Appily Ever After?

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.

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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.

Islands in the Stream: A Meditation on How Time Passes on Facebook

Shortly after the terrible tragedy in Newtown, I received email notifications that my (designated) close friends on Facebook had made status updates. Scrolling through my news feed, my friends expressed the range of emotions that we all felt – horror, sadness, distress, anger, and confusion. Later that day, I popped onto Facebook again and was jarred and a little upset to read that friends who seemed to have just expressed horror and heartbreak were now posting about every day, silly, and flippant things.

Now, why should I be jarred or upset? Hours had gone by. After three, or six, or ten hours, why wouldn’t we be in a different emotional state, and why wouldn’t it be ok to post about it? I started to think that it was not my friends’ posts that were at issue here. Rather, it was the nature of how I perceive the passage of time and sequence of events on Facebook. A couple aspects of this came to mind:

Facebook time is asynchronous with real time. Time is easily condensed on Facebook. Events and updates that might be spread out over the course of a day or several days can be read at a glance, and therefore seem to be happening almost simultaneously. So, our perception of time on Facebook is a combination of how frequently our friends post and how frequently we check in. For example, say I check in twice in two days – at 9am on day 1 and at 9pm on day 2. I know a good bit of time has passed (and the amount of time that has passed is clearly indicated next to friends’ updates), but I still read each status update in the context of the previous ones – especially if I pop onto a friend’s Timeline instead of my news feed.

With this type of infrequent checking, friends’ updates about their varying and changing emotions (which might be reasonably spread out over the course of a day or multiple days) appear to be an emotional roller coaster. If someone has several posts in a row about the same thing, even if they are spaced days apart, the person comes across as preoccupied with the topic. Somehow, I form a view of this individual that brings these little snippets together into one big amorphous NOW. If I were checking more frequently, however, perhaps I wouldn’t lump updates together in this way. I’d “feel” the passage of time and – more accurately – see that the ebb and flow of status updates are like islands in the stream of our lives rather than a direct sequence of events.

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Related to this first point, it occurred to me that status updates are not meant to be interpreted in the context of preceding status updates. Our brains are pattern recognition machines. So, if Facebook status updates follow one after the other, our brains may perceive a direct sequence of events. But, each status update is a snapshot of a moment, a thought, or a feeling. Intuitively, they are supposed to be stand-alone, not readily interpreted in the context of a previous update, even if they occur close together in actual time. Think how different this is from our face-to-face interactions, in which sequence of events matter. For example, imagine that you’re at work, and your co-worker tells you she is on pins and needles waiting to hear back about a medical test. When you see her a few hours later, she is joking and laughing. You assume she either (a) got some good news from the doctor, or (b) is trying to distract herself from the worry. You don’t think she’s just having a good time, out of context of what you learned about her earlier in the day. But this contextualization is not the way it works on Facebook. Linkages between updates are tenuous, connections malleable. We can lay out our stream of consciousness in a way that requires no consistency among updates. Maybe the temporal and logical requirements of the off-line world are suspended on social networking sites like Facebook. Maybe our brains need to catch up.