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We live in paradoxical times. We have more ways to connect than ever before, but loneliness is on the rise.¹ We work fewer hours on average than we did 20 years ago,² but we feel more stressed and overwhelmed.³ We yearn for a 鈥榮lower pace of life鈥�,⁴ but divide our attention between three digital devices while we 鈥榬elax鈥�.⁵

The digital revolution has changed our world fundamentally. It has brought global connectivity and greater equality in access to knowledge. But it has also brought new threats to our mental wellbeing. #Status of Mind, a new report from the Royal Society for Public Health (RSPH), says a digital component (including social media) should be included in the training of all mental health professionals who work with young people.⁶ 鈥楧igital technologies, including social media, are so entrenched in the lives of young people that it is no longer possible to support their health and wellbeing without some knowledge about the impact these technologies and social media platforms have,鈥� says report co-author Dr Becky Inkster, Honorary Research Fellow at the University of Cambridge. 鈥楢s health professionals, we must make every attempt to understand modern youth culture expressions, lexicons and terms to better connect with their thoughts and feelings.鈥�

But it鈥檚 not just young people鈥檚 lives that have been changed: in 2006, just 35% of people in the UK used the internet on a daily basis; by 2016, this figure had increased to 82%.⁷ In 2007, only 22% of people in the UK had at least one social media profile;⁸ by 2016, this figure had risen to 89%.⁹

This article pinpoints some of the chief ways in which the digital revolution is changing us and our clients 鈥� whatever our age. Are we, as therapists, as social beings, alert and equipped to deal with it?

The rise of loneliness

Thirteen per cent of us don鈥檛 have a single close friend, and one in five of us feels lonely often or all the time.¹⁰ And loneliness, while increasingly recognised as a problem for the elderly, is by no means confined to older people: indeed, among those aged 16-24, 65% say they feel lonely at least some of the time, and 32% say they feel lonely often or all the time. By contrast, among people aged 65 or over, 32% say they feel lonely at least sometimes, and only 11% feel lonely often or all the time.¹⁰ According to the Mental Health Foundation, the people most worried about feeling isolated are in the 18-34 age group 鈥� the generation that has grown up with social media.¹¹ And the more time you spend online, the more socially isolated you are likely to feel, says a recent study of 1,787 adults aged 19鈥�32 by researchers from the University of Pittsburgh.¹²

鈥楾echnology has fundamentally changed our world and this generation in particular,鈥� says Dr Jean Twenge, a psychology professor at San Diego State University and author of Generation Me and The Narcissism Epidemic. 鈥楾his generation is more confident, assertive, entitled 鈥� and more miserable. We are malnourished from eating a junk-food diet of instant messages, Facebook posts, email and phone calls, rather than the healthy food of live, in-person interaction. When you consider the loneliness felt by many young people today, it鈥檚 surprising that a larger number aren鈥檛 depressed.鈥�

More anxious, more stressed

According to NHS Digital figures, 37% of adults aged 16鈥�74 are now having treatment for conditions such as anxiety and depression, up from 24% when the last survey was carried out in 2007.¹³ 鈥楾he pace of life is increasing and we no longer have enough downtime,鈥� warns Nicky Lidbetter, Chief Executive of Anxiety UK. 鈥榃e are continually bombarded with all sorts of stimuli, the mental equivalent of overworking your body in the gym every day. If you are already predisposed to anxiety and you are on a treadmill-style lifestyle, it鈥檚 a perfect storm.鈥� In a recent survey, GPs reported that 84% of their patient consultations were for anxiety-related conditions.¹⁴ Stress and anxiety also account for 45% of sick days.¹⁵

Stress is rising too among young adults. Twenge says: 鈥業 analysed data from 63,706 college students and 13,870 high-school students between 1983 and 2007. Thirty per cent of college freshmen reported feeling 鈥渙verwhelmed by all I have to do鈥� in 2012, nearly twice as many as in the 1980s. More also described themselves as below average in mental health and reported common psychosomatic symptoms of depression and anxiety. Compared with their peers in 1982, three times as many high-school students in 2012 said they had trouble sleeping most nights and twice as many students reported being seen by a doctor or other professional for mental health issues.鈥�

