Mental Health Matters – Mental Health and the Internet

Mental Health Matters – Mental Health and the Internet


Hi, welcome to Mental Health Matters. I’m
Shannon Eliot. Today we will be examining the relationship between mental health and
the Internet. Dr. Keely Kolmes is a practicing psychologist
based in San Francisco. She does research and consults on clinical and ethical issues
related to social networking and technology. Dr. Kolmes has a blog called Mindful Musings,
which focuses on mental health issues and therapy-related topics. Veronica Belmont is a technology and gaming-centric
video host also based in San Francisco. She hosts a tech help show called “Tekzilla”
and a science fiction and fantasy show, “Sword and Laser.” Veronica describes herself as
an avid gamer and social networking fanatic with nearly 2 million Twitter followers. Welcome, Veronica and welcome, Dr. Kolmes.
Thanks so much for joining me today. To kick us off, Dr. Kolmes, can you tell us
what trends and relationships we’re seeing between Internet usage and mental health?>>Well right now we’re seeing a lot of research
about how the Internet is affecting our brains. And some of the things that we’re seeing are
things that tell us that it’s affecting our attention and concentration. It’s affecting
our memory and people have used examples that we now rely on Google and other technology
to outsource our memory. It’s also affecting our productivity as that relates to attention
and concentration. And some people are feeling that they are more pulled to respond to emails
and to deal with messages and interact on social networks. And sometimes that gets in
the way of getting other things done that have to happen.>>Veronica, what are some warning signs that
your behavior is becoming negatively affected by the Internet?>>Well as Dr. Kolmes stated, It’s definitely
hard to focus your attention after awhile. I think even the average Internet user can
see themselves being pulled in a million different directions at all times of day. Something
as simple as just answering an email becomes difficult because you’re getting Twitter responses,
you’re getting IMs (instant messages) popping up, you’re getting all sorts of different
information coming at you at the same time. And it’s very difficult to focus. I think that’s totally natural. And unplugging
is more and more difficult as well. I think people feel anxiety when they have to unplug.
They fee as though they’re missing out, that something is happening when they’re not online.>>Dr. Kolmes, I know you mentioned you felt
sometimes a sense of guilt when you couldn’t respond to an email in a couple of seconds.
Tell me about that.>>Yes, well I think I’ve developed a reputation
amongst my colleagues and friends as being an immediate responder to email. And I’ve
noticed that I’ve trained myself to try to get that item out of my inbox. I tend to respond
to things very quickly. And over time, that’s just become unmanageable. I’ve had to think
through what is a more sane, reasonable, manageable, and sustainable way to manage things like
my inbox.>>Well it’s very interesting, there’s this
whole cottage industry blossoming around getting back to inbox zero, like David Allen’s Getting
Things Done methodology. You get emails piling ail day and suddenly you’re overwhelmed and
you have to declare email bankruptcy, which is a term that didn’t exist 10 years ago. You have to say, I can’t answer all these
emails. I have to either put them in some kind of order of importance and I have to
figure out a way to not feel completely bogged down by all this information. The need to
constantly be answering those emails is almost obsessive.>>And I would like to add on to that and say
that this is something that comes up a lot with my clients. My clients are also talking
about this with me and we’re often strategizing how they can get out of that hole of the massive
growing list of emails they need to respond to.>>I even find myself now completely staying
away from my inbox just out of fear of what’s going to be there. I don’t want to look at
this, I don’t want to deal with this right now. But then I get more stressed out because
I’m not answering important emails.>>And wondering what’s sitting for you there.>>Exactly. And knowing that the second I log
in I’m going to lost in a tidal wave of messages.>>And I know with you being in social media
host and a video host and having tons of videos online, that open you up to a lot of comments
and feedback from people. That’s a whole other layer beyond emails. How do you deal with
that? How does that make you feel when you get something less than positive or something
really positive congratulating you on your work?>>It’s funny because it always seems like
the negative comments weigh more heavily on your mind than the positive comments. And
it’s actually a daily trial to kind of balance those out and say, “Well there’s a lot of
people who appreciate the work you’re doing.” Whether you’re a writer, blogger, a video
host, or just someone who works online in general, you’re always going to be getting
feedback. And a lot of that feedback is going to be coming from people who are anonymous,
and there is often times no filter there when you’re anonymous. People say things that they
would never say to your face. And it’s hard. You have to learn how to say, “Well, that
person doesn’t know me. They may not know what I’m trying to accomplish with my work.”
