Thursday, 24 October 2013

The Sale of Certainty

This morning I heard health expert Dame Prof Sally Davis, on BBC radio 4, talking about the health of UK children. (It seems that cases of rickets are on the rise. She suggested the introduction of vitamin supplements for all kids).
During the interview (which you can listen to here, at approx 2h 39min), she was also called upon to comment on mental health issues in family life, and their treatment.
How disappointing it was to hear the same old line trotting out once again, like a soundbite, or one of those management-speak buzzwords that seems to be infectious in the meeting-room spreading from one employee to another. It goes something like this:
 (a lot of mental health problems) "will respond to.... Cognitive Behavioural Therapy... talking therapies..... "

The words used here are telling. They show a lack of understanding about the therapy world; its different modalities, and their potential use in the wide range of mental health issues. The words also show a willingness to endorse, publicly, a particular form of treatment.

I have previously drawn attention to this advertising of the CBT 'brand' here.

Dame Sally makes it very clear to us exactly why she wears this logo on her T-shirt. She says "I believe that we should only offer treatments that are evidence-based."
What she's saying, then, is that she only values treatments (and that includes therapies) which offer a statistical probability of "success" based on "outcome measures", and perhaps therapies which lend themselves to a widely-accessible "treatment protocol".
(For a deliciously sarcastic take on this kind of approach, see my friend Jason Mihalko's blog here).

Dame Sally is, of course, coming from her own training and heritage. She is steeped in the politics of medicine; a world of ever-increasing tension between public treatment needs and public costs. She values 'evidence-based' therapies, because, perhaps rightly, it would be hard to advocate the spending of public cash on therapies that aren't shown to be 'cost-effective'. The taxpayer deserves value for money, of course.

Evidence-based treatments are useful because, in the medical world, they offer the best assurance that a certain drug/intervention will work. The science tells us that in (n) cases, (x) show a measurable improvement compared to a control group who haven't been given this intervention. Therefore, the chances of your symptoms improving with this treatment are predictable to a certain level of probability.
Evidence-based treatments are also seductive, because they offer us a sense of safety and hope for a particular outcome that we are invested in.
We invest psychologically as patients, because we all want our symptoms to improve.
We also - as Dame Sally illustrates - invest financially. This, on a political level, has huge consequences, because government will clearly be much happier to offer therapy that offers clear, predictable outcomes.

Easy, then, to be fooled into thinking that therapies offering statistically-supported outcomes are the 'best'.
Sure, if you have the type of problem that fits neatly into the standardized diagnostic boxes that NICE and the APA prefer. But the problems of our life and our world are, to my mind, mostly in a different category than this.

How many times, for instance, have you lost a night's sleep because of a meeting, interview, or other event the next day that you are uncertain about?
We have all become stressed and irritable, maybe felt depressed, because of an ongoing issue in life that we can't control or predict.
Maybe you have thought about making a major decision in your life but have been held back for some time, because of the fear of the unknown. "If I knew I could get more work over there, I'd leave this job for good. But how do I know...?"

If only there were an assured, statistically-supported outcome, that you could be certain of....!

I don't believe I'm in the business of offering people assured or certain outcomes. Because in lots of ways, I don't believe there are many to be found. However, the selling of empirically-supported therapy is popular because it fits with an economic and medicalized model of human suffering. The natural human needs for self-exploration, mutual discovery and understanding, and psycho-spiritual development, are not necessarily part of the 'treatment plan'.....


Wednesday, 4 September 2013

A-one, a-two- a-three .... and ....

It was the end of the session; one of those last-five-minutes that is an open space for anything to come in. The therapeutic work was done (?) , and the conversation drifted onto ... something quite random.... maybe colds or 'flu or something.....

An observation was made that the therapist had a gravelly voice this week.

"Yes...ok for talking, but with this kind of voice, you can only sing one song... and that's 'I Walk The Line'..."

"Hmm?" Puzzled, curiously. "Never heard of that one."