Always on

One theory behind the rise in stress and anxiety, particularly in young people, is the increased use of digital devices, such as smartphones. The generation of teens to 20s, born since the turn of the century, have been dubbed Generation AO 鈥� 鈥榓lways on鈥�. About half of all 18- to 24-year-olds check their phones in the middle of the night, a fifth check instant messages or social media notifications, and a seventh reply to instant messages.¹⁶

Social media exacerbates the vulnerability of the ego, believes psychotherapist Dr Aaron Balick, author of The Psychodynamics of Social Networking. 鈥業t鈥檚 always been in play, but now it鈥檚 in play 24/7 鈥� people are feeling anxious because they are exposed to a constant state of self-presentation to a virtual audience. It鈥檚 self-referential rather than narcissistic. There is a danger, particularly for the older-generation therapist, [of being] implicitly dismissive of a person鈥檚 online identity that鈥檚 created through social networking sites such as Facebook and Instagram. But a selfie is a self-portrait, [and there is] a desire for it to be recognised and responded to by others.鈥�

Emotional outsourcing

Being 鈥榓lways on鈥� also means that today鈥檚 young people are in constant contact with each other. The much-publicised downside of this is vulnerability to cyberbullying, but there are also positive effects, as the RSPH report points out:6 鈥楽ocial networking offers young people who may be suffering from mental health issues an opportunity to read, watch or listen to, and understand, the health experiences of others 鈥� relating them back to their own reality.鈥� Social media platforms also offer young people 鈥榓 useful tool to make, maintain or build upon real world interpersonal relationships, creating stronger bonds with people they already know鈥�. According to a Pew Research Center/Elon University survey, digital natives are also more likely to turn to 鈥榩ublic problem-solving鈥� through cooperative work such as crowdsourcing.¹⁷

But being 鈥榓lways on鈥� may be creating a generation less able to manage their own emotions, believes Rebecca Kirkbride, 香港六合彩精准资料 senior accredited counsellor and author of Counselling Young People: a practitioner manual. 鈥榃hen there are people available online at all hours of the day and night to seek advice and support from, whether these are friends who are well known in person or more distant 鈥渃yber connections鈥�, young people now are arguably less likely to reflect on their difficulties and find solutions alone than previous generations were, when peers were less readily available.鈥�

So, when they present in the therapy room, are they more likely to expect miracles from their counsellor, and outsource to us the responsibility for their feeling better? 鈥榃hat we might find is less familiar to them is when the therapist says, 鈥淗ow else might we think about this?鈥�, so creating a space of uncertainty, rather than coming up with, 鈥淭his is what I think, or this is what is right鈥�, which they may be used to hearing from their online networks,鈥� she believes.

Compulsive comparison

Life can turn into a performance, particularly for young women, says psychotherapist Susie Orbach in her new book, In Therapy: how conversations with psychotherapists really work. 鈥楾here are only 40,000 teenagers who aren鈥檛 online out of four million. And of those, the girls who post selfies want something like 124 likes on average. They get 26. If they do not get the likes they want, that pulls them right down. So, their whole lives are about representation and validation. It鈥檚 about the production of a body. It鈥檚 not about living in one,鈥� she says. Studies have shown that young girls and women in their teens and early 20s who view Facebook for only a short period of time have greater body-image concerns than non-users.¹⁸

Research has found that excessive use of social media can create feelings of envy and the distorted belief that others lead happier and more successful lives.¹² Not surprisingly, the 16鈥�24 age group are by far the most active social media users: 91% use the internet for social media compared with 51% of 55- to 64-year-olds and only 23% of over-65s.¹⁹ But problems may arise if there is a big gap between the 鈥榩erfect鈥� image that you have created through carefully controlled and edited online activity and your real-life identity. In his paper 鈥楽ocial Media, Social Avatars and the Psyche: is Facebook good for us?鈥�,²⁰ consultant forensic psychiatrist David Brunskill predicts that, if we become 鈥榚ver more image obsessed, self-promotion will overtake self-awareness鈥�. According to the RSPH report,⁶ the platform that鈥檚 most likely to create this 鈥榞ap鈥� is Instagram, which it says feeds a 鈥榗ompare and despair鈥� mindset, increasing both dissatisfaction with body image and fear of missing out (FOMO).