Or they just don’t care, and that’s fine. There are people that I’m reaching who do
care.>>How do you work throughout that? What kind
of advice would you give to an up-and-coming social media personality or an up-and-coming
host posting things on YouTube having gone through it yourself?>>There’s always a light at the end of the
tunnel. I noticed myself focusing in on certain comments and it would stick with me for the
whole day. I had to learn to take my attention away from that and say, “Well, I’m not going
to look at the comments on this YouTube video. I’m going to ignore them.” There are entire
Chrome plug-ins now — plug-ins for Firefox even — that will turn off all comments on
youTube. Maybe that’s not the most productive, but it definitely does take you out of that
immediate need to read the comments and get that feedback that may not be positive. But
at the same time, it’s also my job to stay connected to my viewers and readers and take
their feedback and integrate it into my work. It’s definitely a toss-up.>>Dr. Kolmes. how does increased Internet
usage affect our interpersonal relationships?>>Well it can affect our relationships in
some really wonderful ways and in some not-so-wonderful ways. There are a lot of ways people are now
using social networking to get support for issues that they are dealing with, whether
they are mental health issues or not. I know some folks who had babies or had surgery and
there are now sites where you can coordinate people bringing meals to your house and really
helping you to get through difficult times. So I think it’s really lovely how social networking
can allow people to reach out to their community and actually get the support they need. But
at the same time, there can also be a splintering effect when you’re no longer socializing face-to-face
and maybe feeling isolated. As Veronica had mentioned before, feeling like you’re missing
out on things or being a voyeur to social interactions that are not including you. And
I think those are ways that it can actually increase the sense of isolation and disconnection
that people sometimes feel.>>One of the positive aspects of being anonymous
online is that you can go into these support groups and feel as though you have a safe
place to discuss issues or problems that you are having. I had an interesting experience
years ago when Second Life was very popular. There was an anxiety support group and that
was something that I suffered from personally. And I thought, ok, I’ll check this out and
see what this feels like. I logged in with my avatar and everyone was sitting around
in a circle like you would see at a summer camp. And they were just taking turns and
talking about their experiences. I was concerned about the privacy matter because in that game
you can take screen shots and you can save people’s information, but they forbid that.
That was one of the rules of coming to this meeting. You couldn’t take any screen shots
and when you did, it would make a very loud camera noise so everyone knew it was you and
you would then be banned from the group. So the Internet has come up with a lot of very
interesting ways for people to get together and discuss private matters that they may
not have an outlet for in the real world.>>And in addition to that, there are a lot
of other people who are seeking resources for issues where it’s difficult to find a
practitioner in their area to help. For example, transgender clients or people who are dealing
with issues where there is no specialist in their area. Some of these folks are using
elemental health services, not just to find support groups, but to connect with a clinician
who may not be local, but who is better equipped to help them deal with these issues. This
is another way that the Internet and technology is allowing people to get support and help
and to feel better.>>That’s interesting you bring that up because
that presents a whole other issue of privacy, HIPAA, and whether conversations can be hacked
and people can listen in on you. So how do clinicians navigate that very fine line?>>It’s very tricky right now. Sites that are
the most easy to use and common, such as Skype, are not HIPAA-compliant. There are some other
sites, like Nefsis, that are HIPAA-compliant but not Mac-compatible. Practitioners who
offer elemental health services right now are really struggling to find the best sites
that offer the highest security. And at the same time there are licensing issues. Typically,
in most states, you need to be licensed in the state in which the client resides. So
unless your’e going to have licenses in both states, you’re going to be in a bind if you’re
trying to provide services to people nationally. Now that may change because of his trend in
moving more towards elemental health services. So that’s something that remains to be seen,
how that will be addressed.>>Before the show, I remember you telling
me about your own principle of harm reduction that you were implementing.
