tip of the Spear

The world seems full of tips of spears

Doing the bidding of the savages

I imagine a spear with a stone arrowhead

Bound with twine or

(am I making it up that people did this?…)

Animal guts or entrails

The tip of the spear is bound tightly as a

Clenched fist and

As a dream from which

You can’t awake

As tightly as hope

When you have nothing left

 

Slow Image

Building blocks totter

Sculpture of Chinese letters

Hold the pen tightly

 

Woman on Subway

“Esperanza

Orange

Black woman

Puerto Rico”

 

Random Search

We are all subjects in the kingdom of randomness

Among our uncertain narratives

Hard pressed to find a story that we can live by,

That we can inhabit

How could the vast indifference,

The imperfect glazed bowl

Of our universe

Not make sense?

 

Can’t you see the spark in every

Rose and thistle

In every question and it’s too certain answer?

So long ago, I can’t remember

The inferno is hard to explain to a child

It assumes knowledge that is like a quagmire

Every step deeper in

But more lost

Sucking, slurping, sticky marsh goo

 

They should come to know that they will be judged

And, if not found wanting,

That they will dance away from the platform edges, and eventually embark

Towards a destination

 

If My Life Were Staged by a Puppeteer

(After watching Basil Twist’s SYMPhonie FANTAStique at HERE, NYC, Spring, 2018)

Puppeteers are underrated

We deride them as marionette-obsessed,

As hopeful that the world won’t see the strings

But I have seen puppeteers who perform

In flight

Wet suits slick

With dreaming fishes

And sparkle scarves

Twisting round so they are

In perfect time

With the daydreams

Of a lovelorn

Boy

 

Absolute Zero

How quaint it is to convince someone

That they are valued

We all know that our value

Is measured

In bits and bytes

Binary kingdom

Quantified selves

Our very eyeballs and fingers,

What they see and click and swipe…

Treasure

The delight of pirates and dragons

 

How can we doubt this?

And doubting, how can we then

Reach beyond ourselves to figure out

What matters?

Like playing an arcane card game with high stakes

The Babylonians discovered zero 400 years before Christ

But our distant, round companion

Doesn’t glow with a soft light

Is neither a satisfying ellipse

Nor a road to travel,

Neither a portal, nor a golden and flaming hoop,

Which we jump through and into and beyond

 

Zero is absolute

A closed door

A set point

An off switch

Zero is not infinitely possible

Zero is an unsheltering sky

 

The California Poems (New Poems Added 7/19/2018 After Having Visited California)

 

Boy in band

Your face

At first

Minute reflections

 

Then dust motes singeing tracks of light

You do not know that you are glowing

You think the light on your keyboard is merely ambient

 

But, my boy, light is not empty-transparent

I want you to know the wonder of frenetic photons

Prism magic

Lustrous and linking you to the seemingly tiny red giant

The white dwarf

The wheeling double black hole, bending space-time

Tiny pinprick across galaxies opening rifts

For cosmic rays to wriggle through

Strange backstreets

Charmed quarks

 

On stage now

No thought of the universal

Or of cosmic scales and endings

Just the moment

 

Darling boy, you do not know that you are glowing

You turn to the crowd and speak into the microphone

 

Not Shy

You showed me how to gallop down east 15th street

Making sure to stop two cracks back from the corner

Like we showed you when you were three years old

 

“Faster mama, like this”

 

Hair streaming behind you

A wily shadow

“Can I tell you something?” you asked, when I caught up

Then singing to yourself, skipped away

A jubilant stone on still water

 

Lately your body has become long and solid

It makes me think of sand packed firm along the shore

Yet still fragile

Softening with the tides

 

This summer you started to think about

The kind of person you are with other people

“I’m not shy“ you tell me

And I have to agree

 

But I see you, sweetheart, the many layers of you

A nautilus shell with inner swirls of glass and cloud

I think you know that you are seen and

Like to try on different suits, covered with concoctions of mirrors

I love to see them all

 

