Back pain and stress: making the connection

After years of trying every treatment imaginable, eventually even back surgery, what’s a girl to do to do about her chronic pain? Go searching on the inside.


Here’s the story. I have been struggling with chronic pain for 17 years, since I was 15. Over those 17 years, I have:

  • Tried medication after medication
  • Tried various forms of physiotherapy
  • Tried various forms of massage
  • Tried chiropractors, active release therapy, and medical acupuncture
  • Tried yoga and pilates
  • Tried a four month elimination diet, where I tried to eliminate anything from my body that would cause inflammation
  • Tried a naturopath (yummy corn-silk tea, anyone?)
  • Tried a mindfulness meditation class (MBSR)
  • Tried injections (trigger-point, epidural)
  • Tried osteopathy and cranial-sacral work
  • Been to 25+ medical professionals (I’m guessing here, but it seems about right – about 6 PTs, 8 massage therapists, 3 chiropractors, 2 osteopaths, 8+ doctors)

I have multiple types of chronic pain: back, hip, pelvic. At age 32, I hit the point where it seemed like there was nothing else to be done about my back pain but one thing: surgery.

The back surgery helped with a couple of minor issues but afterward, my back still hurt. It hurt as much as when I first started having back pain, seven years ago. It is hard to admit this to people. People assume that after you have an invasive surgery, take time off work, etc. that you will be healed, or at least on your way to healing. I’ll admit it, I thought this too. I thought that the surgery would at least heal my back pain, and I could turn my attention to other issues. Because of other people’s expectations and my own expectations, it is incredibly difficult to speak about this dream not coming true.

And the key question is: after surgery fails, what next?


To continue my story, we need to go back to last year for a moment. Last year my massage therapist pointed me to the work of Dr. John Sarno. Sarno is a pioneer in the field of mind-body medicine. He came up with the idea of Tension Myositis Syndrome (TMS), claiming that tension in the body, caused by emotional distress (e.g., anger / shame), could lead to chronic pain. He theorized that tension in the body leads to oxygen deprivation in tissue, which leads to pain.

In the Sarno book I read, Healing Back Pain, he makes himself sound almost desperate. The book was written in a way that sounds incredibly defensive, as if he is trying to anticipate any objection the reader might have, and counter it in advance. Unfortunately, at least in this book (I can’t speak for his others), his means of countering is through anecdote.

As much as his theories intrigued me, anecdotes from Sarno were simply not enough to satisfy my scientific mind. Heck, I’m a person who’s taken courses on the philosophy of science and studied hard-core engineering for four years! Let me tell you, Karl Popper and his contemporaries would not have been satisfied by anecdote, nor was I. “If he worked on this for decades,” I thought, “where are the properly designed experiments?”.

Thus, despite my interest in Sarno’s concept, I put the book down and dismissed him as a quack, and his theories as bunk.

Months passed, my pain continued, I had the surgery, and the surgery failed to heal all but the tiniest part of my pain.


Feeling like I had exhausted all options, all I had left was that deep curiosity yet suspicion of the work of Sarno. I started reading on the TMS Wiki, a resource for Sarno-ites, looking for proof that there was actual science behind this.

I found two people: Dr. Howard Schubiner and Abigail Steidley. I listened to an interview that Abigail did with Dr. Schubiner, and determined they were both credible and interesting. I quickly bought Dr. Schubiner’s book Unlearn Your Pain, as well as Abigail’s Mind-Body Toolbox for Pain Relief (an audio course). Both were able to provide tons of evidence that there is something to this idea. (I wanted to provide a list of the evidence here, but it really requires more context. I recommend Schubiner’s book for an excellent start, and I list other resources at the bottom of this post.)

What I know now, in a nutshell:
Psychosomatic disorders do exist, and pain can be psychosomatic.

That doesn’t mean that my mind is inventing the pain, or that the pain isn’t real.

In a simple way, it means that my stress is being stored in my body as pain, and that my stress is strengthening the pain pathways in my body.

When pain is real but isn’t pathological in nature, Schubiner calls it Mind-Body Syndrome (MBS). I am becoming more and more convinced that at least part of my chronic pain, back and otherwise, is Mind-Body Syndrome.

All of this knowledge is why I am now reflecting on my life, both personal and professional. It’s why talks like “I suck, and so do you” resonate so deeply with me. There are aspects of my personality and the way I carry myself in the world (including in my consulting career) that make me susceptible to chronic stress, which lead me to be in a constant state of fight/flight/freeze, which lead to me being in pain. 17 years in, I’ve reached a point where something’s got to give.