Then came a gravelly but tuneful couple of bars - "Because you're mine..... I walk the line..."

Okay - the song has been changed, and the example is deliberately vague - but this is a description of something that happened to me once, as a client in therapy. It was just a moment in the relationship, but now I'm writing about it, I realize that no therapist had ever sung to me in a session before (and hasn't since). What an interesting experience that was, on many levels!

I realize also that I have found myself singing in a session, more than once. This is usually because the musical world has so much to offer us, in illustrating the breadth of human experience. Songwriters, and composers, are chroniclers of the soul. Heartbreak, ecstasy, loss, disconnection, anger, eroticism, it's all out there - in a nicely distilled form that pools in our unconscious and reinforces our shared humanity.
Singing is also part of my life, part of my history. I guess singing in-session in a kind of self-disclosure, too. I am saying something about myself (or perhaps my inner 11-year-old choirboy is...)
In and out of the therapy room, I naturally reach to song lyrics or music, at different moments..... A friend is telling me about a situation brewing with her husband, and I find myself chiming in - "There may be trou-ble ah-ead....".  Another friend stops for a chat, and for the rest of the morning I am singing or humming a song that uses her name. A fresh brew at the office brings delight and gratitude, and I find myself crooning in praise of caffeinated drinks.

I wonder if any therapist colleagues or clients out there have sung in-session, either 'accidentally' or deliberately, in order to communicate something?

In a spirit of playful curiosity, I invite you to share a story on my blog*, if you wish; let's see who the singers are!   ;o)


"Let's Face the Music and Dance" - Irving Berlin (1936)

"Looking for Linda" - Hue and Cry (1989)

"Java Jive" - The Ink Spots (1940)

 *p.s. Professionals are gently reminded to protect the confidentiality of your therapeutic relationships, current and historical


Thursday, 15 August 2013

A-Level ... Results day

Today in the UK, students will be collecting their A-level results. Every year this prompts a slew of media coverage as excited 18-year-olds opening their envelopes to great delight.
Of course, we never see or hear coverage of those young people who are less excited, or even disappointed. This is held from us - rightly, perhaps, to save them from embarrassing exposure, but also perhaps to shield us from the uncomfortable truth that normal people also don't get 'A-star' grades.

There is also media focus on the transition between A-levels and the University system. The effect is to create and perpetuate a myth that A-levels naturally lead to University. I have been wondering about this today. How have we created a rite of passage that narrows so much at the completion of formal schooling?
It occurs to me that the link has been artificially fortified, perhaps for political reasons, since people in higher education do not place a burden on employment statistics - and of course, higher education itself has become a growth industry with fee-paying customers.

The flip side? It creates a cultural script, and sometimes a family script, which then falls upon the young person to fulfill. What happens, then, if a young person isn't ready, academically or personally, for University?

An impasse can be created - one part of the personality says "I want (need) to go to University, as that's what is supposed to happen to me". Another part - the inner, maybe quieter voice - says "I can't," , or "I don't want to".

Experience and T.A theory tells us that when people find themselves in conflict with their cultural or familial script, they can experience a deep sense of shame, as if something is wrong with them. The inner critic - sometimes called the "Pig" Parent - is the engine of this feeling of shame.

I remember coming face-to-face with this cultural and institutional script, when I went back to my school to collect my results. I knew I hadn't done as well as I had hoped; my two years had been dogged by glandular fever and depression. I knew my results had suffered. So it wasn't a surprise when the face of my biology teacher dropped, as I walked up to collect my envelope. He conveyed a kind of collective disappointment with his expression and his words. But I was determined that he wouldn't make me feel ashamed, as I had done already many times in that two-year period.
I made a quip about John Major (the Prime Minister at the time) who had 'only' 5 O-levels, and I observed that it seemed to be enough to get him along in life. I willed a smile to my face, turned, and left... and haven't been back since.

