Feeling Depressed? Here’s a Program That Could Help : Computers: A psychiatrist has developed Dr. Software, which lets people pour out their problems as fast as their fingers can type on their PCs.
If there were a psychiatrist on the Starship Enterprise, this would be it. Meet Dr. Software, an interactive computer program designed to help overcome depression.
Developed by a Malibu psychiatrist and his programmer son, the program encourages you to tell it your problems via computer keyboard. You pop the $199 program into your PC and begin pouring out your gloomy soul as fast as you can type. In turn, the program responds, usually appropriately, with vague encouragements, innocuous truisms and the occasional prod to stop beating around the bush and get back to the subject of depression.
In other words, it responds like a human psychotherapist.
“I feel hopeless,” you whine.
“It is very painful to be in the middle of a depression,” it counters.
“How will you help me?” you plead.
“It is my job to help you learn to help yourself,” it advises.
Thank you, Dr. Software.
“Overcoming Depression,” as the program is actually called, is the work of Kenneth M. Colby, professor emeritus of psychiatry and biobehavioral sciences at UCLA, who developed the program with son Peter.
Trained as a psychiatrist at Yale, Colby, 70, said he began thinking about machine-aided psychotherapy almost from the time he detoured into the emerging field of computers in the 1950s. “From the beginning, my idea was to make an end run around the social stigma associated with mental health problems and to provide low-cost therapy,” he says. Colby’s dream of an electronic couch became feasible with the proliferation of inexpensive home computers in the 1970s.
As Colby points out and the sale of Prozac would seem to confirm, depression is epidemic in the United States.
“According to the National Institute of Mental Health, 25% of the population has it,” Colby says. “I think that number’s too small. Everybody I know gets depressed.”
Currently, only 10% of the depressed population is being treated, he says. Colby sees the untreated majority as the potential market for his program, released earlier this year.
Colby describes “Overcoming Depression” as a “therapeutic tutorial program.” Although the dialogues between user and software shrink are the flashier part of the program, its heart is a series of lessons about depression--what it is, strategies for overcoming it and how to tell if you need further help. The program practices an electronic form of Colby’s specialty, cognitive therapy, a widely accepted therapeutic approach based on the principal that “you can change your thoughts and your mood by changing the way you think about yourself.”
As someone who has been fascinated with computer language for decades, Colby loves the linguistic aspect of the program. The electronic therapist can recognize 30,000 to 40,000 words or expressions that are likely to be uttered in a psychiatrist’s office, from abandon to zonk out. Creating this “thesaurus of words in the interpersonal domain,” as he calls it, is a family affair that includes Colby’s artist wife, Maxine. The Colbys are always on the lookout for new phrases to expand the program’s vocabulary. Former students send choice examples, and the Colbys are faithful readers of such linguistic lodes of psychic pain as the Dear Abby column.
The Colbys have formed a tiny software company, Malibu Artifactual Intelligence Works. “We’re three people in a dining room in Malibu,” Colby confesses.
Almost since Colby began working on psychotherapy programs, critics have denounced him for replacing a flesh-and-blood therapist with an electronic one.
Perhaps because he remembers the heyday of psychoanalysis, when analysts sat out of sight of their patients and rarely spoke to them except to say the 50-minute hour was up, Colby isn’t convinced that depressed users need a corporeal therapist present to feel better.
Lay people who tested the program when it was being developed didn’t object to the absence of a fleshly therapist, Colby says. What sets his program apart from others is that it uses conversational language. The user types in whatever comes to mind, misspellings and all, and the program answers more or less appropriately.
Instead of being limited to yes or no responses, the user can give a detailed, idiosyncratic answer to a question or ask the program any question that comes to mind. As a result, Colby says, the evaluators typically reported that they felt they were interacting with a mind, not just taking a test.
Colby says it was the lay evaluators who urged him to include information about suicide in the program. “I thought it might be a little peculiar talking to a computer about suicide, but they said, ‘No, you’re copping out.’ ” Capable of discussing life-and-death issues, Dr. Software has also been programmed for a little electronic levity. Type in, “I think computers are stupid,” and the program snaps back, “Computers are smart at some things and dumb at others.”
Much of the program consists of information on depression that is hard for the layman to get elsewhere, Colby says. As to the therapeutic advice, he says: “We’re teaching the patient to be his own therapist. That’s what a therapist does too, but he won’t admit it.”
The program is not for everyone, Colby says. There are many varieties of depression, and his program is aimed only at people suffering from “ordinary, garden-variety depression.” According to the program, you are depressed if you are both blue and have a low opinion of yourself. The program helps users decide if they are depressed or not.
Colby’s theory--and thus the program’s--is that people become depressed because they make negative self-comparisons. For example, they may compare their present state unfavorably with the happiness they felt in the past, say, when a dead spouse was alive. To overcome depression, the program urges step-by-step “reprogramming” to eliminate these negative self-comparisons. As a first step, for example, the user is advised to go for just five minutes without making any self-comparisons.
In Colby’s view, depression is “a condition, not a disease.” Nonetheless, a section of the program analyzes a user’s symptoms and advises the user whether he or she is a likely candidate for antidepressants. A seriously depressed person should not turn to alcohol, become celibate, take tryptophan, or join a cult, the program advises. He or she should call a university psychiatry department and ask for the name of a psychiatrist trained in psychopharmacology.
So far the Malibu company has sold about 100 copies of “Overcoming Depression.” But the Colbys are anything but blue about the future. They are negotiating with a major international hotel chain to have the program put in its hotel rooms, next to the Gideon Bible. And the Colbys believe that both depression and computers are here to stay.
“We think computer-aided psychotherapy is going to be a billion-dollar industry in 10 years,” Peter Colby predicts. “And,” he adds, “it’s the one part of the health-care industry that’s going to come down in cost.”
