But games (rule-bound, often driven by winning) and play (largely unstructured, open-ended) are not necessarily coincidental and sometimes are even antithetical to one another. By programming a narrow set of behaviours to be rewarded, these apps foreclose the unexpected, the creative. If a solitary training programme replaces care, as social scientist Gregory Bateson suggested, \u201cLife would then be an endless interchange of stylised messages, a game with rigid rules, unrelieved by change or humour.\u201d All game and no play makes us dull \u2013 even if we feel momentarily relieved.<\/p>\n
That interactive machines might make us feel good is nothing new, nor is automating out the therapist while still claiming that mental healthcare is taking place. In the late 1950s, Dr Charles Slack fabricated tape recorders that counted how many words they recorded, and then passed them out to \u201cteenaged gang members from Cambridge\u201d, paying them a scaled rate to talk to themselves.<\/p>\n
Read more about mental health apps:<\/strong><\/p>\n The more they talked, the more their tallies climbed \u2013 as did their reward: cash. Slack noted that \u201csome of the participants said they felt better for having talked this way.\u201d Speaking was incentivised, it became a game.<\/p>\n Only a few years later, and across Cambridge at MIT, Joseph Weizenbaum debuted his 1966 program ELIZA, which took the idea of mechanised soliloquy to a new level. The ELIZA experiment was intended to demonstrate that \u201ccommunication between man and machine was superficial.\u201d<\/p>\n An early chatbot, Weizenbaum programmed ELIZA to \u2018parody\u2019 a \u2018client-centred\u2019 therapist doing a preliminary intake with a new client. Weizenbaum was in for a shock: many people didn\u2019t quite find the interaction meaningless, even if technically and clinically it was. Emotionally, they enjoyed <\/em>\u201ctalking\u201d with ELIZA \u2013 though they knew quite well she was merely programmed to talk back \u2013 even going so far as to ask for privacy to be alone with \u201cher\u201d.<\/p>\n Ever since, and over Weizenbaum\u2019s protestations, psychologists and computer scientists alike have worked to develop programs that might help us. In our contemporary time, these apps have taken the pleasure and novelty of re-encountering the self through the computer (or tape recorder) and combined it with our habitualised self-tracking and our current emphasis on wellness activities at the expense of deeper work and systemic solutions.<\/p>\n As Weizenbaum knew then, and we do now, a fleeting feeling of accomplishment is quite different from what psychotherapies predicated on depth and play offer. If we don\u2019t think of Slack\u2019s tape recorder as therapy<\/em>, why is a reward for, say, doing a breathing exercise as an end unto itself any better? While one may feel relieved in the moment, no deep work has occurred; a bandage may stem bleeding for a time but won\u2019t heal a patient in need of surgery.<\/p>\n Rigid rules and notifications demanding in-app attention (along with quests and badges) have indeed supplanted true play, and therefore also, for some, therapy. There is no human there in the program, nor human relationship, to ensure a continuity of care or to assist in playing and replaying, especially when it\u2019s frightening or uncomfortable. These games, and their outcomes are, if nothing else, predictable, even as they might secure an individual\u2019s participation in the scheme.<\/p>\n Read more about mental health:<\/strong><\/p>\n Worse, the gamification of care is not neutral; it exists to entrain users, whether a platform delivers on its promised results or not. As game designer and scholar Ian Bogost wrote of gamification\u2019s invention by consultants, it was: \u201c\u2026a means to capture the wild, coveted beast that is video games and to domesticate it for use in the grey, hopeless wasteland of big business.\u201d<\/p>\n The business at hand is Big Therapy, which is increasingly lucrative. The digital health market was worth billions of dollars before the COVID-19 pandemic; now, online therapy companies are being traded publicly on the stock exchange, tele-health visits are 38 times more frequent than they were just two years ago, and employees are treated to a barrage of company-sponsored wellness reminders and initiatives while competent care has become no more affordable or accessible.