In Morro Bay

You carved your initials on a juicy, round cactus

Excited that you also wrote a T for me

Marking that we were together

Even though I sat, warm, in the car

Sheltered from the mist and wind swirling about the throat of the distracted volcano

where you played

 

Outside

In a storm, the world outside is temperate and ordered

A Bach etude

Soft moss under feet

 

Even the eye of the storm is never truly still

It both exceeds and falls short of our well-worn reference points

It is like a slumbering archetype,

A shadowy ideal

 

Our fear of storms requires no explanation

“For beauty is nothing but the beginning of terror“

Serene disdain

Annihilation

Awe

 

But awe is not selfless admiration

It is the last shred of dignity and the relief

That comes from knowing

You do not yet have to say yes to the truly still point above the fray

 

We Should Have Known that Silicon Valley Was Just Another Bad Boyfriend

big tech red flag
Illustration: Rebecca Zisser / Axios

We should have known that Silicon Valley’s creepy, peeping-tom, data-stealing incursion into our lives was going to end badly. There were red flags from the very beginning. How did we miss them? Why did we ever think that “disruption” was a good word? Doesn’t the acronym, FAANG, for these dominating, digital behemoths give us a clue?

I think an apt metaphor here for understanding how and why we all, systematically, ignored these red flags is the bad boyfriend/girlfriend phenomenon. Since I have had experiences with bad boyfriends (BBs), I will write from this perspective. But of course it applies equally to any romantic partner.

Most BB experiences follow three stages:

  1. Although the BB was charming at first, red flags are there from the beginning. He soon starts letting you down and making you unhappy.
  2. He takes advantage of your love for him to keep behaving badly.
  3. It takes a long time for you to realize that BBs never really change.

Here is how this maps on to the big Silicon Valley companies:

1. The red flags are there from the beginning. Let’s start with Mark Zuckerberg and Facebook, arguably among the worst of the worst BBs. As recently described by Julia Carrie Wong, who was one of earliest users of the proto-Facebook site thefacebook.com, she recalls a leaked IM exchange between Mark Zuckerberg and his friend. It’s worth reading the article in full, but here is the IM exchange, originally published in Silicon Valley Insider:

ZUCK: yea so if you ever need info about anyone at harvard

ZUCK: just ask

ZUCK: i have over 4000 emails, pictures, addresses, sns

FRIEND: what!? how’d you manage that one?

ZUCK: people just submitted it

ZUCK: i don’t know why

ZUCK: they “trust me”

ZUCK: dumb fucks

This BB is just the worst. Trustworthy and innocent in front of you, backstabbing and demeaning behind your back. When you catch him, he acts innocent, surprised – just like Mark Zuckerberg acted when he testified in front of Congress last month. But this was his plan from the very beginning. You need to start paying attention now! It would be best if you broke up with him sooner rather than later.

2. He takes advantage of your love for him to keep behaving badly. But you don’t pay careful attention and you don’t break up with him. Instead, you keep rationalizing his bad behavior away, so he knows he can keep getting away with murder. Your relationship with Facebook is again a perfect example again. Take the Cambridge Analytica scandal – it’s old news! That story already broke back in 2015 in a Guardian report about Sen. Ted Cruz’s presidential campaign wrongfully obtaining data from tens of millions of users. You complained a bit, but forgot about it after a few weeks.

 But let’s not forget, you have other BBs in your life. What about Google’s active hostility towards privacy? Whether it’s the creepy Street View violations when Google Maps first launched or, way back in 2012, when Google was fined a measly $22.5 million (less than .1% of Google CEO Larry Page’s net worth at the time) for overriding privacy settings in Apple’s Safari browser? Your response?: Privacy, schmivacy. Google’s old “don’t be evil” motto just means that anything less than evil is ok, right? Makes sense!