A recent study by the University of Leeds identified a 鈥榗ompulsive internet habit鈥�, where users replaced real-life interaction with online chatrooms and social media sites or browsing porn and gaming sites, to such an extent they could be labelled internet addicts.²¹ 鈥極ur research indicates that excessive internet use is associated with depression, but what we don鈥檛 know is which comes first 鈥� are depressed people drawn to the internet or does the internet cause depression?鈥� says Dr Catriona Morrison, Senior Lecturer in Experimental Psychology and Director of Learning and Teaching for the Institute of Psychological Sciences at the University of Leeds. 鈥榃hat is clear is that, for a small subset of people, excessive use of the internet could be a warning signal for depressive tendencies.鈥� There are some small-scale studies that also suggest a link between excessive use of Facebook and incidence of obsessive-compulsive disorder.²²

Kirkbride advises practitioners to be as curious about their clients鈥� online social networks and behaviours as they are about their relationships at school and home. 鈥楶ractitioners are uniquely placed to help young people think about and reflect on the tensions between their online and 鈥渞eal鈥� lives, in order to make meaning and sense of their existence and identity at a crucial point in their development,鈥� she says. 鈥業 find clients coming to me and saying, 鈥淢y parents have taken away my phone as punishment.鈥� Some parents have little realisation about what that means to the teenager and their identity and their social connections.鈥�

Meeting and parting

Twenty-seven per cent of new relationships now start via a dating website or dating app, according to the Online Dating Association.²³ It鈥檚 not just the younger generation who date online: according to an Age UK survey, 38% of people aged 50-59 and 37% of those aged 60-69 met their partners online.²⁴

But along with the convenience of having a greater choice of partners available at the click of a mouse come new challenges in the emotional arena, such as 鈥榖readcrumbing鈥� (being on the receiving end of sporadic messages that keep you 鈥榟anging on鈥� for someone who has no intention of taking the relationship further), and 鈥榞hosting鈥� (the ending of a relationship by abruptly cutting off all contact). Plus, not every online dater is looking for a relationship. According to a 2016 survey by HTC, 24% of people surveyed said they continued to keep their profile active even when in a relationship.²⁵ 鈥楶eople use sites such as Tinder to get validation 鈥� how often they get 鈥渟wiped right鈥�,鈥� says psychologist Dr Martin Graff from the University of South Wales.

And it seems to be more talk than action. A recent survey of 27,000 people that found that young adults aged between 20 and 24 and born in the 1990s were more than twice as likely as those born in the 1960s to report that they had had no sexual partners since the age of 18.²⁶ 鈥榃hat we are seeing is this group is less likely to hook up, so to speak, than previous generations,鈥� says study co-author Ryne Sherman, Associate Professor of Psychology at Florida Atlantic University.

Playing out our relationships more publicly online inevitably has its flip side, says Graff. 鈥楢t the very beginning of a relationship, for example, the one thing we all probably do (even if we don鈥檛 admit it) is check out a new love interest online. There is also evidence that online surveillance continues into married life, not only motivated by the desire to find out what a partner may be doing offline, but also what they do online 鈥� further evidence that we now live in a part-time online world as well as an offline one.鈥�

But making a 鈥榗lean break鈥� from former partners is harder than before. One-third of people say they use Facebook to monitor the activities of former partners, according to one survey.²⁷ 鈥楤efore the advent of social media, when a relationship was over, you could choose to have little contact. Now, it鈥檚 possible to 鈥渨atch鈥� each other鈥檚 lives on sites such as Facebook,鈥� says Graff. Actively monitoring an ex on social media has been linked to greater distress and difficulty in moving on from a relationship.²⁸

Where next?

The experiences our clients bring into the therapy room are a microcosm of the cultural changes happening in the wider world. Inevitably, the digital revolution of recent decades has affected our work with clients and the issues they bring into the room. But how? What is happening in your counselling room? How well are we equipped to respond to the changes going on in our wider world?

For good and ill, the digital revolution is unstoppable, but we can go forward armed with some of the learnings from the first generations of the digital age.

Sally Brown is a counsellor and coach in private practice (), a freelance journalist, and Executive Specialist for Communication for 香港六合彩精准资料 Coaching.

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