As a psychotherapist in private practice, I can't help but notice that Facebook is wreaking mischief in some of my clients' personal lives.

One client caused a family scandal when he established privacy settings that prevented some, but not all, of his relatives from seeing his status updates. A 14-year-old client gave up Facebook for Lent, yet still managed to become entangled in a high school "de-friending" drama. A third client "disallowed" her arch Conservative brother from commenting on her statuses after he started arguing with her politically liberal friends. And finally, a 20-something client tried to gauge the temperature of his on-again-off-again girlfriend based on how often she "friends" or "de-friends" him.

Indeed, social media offers the online universe a whole new arsenal to offend, snub, flirt, spy on, and make public declarations about those we "like" and those we don't. Given the growing ranks of users, it's hardly surprising that Facebook is making its way onto the therapy couch.

"I absolutely agree that Facebook creates stressors," said Stacey Nunez, a Manhattan-based psychotherapist, noting that many of her 20-something female clients have severe anxiety and depression as a result of their Facebook usage. "They cyber-stalk ex-boyfriends and fantasize about what these people are doing in the photos," she explained. "It often creates false expectations as well as low self-esteem, which in turn creates difficulty connecting when placed in a face to face situation."

Research appears to back this up. According to psychologists at Edinburgh Napier University, Facebook stresses people out. In a study of 200 students, researchers observed a correlation between stress levels and the number of Facebook "friends." Apparently, the more friends a person has, the more one worries about missing important social information, offending contacts, rejecting user requests, deleting unwanted contacts, being entertaining, or using appropriate etiquette for different types of friends." Additionally, Facebook can engender lifestyle envy. http://www.napier.ac.uk/media/Pages/NewsDetails.aspx?NewsID=187

Lest the media be confused with the message, one might argue that Facebook isn't necessarily creating drama, just reflecting subtle relationship dynamics that lurk beneath the surface. Social media is, after all, a modern form of storytelling, predicated on people's desire to share their stories in moment-to-moment sound-bites and colorful narratives. Where else can I follow the daily chronicles of my childhood friends and long lost relatives, or enjoy the chapter-by-chapter unfolding of my friend's sojourn into single fatherhood?

But by pronouncing precisely who likes and doesn't like who and who is doing what, Facebook tells us in black and white letters and full-color photos what we might otherwise read between the lines and perhaps wish we could ignore.

One thing is for sure: Facebook can be a virtual breeding ground for aggressive and passive-aggressive behavior, especially for those who haven't mastered the art of direct communication. One client complained that, following a few arguments, her husband publicly vented his frustrations in their marriage by making generalized critiques in his status updates - eg. "I don't understand why some people always over-react."

Another psychotherapist, who asked to remain anonymous, disclosed that a client who works as a professional photographer broke up with his girlfriend after she repeatedly questioned him about pictures of other women he posted on his site. Even after the relationship ended, she continued to harass him by "friending" mutual acquaintances of theirs and making sarcastic remarks about him on their Facebook status updates and photographs.

"I find that Facebook can have devastating effects on the younger set, especially 13 through early twenties", explained Dr. Sandra Mann, a Manhattan-based family therapist. "The socialization of teenagers when they're undergoing rapid brain development and learning social skills that will take them into adulthood is hard enough without faceless assaults. The lack of empathy that comes from not observing body reactions to comments are most troubling. Even the slightest rejections can rock the strongest egos."

In my private practice, I've observed that Facebook can be particularly insidious for clients coping with divorce and family feuds, regardless of age. One client whose large extended family split into factions after a nasty inheritance scandal told me he gets re-traumatized every time he sees his estranged cousins commenting on his neutral cousin's status updates, and vice versa. "I don't want to see picture of these people and their kids. I want nothing to do with them," he said.

The grass also appears to looks greener on Facebook for clients with low self esteem who report that their lives don't appear to measure up to their friends who have better spouses, lifestyles, and careers. A single client of mine who recently turned 30 felt conflicted about the engagement announcements and wedding pictures of so many classmates.

"It's all relatively new, and humans have adapted from horses to autos; letters to phones," explained Dr. Mann. "The next generation will figure out how to protect themselves better. It's the clean-up from this first iteration that will be most troubling."

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