My thoughts today are with the happy ones, yes. The ones who have their future mapped out nicely. Great!
But my thoughts are also with those whose maps aren't so clear - just as mine wasn't. They will tread a different path, but it may be better - more autonomous - for them. The road less travelled, perhaps.


Friday, 7 June 2013

The Other Side of the Wafer-Thin Barrier

This week, SOAP (Speak Out Against Psychiatry) held a demonstration at the Institute of Psychiatry in London. It follows a long period of widespread criticism of the DSM and its political influence.
I'm with the SOAP people in spirit, because I think someone needs to hold up a mirror to psychiatry, and I hope that psychiatry will be smart enough to look earnestly at itself.

I've written a little about this (see here and here) but I am by no means the most vocal critic or the most prolific writer on the DSM5 and all its problems. A good distillation of the issues, which is kept up-to-date with current material, can be found on the Beyond Meds blog - the DSM update page is here.

The SOAP web page for this event is well worth a read. There, they explain their position that human suffering is more than a medical issue, and so we should not rely upon a medical treatment for wider problems. Normal human experiences, they say, are being medicalized which results in people being labelled.
I agree, and have agreed for some time.  The DSM5 threatens to turn grief into a disorder, and child tantrums into a disorder. This is a dangerous form of 'mission creep'.

My instinctive opposition to diagnostic labelling comes, I think, from what I have learned in my training and experience as a psychotherapist. I have also had some experience of the mechanisms of psychiatry and psychopharmacology, which lead me to believe that both practices have departed significantly from what I hold to be the work of healing mental illnesses.

An article shared on Twitter recently notes that "Psychiatry was not - on Freud's watch - to be swallowed by medicine". Perhaps Freud intended that psychoanalysis be practiced by people who did not go through the sheep-dipping of medical training, and who could connect in a different way to their 'patients' as a result. Clearly, Freud knew that looking at people through a medical lens could be an inherently limited approach.

It's interesting to note the boundaries getting fuzzy here, between psychiatry (which is a branch of medicine) and psychotherapy. It's true that some psychiatrists are also trained psychotherapists who have undertaken extensive personal therapy themselves. But it's true too that many psychiatrists are just doctors. Some of these doctors are working on the assumption that their medical degree and psychiatric training entitles them to carry out psychotherapeutic enterprises under the banner of psychiatry. They also work on the assumption that their medical training (and with this I include the social, cultural, and heirarchical effects of medical and psychiatric training) will not somehow infiltrate the relationship, and the treatment that they offer. As if the person that we are, and the experiences we have, can somehow be irrelevant once we are in the room with a patient.


The article also quotes Robert Spitzer, who headed the development of DSM-III. In a hugely telling remark, he is reported to have said: "..looks very scientific..... It looks like they must know something". For me, this is symbolic of the eternal struggle of medicine as a science - to name, to understand, and thus to defend against the impossible anxiety of NOT knowing.

"The medical model is a wafer-thin barrier against uncertainty" - Irvin Yalom

So, I question psychiatry as it's practiced today because of its over-emphasis on naming, and understanding stuff - much of which (like grief, tantrums, and the stress of someone's death) is actually the stuff of LIFE and not really there to be understood through a medical model.
I want to be prepared to sit on the other side of that barrier, where there is chaos, confusion, or hurt, and allow that to be the stuff. Because that's what I believe people want and need from soul-healing.

Here's the article, by the way


Monday, 27 May 2013

I'm featured in the Colchester Gazette

This week I was interviewed by the Colchester Gazette, for a feature on people & their work.

I explained how & why I came into psychotherapy as a job (actually a vocation), and what it's like to be a psychotherapist.

It also gives a good sense of how I view the role of ongoing therapy; during training and beyond. Not everyone in the 'trade' is with me on this one, but I am happy that my view is fairly represented.

It's not the best photograph of me, but at least it gives the right representation - I'm ready to listen!

