A wonderful and courageously honest blog post from Shira Renee Thomas on the experience and stigma of clinical Depression. The personal (and economic) burden of psychological disorders is profound, and greater than that of any other type of disease – including diabetes, cancer, and cardiovascular illnesses! Over 350 million people worldwide suffer from Depression. Yet, we’re only now waking up to the importance of thinking of Depression and other psychological diseases as a public health crisis that requires much, much more awareness and many more resources to reduce stigma and help alleviate individual suffering.
What is going on in this picture? I’m the one on the right.
Well, I was having a special moment with Shifu Shi Yan-Ming, a master of the Shaolin Kung Fu tradition. Our conversation was part of the Rubin Brainwave festival. I was fascinated to hear about his life, from the age of 5, as a Shaolin monk, training in the most rigorous Kung Fu discipline. The title of our conversation was “Discipline as Art” and as was obvious from his demonstration on stage, his physical prowess is impressive and beautiful. You can sense the focused energy he devotes to his art, the discipline of Kung Fu.
In many ways, my conversation with Shifu (an honorific indicating a master in martial arts) was an action meditation, an illustration of how he thinks about his place and relationship with the world.
Me, asking about his feats of Kung Fu training: “Why did you learn to break a brick with your head?”
Shifu, with a laugh: “Someone asked me to!”
Me: “How do you talk to your students about overcoming obstacles in their life, about dealing with emotional challenges?”
Shifu: “I tell them to just do it!”
Like Kung Fu, his philosophy is action-oriented and full of focused energy. When facing obstacles in your life – just do it. Nobody changes you, you change yourself.
I had a great time talking with David Shriner-Cahn of Tend Strategic Partners about making the most of a stressful day and putting your emotions to work for you!
An interesting thought piece by Glynnis MacNicol on what might happen when the life you are living online diverges sharply from your real life. Ms. MacNicol alludes to some of the potential costs, which I imagine are indeed a risk. At the same time, I can’t help but wonder if we could use technology to create a “highlight-reel self” not to hide or be in denial, but to forge a new story of our lives in an attempt to break out of old, stuck ways of feeling about ourselves. It could be an act of “re-visioning” if we do it right.
A study suggests that more frequent mobile phone use might make you more anxious. This could reflect the burden of constant social connectedness, or even nomophobia – the “no-mobile-phone phobia” of losing connection. But we shouldn’t forget that this is a clear chicken and the egg question….. Are devices making us anxious, or do people who are already anxious just use devices more frequently?
I recently had the pleasure of doing a talk-back with Congressman Tim Ryan on the role of mindfulness – focusing your awareness on the present moment – in education, as part of the Rubin Museum’s Brainwave Festival in NYC. The film, called “Changing Minds at Concord High School,” followed an entire school as they took part in a mindfulness training program. This school is unique in that it is a transfer school, a last stop for many kids with a history of school failure and discipline problems. The twist here is that the students both filmed the experience and conducted a study – of their classmates! – comparing the effects of mindfulness training with that of a placebo. We also included a science curriculum on the neuroscience of mindfulness – how it can change our brains for the better. I was the lead scientist on this project, so the kids were my “research assistants.” The project was spearheaded and directed by the amazing Susan Finley and filmed by the equally inspiring Peter Barton (with the help of the students). Our outstanding scientific advisors were David Vago and Robert Roeser. There is a lot that was amazing about this project, these kids, and this film. I want to focus on just one aspect, which hinges on the phrase “The medium is the message.”
The medium is the message. This phrase was coined by Marshall McLuhan who put forward the idea that the “form of a medium embeds itself in the message.” That is, the medium in which we experience something influences how we perceive the take-home message. Using movies as an example, he argued that the way in which this medium presents time has transformed our view of time from something that is linear and sequential into something that reflects patterns of connection across people and places. I am obviously no film theorist, but I apply this notion to the idea that different media provide us with an array of tools that can help us create a narrative of ourselves and the world that is unique to that medium.
Film and self-identity. In the case of our film “Changing Minds at Concord High School,” I believe that one way that the medium was the message for our students was that film is able to portray individual identities as being truly flexible and changeable. I think that the teens at Concord High, many of whom have experienced tremendous challenges, stress, and obstacles in life, didn’t believe as a group that change for them was really possible. But what our program strove to do, using converging media – film, scientific readings, mind/body experiences of mindfulness – was to convince these young adults that they really could change their brains, change counterproductive habits of thinking, and find the tools to focus more and let negative feelings go. As we move on to Phase 2 of the project by refining and developing our program, we are asking the fundamental question: How can we best use these tools to teach teens to view themselves and the world differently, creating a narrative in which personal change is possible?
Our digital mirrors. I think these issues are especially important to consider now, in this era of social media and reality television in which we crave to see ourselves reflected back to ourselves. We can criticize this, and analyze this, but the fact of it borders on the irrefutable. We know that it’s easier than ever before to document our lives via pictures and videos on our mobile devices, and share them with our digital networks. And we love to do so. Social media, through which we share our images of ourselves and our lives, are an immeasurably huge and complex array of mirrors into which we can gaze at ourselves. There may be costs and benefits to this, but it simply is. The power of this, however, is that we now have a new set of tools to curate our beliefs about who we are – hopefully for the better. And perhaps we believe this evidence of who we are more strongly because it is concrete, it is documented, it receives “likes” and is seen by others and thus is real. I’m liked therefore I am.