Could you talk a little bit about that and why you find giving therapy is also therapeutic
to you?>>One of the things I had been noticing recently
is that I wasn’t getting the same bang for my buck from my Internet usage that I used
to. I was also experiencing that sense of overwhelm at my inbox and feeling that I was
getting a lot of random contact from strangers asking me questions, as well as job opportunities
as well as people wanting to become my clients. And it was getting really hard to figure out
how to tame my inbox, how to focus my attention the things that really matter. One of the things I noticed is that when I
would spend a 50-minute session with a client — where I’m not checking my email or looking
at my phone — there was something very refreshing about that period of focus and really paying
attention to another person with no gadgets in sight, at least not mine. Sometimes my
client might get a message. I was thinking a lot about that and how I
found that really healing to have these moments of engagement. And it made me really think
about how I could have more of that in my life outside of work.>>This next question is for both of you. I’m
curious how Internet usage affects pre-existing mental health conditions. Veronica, you talked
a little bit about your anxiety and how Second Life helped you with that. Are there any other
ways that the Internet has helped you with that? And conversely, are there any ways that
made it worse?>>That’s an interesting question. From an
anxiety point of view, I have to say that it’s made things a little worse for me personally,
just because I do have the fear of missing out syndrome, I guess. I don’t think it’s
technically a syndrome yet, but maybe someday. It’s that sense that you are not doing the
thing that all the other people are doing at that moment. You see photos on Instagram,
updates on Foursquare or on Facebook of cool parties happening. You think, “Why wasn’tI
invited to that? That looks really fun.” But for me, it’s really more about learning when
and how to unplug. If I’m having a nice dinner with my husband and we’re sitting there and
both on our cell phones at the same time, there’s that sense that we’re not really connecting
in the same moment and place and enjoying each other’s company. It’s really a process
of both people needing to learn how to put the phones down. Maybe make a rule that once the check comes,
that’s when you’re allowed to go back and look at Twitter or check your email. Little
rules like that can help set the guidelines for that kind of situation.But overall, it
has made my anxiety a little worse because I do feel that constant need to be connected.
Maybe that’s a product of my career and the job that I do, but I see it in all sorts of
people, so I think it’s a little more widespread than we like to admit.>>I like how you’re talking about negotiation
around the rituals and conventions and norms in your relationship.>>There are some apps. We’ve spoken in the
past about Pair, which is a an app for people in a relationship to share cute moments together.
You can thumb kiss by putting your thumb on the screen at the same time and it lights
up pink. Little things like that are cute, but I don’t think they are a solution for
this kind of scenario. But they can help. If you both love technology, it’s a great
way for you to have a little moment together.>>And I think in response to the question
about pre-existing mental health conditions, I think it depends on whether people are using
technology in ways that promote health or are further enabling their depression or anxiety
to hurt them in some way.>>So building on that, how would you work
with someone coming to you seeking treatment for an unhealthy relationship with the Internet?>>I think the best strategy is really an individual
approach. I’m really interested in talking to people about what a healthy relationship
with the Internet looks like for them. I think that it’s no more helpful to tell a person
to just stay off the Internet than it would be to tell someone with food and eating issues
to just stop eating. Most of us have work lives and social lives that require us to
be online, so I think really looking with my client at what they’re doing — what feels
like it’s hurting and what feels like it’s helping — and devising a plan that actually
feels healthy and manageable for them is the best thing to do. And that’s why I call it
a harm reduction strategy. It’s something that minimizes the harm and increases joy
and connection.>>I was actually looking at a new Chrome extension
called Morphine recently, which allows you to view the sites that you consider fun only
once you’ve earned a certain number of points doing productive things. So if you try to
visit a website like YouTube, for example, it will just be blocked off. And if you’ve
accumulated enough points in the add-on, you’ll see a little marker that shows how many points
you need to turn that video on. So if you’re doing email and being productive, you accumulate
points and then you can have your fun once you’ve done your actual work.>>Kind of like that old chart we had when
we were kids with the gold stars…>>A star chart, exactly.>>…and then we got our allowance.>>It’s kind of sad in a way that we need to
build these things into our browsers or operating systems to actually keep us productive, but
at the same time, there seems to be a need for it.>>And there are other tools, such as Leechblock,
Metimer — I think Rescue Time may be one. AntiSocial is a new one, and their tagline
is “Just look at how much work you can do when you turn your friends off.” But people
are really needing these tools to help focus their attention when they’re online.>>So for both of you, how is the new age of
social media affecting your identity and how you see yourself?>>That’s a really great question. What I’ve
noticed is that people are making filtered version of themselves that they share online.