Read the article here 


Tuesday, 7 May 2013

Guest Blog for Colchester Circle

This week I am pleased to be working in partnership with Colchester's lifestyle magazine, the Colchester Circle.

I have written a post, aimed mainly at people in a relationship who might be thinking about what's good (and what's not so good) about it.

Click here to go the site and have a read!


Friday, 19 April 2013

A Prayer Poem (read at risk of being inspired)

A lot has been going on in the world in the last days & weeks. It's a constant stream of sadness, anger, frustration, disappointment - you name it. A Twitter-correspondent recently noted that she found the newspaper she'd bought "thoroughly depressing".
I guess we do live in a world that looks like that.

Religious or not, one can perhaps find some inspiration in this prayer-poem that I stumbled across some time ago. Someone - I know not who - had pinned it onto the office wall, for all to see. Now I'm pinning it here!
What I like about this prayer-poem is that it takes the disappointment and hurt, and transforms it - into a reason to be compassionate. How lovely. I hope it stimulates some helpful reflection for you too.

Sometimes, Lord,
it just seems to be too much:
    too much violence, too much fear;
    too much of demands and problems;
    too much of broken dreams and broken lives;
    too much of war and slums and dying;
    too much of greed and squishy fatness
        and the sounds of people
            devouring each other
                and the earth;
too much of stale routines and quarrels,
    unpaid bills and dead ends;
too much of words lobbed in to explode
    and leaving shredded hearts and lacerated souls;
too much turned-away backs and yellow silence,
    red rage and bitter taste of ashes in my mouth
Sometimes the very air seems scorched 
    by threats and rejection and decay
        until there is nothing
        but to inhale pain
            and exhale confusion.
Too much of darkness, Lord,          
    too much of cruelty
        and selfishness
            and indifference…
Too much, Lord,
    too much,
        too bloody,
                brain-washing much.
 Or is it too little,
    too little of compassion,
    too little of courage,
        of daring,
        of persistence,
        of sacrifice;
    too little of music
        and laughter
            and celebration?
O God,
make of me some nourishment
    for these starved times,
        some food for my brothers and sisters
    who are hungry for gladness and hope,
        that, being bread for them,
    I may also be fed
        And be full.

"Sometimes, Lord, it just seems to be too much" 
- from the book "Guerillas of Grace" by Ted Loder 


Wednesday, 3 April 2013

Living the Quiet Life - Some Thoughts on Humility

The new Pope has generated lots of discussion around the world over the past few weeks. (That's aside from the Catholic 'elephant in the room' of abuse, of course. But I'm not here to talk about that).
What struck me was what I heard about his lifestyle as a cardinal. He chose a small apartment, cooked his own meals, and used public transport. He made his lifestyle deliberately modest, in order to demonstrate his attitude to service.
Later, after the white smoke rose from the chimney, he emerged onto the balcony and made another demonstration of his attitude, by asking the people of the church to pray for him. And to pray with him. The ulterior: I'm just like you. We should do this together. I am not more special than you; in fact, I need your help in this job I'm going to do.
It feels to me that these are important demonstrations of humility and could be very helpful in the ongoing struggles of the Catholic church.

And then, more recently, I noticed it happening again: this time, Justin Welby, the new Archbishop of Canterbury. An innovative change to the normal ceremony - added by Welby himself - had him intercepted at the door of the cathedral by a youngster. It was quite something to watch.
See it here at about 2min 50sec.  
A 17-year-old asked him "Who are you? Who sent you? And what confidence do you come with?". His reply was "I'm just me, basically, and actually I know nothing. I'm not coming with confidence, I'm coming with fear. But I'm here to serve".
Again, I was struck by the sense of humility in this segment. It was a clear indication from the Archbishop that, despite the presumed power and authority of the position, he wishes to be seen as 'only' human.

I haven't seen such obvious public displays of humility in a long time. Most media output in the UK is dominated by people who exude quite the opposite; take Simon Cowell, for instance, whose self-absorption and grandiosity has actually become a kind of joke. Our culture seems to be evolving more and more in the other direction......

