Mimi Winsberg - Speaking in Thumbs: A Psychiatrist Decodes Your Relationship Texts So You Dont Have To

If a pair of Bottega Veneta ballet flats could stomp, then I would say Agnes stomped down the long hallway and into the cavernous room that is my office. Instead of flinging herself onto the gray sectional, she leaned stiffly against a drafting chair, clutching her phone like a sacred tablet. Her nails were the color of the accent wall, the carpet, and the cigarette pack peeking out of the purse slung low against the thigh of her white capri pants: celadon.

I had acknowledged her arrival and was waiting for a response. At thirty-two, Agnes was used to being the smartest person in the room, and it showed in the way she carried herself. She was an MIT graduate and a level-six engineer at Facebook, making more money than a surgeon or a top corporate lawyer. Now she was wearing a mixture of scowl and pout.

I dont get it, she said, thrusting the ridiculously dim screen of her phone at me. I put on my glasses, which I seldom do around my patients. A text message from a man named Jason read, Lets talk when you are back from your trip.

Whats the matter? I ventured.

They had met online recently and had just spent a lovely weekend together, talking, hiking, cooking, feeling. She was hurt and annoyed by his text and wasnt sure why. What does this mean, how should I respond? she asked. I could read the subtext: Why isnt the relationship developing the way I think it should?

You know about sharks, how they have to stay in motion? I said.

Otherwise they die, she replied.

Exactly. People assume relationships are like sharksthat they need to move forward to survive. Well, theyre not; they move in mysterious ways, or sometimes not at all.

Agnes slumped into the drafting chair, rolled it beside me, and handed me her phone. We began to dissect her online chats with Jason to see if we were dealing with a shark, or perhaps an animal with a better chance of survival.

Ive got a story for you.

Its my own story, but Ive been a psychiatrist long enough to know that its a common one. Over twenty-five years of practice, my couch has provided me with a window into peoples intimate livestheir hopes, their dreams, and their worries. It has shown that we are all creatures of romantic attachment, not to mention the victims of epic dating fails. I have listened to countless colorful accounts of my patients online datingjust like Agnesstheir heartening successes and their heart-stopping failures. The thrill of connection, and the agony of rejection.

So if Ive got a story, its only because youve had so many stories for me.

Those narratives themselves have always been psychiatrys bread and butter. While medicine continues to grasp for the biological and genetic underpinnings of mental illnesswhich neurochemicals cause us to be depressed, anxious, compulsiveour stories remain a quick and reliable tool for understanding ourselves, available to one and all.

In psychiatry we call it the heuristic approach. A heuristic is a problem-solving method that uses shortcuts to come to quick conclusions. We cant analyze every synapse, download every experience, and sum up a person. We likely never will. But the heuristic approach offers us something else. Through stories and the way we make them meaningful, we can engage in a fruitful process of learning and discovery.

Scientifically speaking, stories have a bad rap. Anecdotal evidence is considered by science a lesser form of knowledge when compared with cold, hard data. Feelings, impressions, unsupported theoriesthey abound in the writings of psychiatrys forefathers, largely dismissed today. Freud himself acknowledged that his case histories should read like short stories; they lack the emphasis on data that weve come to expect, the serious stamp of science. He focused instead on the connection between our narratives and our symptomsthe idea that our psychiatric conditions could be understood by analyzing the stories we tell ourselves about life events.

I witnessed firsthand the role that stories can play in understanding symptoms when I was in medical school. I had elected to do some work in refugee camps in Asia, as well as a rotation at a local clinic that served Southeast Asian refugees. Many of the patients had not only been displaced but suffered significant trauma. Their stories, relayed through an interpreter, were both tragic and compelling. One Cambodian woman described a psychosomatic blindnesslosing her sight after watching her husband being stabbed to death with sharp sticks. As Freud suggested, her symptoms could only be understood through her recollections; no eye exam or CT scan could do them justice. This experience brought my interest in mental health into sharp focus. Even when I was a young medical student, my willingness to listen to peoples stories could be powerful and life changing, for them and for me.

It is what we do as humans, after all. We tell stories about ourselves and the people in our lives. Some of the stories are true, some distorted, some frankly false. As a psychiatrist, I am trained to listen to patients stories in a specific way: to draw out their histories, their family backgrounds, their symptoms and struggles. Some of what I do is to help patients tell a new story about themselves.

And of course many of the stories I have heard in my practice have been about lovelove being one of the greatest stories, one that gives our lives meaning. Love is always a story we tell first to ourselves and then to each other.

For three years, I did my listening at the very place that is credited (or blamed) for inventing the predominant means of online human communication today. At Facebook, I listened to Silicon Valleys alpha and beta testers, its disrupters and innovators. The inventors and shepherds of the algorithmthat impenetrable sequence of code that promises deeper and more profound connection with our fellow humansthey were and still are my patients. Those geniuses who know how you tick? I know how they tick.