future therapy stories

Using creative writing, Jeannie Wright explores how technology may impact on personal therapy in the future and invites readers to develop their own endings to her story…

‘THE development of sophisticated computer-generated representations of the self (avatars) for use in mental health environments is already underway at the time of writing… Think of a place in cyberspace where clients can select their counsellor from a range of avatars, an image that they can relate to completely by gender, colour and appeal. The human soul behind the avatar is real - the physical representation need not be. Add a virtual environment that has no physical restrictions on any level - not even being bound to the planet earth, or indeed to any reality. Let the client remain anonymous by changing their identity through their avatar, and then use that choice of physical representation within the therapeutic work to explore role-play, identity management and the client’s true perception of the ‘real self’ (www.ismho.org).

If you’re reading this story, it might be because you don’t trust technology, but like stories. Safer. Less likely to take over the world or turn monstrous. The beginning of this story is inside a room, like any other therapy room. I designed it, inside my head. Today it has two long windows, sun pouring in, some rich coloured rugs - dark red and indigo. A simple room but the details are luxurious - a smooth soapstone carving, deep upholstery. The person facing me, the avatar therapist, was also created inside my head. Sometimes I change her to a him, change race, age or height. At the moment she’s a tall, dignified, black woman, a Toni Morrison wisdom about her. She’s got a watchful kind of face, alert, but not without a sense of the absurd, a bit of humour around the eyes. She doesn’t say much. I do most of the talking during our meetings. I know she loves me. She’s welcoming, warm, hugs me when I first sit down and when I leave. I let her do this. Let them alter the programme to do this. It took time. I decided that anyone who could write ‘Beloved’ or ‘The Bluest Eye’ could be trusted. I had never let anyone else put their arms around me. I had her smell of lemons and vanilla; scents I’d read about in another book and tried them out beforehand. She felt soft, cushioned. I like to rest my head against her. Once I decided we’d both lie on day-beds adjacent to each other, like those used in courtyards in Mexico for siestas. It was intimate and comfortable but I found it too difficult to stay awake, so we went back to chairs.

At the beginning she mostly nodded, smiled, made encouraging sounds, ‘Hmmm, yes’. She’d also pick up some of my words and put them together with my body movements, facial expressions and tone of voice. I knew she had no axe to grind. I felt understood.

The scans were accurate. The brain images had shown a deficit in my early bonding - an attachment disorder, they said. The mapping produced a series of statistically meticulous representations of those areas of the limbic brain which needed balancing. The instructions suggested attention might be directed to this medication (with side-effects in bold) or to this or that form of psychotherapy. I’d opted for relational sessions and self-designed avatar - more expensive than drugs in time and money, but I was wary of trusting anything, swallowing anything and having so little control of the consequences. So far, we had met six times. I’d opted for a 10-session package and could view the recordings of our meetings freely, at will. When I watched myself in the room with her, it seemed I was beginning to soften. Gradually, I could see a relaxation of some of the muscles around my mouth. The shoulders dropping a little, hands and arms looser, fingers relaxed.

I also followed a series of ‘writing in therapy’ exercises. I’ve never been easy about talking to other people about my thoughts and feelings. I could write in private, whatever I liked and when I liked. I could also see, when I re-read the writing, that I was beginning to switch perspective. Less about the past and what had become, in my mind, ‘the pit’ and more about the present.

After five sessions, the scan showed progress. As I left the room after the eighth meeting, I was handed the recording as usual and a disk. That evening before eating with some friends, I played it, casually, in between pouring drinks and slicing fruit.

‘Attention might be paid to movement,’ it said. ‘Choose from the following:

Movement with music
Drumming
Water and waves
Six rhythms’

The instructions said I could change the room and the avatar if I wanted to. I was comfortable with her but decided to enlarge the room and remove the rugs. A wide wooden floor now and long arched windows right down to the floor. The pool was warm and the tiles light blue. The light on the water reflected on the white walls of the room. First, I floated on my own, watching the light dancing and flickering. I moved my arms and legs, opening and closing, opening and closing. She stood at the steps of the pool with a large towel and wrapped me round in it when I got out. For a while I leant against her. She sang something, very quietly, without words. I had chosen movement with music. She took my hands and asked if I was ready to move.

For the next two sessions we moved through a series of stages, the music changing from gently melodic and slow through to strident discords and urgent rhythms that seemed to follow where I led.