Being humble is weak.
You're under-rating yourself - brag a little to get ahead. **
In fact, brag a lot.
Brag louder, and more, than the others.
Don't be quiet or unassuming.
Quiet guys finish unnoticed.

In the therapy industry, the tide is also flowing that way. A colleague in the US has observed recently how counselling/therapy has become "commodified" - partly due, I think, to an increase in competitive marketing trends.
Yes, therapists are now bragging to get ahead, too. I have noticed it myself. I spotted someone on social media recently describing themselves as "known for quick results". Elsewhere, people offer 'testimonials' in their literature, perhaps unaware of the inherent bias. What I see is a widespread decrease in humility.
 Odd, perhaps, when the BACP Ethical Framework describes humility as one of the "personal moral qualities" essential in ALL therapists.
"Humility: the ability to assess accurately and acknowledge one’s own strengths and weaknesses." (BACP, 2013)

Personally, I would choose as a therapist (or refer clients to) someone who makes no bold claims on their website. If they did, it would turn me off. I like it when people suggest that therapy "may" be a real help, rather than saying it "can" change your life. Words are important; tone is important; the ulterior (unspoken) message is the one that really gets through.

Maybe we just need more of it in the world.....?
Generally, I think humility could make the world a bit less 'in-your-face'; a little quieter, perhaps. It might help us in recognizing ourselves and each other as normal, faulty human beings - rather than cultivating a culture of celebrity, competition, pressure on others, pressure on self.

The problem with humility is ... that to be humble involves just quietly getting on with what you do, making no song and dance about it, not asking for any awards or prizes (although BACP are offering them!). In an increasingly competitive commercial world, we are driven to NOT be quiet.

In general society, humility is normally practiced only in quiet corners (that's the point, after all). But as a result - the virtue, benefits, and rewards of humility are chronically under-advertised. So thanks be, to Pope Francis and Archbishop Justin.....
for making a song-and-dance about NOT making a song-and-dance.


** In Transactional Analysis, there is a tradition of  using 'bragging' as something healthy. I broadly agree with this, because it's done in an I'm OK-You're OK spirit. In other words, it's not about bragging to be one-up on others; it's more to do with fighting the internal critic (or Pig Parent).
Bragging at the expense of others is a widespread behaviour which implies an "I'm better than them" position (I+U-). This may be significant of the "Take It" driver (Tudor, 2008).

Humility is an antidote to "Take It", as Tudor suggests: 
"Just as awareness and understanding helps the individual, so too the social psychological analysis of the social, political, and economic consequences of the 'Take it' driver message may help the social awareness of individuals, groups, peoples, and even nations to resist oppression and to commit to cooperation." 
 Sounds like humility in action to me. 


Tuesday, 26 February 2013

In Memoriam - "Tony the Greek"

I work a lot with people who are dying, or their family members. Every so often, I go to a funeral. This is always because I have developed some kind of special connection with the person who has died. I haven't made a habit of it; I find that however positive, realistic or even celebratory the ritual is, I am always left with the heavy reality of loss and death. And actually, I don't want to dilute that important inner reaction, by sitting through too many such occasions. I want to keep a healthy respect for deaths, and remain open to their impacts.

In the Autumn of last year, I met a man in his 80's. he was rather isolated socially and kept himself to himself. But he was clearly needing some support, both physical and psychological. I was asked to spend some time with him, not in a formal capacity, but simply to help build some trust and communication between him and the organization. So I went over and had a chat.

"Tony" quickly started talking about his background and his nostalgia for 'home' (Greece). I commented that many men of his age 'back home' would be sitting outside a cafe in the sunshine, smoking and drinking black tea, playing chequers or cards or........

"Backgammon! I would be playing Backgammon. Oh, yes." His face came alive. "Do you play?"

