Wednesday, February 22, 2012

An App for your anxiety...

Continuing in the thread of yesterdays post about a science App, I should mention the blip of interest (and controversy) over the putative appearance of an array of 'therapists in your iPhone or Android phone." Benedict Carey offers a recent review. My first reaction is one of complete aversion, thinking that therapy is best cast in a social web of narrative, but as Carey notes:
The upside is that well-designed apps could reach millions of people who lack the means or interest to engage in traditional therapy and need more than the pop mysticism, soothing thoughts or confidence boosters now in use.
It is a fact that some cognitive missteps are of a very mechanical nature, reflecting glitches in stimulus-response matching. Here is a nice example of the app approach:
..cognitive bias modification...seeks to break some of the brain’s bad habits...and is straightforward. Consider people with social anxiety, a kind of extreme shyness that can leave people breathless with dread...many who struggle with such anxiety fixate subconsciously on hostile faces in a crowd of people with mostly relaxed expressions, as if they see only the bad apples in a bushel of mostly good ones...Modifying that bias — that is, reducing it — can interrupt the cascade of thoughts and feelings that normally follow, short-circuiting anxiety, lab studies suggest. In one commonly used program, for instance, people see two faces on the screen, one with a neutral expression and one looking hostile. The faces are stacked one atop the other, and a split-second later they disappear, and a single letter flashes on the screen, in either the top half or the bottom....Users push a button to identify the letter, but this is meaningless; the object is to snap the eyes away from the part of the screen that showed the hostile face, conditioning the brain to ignore those bad apples. That’s all there is to it. Repeated practice, the researchers say, may train the eyes to automatically look away, or the frontal areas of the brain to exercise more top-down control.
Some studies claim positive results with these simple games equivalent to normal therapy, other find no effect. There are the usual issues of whether positive outcomes are a placebo effort or undue attention is being paid to positive data, while negative results are rationalized or downplayed. The strongest claims seem to be for anxiety disorders, not depression.

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