Always at the end I would lie on the floor as she talked me through some breathing exercises, describing how my limbs would feel heavy and warm. The visualisation would end with suggesting that I could feel as relaxed as this in a place of my imagining.

I wanted more.

You, the reader can now choose an ending. Here are some possibilities (see next page for more) or you could create your own...

We worked out a date for a final meeting. The scans were looking good and a follow-up might not be necessary, but I had the option. I could carry on with the writing in my journal any time and the relaxation techniques I’d learned were programmed into my home and work computer. I was living with a friend now - very new to me, but it seemed to be OK. They asked me if I’d recommend the system to a friend.

‘Sure,’ I said.

The next time I entered the therapy room, they said the system had crashed. If I came back in a week, they’d try and retrieve the avatar and settings. My hands were shaking as I left and made a drink at home. I’d lost her. The sobs took me by surprise. I’d never done this except with her.

Kate Anthony invites members of the International Society of Mental Health Online (www.ismho.org) to respond…

l That’s how I started our next session.

‘I want more,’ I said. She gave me that tender smile, wise and mysteriously luminous.‘You’ve put a lot of loving care into creating me,’ she said, ‘an avatar you can trust. Will you trust me one more time?’ I gave her a tremulous smile.

‘Yes.’

‘Turn around,’ she said. ‘Slowly, slowly. What do you see?’

I revolved until I faced one of the tall arched windows.

‘I see a window.’

‘You created the window, so you can change it. Let it become a highly polished mirror.’

The glass shimmered and changed. In its reflective surface, I saw myself.

‘Now,’ she said, ‘tell me exactly what you see.’

Liz Zelvin, Therapist
www.LZcybershrink.com

l I decided I am finally ready to risk the emotional pain of exploring what the scan had meant by an attachment disorder. Before it felt too frightening but I know I am safe in this therapy. I can approach difficult topics that would have overwhelmed me before. I don’t change the therapist from the Toni Morrison avatar any more as I am fond of her. She is familiar, warm, reassuring and she will be with me when we recreate my early childhood experiences in the therapy room. She will make the difference. This time I will have someone who can take care of me, be there for me. I am beginning to understand what hope is, I think, as I click into the next therapy session.

Judy Tiktinsky, Therapist
www.helphorizons.com

l The police asked why just the one computer? Why would someone bother to break in and steal just for one lousy computer? Melody, the office secretary had no idea. The on-staff psychiatrist speculated that it was the program. But there were so many possible suspects if that were the case. The computer was easily replaced and the back-up program was installed and they were back in business within a few days. So everything was business as usual.

Except somewhere out there was a person badly addicted to the program. Someone who had lost control of their senses in a cyber-psychotic kind of way. It was almost a week since the crime occurred. It had been a week since anyone had heard from me, though I was not aware of the time. With no one to remove me from the program, I was still attached to it in my mind. I didn’t want to leave. I was happy. I felt weak, but I ignored it.

They had missed me at work. Apparently, I had many calls while I was ‘under it’. Finally someone got the superintendent to check on me. Poor old man poked his head in, saw me on the couch and had a heart attack right on the spot! Luckily, a neighbour heard his moan and called the ambulance. It was too late for me though. But the neighbour was heard to say, ‘At least she died with a smile on her face’. That became consolation for everyone.

Donna Anderson

l The hypnotist counted to three and I awoke from my relaxed state. I immediately recalled that he had asked me to imagine what counselling would be like in the year 2018. Had my imagine run wild or had I somehow tapped into the reality of our virtual future? ‘This could work’, I told myself while my brain scrambled through the innovative concepts that would need to be mastered to bring such a vision into being. ‘Yes, this could work!’

Dawn DuBois MSW, RSW, Therapist
www.sunrisecounselling.com

l With one more session yet to go, I finally chose to continue with the same avatar therapist. The easy warmth and comfort of her helps me to move along in my self-exploration. After years of looking for a safe place to deal with ME, I have found it in an unlikely yet convenient place: my own home.

The new instructions contained two short words, ‘go deeper’. I sit on the edge of the pool just thinking for a while. Finally, as though beckoned from below, I slipped in the water and sank to the bottom of the pool. Above, the blue skies are sparkling and the sun is just beginning to sink. I know that if I don’t figure out the instructions soon, I will drown.

In the end, it comes to me. I think I am falling in love with my avatar therapist. My motivation for continuing this way had evolved to the next step. When I thought that I was creating my perfect therapist, I was actually creating my cyberdreamgirl. Instead of being able to go deeper with my journal, to feel things more genuinely, I was creating a warm and comfortable haven to rest and rely on. At least here, I feel the love.