This digital infrastructure also provides a profound opportunity for those trying to support growth and positive change in youth. If we help youth document the possibility of change – like we did in “Changing Minds at Concord High School”- they may start to believe it applies to their own lives. This is particularly important for those of us who aren’t used to feeling that the world is full of possibilities. In this way, social networking may be a medium that gives the message that change is possible and that our limitations are as fluid as the flow of information.
I was very interested to read this funny take on psychology smartphone apps in the New York Times (by Judith Newman) – or more accurately, how NOT to build a psychology app. I just blogged about this general topic in my last post, and what struck me most about this article was the notion of time.
Art by Emily Flake (published in the New York Times 4/5/2013)
This article seems to suggest that mental health apps should quickly and effortlessly facilitate our relationships, efficiency, and well-being. As Newman writes in the article: “All of these apps require thought. Lots and lots of thought. Thinking is what I do all day long. I needed something that would turn my mind off, not on.”
Great point. Maybe we don’t want the app to be our shrink – because when we go to a therapist, we tend to have a set of expectations that involve spending a good deal of time and energy (unless we’re just looking for a medication fix). Apps, by their nature, are fast, easy, and mobile. So, most of us expect that a psychology app will be a shortcut to mental health. We shouldn’t have to spend time learning how to use the app or being on it too much – at least not so much that it’s taking away from “having a life.”
This view tells me that there is a potentially deep disconnect here: between what many of us in the mental health field think of as the promise of mobile health technologies and what everyone else thinks. Many psychologists see a future in which apps and computerized therapeutic tools break down barriers to treatment, which can be too expensive and intensive for many. For example, for the most common class of psychiatric disorder, the anxiety disorders, only about 20% of anxious people receive treatment! So, the psychologists are thinking, jeez, mobile technologies offer so many amazing possibilities for integrating mental health treatment into the daily life of people who are suffering. Let’s create an app for that!
But we need to think through our approach carefully. If we just put the same old (frankly boring) computerized interventions on smartphones, will that actually help us reach more people? How many will choose to use these tools? Maybe some, but perhaps not many. Perhaps what most of us want from an app is the digital and interactive version of the self-help book – you can take it or leave it, pick it up and put it down after a few minutes and still get something from it, and which doesn’t feel like just another source of techno-burden.
So, what is the take-home message for the mental health professionals? Make it fun, make it fast, and make it effective or get back to work on making traditional treatments better.
I just attended the second annual Entertainment Software and Cognitive Neurotherapeutics Society (ESCoNS) conference. Say that five times fast. This conference brought together people in the gaming world with cognitive neuroscientists. I went because I’m developing (and testing) an app that I believe can help people reduce stress, worry, and anxiety in their lives. In addition to more deeply exploring how to make mental health truly fun, I felt that I was seeing the future of mental health unfolding before my eyes.
Here are four ideas I think will change how the field of mental health will look in a decade (or less):
1. Mental health care WILL BE gamified. The mobile revolution and app zeitgeist have changed how we get things done. We want an app for everything because we want our life mobile and streamlined, and the minute we think we want to do something, we want a device to help us do it. We also are trusting ourselves (and our networks) more and professionals less. This is the self-help movement taken to a new level. If we can seek mental health support on our devices rather than through a professional, more of us will do so. This plays into our growing tendency to feel more comfortable with devices than with others – this may be good or bad, or somewhere in between, but this is how it is. I believe that it is not whether mental health care will be gamified, it is only a question of how and when.
2. Fun will motivate mental health treatment seeking. Scientists interested in human beings understand how to break something down into its component parts (whether an idea, a behavior, or a biological response) to study it, but scientists are not trained to construct something that is fun and that motivates people to come back again and again. That is art and intuition, combined with a lot of experience and good old-fashioned luck. If we want to reach the greatest number of people, and help them integrate mental health interventions into their lives, we need to make mental health fun.
3. Training your brain….with video games? The idea that you could train your brain with video games is still perceived by many to be in the realm of science fiction. But if you think about the fact that every experience we have, particularly repeated experiences, change our brains – why wouldn’t a video game? This reflects the important concept of neural plasticity – that the structure and function of the brain is malleable and changeable not just in childhood, but throughout the lifespan. In addition to games that can train different abilities (e.g., attention in kids with ADHD) technologies like virtual reality are being used as safe and effective ways to treat everything from addiction to post-traumatic stress disorder.
4. The Emotional Brain is a “buzzing” target for intervention. In the 20th century, psychology was dominated by cognitive theories of how the brain works and what causes mental illness. Emotion was a little blip on the screen, an irrational irritant to the otherwise rational, predictable, and orderly domain of the thinking mind. Now, that irritant is an increasingly important focus of research. For example, not much more than a decade ago, economic decision making was understood as a “rational” process. Now it’s assumed that emotions influence our decisions, for better and for worse, and the task is to figure out how. The effect of emotion is not “irrational.” Rather, it reflects the fundamental integration between our ability to feel and to think. Without one, the other is deeply impoverished. As an emotion researcher, my colleagues and I are happy everyone has caught up – it’s about time! Emotions are the engines of our lives – and of psychopathology. No real living happens in an emotional vacuum.
It was clear to me from the conference that there is an emerging field in which the gaps between clinical psychology, cognitive neuroscience and entertainment are being bridged. This field is fundamentally interested in the emotional and social brain and “healthy emotional brain architecture” will be the goal of many computerized, gamified interventions. Increasingly, people predict a (near) future in which games will routinely be prescribed in the doctor’s office, and may eventually replace the office visit. If we can change our emotional brains, we can change ourselves. At least, that’s what many are counting on.