Dr. James Beckerman is a cardiologist with the Providence Heart and Vascular Institute in Portland, Oregon.
And he’s also a jock. He serves as the Vice-Chair of the Oregon Governor’s Council on Physical Fitness and Sports, as well as the team cardiologist for the Portland Timbers major league soccer team.
In a recent article, he tells the sad story of the time the running watch that tracked his regular runs stopped connecting to his computer.
As Dr. Beckerman points out, the earliest studies of pedometers demonstrated that the mindfulness afforded by documenting simple activities like walking or running tends to increase those overall activity levels. But when, he wonders, does mindfulness actually become mind-numbing?
When his own running watch stopped working, he was suddenly unable to upload the data collected on his runs for a few weeks. And in the self-tracking world of connectivity, he explained that this meant only one thing:
“My runs never happened!
“Because one thing I’ve learned about the Quantified Self is that if you can’t document it, then you can’t prove you did it.
“It bothered me that I even cared. But I recognize this phenomenon as ‘The Dark Side of the Quantified Self’ — there is a tendency to become so dependent on the secondary gain experienced by documenting our activities that our experience of the activity itself is tied to its documentation.”
The Quantified Self movement that Dr. Beckerman mentions promises “self knowledge through numbers” for those people interested in – some might say obsessed with – keeping careful track of things like their sleep, exercise, diet, mood, sweat, caffeine, work patterns, dreams, memories, sexual activity, social habits and pretty well anything else that’s even remotely trackable in life.
But that’s only half the fun for Quantified Selfers. There’s also the appeal of documenting, charting or graphing data about yourself, as well as sharing your personal numbers with other people.
For some, tracking may not so much be about “fun” as it is about dependence, according to Milwaukee’s Michelle Jackson. The 39-year old has lost over 100 pounds since March with the help of a diet and fitness tracking app called SparkPeople. Described in a CNN Health interview in September as “data-obsessed”, she reports that, during the few times when this app malfunctions because of an update:
“I feel really almost debilitated. I’m very dependent on it.”
Dr. B. further explains that there is a tendency to become so dependent on the secondary gain experienced by documenting activities that our experience of the activity itself is tied to its documentation.
He invites his readers to consider, for example, their Facebook accounts:
“You and your friends are posting updates, photos, links, and check-ins. Why? Because you really care if the kid who used to pick on you in high school reads some random blog post, knows that you’re killing time at the Gas N’ Sip, and sifts through the fifty photos you posted from dinner last night?
“Nope. It’s because with status updates, there are ‘likes.’ There are comments. There are shares.
“It’s because we are, unfortunately, judging our own tastes, experiences, and even (gulp) the cuteness of our kids based on whether our questionably curated group of friends thinks that they are as awesome as we do.
“As we use similar technology to quantify ourselves, let’s be careful that we don’t fall into the same traps. Quantity doesn’t always mean quality, especially when it comes to the self.”
Even as an early adopter of social media, and especially as an advocate of mindfulness as a technique to improve health outcomes, Dr. Beckerman warns his readers about the collective tendency to lose the joy of a tasty meal in the hurry to input calories on a tracking device.
With small, affordable tracking sensors, we can can now log all sorts of human metrics: brain wave patterns during sleep, heart rates during exercise, leg power exerted on bike rides – but also our experiences like places visited or sounds heard. So instead of just enjoying ambient sounds out in real-time nature while being outdoors, for example, we are documenting, graphing and sharing information about those sounds we hear.
Dr. B. also warns Quantified Selfers not to mistake gamification for a true runner’s high.
Gamification in self-tracking technology means using game mechanics in non-game contexts in order to engage users. These can include the use of achievement badges, leaderboards, progress bars or challenges between users to encourage greater participation. Gamification may be important to the future of self-tracking apps because we know that only 5% of apps (including health apps) are still in use 30 days after download.
It may well be that only 5% of apps are worth using.
As Paul Cerrato, editor of InformationWeek Healthcare, wrote recently in his column about what he calls “digital snake oil”:
“Testimonials from famous athletes and actors turn heads, but they rarely prove that a treatment protocol – or an app – can cure your baldness or lift your depression.
“The vast majority of apps that find their way onto your radar screen call for a healthy dose of skepticism.”
Technologies that are used to keep track of all this personal information include cameras, phones, tablets, GPS devices, accelerometers and wearable wristbands, headbands or patches with embedded technologies able to measure bodily functions or movement. Some committed self-trackers even regularly send stool and blood samples for analysis and use commercial genetic tests in order to construct a detailed map of their bodily functions and wellbeing. And then they can tell their online friends all about it. . .
A MedCityNews article called Are We Headed Toward The Over-Quantified Self? examines when self-tracking crosses the line from enabling and empowering people to bombarding them with data, including this Tweet from California cardiologist and author of The Creative Destruction of Medicine, Dr. Eric Topol:
Sociologist Dr. Deborah Lupton has looked at the QS movement through an academic lens in her blog, The Sociological Life:
“In a world in which risks and threats appear to be ever-present, the certainties promised by the intense self-monitoring of the ‘self-tracker’ may be interpreted as a means of attempting to contain risk, to control the vagaries of fate to some extent.
“Self-tracking represents an intense focus on the self, and using data about the self to make choices about future behaviours.
“In relation to health matters, self-tracking offers users of such technologies a strategy by which they feel as if they can gather data upon their health indicators as a means of avoiding illness and disease. The self-knowledge that is viewed as emerging from the minutiae of data recording a myriad of aspects of the body is a psychological salve to the fear of bodily degeneration.”
Dr. Lupton also describes how this kind of self-surveillance has shifted from an inner-directed preoccupation with the body/self to what sociologists call a performative mode: inviting further scrutiny from one’s friends and followers on social media, just as Dr. Beckerman suggests we already do with those frequent social media updates.
The thrill is gone for some former Quantified Selfers, however.
Consider, for example, Alexandra Carmichael who, after 18 months of tracking 40 measurements every single day, decided to just quit, as she so eloquently described in this excerpt from her popular poem published in Quantified Self called Why I Stopped Tracking – ©2010 Alexandra Carmichael:
My self-worth was tied to the data.
One pound heavier this morning?
2 g too much fat ingested?
You’re out of control.
Skipped a day of running?
Didn’t help 10 people today?
It felt like being back in school
Less than 100% on an exam?
I’m starting to realize
That I need to
That I’m more than the numbers
That I’m beautiful, strong, and super smart
I don’t need data to tell me that.”
Dr. H. Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice, and the author of the book, Overdiagnosed: Making People Sick in the Pursuit of Health, might agree with Alexandra’s conclusions. He believes that individuals who monitor themselves closely are pretty much guaranteed to find something “wrong.”
Contradictory as it sounds, he says abnormality is normal. And as he was quoted in The Atlantic last summer:
“Data is not information. Information is not knowledge. And knowledge is certainly not wisdom.
“It brings to mind the fad a few years ago with getting full-body CT scans. Something like 80 percent of those who did it found something abnormal about themselves.
“The essence of life is variability. Constant monitoring is a recipe for all of us to be judged ‘sick.’ Judging ourselves sick, we seek intervention. And intervention, usually with drugs or surgery, is never risk-free. Doing no harm often demands doing nothing. The human body is, after all, remarkably sturdy and self-healing.
“Arming ourselves with more data is guaranteed to unleash a lot of intervention on people who are basically healthy.
“Frankly, I’d rather go river rafting.”
Q: Is Dr. Beckerman right in worrying that we risk losing “the joy of a tasty meal in the hurry to input calories” on our self-tracking devices?
* (from my other site, Heart Sisters