A report from the New York Times raises questions over how the teletherapy startup Talkspace handles user data.
- In the report, several former employees said that "individual users' anonymized conversations were routinely reviewed and mined for insights."
- Talkspace denied using user data for marketing purposes, though it acknowledged that it looks at client transcripts to improve its services.
- It's still unclear whether teletherapy is as effective as traditional therapy.
A recent report raises questions over how the mobile therapy company Talkspace handles user data.
Launched in 2014, Talkspace is an app that provides its users access to licensed therapists through text, audio, and video. To access therapy, users fill out a questionnaire to get "matched" with a therapist, and then, for prices starting at about $200 per month, they begin chatting with their therapist through whichever medium they prefer.
This model can help make therapy more accessible for people short on time or money. But according to a new report from The New York Times, former employees say that "individual users' anonymized conversations were routinely reviewed and mined for insights," and that Talkspace data scientists "shared common phrases from clients' transcripts with the marketing team so that it could better target potential customers."
The company denied using client conversation transcripts for marketing purposes, but did acknowledge that "data science and clinical leadership will from time to time share insights with their colleagues."
Former employees also questioned the legitimacy of certain interventions by the company into client-therapist interactions. For example, after one therapist sent a client a link to an online anxiety worksheet, a company representative instructed her to try to keep clients inside the app.
"I was like, 'How do you know I did that?'" Karissa Brennan, a therapist who worked with Talkspace from 2015 to 2017, told the Times. "They said it was private, but it wasn't."
Other former employees said the company would pay special attention to its "enterprise partner" clients, who worked at companies like Google. One therapist said Talkspace contacted her for taking too long to respond to Google clients.
Talkspace responded to the Times with a Medium post, which claimed the Times report contained false and "uninformed assertions."
"Talkspace is a HIPAA/HITECH and SOC2 approved platform, audited annually by external vendors, and has deployed additional technologies to keep its data safe, exceeding all existing regulatory requirements," the post states.
However, if the claims in the Times report are true, Talkspace may have violated the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule, which prohibits providers from disclosing patients' medical data for marketing purposes, unless the patient gives authorization.
"If it is true that Talkspace used information from private therapy sessions for marketing purposes, that is a clear violation of trust with their customers," Hayley Tsukayama, Legislative Activist from the Electronic Frontier Foundation, told Salon. "All companies should be very clear with their customers about how they use personal information, make sure that they don't use information in ways that consumers don't expect, and give them the opportunity to withdraw consent for those purposes on an ongoing basis. Talkspace trades on its trustworthiness and mentions privacy frequently in its ad campaigns. Its actions should be in line with its promises."
(It's also worth noting that Talkspace recently threatened legal action against a security researcher who wrote a blog post outlining the potential discovery of a bug that allowed him to get a year's subscription for free. A report from TechCrunch notes that Talkspace rejected the findings, and that the company does not offer a way for researchers to submit potential security bugs.)
Beyond privacy concerns, the report also raises questions about the efficacy of teletherapy, especially within a corporate model.
"The app-ification of mental health care has real problems," Hannah Zeavin, a lecturer at the University of California and author of an upcoming book on teletherapy, told the Times. "These are corporate platforms first. And they offer therapy second."
The main problem with judging the efficacy of teletherapy is the lack of solid research — it's too new to comprehensively compare it with in-person therapy. Still, some studies suggest it could be useful for at-risk populations, or for people in the wake of a disaster.
'It's just not therapy'
But others remain skeptical.
"Maybe [teletherapy] products and services are helpful to certain people," said Linda Michaels, a founder of the Psychotherapy Action Network, a therapists advocacy group. "But it's just not therapy."
Proper therapy or not, it's worth considering how platforms like Talkspace use — and possibly even depend on — user data. In a 2019 opinion piece published in the Times, Talkspace co-founder Oren Frank wrote:
"The vast amount of information each of us possesses is far too important to be left under the control of just a few entities — private or public. We can think of our health care data as a contribution to the public good and equalize its availability to scientists and researchers across disciplines, like open source code. From there, imagine better predictive models that will in turn allow better and earlier diagnoses, and eventually better treatments.
Your health care data could help people who are, at least in some medical aspects, very similar to you. It might even save their lives. The right thing to do with your data is not to guard it, but to share it."
Reveri Health has launched a new stress-relief self-hypnosis program through Amazon Alexa to help combat the anxiety of COVID-19.
- Hypnosis refers to a trance state that is characterized by extreme suggestibility, relaxation, and heightened imagination.
- Hypnotherapy can be used to help you quit smoking, to manage chronic and acute pain, during labor and childbirth, as well as to ease stress and anxiety.
