When so much of what we want and need can be procured on our computers, tablets and smartphones, perhaps it comes as little surprise that we’re entering an age of happiness apps. And no, I’m not referring to Seamless, the food delivery app, or Tinder, arguably its equal in the realm of online dating. Sharing this space of buzz-worthy technologies is a growing contingent of mobile and web applications specifically designed for improving mental health. Some even come with the promise of real happiness. How do they work exactly? Apps like Happify allow users to track unhealthy patterns in their behavior and thinking and through a series of activities, provide strategies to challenge and to reform those patterns. Then there are others like Talkspace that directly connect users with online therapists and coaches.
Admittedly, as someone who frequently takes on more than she can chew in both her professional and personal lives, I was intrigued by the idea that the secrets to healthy living may have been resting in my cell phone all along. No doubt the concept is a seductive one, but does it work? And more importantly, for those in desperate need of counseling, can they get adequate treatment via a screen?
Before exploring these questions, I reached out to Dr. Ed Diener, a senior scientist at Gallup with more than 30 years of experience in the field of positive psychology, a branch of psychology centered on human flourishing. My first thought was if app developers had devised exercises to promote happiness, they presumably also had metrics for measuring it, which begged the question: What is happiness anyway? Perhaps it seems fairly obvious, but if asked to explain it to, say, an alien visiting Earth for the first time, I’m not sure I could.
“First, it includes subjective well-being,” explains Dr. Diener, clarifying that “[a] person high in subjective well-being is satisfied with his or her life and important life domains such as friends, work, health, and so forth.” His explanation is as succinct as mine would likely be garbled; the alien offers his thanks. Granted, Dr. Diener has had several decades to mull it over and in the span of his long career, witnessed the definition of happiness evolve to include other components, such as a person’s social relationships, as well as her sense of purpose. Another important factor is mastery, says Diener, which he defines as both the mental and physical skills people possess to pursue their goals.
But how can scientists study the effect of these factors on a person’s overall sense of happiness? As Harvard professor Michael Norton ruefully noted, “You can’t randomly select people to get divorced or lose their job.” No, perhaps not, but recently, a team of researchers had an opportunity to study the science of happiness on an unparalleled scale. First, they paired up with a non-profit organization working to improve the living conditions of poorer populations in Latin America. And over the course of several months, they studied the happiness of slum dwellers who had recently received newly constructed homes.
“We find that subjective perceptions of well-being improve substantially upon receipt of improved housing, but that eight months later, about 60% of that gain disappears,” explains Raimundo Undurraga, one of the three economists involved in the project. In other words, the recipients of new housing reported to be happier initially, but when Undurraga and his team checked in with them eight months later, much of that happiness had dissipated. Nevertheless, as Undurraga reminds me, beneficiaries of the program were still happier than they had been prior to receiving a new home.
I ask Undurraga if he and his team found these results a little depressing. “It would be great if happiness behaved linearly and so positive shocks on the happiness of the poor were permanent in their life…” he says frankly. “But what can human beings do with their own nature?”
Well, according Dr. Brett Steenbarger, a professor at SUNY Upstate Medical University and longtime coach of traders and hedge funders, there is actually quite a lot that humans can do or more precisely, that their clinicians can do. “In my experience,” Steenbarger tells me, “therapy changes lives by helping people become more aware of the patterns that recur in their lives and that hold them back from their ultimate desired ends. Different therapies cast those patterns in different terms…but all therapies are about pattern recognition and pattern change.”
And if therapy has the potential to literally change lives, nearly 10% of the US population stands to benefit. That’s the total number of Americans estimated to be suffering from depression, says Dr. David Mohr, a professor at Northwestern University Feinberg School of Medicine. Another 7%, he adds, is struggling with major depression. Unfortunately, even if every single one of them could improve with some form of therapy, Mohr cautions that the “[b]arriers to treatment are many.” Chief among them, he lists cost, time, and stigma — all of which makes the convenience and accessibility of virtual therapy an especially appealing alternative to traditional counseling.
IntelliCare, a suite of 12 free apps developed by Mohr and his colleagues at Northwestern, is intended to remove some of those barriers for people specifically suffering from anxiety and depression. According to Mohr, it distinguishes itself from other applications by keeping users engaged through fresh content and if desired, a coach who can monitor their progress.
“But most people download apps, look at them once or twice, and never go back,” Mohr tells me, and admittedly, I count myself among them.
As research for this piece, I downloaded the app Happify and for five days, went through its skill-building activities and games. Though initially very intrigued by the prospect of “lasting happiness,” I found myself putting off the app’s daily exercises — at first until the early afternoon and then the evening, until finally an entire day had passed and I hadn’t once signed in to complete my happiness workout. To be fair, when I actually did do what was recommended, it felt quite useful in encouraging general mindfulness — what some might call the art of living in the moment — as well as making me more cognizant of some recurring negative self-talk. Had I been more disciplined and used the app for a longer stretch, perhaps my progress would have been greater still; indeed, its co-founder and president Ofer Leidner tells me that 86% of users were happier after just 8 weeks.
But as Mohr noted, carving out time in our frenetic lives can be a challenge, and if motivation and discipline are requisites for the best therapeutic outcomes, how do app users fare without the guidance of a counselor or therapist? According to Dr. Steenbarger, probably not too well. Steenbarger stresses the importance of a trusting relationship between patient and therapist as a “key motivational ingredient” and is not convinced it can be adequately forged via video sessions and messaging — the conduit of choice for many mobile and web counseling services.
More important still, says Steenbarger, is identifying what actually ails the patient, and he wonders how a proper diagnosis can be made sight unseen. “Some psychological problems do indeed have a biological basis,” he tells me, “and I’m not sure phone or computer interventions can adequately pick that up.” His concern taps into one that I’ve been harboring since beginning this project, and that is, there is certainly a difference between someone like me, who could probably learn a thing or two from these technologies, and someone with more serious problems, who needs the close guidance and attention of a medical professional. As Steenbarger puts it, “[t]he phone and computer can very much help people help themselves; therapy is very useful when self-help is not enough.”
What also should be brought into the discussion is the question of user privacy. Roni Frank, co-founder of the online therapy platform Talkspace, assures me that “[a]ll of the chats between therapists and their clients are private, encrypted, and stored in a secure manner.” But not every app guarantees that same level of security. In fact, up until fairly recently, even the federal website AIDS.gov failed to encrypt sensitive user data, and it wasn’t until security researcher and attorney Steve Roosa exposed this failure that proper measures were eventually taken.
But in the case that apps do use encryption, personal data may still be vulnerable, says Roosa, as encryption “is only a small piece of the security puzzle.” Another piece? The back-end technologies that many web and mobile applications employ to run; these, too, are not immune to attacks. Additionally, he warns that user accounts may be compromised if mobile and web platforms do not require complex passwords or set a limit to password guesses.
If privacy cannot be guaranteed, I wonder how understanding these risks might limit what users go on to divulge and ultimately, what they get out of their virtual therapy. Again, I turn to Roosa. What might he tell app users looking for happiness online?
“I would say put your radar up and be vigilant.”