I may have deleted my Facebook account years ago, and use DuckDuckGo instead of Google to protect my privacy and personal data, but I should come clean and talk about my own darling, Amazon. Amazon, which doesn’t allow ample time for its employees to have bathroom breaks; which is running every mom-and-pop store on the planet out of business; which seems to value growth and efficiency above all, no matter what the consequences for individuals or society.  I still love you Amazon because you make my life easier. I’m finding it very hard to leave you, even as you become like an evil robot overlord more and more every day, and my life becomes drearier and more draining after all the looking at clicking and swiping and buying on that no-longer-charming glowing screen?

3. BBs never really change. The current litany of Silicon Valley mea culpas are drowning us. It’s hard to hear anything over all that gnashing of teeth. But once that dies down, you know that your BB will try to go back to doing what he does best – whatever he wants without concern about the cost to you or anyone else. Don’t fool yourself. It’s way past time to wake up.

Techlash is now, and many of us, perhaps for the first time, perhaps in a more powerful way than ever before, are realizing that the digital ecosystem might have made our lives more efficient, but has also increased cruelty, indecency, ugliness, and inhumanity around us. In this ecosystem, negative information is amplified at the expense of positive information. The “connected” world isn’t happy. We feel free when we put those smartphones down. Scared, but free. Much like leaving a bad relationship. We have to double down on being human again.

We should have all paid attention. Don’t expect BBs to ever really change. If you’re stuck with one, like we probably are with our Silicon Valley BBs, just remember, it’s up to us to call the shots and make things better.

Blog Post for Psychology Today – Can’t Fight This Feeling: Technology and Teen Anxiety

Social media and digital technology must have an impact on our emotional lives because our social lives—whether analog or digital—always do. In my recent article for Psychology Today, I write about why we must move beyond “Is there an impact?” to “How, Why, and under What conditions is there an impact?”. Read the full article here.

Blast from The Past – Politics and the Culture of Fear: Is There a Place for Digital Disruption?

With the election less than two weeks away, we’re revisiting a previous post on “Politics and the Culture of Fear: Is There a Place for Digital Disruption?”:

It feels as if we can’t escape the culture of fear and extremism that is pervading politics. Political discourse is more vitriolic than ever after San Bernardino and Paris, and during the months of partisan name-calling and ugly mud-slinging among candidates for the U.S. Presidential Race. And clearly, there are no easy solutions to unraveling this vicious cycle.

During the Christmas holiday, I had an experience that perfectly illustrated this to me. My family and I were at a friend’s house for a holiday event, and I overheard her guests talking as I walked through the kitchen. I heard, “The more he says, the more I like him.” Then, “He says the things we all think but are afraid to say.” I started to get that sick feeling in the pit of my stomach, hoping they weren’t talking about Donald Trump. Then I heard, “The only problem with building a wall between Mexico and the U.S. is that it will have to be so big that it’s impractical and expensive.”  I tried to talk myself off the ledge, saying to myself, “Don’t open your mouth, just keep walking, don’t say anything, it won’t help or change anyone’s mind…..” But then as I was about to turn the corner, safely avoiding a conversation that would surely have turned ugly, I heard, “Of course we should ban Muslims from entering the country. Look what they did in Paris.” So, I turned sharply on my heel and unwisely marched over to the little group sitting around the kitchen table.

“Excuse me,” I said, “but I couldn’t help but overhear your conversation, and I wish that you would consider the fact that excluding or persecuting people solely on the basis of their religion or ethnicity is how (voice rising) the Holocaust started.” And then, when the response to that grenade lob was dropped jaws and the explanation, “It would only be temporary,” I looked at them incredulously, probably with disgust on my face, and said, “That’s what Hitler said and” just in case they didn’t get it the first time, “that’s how the Holocaust started.” Then I abruptly left, muttering, “This was a mistake, I can’t talk about this…..”