- Reveri Health, headed by Ariel Poler and Dr. David Spiegel, has launched several self-hypnosis skill programs through Amazon Alexa and Google Assistant, one of which is designed to combat the anxiety surrounding the COVID-19 global pandemic.
Hypnosis refers to a trance state that is characterized by extreme suggestibility, relaxation, and heightened imagination. Hypnosis can be thought of as a tool to be used during hypnotherapy, which is, in simplest terms, the practice of hypnosis for therapeutic purposes.
Hypnotherapy has been used in practices such as:
- Helping people quit smoking
- Relieving chronic and acute pain
- During childbirth (referred to as hypnobirthing)
- Navigating the cause of mental health issues such as anxiety, PTSD, or depression
Hypnosis has been shown to impact three separate areas of the brain:
First, there is a decrease in activity in the part of the brain that is responsible for psychological functions such as decision making, evaluation processes, and emotional regulation. Then, there's an increase in the connection between the part of the brain that controls your working memory and self-control and the part of the brain that plays a significant role in pain perception, social engagements, and emotions. Lastly, there are reduced connections in the parts of the brain that control neural activity and cognitive tasks.
Hypnotherapy via Amazon Alexa and Google Assistant
Clinical trials of the Amazon Alexa stress relief skills have showed a significant decrease in anxiety amongst users.
Image by Reveri Health
What is hypnotherapy?
Hypnotherapy takes advantage of the relaxed, suggestible state your brain is in to alter our perceptions of things.
Hypnotherapy expert Diane Zimberoff (cofounder of the Wellness Institute) compares our subconscious mind to a computer's filing system. Our subconscious is like a hard drive. We store experiences, emotions, thoughts, and other processes there.
Hypnotherapist Judi Vitale describes:
"With hypnosis, you might want to help someone stop smoking by suggesting the taste or smell of cigarettes is worse than it actually is. But a hypnotherapist can use age-regression techniques [during hypnosis] to examine the impulse that fuels the client's habit.
Self-hypnosis can aid in pain management, quitting smoking and stress relief.
Self-hypnosis, according to Reveri Health, is a type of hypnotherapy that can be done via an audio guide. You can do this in the comfort of your own home. First, you follow a series of instructions to get you into a focused state of attention (what is referred to as the hypnotic state).
Once you are in a calm and focused state, the therapy track will begin. After you hear and absorb all of the suggestions in the session, you will be guided out of your hypnotic state.
Reveri Health was cofounded by Dr. David Spiegel, who is considered one of the United States' most respected experts in clinical uses of hypnosis, alongside Ariel Poler, an passionate investor in the field of human augmentation.
With a team of psychologists, doctors, designers, and engineers, Reveri Health is dedicated to the belief that we can all feel better by changing the way we think - and one of the best tools to do this is the use of hypnotherapy.
Clinical trials for Amazon Alexa self-hypnosis have revealed very encouraging results.
According to Poler, Reveri Health has run clinical trials using self-hypnosis tracks through Amazon Alexa and Google Assistant at Stanford University that focused on the ability to quit smoking and pain management.
The results of the pain management via hypnotherapy trial showed that pain ratings of users moved from an average 5.1 to 3.95 after using the Alexa Hypnosis pain relief app for 3 months. This specific trial also showed that hypnosis reduces pain by up to 50 percent over a year among women with metastatic breast cancer.
While it's important to note that self-hypnosis doesn't work for everyone, these results suggest there may be a new wave of hypnotherapy treatments that are available in the comfort of your own home.
"Alexa, start hypnosis stress relief."
Reveri Health has launched a specific program (which is currently being offered for free) to help combat the anxiety around the COVID-19 global pandemic.
If you're near your Alexa device, find a comfortable position, and then say: "Alexa, start hypnosis stress relief."
The voice of Dr. Spiegel will take you through a short hypnotherapy session that was designed to help you manage stress and anxiety that can be generated from the current COVID-19 pandemic.
This is a 10-15 minute session that you can repeat as many times as you'd like for free. You can begin using this service by clicking here.
The Brazilian government has been trying to answer this very question in its ever-growing prison population, which has doubled since the year 2000.
In 1953, long before shots of ayahuasca were paired with cacao elixirs at Burning Man Decompression parties, William Burroughs traveled around South America in search of the mystical beverage called yagé. Though Burroughs is remembered predominantly as a heroin junkie, he documented not only the hallucinogenic qualities of ayahuasca, but also the scientific possibilities of this intriguing blend of vines and leaves.