No, I didn't, sadly. I had never learned. "I will teach you! Will you be here next week? I will bring my board. I will show you how."

And so our relationship cemented. Week by week, he would bring his backgammon board. It came in a tatty supermarket bag, but when opened it revealed a beautiful sultry mix of dark brown wood inlays. It looked to me like it was itself Greek. Small intricate geometric patterns sat around and inside the traditional Backgammon board, with its triangular spikes pointing upwards.

The basics explained, Tony set about teaching me. Advice came thick and - oh my, so very fast. His play was accomplished, slick, and natural. He played at least 2 moves in advance. I, on the other hand, needed so so much time to think, and think, and finally decide what piece to move, and then move it and -

"Noooooo! Why are you putting it there? I will knock you!" The voice was deep and gravelly and filled with life, though it came from a frail and fragile body. So frequent were his interventions, it seemed to me he was actually playing two games - his and mine - and enjoying the educational commentary.
"I think this time, we are having a game of running"...... "I see your stone here, but I am taking a chance anyway." ...... "You throw a three or a six, I will get you - oh yes, you will be sorry."
I tried hard to keep up and absorb the teachings.

At first I had felt a little worried about this use of my time. What would my colleagues think? But after a few weeks, as this teaching continued, I noticed the therapeutic value in what we were doing. This man - frail, weak, and debilitated by disease, was adjusting to a shrinking life. When we played backgammon, he had opportunities to be cunning. Deceptive. Aggressive. Frustrated. Angry, even. Kind. Generous. Sporting. Fair. Funny. "Double six, baby!"
He reminisced. In between games, he would tell me stories of his life; how he & his wife had met over 60 years ago. How he had built up a business. How he had been widely known in his part of London.
And he was teaching me, a younger man, who knew nothing. What a glorious opportunity for him to feel, and share, the wisdom of his age. And for me to learn from him. Something important passes between old and young when this occurs; I remember reading something about this in the men's literature (Alan Chinen, perhaps, or maybe Moore & Gilette). The older man gains from his role as initiator, and the younger man grows by initiation into a new version of manhood.
It also brought to mind the life-stages suggested by Erik Erikson; particularly "Generativity vs Stagnation", and "Integrity vs Despair". One reading of the term "Generativity" suggests a kind of passing-on of knowledge, values, culture, in a way which enriches the lives of younger people, but also wards off the feelings of stagnation and lack of purpose that are possible in older life. Generativity, then, is about contributing to a community - large or small- that will continue after one's death.

Eventually, in the New Year, there came a day when something shifted. After looking around the board, and again at my dice (several times), I realised there was a move I should make; one he'd been reiterating to me for a long time. Silently I picked up the piece and placed it in a good, solid, strategic position.
"Hmmmmm," came the approval. "You are learning."
Inside, I positively glowed. How wonderful.
And later, when a stranger came to look on in puzzlement at our game, I was given an even greater honour. He looked up at the spectator and said:  "I'm so glad I met Ian."
Thence our relationship rebalanced. I grew, and we became less unequal (although to be fair, the change wasn't huge. He had been playing for 76 years, and I only a few weeks!)

I fear that, as the ageing population grows, there is an increasing potential for them to be unconsciously resented as a burden on the state and society as a whole. Hints of this can be seen already in the growing UK debate about the future of old-age care, and how it's paid for. How sad, then, that this might get in the way of our learning from them, respecting them, and appreciating their role in teaching us the values - and value - of life.

As long as I live, whenever I play Backgammon, I will hear that voice. And I hope I grow old enough to teach the game to another, in such a meaningful way.

Thank you, Tony. And blessings.


Tuesday, 12 February 2013

The Carom Transaction in Social Media

I have fallen out of love with Facebook. I have become attached to Twitter. I have discovered LinkedIn. This is my current position; it may change!

Over the several years that I've been involved in social media, I have noticed more the vast array of transactions on display. Some social, some psychological, but all the different permutations of the Berne's original dual ego-state model are there.