Michelle Drew MEd, Advisor
www.softshoulderadvice.com

l I wanted more and part of me felt scared about that. I thought back to the very first session with Margaret, the avatar assessment counsellor, who talked with me about the therapy. She explained how all the different avatar therapists were generated from a central state-of-the-art AI system, affectionately called ‘Mother’. With access to Mother’s knowledge of more than 200 years of psychotherapy theory and research, as well as medicine, art, and literature, the avatar therapists were well prepared to understand, help, and adapt to meet the needs of their clients.

‘We avatars here at this centre are quite autonomous, and quite real in many ways,’ Margaret said, smiling. ‘However,’ she added, ‘a human therapist oversees each avatar in order to assist and guide them, when necessary.’

I hadn’t paid much attention to that part of the informed consent because I was so captivated by the idea of being able to choose among the avatar therapists. But now I remembered clearly the last thing that Margaret had said:

‘At any point you may talk directly with the overseeing human therapist.’

My mind ran along a thread of questions. How involved was this overseer in my sessions? Could I still trust this person not to interfere with how well it was going or somehow spoil my avatar therapist? I thought back to my own mother, the Master Puppeteer who had destroyed my childhood.

Or maybe it was the guidance of this human professional, behind-the-scenes, that had made the therapy so helpful. Could I possibly trust that person like I trusted my avatar therapist? Could I possibly trust any human like that!

Perhaps I should meet with the overseer.

John Suler, Professor of Psychology
http://www.behaviour.net

l Pleased that for once, the demonstration had gone as well in front of an audience as it had in private, the keynote speaker stepped out of the glare behind the podium and scanned the lecture hall. All eyes were still fixed on the screen behind him, taking in this latest showcase of synthetic training technology. Sure, there were plenty of little wrinkles still to be ironed out and the whole synthetic life ethics draft was plodding its way through committee at a glacial pace. But soon, he was convinced, every synthetic therapist would be trained - as the protagonist had been in this demonstration - with the experience of going through therapy to address implanted psychological disorders.

Many in the early tests had failed the whole experience, revealing enough bugs in the synthetic therapists to keep the software generators busy for months. But some really shined, like this one, his favourite; they could go on and experience many different rounds of therapy for many different implanted disorders. They would eventually make the best synthetic therapists. As the audience began to murmur and applaud its way out of the silence which had gripped the hall, he thought wistfully back to the time, not so long ago, when most avatars were just artificial personae backed up by real people, and marvelled at his own feelings of nostalgia.

Greg Mulhauser, Site Editor
http://counsellingresource.com

l I realised I was not ready for termination. This therapeutic relationship had been so beneficial and I wanted to continue. But I wanted to experience this avatar in the flesh; I wanted to experience face-to-face therapy. I had read so many books about the therapeutic process of generations past and I did not want to feel the least bit slighted. I asked if we could meet in person for our final session. I was told that this was possible but that I might find the meeting disappointing. I scheduled an office appointment despite the warning.

A woman whose words had been much wiser than her years greeted me. She had an A-line short skirt on, grey pinstripe with a freshly starched white blouse. Her matching pinstripe jacket was hanging near the door. She wore tights and black low-heeled pumps. Her hair was pulled back in a bun. She began talking but I could not hear her. I was struck by the lack of movement and freedom she represented. Her hierarchical appearance wasn’t at all the comforting image I had created during these past few months. Her attire represented the antithesis of the comforting picture in my mind. I could tell too that she sensed my discomfort. The flow was gone. I felt responsible for this haphazard meeting of strangers. Even though I had experienced her soulful work and had benefited tremendously from her skill, I could not shake what I saw before me - a woman bound to tradition and expectation. I wondered if she had somehow settled in life. I wanted to give her back what she had given me. I wanted to see her run free. I sat through most of the session in a daze. Our talk was mostly fundamental. We exchanged expressions about how nice it had been to work with one another. The avatar therapist in my mind was like a good and whimsical novel that provoked a sense of healing. My ending to this wonderful and peaceable work was harsh and less dimensional. I walked out of her office unfocused and ungrounded.

DeeAnna Merz, Counsellor
www.merzconsulting.com

Kate Anthony is CPJ’s Associate Editor for IT. She would be pleased to receive contributions for this column. Please contact her via BACP or at
kateanthony@aol.com