It’s almost like a curated version of yourself, where you’re putting forward all the positive
aspects of your life, your personality, and your pictures. Those are the forward-facing
things to the general public. And that makes total sense. I mean, no one — I say that
but at the same time, there are over-sharers out there who will over-share every single
aspect of their lives. It seems to be in two different kinds of camps: people who are definitely
protecting the less awesome parts of their personality and people who are just kind of
Internet vomiting all over everything, saying, “This is my life, deal with it. Meet me on
Facebook if you want.” It goes both ways and both ways are good and bad for different reasons.
Actually, with the over-sharing, I don’t know if that’s ever good necessarily. I’m not a
victim of that. I like to stay more on the curated end.>>It’s interesting because I work with a lot
of people who are very involved in technology, and a lot of people are really wrestling with
what face do I put forward and what do I do for different audiences with friend groups
and how they shape their identity and their persona. And I know there’s some research
— I believe by Danah Boyd and Alice Marwick — on how teens are very savvy about this
and how easy it is for adults to misinterpret some of the postings that they post when they
are really direct messages for other people. I think these are really great points that
Veronica is raising. And for myself, what I’ve noticed is I have really honed a professional
identity online. And as a psychologist, I feel a lot of responsibility and reduced freedom
because I can’t share the same kinds of things I used to share in my personal networks with
my friends. And it’s a real loss of freedom in some way, having to carry the responsibility
of the awareness that clients might be reading what I post.>>It’s kind of funny, too. When you break
out of that mold that you’ve built for yourself online somehow. I tend to get a lot of feedback
if I ever swear online, for example. I try not to do that because my mom reads my Twitter
feed, but when it does slip out once in awhile, the feedback that I get is enormous — “I
can’t believe you did that. That’s so unlike you.I would never expect you to use that kind
of language.” And I know it’s not the most professional kind of language, but I’m also
a real human being and sometimes I have strong opinions about things and they’re going to
come out. So it’s funny the way that these perceptions get built up about you based on
this persona that you’re making online for yourself. When you crack that mold, it can
be difficult for people to understand.>>That said, when people meet you for the
first time, after having followed you online for however many months or years, are they
every surprised? Do they ever say, “I thought you’d be different.”?>>You know, I don’t get too much of that.
Maybe mostly with the swearing. [LAUGHTER] It is interesting. I’ve gotten that once or
twice, where people are surprised by different aspects of my personality. I can’t pull any
particular one off the top of my head right now. But yeah, you definitely build up an
online persona and it doesn’t always completely 100 percent gel with your meet space persona.>>So a recent Newsweek article by Tony Dokoupil
on the Internet and DSM states: “Peter Whybrow, the director of the Semel Institute for Neuroscience
and Human Behavior at UCLA, argues that ‘the computer is like electronic cocaine,’ fueling
cycles of mania followed by depressive stretches. When the new DSM is released next year, Internet
Addiction Disorder will be included for the first time, albeit in an appendix tagged for
‘further study.’ China, Taiwan, and Korea recently accepted the diagnosis, and began
treating problematic Web use as a grave national health crisis.” Dr. Kolmes, what are your
views on Internet addiction and its introduction into the DSM?>>It’s very controversial. I have very mixed
feelings about it myself. And I really want to see more research as it comes along. I
have trouble with the naming of addictive disorders for each new thing that comes along.