I found this conversation terrifying – not only because the thought of Trump as Presidentimages is terrifying, nor because I was disappointed in myself because I lost my cool, and created an extreme, unbridgeable divide between our viewpoints by invoking the Holocaust. No, this conversation was most terrifying because these people were not bad people. They were the type of people I appreciate: good, kind, hard-working people who love their kids and their family.

So where does that leave us?

I don’t have a solution, and indeed, my own extreme reaction during the kitchen table conversation shows that I lack objectivity and am certainly part of the problem. I do, however, as a scientist believe that we can harness what we know about our minds and brains to neutralize this vicious cycle of social and political extremism. Could digital disruption help move us along a path to such change? There might not be an app for that, but below I list three steps I believe could put us on the road towards digital disruption of the political culture of fear.

1. Frame political extremism as an emotion regulation problem. Before any digital disruption can happen, we have to make sense of the problem and have a concept of what’s going wrong. We have all had one of those kitchen table conversations I described above. In these conversations, our emotions get the better of us – fear, disgust, anger. This is a problem in how we control our emotions and how our emotions control our thoughts, decisions, and actions – something psychologists call emotion regulation. The problem is that our strong emotions rarely convince our debating partners. Instead, they solidify the views everyone already holds, causing us to cling to them even more strongly and rigidly. Common ground is lost, and the divide between perspectives seems increasingly unbridgeable.

Imagine how a version of that kitchen table conversation happens on the political world stage, sabotaging attempts at diplomacy and mutual understanding. The result is not just upset and angry people. Now the result is that our emotions directly shape political discourse, legal decisions, and policies that can affect generations to come.

Thus, a first crucial step towards disruption of the political culture of fear is to frame political discourse in terms of emotion regulation – applying what we know about what goes wrong and how to fix it on the individual and group level.

2. Use technology to promote empathy. Recent research in political psychology suggests that empathy can help heal rancorous political divides. A recently-published study showed that when political advocates fail to understand the values of those they wish to persuade, this “moral empathy gap” causes their arguments to fail. However, when political arguments are reframed in the moral terms of the other side, they are more effective. For example, when asked about their views on universal healthcare, conservatives who heard “purity arguments” (e.g., sick people are disgusting and therefore we need to reduce sickness) were friendlier towards universal healthcare, compared to when they heard “fairness arguments,” which are more consistent with liberal values.

If we can use technology to bridge the moral empathy gap, we might be able to reduce political polarization and promote better emotion regulation, more compromise, and deepened understanding. Virtual Reality (VR) might be one such technology. I previously wrote about Chris Milk’s thought-provoking TED talk on VR as the “ultimate empathy machine.” By creating a sense of presence and of real interactions with people and worlds, VR forges empathic bridges leading to greater understanding and compassion. In his work with the UN, Chris Milk uses VR to vividly portray the plight of refugees to politicians and policy makers. How does seeing and experiencing the suffering of 5-year-old children in the refugee camps influence policy making?: Almost certainly for the better.

3. Use technology to calm the fearful brain. As political ideologies become increasingly polarized, neuroscience research suggests that the differences between liberal and conservative viewpoints may extend beyond policy preferences to fundamental differences in the “fearful brain.”

In a paper I wrote in 2014 with Dave Amodio, a professor at NYU, we found that children of liberal compared to conservative parents showed a stronger “N2” brain response to mildly threatening and conflicting information. A greater N2, derived from EEG, suggests more openness to uncertainty, ambiguity, and threat. A culture of fear, in politics or otherwise, is marked by the opposite of this: inflexibility and discomfort in the face of uncertainty and ambiguity, along with resistance to change. These aspects of fear are part of the foundation upon which intolerance is built.

What if we could create computerized interventions that promote our ability to cope with uncertainty and change – perhaps by strengthening the N2 response? My research on the stress reduction app Personal Zen, as well as other research, shows that this may be possible. More research is needed, but if science-driven digital mental health continues to evolve, reducing the political culture of fear could soon be in the palm of our hand.