Can an App Be a Therapist? The Problems With Using Screens to Tackle Mental Health

The quantified self is a confusing, prickly fellow. Surely we all want to hate him: the self-absorption, the just-perceptible noting of calories over what should be a convivial dinner, the smug clocking up of steps and reps. But there’s undeniably something about human nature that makes us all intrigued by ourselves and our bodies, and something compelling in seeing data about them. As such, it’s not just those _Wired_ reading Apple watch wearers that are forever peering into their navels and counting the contents. It’s no longer the preserve of the gym bunny to track her movement, of the kale-queen to track her calories, of the next _Belle de Jour_ blogger to track her orgasms.

Now, there’s a new way to think about, clock and measure the self. But it’s not about our bodies, or even mindfulness. It’s about mental health, that scary entity that will never be as easy to plot in a graph as our heart rate or body fat percentage. Earlier this week I wrote about a new app launched by Ustwo (the people who created the wildly successful Monument Valley mobile game) called Moodnotes, which uses the principles of cognitive behavioural therapy (CBT). In a nutshell, CBT is a form of talking therapy that aims to help patients tackle unhealthy thinking patterns that lead to unhealthy behaviours, and is often used in the treatment of anxiety and depression.

I can’t help but feel uneasy about this. The makers Ustwo and US-based company Thriveport stress that the tool shouldn’t be used as a replacement for medical help, medication or therapy. However, I still feel that maybe there’s something jarring about taking therapy principles and putting them into everyone’s hands along with a chirpy little Emoticon-like interface. While the app isn’t targeted specifically at those with existing, diagnosed mental health issues, it borrows from the language of psychological practice and dumbs it down, repackaging it for the Flappy Birds market and making “thought checking” as easy as going up a level on QuizUp.

Yet surely there’s some good in making taking control of mental health more democratic. If it’s worked for tracking calories, surely it can work for tracking mood? It can, but it also feels slightly dangerous. As someone who’s experienced CBT, eating disorders, OCD and using tracking apps, I feel these tools can be risky in the wrong hands, such as those belonging to the people Moodnotes purports to benefit. For someone with an eating discarder, compulsively tracking calories becomes an obsession, to constantly lower that total, or to build up those burnt off. When you “fuck up”, you see by how much: it’s a stark screen staring back at you with terrifying little digits. If you’re OCD, tracking can become another compulsion. Granted, so could lacing your shoes a certain way, or only eating an odd/even number of grapes. But I worry about encouraging the use of an app that rewards logging and tracking in those who obsessively log and track as it is.

There are obvious benefits to taking ownership of moods, and to striving to deal with unhealthy thoughts in a way that wards off negative behavioural patterns. But I do feel tools like this shouldn’t be treated without caution. If an app is marketed on using CBT techniques, those who’ve tried such treatments will naturally be intrigued. And while it’s good to democratise certain treatments, this therapy-lite makes me nervous. Mental health issues aren’t solved by Emojis. Smiley faces feel patronising. If we’re spiralling into anxiety, I struggle to believe that a little white screen and a cutesy little lightbulb asking “what thought contributed most to you negative feeling” will do anything other than compel us to hurl our phone into a wall.

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