Smartphones Are Teddy Bears and Blankies for Adults

Harvard psychiatrists say applying object-relations theory could improve digital health engagement
Peter Wehrwein

Developing apps and other digital health tools is one thing. Getting people to actually use them is another.

Writing in this week's JAMA, two Harvard experts say that applying a  little bit of object-relations theory might help developers, researchers, clinicians, and patients to make digital health more effective

As Jonah Cohen, PhD, and John Torous, MD, explain, object-relations theory says that as children age, they separate from primary caretakers.  To calm the anxiety and bad feelings that come with that separation, they often attach themselves to an object of some kind, classically a stuffed animal, doll, or blanket. 

"The smartphone may function as a type of transitional object for an adult," say Cohen and Torous. "The smartphone allows an individual to feel comforted and connected to others when feelings of physical pain, sadness, or other negative emotions arise."

They point to the behavior of people quickly picking up their phones when someone they are with leaves momentarily.

Cohen and Torous say leveraging the smarthphone as the adult version of a transitional object might mean using coaches and other unlicensed professionals to support an app or digital health effort. "Patients who feel protected and cared for by research staff may be more likely to engage with the object (i.e., smartphone) that connects them."

In other words, make the smartphone even more comforting.

They also say that assessments and surveys delivered by the smarthphone may tap into object-relations psychology. Children start becoming more aware of their feelings when they separate from their primary caregiver and attach themselves to transitional objects. The same phenomenon may occur with adults who are attached to their smartphones.