Ayahuasca was first “discovered” by Western science in 1851, when the Victorian naturalist Richard Spruce made his way around the Amazon (Burroughs later read his work). It would take the “father of ethnobotany,” Richard Evans Schultes, to bring ayahuasca to mainstream awareness. Ironically, perhaps, Burroughs and Schultes, both Harvard graduates, ran into one another in Colombia in 1953 while documenting yagé.
Burroughs never achieved the scientific results Schultes did. While the Beat writer focused on a book (eventually downgraded to an article) on the science, he was known for dramatic statements like, “NO ONE IN HIS SENSES WOULD EVER TRUST ‘THE UNIVERSE.’” A powerful observation in his letters to pal Allen Ginsberg, but not getting him published in Nature anytime soon.
Interestingly, when traveling through the Putumayo region of Colombia, Burroughs predicted a global ayahuasca boom. Today eco-luxe tourism is rampant in the Amazon, with rock star shamans grappling with sexual abuse accusations. In Los Angeles, yoga teachers who’ve drank the brew feel justified in labelling themselves “plant medicine shamans” after circumventing the rigorous dieta and apprenticeship process. With so much spiritual capitalism occurring around this drink, what benefits can actually be gleaned?
The Brazilian government has been trying to answer this very question in its ever-growing prison population, which has doubled since the turn of the century. In 2013, volunteer therapists working with Acuda, a prisoner’s rights group based in Port Velho, began integrating yoga, reiki, and ayahuasca ceremonies as part of a wide-scale rehabilitation effort to help the half-million-plus inmates scattered across the nation.
While the brew is less studied than other entheogens, early reports are positive. One small study in Brazil saw a meaningful reduction in depression in volunteers. A larger follow-up saw a 64 percent success rate in treating depression. Another study focused on its potential application in treating addiction and other “diseases of civilization.” Some speculate that ayahuasca might have even wider-ranging applications:
The plant has shown potential to help people recover from trauma, PTSD, addiction and depression, as well as cancers and other afflictions.
The larger question of ayahuasca’s scientific and spiritual applications was entertained in the 2010 documentary, DMT: The Spirit Molecule, which has been viewed millions of times on Netflix, Youtube, and other streaming services (and which I served as music supervisor for). Parsing credible science from anecdote is always challenging, yet the transformative effects of ayahuasca are well documented.
Context matters. Last week I wrote about how mindfulness meditation might be dangerous for prisoners, but thus far ayahuasca seems beneficial for helping prisoners reflect on their crimes and, by extension, reducing recidivism rates.
This treatment is not universally welcome. One Brazilian resident, whose daughter was killed by one such prisoner, wonders how the murderer is allowed to enter the jungle to drink sacred medicine. The bigger question here involves the role prisons play in society: punishment or rehabilitation?
This question is particularly pertinent in the United States, which holds more prisoners than any other nation. While no one is advocating that prison should be pleasurable, some view it as an opportunity to prepare inmates for reintegration into society. Many facilities accomplish the opposite:
Prisoners in supermax units experience extremely high levels of anxiety and other negative emotions. When released—often without any “decompression” period in lower-security facilities—they have few of the social or occupational skills necessary to succeed in the outside world.
Others believe prison serves one purpose: justice. One libertarian argument even states that punishing prisoners is more merciful than trying to rehabilitate them:
Justice requires punishment, punishment must be deserved, and just desert requires a punishment in proportion to the crime committed—neither too much, nor too little. This is far preferable to the senselessly draconian sentences and the perpetual monitoring and post-imprisonment sanctions subject to the whims of a grimly humanitarian state.
The latter argument is more nuanced than that singular quote, though that sentiment does conclude the writer’s overall idea, which boils down to this: Are we trying to help criminals or keep them as far away as possible? Do we turn the other cheek or demand an eye, a head, an entire body for an eye? The prison system is broken. Do we want to try to fix it, or let it continue on the corporatized retributive path it’s been leading for decades?
At least in terms of ayahasuca, I can respond thus: on the three occasions I’ve sat for ceremony I’ve left recharged, reflective, and grateful. Though the most intense psychoactive experiences I’ve had—more so than psilocybin, LSD, MDMA, mescaline, and peyote—I never felt anxious. The ceremony provides an opportunity to reflect over your life; if you don’t like what’s simmering below the surface, chances are the ritual might result in existential duress.
But coming to terms with what’s inside of you is more transformative than ignoring it, which is, from my studies, conversations, and experiences, the true power of ayahuasca. That this brew might help alter the course of a life gone astray is enough incentive to integrate it into the prison population. The medicine is social, spiritual, and therapeutic, but most importantly, it provides a human approach to aiding others. If the science continues leading in this direction, we should follow it.