<\/p>\n In the turn to gamification, patients are asked to consume their care and to be satisfied with only caring for themselves. The user is now solely responsible for their own wellbeing; momentary symptom reduction is the only aim. Putting the responsibility of treatment solely on the person in crisis is not just a problem of\u00a0how\u00a0<\/em>care is delivered, but of care itself.<\/p>\n It\u2019s all fun and games until someone gets hurt: these apps skirt oversight, collect large swathes of personal data, and can prevent users from seeking out full-fledged therapeutic\u00a0support when they need it most.\u00a0These same users are already the most vulnerable systemically to counting, data collection, prediction, and are least likely to have access to more robust, interpersonal, and, yes, playful forms of care.<\/p>\n We cannot praise therapy apps for their claims about expanded access and patient compliance without looking at the games they\u2019re playing with mental health.<\/p>\n The Distance Cure:\u00a0A History of Teletherapy<\/em><\/a> by Hannah Zeavin is out now (\u00a330, MIT Press).<\/p>\n <\/p><\/div> By Hannah Zeavin Published: Friday, 15 October 2021 at 12:00 am A cute penguin. A millennial pink interface. \u2018Allies\u2019 and \u2018bad guys\u2019. A new class of therapy app promises not just to help those in emotional distress, but to make therapy a fun and enjoyable experience rather than a beneficial if sometimes painful labour. That […]<\/p>\n","protected":false},"author":24,"featured_media":66,"template":"","categories":[1],"acf":{"readingTimeMinutes":"6"},"uagb_featured_image_src":{"full":["https:\/\/c01.purpledshub.com\/uploads\/sites\/42\/2021\/10\/mental-health-apps-mobile-games-will-never-be-able-to-replace-proper-treatment.jpg",1200,800,false],"thumbnail":["https:\/\/c01.purpledshub.com\/uploads\/sites\/42\/2021\/10\/mental-health-apps-mobile-games-will-never-be-able-to-replace-proper-treatment-150x150.jpg",150,150,true],"medium":["https:\/\/c01.purpledshub.com\/uploads\/sites\/42\/2021\/10\/mental-health-apps-mobile-games-will-never-be-able-to-replace-proper-treatment-300x200.jpg",300,200,true],"medium_large":["https:\/\/c01.purpledshub.com\/uploads\/sites\/42\/2021\/10\/mental-health-apps-mobile-games-will-never-be-able-to-replace-proper-treatment-768x512.jpg",768,512,true],"large":["https:\/\/c01.purpledshub.com\/uploads\/sites\/42\/2021\/10\/mental-health-apps-mobile-games-will-never-be-able-to-replace-proper-treatment-1024x683.jpg",800,534,true],"1536x1536":["https:\/\/c01.purpledshub.com\/uploads\/sites\/42\/2021\/10\/mental-health-apps-mobile-games-will-never-be-able-to-replace-proper-treatment.jpg",1200,800,false],"2048x2048":["https:\/\/c01.purpledshub.com\/uploads\/sites\/42\/2021\/10\/mental-health-apps-mobile-games-will-never-be-able-to-replace-proper-treatment.jpg",1200,800,false]},"uagb_author_info":{"display_name":"importmanagerhub@sprylab.com","author_link":"https:\/\/c01.purpledshub.com\/bbcsciencefocus\/author\/importmanagerhubsprylab-com\/"},"uagb_comment_info":0,"uagb_excerpt":"By Hannah Zeavin Published: Friday, 15 October 2021 at 12:00 am A cute penguin. A millennial pink interface. \u2018Allies\u2019 and \u2018bad guys\u2019. A new class of therapy app promises not just to help those in emotional distress, but to make therapy a fun and enjoyable experience rather than a beneficial if sometimes painful labour. That…","_links":{"self":[{"href":"https:\/\/c01.purpledshub.com\/bbcsciencefocus\/wp-json\/wp\/v2\/rss_feed\/65"}],"collection":[{"href":"https:\/\/c01.purpledshub.com\/bbcsciencefocus\/wp-json\/wp\/v2\/rss_feed"}],"about":[{"href":"https:\/\/c01.purpledshub.com\/bbcsciencefocus\/wp-json\/wp\/v2\/types\/rss_feed"}],"author":[{"embeddable":true,"href":"https:\/\/c01.purpledshub.com\/bbcsciencefocus\/wp-json\/wp\/v2\/users\/24"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/c01.purpledshub.com\/bbcsciencefocus\/wp-json\/wp\/v2\/media\/66"}],"wp:attachment":[{"href":"https:\/\/c01.purpledshub.com\/bbcsciencefocus\/wp-json\/wp\/v2\/media?parent=65"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/c01.purpledshub.com\/bbcsciencefocus\/wp-json\/wp\/v2\/categories?post=65"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}![\""Book\"](\""https:\/\/images.immediate.co.uk\/production\/volatile\/sites\/4\/2021\/10\/The-distance-cure-c361034.jpg?quality=45&resize=556,556"\" "\\"\"The-distance-cure\"\\"\/")
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