From therapist's couch to client's screen

On hearing that Robert St Clinic psychotherapist Kyle MacDonald was breaking the boundaries of his quaint cottage clinic in Ellerslie, Auckland, to push ahead with an online therapy programme launch in California, we were intrigued. What interesting juxtapositions: tangible treatment room near the predictably ordinary Ellerslie shops; virtual treatment kicking off in the pumping, scantily clad environs of Venice Beach.

The programme is about treating Social Anxiety sufferers, the 7% of adults who daily struggle to look others in the eye and speak. That’s what it looks like from the outside – a quiet struggle. On the inside the panic and anxiety is deafening – panic will set in long before having to speak and will continue long after performing the social exchange.

MacDonald, a specialist in dealing with anxiety, trauma and related disorders, feels he can help an infinite number of people with an online toolbox they’ll access every day, safe in their own home zone.

However, you’d think that the best way to get Social Anxiety to loosen its grip on a sufferer would be to actually draw it out of the house and sit it down on a psycho-therapeutic sofa. Certainly you think this in an age where virtual and digital realms make it easy for social anxiety disorders to keep people tucked away, where the keyboard makes sure social interaction can be prepared. Predictable. Typed in. Controlled.

But MacDonald is hopefully confident that at end of his novel course clients will be infinitely more comfortable about stepping out of their social comfort zone.

“The course is made up of a combination of things that, from my experience and all of the empirically backed literature, I know work. There are treatments a little like this out there but they’re much more static, like for instance an online book based on CBT. My course is somewhere between a self-help book and online therapy with lots of engaging parts” he says.

Kyle usually sees clients in Ellerslie, Auckland. Now he'll see them online too.

Kyle usually sees clients in Ellerslie, Auckland. Now he’ll see them online too.

“I have used different schools of thought, bits and pieces. We cannot yet measure how effective delivering the course this way will be. It is a pilot. But if the outcome is that the person gets enough engagement through it to then seek out therapy where ever they are in the world then that’s a good outcome – it operates as a bridge.”

The course fits snugly into MacDonald’s blog, a delivery platform that Californians probably already love: American leading psych site,, just welcomed MacDonald’s site into their Top Ten listing. MacDonald says that creating the course grew out of things he too loves: IT and psychotherapy.

One of the things that came out of me doing a lot of social media was I started to think from the inside out: what is the effect of all this? IT tends to accentuate how we are naturally i.e. extroverts will use it in extrovert ways.”

People who are healthy and happy, enjoying a good social matrix, tend to use it to further that. But people who suffer from Social Anxiety rely on tech to avoid the parts of life that make them more anxious. The good and bad is where my interest lies.”

“The idea of the course is, if they are struggling with meeting face to face, they are struggling to get out of their house, so let’s meet them that way – a technological house call if you like. ”

It’s hardly news to state that some people choose careers in the likes of IT (information technology) because they can foster their social anxiety in the minimally social environments. Nearly everyone is familiar with an iconic computer nerd of some sort- TV shows like (U.S) The Big Bang Theory started off glamorizing awkward computer game-mad geeks and the most recent Silicone Valley start-up comedy goes several steps further with the IT stereotype.

But Kyle stresses that people with Social Anxiety can choose several career paths, including IT. The key is balancing acceptance with ambition and passion; OK, with this condition you wouldn’t head out on the road making cold call sales. But a more forgiving social environment that houses a role you really want to get could be the push that sees an anxious person engaged in breaking their own boundaries. 

“We don’t want to pathologise things too much though. There are people whose lives are not full of other people…..they may be perfectly happy.  It’s when anxiety stops them from doing what they want to do that we have a problem.”

The core components of MacDonald’s programme are teaching clients to become mindful and helping them tell their own story. Mindfulness – a popular practice Westerners have plucked from Buddhism to help them wind down from helter-skelter lives – gets you to pay attention to the moment; making sense of your own ‘life story’ helps you understand yourself and possibly even complete a broken picture of your life.

“I say to clients there is no such thing as crazy when you understand the story. Crazy is distress without knowing why you’re feeling that way. Trauma work, broadly defined, is about helping people understand how emotional development gets affected, limited, and in some cases quite profoundly damaged by the circumstances people grow up in. As much as anything it is helping people to understand that this stuff has a place in their story. We only know what we know.”

When asked if there is a particular kind of social anxiety sufferer who will perhaps get more out of this programme than others, Kyle’s says they will be people who want to do something about their suffering, but don’t know what to do. For them it will be a way of structuring motivation.

Having a free tour round the reveals an array of engagement methods including an entertainingly written free e-book that’s worth downloading. Even on your own, you won’t feel like you are, because as well as the personalised video clips, a bearded Kyle-caricature smiles out at you with gleaming white teeth from all over the webpage.

It all looks, um, a bit American.  We cheerfully asked Kyle if he wants to be the next Dr Phil: do other people ever suggest that to him? Surely they do what with his radio, The Nutters Club and now this book…?

“Certainly not. And I hope they don’t. Dr Phil can’t actually practise psychology. ”

Oh dear. That’s right. There was something to do with Britney Spears and Oprah being angry and Dr Phil getting struck off – but that’s another story.

To learn more about details of this story, treating social anxiety with Kyle MacDonald, a New Zealand practicing psychotherapist, click here.