I’ll confess that I have difficulty with the concept of sex addiction. I think that very
often what is happening is that people are depressed or anxious and we already have diagnostic
categories that describe these things. These diagnoses may lead people to egg in behaviors
that are not so healthy. So it’s unclear to me whether Internet addiction is the appropriate
diagnosis for someone who is spending a lot of time on the Internet. Are they socially
anxious and is this a coping mechanism? Are they depressed and can’t leave the house so
they are spending a lot of time online? So I would prefer to look at what the underlying
issue is before I plunk another diagnosis in the DSM about that.>>So why do some people develop problematic
behaviors with the Internet? Why is it so hard for us to disconnect?>>Well I think it’s some of the things that
I’ve mentioned, like if someone is already experiencing a mood disorder. But I also think
our culture is changing so quickly, and now our work and social lives are all coming at
us through our laptops and our phones. It’s one of those things where things are changing
so quickly and we haven’t yet developed coping mechanisms for how to manage it. Veronica
and I have both talked about feeling overwhelmed by our inboxes at times.>>I”m a good case study.>>As am I. And so I think a lot of people
are trying to figure out what to do with this problem. I’ve been on the Internet since 1993
and when I had 10 people emailing me, this wasn’t a problem. So I don’t know if the problem
is the Internet or if it’s that now everyone is on the Internet and it’s so pervasive.
The expectations of response time or feeling like you should be done with work at the end
of the day but people are still sending you messages is part of what’s the problem. I
think that’s making it pretty complicated for people.>>And especially I know high-level corporate
folks — or high-level folks in any organization — the ones that go on vacation with their
Blackberry who are not really on vacation and texting at the beach.>>And there’s pressure. There’s pressure within
corporations to be available like that. And people are rewarded for performing at that
level. So people are being rewarded for not taking time off.>>It’s very difficult when, as you said, your
social life, your work life, and your personal time fun are all wrapped into the same kind
of space. My work, my social, everything is online and when I want to escape from that,
I go into World of Warcraft or I go into some other kind of online game. It seems like it’s
cyclical. But at the same time, I feel like on a personal level people who want to learn
how to unplug — doing things outdoors like hiking or getting out into nature a little
bit. I’m learning to associate positive feelings of well-being with those kinds of experiences
as much as I do with the experience of being in an online game. And so that’s kind of helping
me to break out of that “always plugged in” mode, knowing that it will be readily nice
to get outside for a little bit today and not have to deal with my inbox.>>Some of the strategies I’ve been employing
are things like just checking email a certain number of days, which takes some reassuring
self-talk that those messages are not going to go away. They’ll still be there when I
check my email later. And giving myself permission to just be in read-only mode, that I can go
and look but not respond. And doing blackout periods, where I shut down at a particular
time –whether it’s 8 or 9 at night — and then say I’m not checking email or social
networks for another 12 hours. I’m focusing on other stuff. If I want to connect, I’m
picking up a phone and calling a friend, like we did in the old days.>>I don’t even know how to talk on the phone
anymore. But it is true. There have been numerous studies done that show that having your computer
in the bedroom at night can lead to a lot of issues, both with intimacy and getting
proper sleep. The bedroom should be for two things: sleep and sex. That’s it. It shouldn’t
be for email. So I think that we’re learning to put the Internet and social media in its
proper place. Definitely turning the computer off at 7 or 8 at night and giving yourself
a few hours of wind down time before you hit the sack is very important, not just for mental
health, but for your physical health as well.>>Well thank you so much, Veronica. And thank
you, Dr. Kolmes for being here today. I really enjoyed our conversation and found it really
informative, so thank you.>>Thank you for having us.>>To read Dr. Kolmes’ blog, Mindful Musings,
visit her website at www.drkkolmes.com. If you’d like to learn more about Veronica
and her views on technology, visit her website at www.veronicabelmont.com. To read the Newsweek
article by Tony Dokoupil on the evolving relationship between mental health and the Internet, visit
www.newsweek.com. If you are interested in tools that monitor
your Internet activity, you may be interested in the following: Leechblock is a Firefox
add-on designed to block time-wasting sites. Learn more and download at: addons.mozilla.org.
Anti-social is a productivity application for Macs that turns off the social parts of
the Internet. Learn more and download at: anti-social.cc.
StayFocusd is an extension for Google Chrome that increases your productivity by limiting
the amount of time spent on time-wasting websites. Learn more and download at: chrome.google.com/webstore. Thank you so much for watching. We’ll see
you next time.

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