Derek is the author of Whole Motion: Training Your Brain and Body For Optimal Health. Based in Los Angeles, he is working on a new book about spiritual consumerism. Stay in touch on Facebook and Twitter.
Health psychologist Kelly McGonigal discusses a three-step process to shift your mindset when anxiety creeps in.
Fear and anxiety disorders affect 20 percent of the American population, making these disorders the most prevalent psychiatric problem in the nation. While many understand anxiety as an overstimulated response system reacting to an uncertain environment, NYU Professor Joseph Ledoux believes this evolutionary argument is misguided.
We have not inherited feelings from our animal predecessors, he says, but rather inherited “mechanisms that detect and respond to threats." Consciousness plays a decisive role in how we translate messages we receive from our environment. In Anxious he writes,
When these threat-processing mechanisms are present in a brain that can be conscious of its own activities, conscious feelings of fear or anxiety are possible; otherwise threat processing mechanisms motivate behavior but do not necessarily result in or involve feelings of fear and anxiety.
Anne Marie Albano, Professor of Medical Psychology and Director of Columbia University Clinic for Anxiety and Related Disorders, works with anxiety, which is actually her advice as well—work with it, not against it. Sensations of anxiety evolved to protect us. This system, she says, goes awry when you perceive immediate danger that isn't really there.
An example: About a decade ago I had a severe panic attack in an East Village restaurant. I'm not certain of the trigger, but it caused me to rise from my seat to flee to the bathroom. I walked roughly ten feet and didn't wake up for nearly a minute, when I was cradled by a woman I apparently landed on.
(Turns out I walked twenty feet after blacking out, straight into a wall and then onto the poor woman. I only knew this because, unbeknownst to me, a woman I had recently met was seated nearby. Ironically, she is a neuroscience journalist who had just published a piece on the brain and anxiety.)
Two days later I had another attack at the Wall St subway station in which I nearly blacked out. Every subsequent time I entered that station an attack occurred. My workaround was walking a few blocks to City Hall and thereby increasing my commute time, which is always fun in a New York City winter. I didn't return to that restaurant for years.
As Albano phrases it, we envision an immediate danger that isn't there. We do it all the time. Research shows that roughly 50 percent of our day is spent thinking about something not in your immediate environment. Other research shows that we have thousands of daydreams every single day. How we fill that mental space can bring great pleasure to our lives, but it can also cripple us.
Albano differentiates between everyday anxiety (which we all have and is helpful as our brain evolved to cope with stress)—and chronic anxiety. That's creating a big problem, socially and economically: one study found that Americans lose 321 million work days every year due to anxiety and depression, which costs the economy $50 billion. More Americans head to the doctor for anxiety than for migraines or back pain. The World Health Organization claims anxiety disorder is the most common mental illness on the planet.
Cognitive behavioral therapy has been the most successful course of treatment, according to Albano. When combined with the right pharmaceutical treatment for anxiety she says symptoms can be alleviated. Of course, this is a challenging balancing act, given our pill overload. Cure-alls are impossible when anxiety is so individual and specific. Albano is hopeful; the cognitive and biological mechanisms behind anxiety are being discovered, which she believes will disrupt the chain between a trigger and attack. She also believes we'll soon be able to address the process in young sufferers to tamp down the process earlier in life.
While Albano is a fan of talk therapy and pharmaceutical interventions, health psychologist Kelly McGonigal discusses a three-step process to shifting your mindset when anxiety arises.
- Acknowledge stress when you experience it
- Welcome the stress by recognizing that it's a response to something you care about
- Make use of the energy that stress gives you, instead of wasting that energy trying to manage your stress
Before I understood the depths of my disorder (which thankfully, I no longer suffer from) that third step was part of my arsenal. When an attack occurred I'd run around my neighborhood or jump on a treadmill. Anxiety is physiological as well as psychological; using your bodily systems to work with, instead of against, it is therapeutic.
Because anxiety can “create a state of concentrated attention," McGonigal suggests using that intense focus for something positive. Let's face it: triggers are everywhere. If one of every five people suffer from this disorder something cultural is happening. And when so many people are unwilling to talk about it, scared that it's “only in your head," as I was told for so long, we need to create supportive environments, which on a broad level we definitely are not. Given our current health care uncertainty, not everyone can afford the therapies Albano suggest, useful as they might be.
Your brain is wired for anxiety, as Albano suggests, as well as for dealing with it. Reframing your mindset is available to you at every moment. It's not easy, but it just might help you work with your mind instead of fighting it every step of the way.
Derek's latest book, Whole Motion: Training Your Brain and Body For Optimal Health, is out now. He is based in Los Angeles. Stay in touch on Facebook and Twitter.