Off the Couch

Thoughts about the therapeutic process, and the dynamics of client-therapist interactions.

When Do Cell Phones Improve Psychotherapy?

Do cell phones have a place in your therapist's office? If so, when and how?

I am sitting across from Stanley* who is talking seriously about some of the difficulties he is having with his wife. His cell phone bings to indicate a new message every few minutes. He seems completely unaware of the alerts, and keeps talking through them. Once in awhile the phone rings with an incoming call. He automatically checks the readout to see who is calling. Usually he just keeps talking to me, but every so often he says, “I have to take this. Do you mind?” I never get a chance to answer before he picks up, but I have begun to open up questions about his question in our therapy.

For example, I wonder if he really wants to know if I mind. And what would he do/say/feel  if I said that I did. I also wonder if this is something that he does when he is at home, and if he has ever really checked with his wife and his children to see if they care that his work life (and who knows what else) is always making its presence known when he is with them?

He replies with a grin that his kids and his wife do the same thing. Their phones are always on and always signaling incoming messages and calls. “And does it ever bother you when that’s going on?” He shakes his head. “No, it’s just the way things are these days. You have to get with the times, Diane.”

Is he right? In fact, am I already there? I check my emails on my phone, and have been accused by my husband of doing it too much, although I don’t do it nearly as much as some of our young friends, who do it throughout meals or any social contact. I also have always kept my cell phone on for emergencies, even while I worked, which is a controversial position to take in my profession. But when my son was young I felt more secure paying attention to clients if I knew that his babysitter could reach me in case of an emergency, so I decided that it was actually more productive than not. The calls were infrequent, however, on occasion a call on that phone has been problematic for a client, which has inevitably led to productive and meaningful discussions of a variety of different issues.

Freud once wrote that clients’ symptoms “join in the therapeutic conversation” by appearing during a therapy session. I think that sometimes this is also true of a client’s cellphone, as for example when Stanley and I were able to explore, from a first hand point of view, what it meant to each of us to have his outside life coming into my office. I also find it useful with adolescents, who are constantly in contact with friends during their sessions. I often get information about difficulties in these interpersonal interactions in the moment that they are occurring. However, as is true in almost everything in life, there is a downside to this process.  

We know from current research that we are not really able to do more than one thing at a time. "People can't multitask very well, and when people say they can, they're deluding themselves," says neuroscientist Earl Miller, a Picower professor of neuroscience at MIT. Apparently we actually can only focus on one thing at any given time. Peter Sagal, host of NPR’s  “Wait Wait…Don’t Tell Me,” says that he has found that he works much better when he turns off all of his internet connections.  But many youngsters say they concentrate better when they are also able to be in touch with their friends. It’s a conundrum.

In therapy, even if a client isn’t looking at a phone, constant bings and rings throughout the session can be distracting to both participants, taking both of our minds away from whatever we are focusing on.

Of course, this may be the point. I don’t sit in a lot of meetings, so I have not had the repeated experience of colleagues tapping away on their phones while someone is talking to the group. I have completely mixed emotions about this phenomenon, and don’t know what I would do if I were regularly in that situation. On the one hand, I would be irritated. The behavior is rude, the person is clearly not fully present, and therefore, why bother with the meeting in the first place? On the other hand, especially if I were bored or uninterested, I would want to be doing the same thing. From a psychodynamic perspective, if I refrained from doing it, I would be angrier because I was stopping myself from having the same release from the meeting that my colleague was allowing him or herself. If I joined in the behavior, I might feel less irritated, which would possibly mean that I was actually able to be more attentive to the boring material being presented. But then I might also feel guilty or ashamed, which would actually be distracting, so any benefits would be lost. Of course all of this begs the question of why people have to be present at some meetings.

I am fine with colleagues and supervisees taking an occasional emergency phone call during a class I am teaching or in the occasional meeting I have to attend. But I confess that I do not like it when I am participating in a conference, either as a presenter or a listener, and all around me people are texting, emailing, and e-chatting on their phones and pads. I think that the lack of attention affects the presentation – whether mine or someone else’s. When you know, as a presenter, that people are not paying attention, you become distracted yourself. It’s hard to speak to a non-listening audience. And it’s a vicious cycle, because it’s hard to listen to a distracted speaker.

And perhaps this is the answer to the question of whether cell phones should be on or off in a therapist’s office. If they are on for emergencies, then they are not distracting. If they are part of a person’s essence, crucial to that person’s day-to-day life, they bring who that person is into the therapeutic space. And this of course is part of the point of therapy. But at the same time, they will distract from focus. And this may be something to try to understand.

In Stanley’s case, we began to understand that it was actually very difficult for him to focus on our discussion of his relationship with his wife. And that this had something to do with fears of being overwhelmed by how much he cared about her and needed her. As we started to open up and work on a fear of being rejected that had been part of his social relationships since adolescence, Stanley found it much easier to silence his phone during our sessions. To his surprise, one day he asked his wife and children if they would be willing to set aside some phone-free time to be together. To his even greater surprise, they were all eager to try!   

 

*names and identifying information changed to protect privacy

Teaser Image Source: File: #16470002

F. Diane Barth, L.C.S.W., is a psychotherapist, teacher, and author in private practice in New York City.

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