Depression, Trust, and Therapy

When you have depression, it’s hard to talk about. It’s hard to open up to people and explain to them what depression is, what it’s like to live with, and what the causes of your depression are. So, when you find someone that you can trust and feel like you can open up to, it’s a revelation. You feel like there’s someone in the world that you can truly be yourself around. Often this is a friend. Of course, you have to be careful not to over due the depressive talk, because you could bring them down and eventually push them away.

It’s understandable, when shits bad and all you talk about is your problems, it can eventually come across as whiney, especially if the other person is in a similar situation. If they have depression, they will get it, if they don’t have depression, they will be as support as they can for as long as they can, but eventually, they’ll say something like “get over it.”

So, if you’re lucky enough to have a good health plan (in the US) and a good salary, you might be one of the lucky people that can afford therapy from a licensed professional that will never say “get over it” to you. They will help you work through your problems and do so in a safe place. You can tell the right professional anything and they will help you deal with that. In the cases that they cannot help you, something’s outside their expertise (like gender dysphoria) they might refer you to a specialist in that field.

The important thing about all this, which helps to build trust with the therapist, is that everything about these visits is safe and secure. No one need know that you are visiting your therapist, but the people that you tell. However, if you cannot afford that sort of help, then there are apps that are supposed to help you. One such app is Better Help. However, if I was using it, I’d immediately stop. They share “anonymous” data with third parties, according to a Jezebel report.

One of the companies they share this data with is Facebook. Which is a huge red flag for me. Facebook, if you have an account (and to some extent even if you don’t) has a huge amount of data about you. It uses super cookies to continually track you even when you aren’t on the website, it buys data about people to build profiles, and it uses sophisticated tools to build shadow profiles for people that are not on their service.

I had Facebook for years, basically from the day it came to The University of Pittsburgh, up through 2016 election, so basically around 10-12 years worth of ever decreasing data. Even deleted, they probably kept something about my profile. Since they know that I don’t have a Facebook account, they are able to build a profile about me from data they acquire from other sources. It’s likely they scrape websites, like Good Reads (where I review most of my books) and loyalty rewards (I don’t have any at stores like Target) to build a profile of things that I’d want to buy. They sell ads, so they use this information to understand what someone my age might want to buy and to sell better targeted ads.

They have developed a profile about me, from anonymous data. This means, they have sophisticated tools to de-anonymize data. Given that, according to the article, they know when people are depressed and upset, they already have a set of users that they’ve flagged as candidates for mental health support. They have the tools to associate data from Better Help with an actual person. I don’t know about you, but I do not want Facebook to know anything about my mental healthcare.

This, to me, represents a vital break in trust between patient and mental health provider. I trust that the only people that know about my care are those I tell, my doctor, and my health insurer. I trust this, because it is the law. The law helps me feel safe and allows me to have better trust in both my insurer and my doctor. The law, HIPPA, requires YOU to consent to any data transfer and asks for it before it can even occur, every time. So, you might consent to share the minimum amount of data, but that data is more than sufficient to do harm, in the long term.

People seeking help are vulnerable. They can be preyed upon. Even a good therapist who doesn’t like dealing with a specific health insurer can make you feel preyed upon. A company as unscrupulous as Facebook will target you and take advantage of you. It’s dangerous and must stop. If you use Better Help, look for an alternative. If you use Facebook and you can stop, you should stop.

Trust and Networks

At work today, my team and I went through training on something called the “Speed of Trust” which essentially argues that the more trust an organization has the less costs there are associated with doing business. Not only are things cheaper, but they happen faster. I was actually pleasantly surprised, I’m typically pretty skeptical of things like this as a rule because I feel that they compress extremely complicated ideas down to a single scale to be measured on. However, with the facilitator’s contribution of how the different types of powers interact with trust it became a lot more meaningful, even if there were so many platitudes provided by the author of the book during the videos that were shown.

I think that there’s one area that was definitely missing from this topic that was only moderately touched on – Networks. There are plenty of network theories that discuss the obvious cost savings and accumulation of social capital in better ways than was covered in this discussion.

Social Capital is a way of measuring how much influence you have in a network. Unfortunately, the only networks that were recognized in this method are the formal networks that are created simply by being an organization. There was no discussion of how people can create informal networks that can have more influence on the organization than the actual formal network structures. For instance, if I want to change the direction of some project and I’m struggling within the project itself, I may try to use my formal structure of going up through my manager over to one of the managers of the people on the team. However, this is typically considered poor form, another option would be to discuss the topic with someone else that is influential and spend some social capital and have the problem resolved informally. These networks can influence the structure of organizations because people that are managers may not be the thought leaders in the organizations. When striving for change in an organization it is crucial to expend social capital on the most influential people – titlewise or otherwise.

Furthermore, these networks can enable anyone to generate more powerful ideas. As you discuss issues or ideas with many different people in the organization and include their suggestions or comments around the idea/issue it’s possible to create significantly better ideas. Then whenever you’ve come to the point where you’d like to enact your idea, you’ve already built a coalition of support through your conversations and will have more successful ideas.

The Speed of Trust course was pretty useful to help determine how to address trust issues in an organization. It’s important to identify where and how things are going wrong. However, I think it’s important to keep in mind network theory to maximize the benefit of trust.