Looking at the different ways in which people use the platforms of Facebook, Twitter et al, I have been reminded of an old, seldom-used bit of Transactional Analysis theory which I now feel deserves a fresh look.

The Carom Transaction

In the wider literature this first appears in Woolams & Brown (1978) although it's a very brief mention. Very simply, it's a kind of transaction where the speaker says something to another person in the vicinity of a third party ... the third party is the real recipient of the strokes. It's an unusual transaction because of its use of an intermediary. It is also an example of the social & psychological levels of action (i.e. Berne's third rule of communication*)

Here's a basic example:

"Carom" is a broadly European term that is found in Carom Billiards, where players must deliberately bounce (carom) the cue ball against a cushion or another ball, in order to progress. Carom transactions, then, are used to 'bounce' a message off one person, so that it 'rebounds' off to the next one (the real target).
Caroms may be used deliberately in a therapy. Usually this is done in order to reinforce a particularly important message, or to convey a point that couldn't be done directly for some reason. The client's partner, or other members of a group, may be the 'bounce-ees' in this respect.

The Carom in Social Media

Looking at Facebook and Twitter etc, it becomes clear how many of the postings, status updates or tweets are not actually intended for the supposed recipient. In fact, caroms are in play all over the place - intentional or not. The 'bouncees' are those others-out-there; the folks on one's Friend list (in the case of Facebook), or just other users in the Twittersphere (which can potentially mean millions of people!). Obviously the more public the settings, the more potential bouncings there might be.

Here are a few examples I have found:

1. The Old-fashioned carom

Simply, an indirect message conveyed in the manner we've just seen. Here's a kindly example:

Now, nearly everyone knows what a nice person Louise is. This is much more powerful than sending a text, or perhaps even a thank-you card (although that might depend on the wording). But it's potent; maybe because of its public nature, as depicted in the diagram below.

Of course, this kind of carom can be used in a not-so-kindly way. I have refrained from posting an example here, but I'm sure you have seen a status update in your feed that's of the "Levon is a doo-doo-head" variety.
I have seen this kind of carom escalate into something really gamey and poisonous; family feuds and bitter disputes have been played out in this manner.

2. "Now Hear This, Now Hear This"

This is an interesting one, where the 'target' of the message is everyone. The bouncee may not even be present amongst that following, but be referred to in the posting itself. Here's an example:

This is a loving parent. What's interesting is that the child isn't actually the recipient of the message. On the social level, this is a birthday greeting to someone (who 'happens' not to be there). I suspect that an ulterior message is being conveyed, and that the 'others-out-there' are the intended recipients (below).

Other forms of this type of carom can easily be found. If you "like" a particular posting or group, for instance, it can be a way of conveying a message to those around. (They will see that you've clicked on "No Tolerance for Domestic Violence", or "I Hate People Who Stand Still on the Escalator", and will know this about you).

3. Social Media as Marketing, or "Hey, Google, Look at Me!"

This is a double-rebound carom, which I think has been born of the digital age. In this situation, users of Facebook, Twitter, and bloggers in general have taken to using their social media as a marketing tool. Google (other search engines are available) is the driver behind this; SEO gurus tell us that Google looks for "quality content", and so we merrily type away in the hope that Google will hear us **. Of course, Google may not hear what we're saying; we just need Google to know we're here. Our Facebook Friends, Followers, and the general public may hear us, and if so that's good - but there is the added dimension of telling Google something about ourselves.

(Pink lines show the second carom phase)


* Berne's Third Rule of Communication: Where there is a transaction on the social and psychological level, the outcome will always be determined by the latter.

** I am aware that many, many people write blogs and use social media for reasons other than marketing. Astute and/or prolific readers will have seen examples of those that do (write for marketing purposes) and those that don't. I can usually tell the difference; there is a difference in tone, and the 'marketing' writer often has little or no engagement with those who comment/tweet back etc.