When I was a psychology intern working in a large city hospital, I was assigned the case of a middle aged suburban matron who presented herself to the medical emergency room requesting a “full body” CT scan. Her reason? She suspected that there was a chip implanted in her body that connected to a distant machine which controlled her and caused her to feel sensations in her body and shocks in her mind. She was also convinced that this machine was designed as an exact replica of her body, a kind of technological voodoo doll manipulated by members of a nefarious conspiracy. This uncanny delusion of having one’s body controlled by a machine, which both affects and looks like one’s body, but is not under the control of the self was originally described in 1929 by Viktor Tausk, a protégé of Freud, in a short paper that remains a minor but obscure classic, entitled “On the Origin of the Influencing Machine in Schizophrenia.” The author surmised that the machine delusion always involved a psychotic projection of the human body. At the time of my internship and during my years of working in an inpatient psychiatric setting (all before the millennium), I saw a surprising number of patients who had “influencing machine” delusions: all characterized by a machine controlled by others with remote access to a “virtual” model of their bodies. Some of the patients even drew their delusional machines for me with remarkable similarity. My patient’s delusion turned out less rare than its bizarre specificity might have predicted, perhaps because it provided a fitting metaphor to convey the sense of alienation of mind and body that can be a hallmark of mental illness. Clearly something about the human mind lends it to readily equate body with machine, since in 1929 when Tausk’s paper was written, the technological revolution had not even been dreamed of.
And yet now that we are past the millennium some things that might have once seemed the stuff of uncanny delusional thinking do not sound as implausible as they once were. Now we have real “influencing machines” that can in fact control the body, just as our minds can remotely control intelligent machines. Electrodes are implanted to stop seizures, tics, depression, OCD. Children and adults who play video games do it through avatars, which are visual replicas of themselves. We can have a “second life” in which we can inhabit new bodies and live in an online parallel universe. Google glass, almost ready to launch for the general public, may be one of the more surreal iterations of a true influencing machine, literally functioning as an adjunct to the body, an extension of our brains and eyes. The Fitbit and related items can literally track one’s every move. It may no longer be sci-fi to contemplate someone falling in love with the operating system on his or her phone (the plot of the recent film “Her” in which the electronic seductress is Scarlett Johansson) and now when we see people talking to themselves, the last thing we might imagine is that they are hearing voices. It isn’t news that most humans alive today, with the possible exception of certain religious groups who ban modern technology, are constantly influenced by and in turn influence our personal machines.
Obviously a lot has changed since the days when I worked in the hospital where I encountered the delusional patients. In those days, medical records were all on paper. There were no PC’s, no cell phones, no video games, no Internet, no Youtube. Amazon was a river and Apple was a fruit. Minds and machines were not literally interconnected as they are now. It is not news to say that there has come to be a seamless convergence of people and machines. Yet even those of us inclined to self-reflection rarely have the distance to step back to see how easily this has happened, so enhanced and augmented have we become by our technology. Try to walk down a city street without looking at your phone, and try not to bump into the dozens of others who are, even if you are refraining. Think of how you feel if your cell phone is broken, lost or stolen; it can almost feel like losing a part of your body. We have all had the frustrating experience of waiting at a cell phone store for a very long time as clients in front of us line up like needy children at the school nurse’s office, needing TLC for their boo boos. It can be a personal catastrophe if one’s computer crashes and who has not felt like taking revenge on a sluggish printer?
So what of the contemporary self that is inextricably linked to all sorts of machines? Well what of it? Ho-hum. Haven’t we been over this? Even those of us from the dark ages of paper charts and landlines KNOW we are yoked to our smart devices. What else is new? Yet actually all this is new considering the sweep of human history. Yet it is odd that we can barely remember what it was like when we were not so hooked up. And some are not in a position to remember this since is the world they have been born into. There must be a primal way we relate to machines, so much so that we are barely aware that they are buttressing us. Otherwise why have so many people come up with delusions of this nature before technology actually took hold of our minds and bodies? In an inverse of my former patient who misinterpreted changes in her mind to be due to outside “influencers” who were controlling a mechanical duplicate of her physical body, now most of us do not seem sufficiently cognizant of the ways our machines are changing our relationship to our own minds, bodies and significant others. In both situations, the influence is behind the scenes and insidious. What once was the stuff of delusion IS our current reality, and we too do not quite know the boundaries between our selves and our machines.
But forget about adults and the technological innovations that lend themselves being extensions of our bodies and minds; what of selves under construction who grow up in the new world of the “real” influencing machines, who never knew the world to be otherwise? As a therapist who works with very young children, I am constantly struck by how little parents stop to evaluate the complex ways machines can impact children’s development and the emergence of the self and even the map of their own bodies.
From Baby Einstein to the Common App, it is now inevitable that human minds are destined to engage with technology throughout development. And yet just recently the American Academy of Pediatrics has suggested that children under the age of 2 not be over-exposed to words and letters on screens, recommending prevention so that the crucial interactive aspects of learning to read will be not be subverted by electronic books with all their stimulating bells and whistles. Is this even possible? Given that there is no turning back, nor even really much chance of finding a control group of children not exposed early to technology in some way, our best shot is being mindful and self-reflective about our influencing machines and the ways they can, when not properly monitored, lead to alienation and fragmentation of the self and relationships. Toddlers know how to turn on the iPad almost by intuition and navigate to the programs or games or images that delight them, while older children find powerful avatars in video games. No one wants plain old toys for gifts anymore. Adolescents find a world on Facebook and social media and we are all hopelessly merged with our smartphones and computers. These devices are omnipresent, addictive, distracting and empowering all at once. I often see adults pushing baby carriages and talking animatedly, but not to the baby, to their phone. Recently I saw a child tumble from her stroller into the crosswalk because her caregiver was looking at her phone in one hand as they crossed the intersection. Parents stand on the sidelines of their children’s sports activities occasionally looking up at the field while they simultaneously keep track of favorite sports teams’ scores on the Internet. We could go on and on about these ironies, but we hardly notice them ourselves.
Where do we draw the line? Though we have heard endless debates involving the pros and cons of our digital world impacting learning and attention, as well as the ways vulnerable and troubled children are at risk when their screen time is not monitored, I do not think we are sufficiently mindful of the small and daily ways the emerging self can be impacted and fragmented by machines controlled by and controlling themselves and others.
As machines come to retool and reconfigure our minds, parents, educators and those of us in the mental health fields need to know how to separate the risks from the benefits, and learn how to identify the impact of the electronic footprint on children’s development. In my practice I have seen children whose interactions with the adults in their everyday lives are constantly mediated by machines: someone is always on or near a machine. There is rarely an uninterrupted conversation. Abstinence is not an option. When thinking about children, we all have to remain mindful of ways our real influencing machines can erode the boundaries between mind and body, self and other, fantasy and reality. If we do not remind ourselves to maintain or even notice these boundaries, we run the risk of raising children who may not fully be able to distinguish where selfie ends and self begins.