When people encounter stress issues, they frequently assume that they have to remove the stress from their life. Honestly, this is impossible in modern life. Personally, I would much rather work on my ability to cope with the stress. Abigail’s own story is that working on her ability to cope with negative emotions helped her heal her chronic pain, and so I am attempting to follow the same path.

I don’t know if others out there are interested in this topic. Because my career is such a huge, important part of my life, my first reaction when I discovered this situation was to think, “Wow, I have to share this with everyone else who does what I do and might be suffering!”. But honestly, I don’t know how many people are dealing with the same issues. What I do know is that all of the following pain issues have been linked to mind-body syndrome:

  • Back / neck pain
  • Pelvic pain
  • Irritable bowel syndrome / interstitial cystitis
  • Fibromyalgia, whiplash
  • Chronic fatigue syndrome
  • Tension headaches, migraine headaches
  • Carpal tunnel syndrome

This is not to say that these issues are never caused by actual physical abnormalities. But doctors say that if there is no evidence of tissue / nerve damage yet you still have pain—if your MRIs don’t really show anything and you’ve tried everything else Western medicine has to offer—you should consider the idea that your pain might be caused by mind-body issues.

If you think you might be dealing with a similar situation, do reach out to me – mere@ (thisdomain). I would love to share what I know and talk more.


Resources to learn more:

  • Audio course I’ve used:
    • Mind-Body Toolbox for Pain Relief by Abigail Steidley (this is wonderful and worth every penny; oodles of material delivered by a compassionate and educated coach)

More resources can be found on Abigail Steidley’s free resources page.


Interested in my posts on related topics? Try:

Coping With an Addiction to External Validation

In my last post, I wrote about the need to be vulnerable with clients. In an effort to simplify the post, I glossed over something rather important: the desperate need for external validation that many of us have, and how it affects us in the workplace. Let the vulnerability continue!

In her talk at the 2013 Dare Conference, “I suck, and so do you!,” Karen McGrane explains how consulting requires a facade of absolute knowledge, when in reality, most of us are very anxious about our skills. She describes that this duality is a “push/pull” situation, where we have to spend all of our time acting the expert, while we desperately seek validation from our clients.

Karen’s thoughts are echoed by the predecessor piece to her talk, a post on A List Apart entitled, “Give a crap. Don’t give a fuck.” In the piece, Karen also talks about external validation and the need to stop worrying about what others think. She says:

“Care deeply about your personal values and live them fully in this world. Don’t get caught up in worrying about other people’s checklists to tell you what good work means to you.”

Honestly, when I first read Karen’s article, and later saw Karen’s talk, my heart started screaming, “YES!”. Someone understands me. Someone gets what this is like. It’s completely true: all of my career, I’ve relied on the approval of my clients and colleagues to feel good about my work. Worse, since so much of my identity is wrapped up in my job, and being a consultant, this means that I’ve relied on the approval of my clients and colleagues to feel good about myself.

My need for external validation manifested in the following behaviors (just a sampling):

  • Being fearful of making a mistake, and having to admit to a client that I made that mistake (and as I saw it, therefore having to admit to them that I wasted their money)
  • Being fearful doing something that would upset the client and cause them to ask for a new consultant, or fire my firm outright
  • Being fearful of asking a client a stupid question and being perceived as too inexperienced and not worth my consulting rate
  • Being fearful of a client’s proposed design solution being better than my proposed design solution
  • Being fearful that clients wouldn’t like my designs and would think I was a bad designer
  • Etc…

As you can see, looking for external validation for everything I did led to an incredible amount of fear in my life.

That said, at the end of Karen’s talk, mostly all I knew was that I needed to work harder on not needing external validation. I had no idea how to do that, save just reminding myself now and then. Karen claims that self-compassion is the way out, but I’ve been doing a lot of reading on self-compassion lately and this doesn’t resonate with me as a solution for the problem of external validation. I think self-compassion is critical to coping with the negative emotions that are caused by criticism (self-inflicted or otherwise), but I don’t see it as a means to stop caring about what others think. (It’s quite possible that as I continue my self-compassion journey I will change my mind on this. I admit I am quite a novice.)

So what can we do about this overarching need for external approval? Honestly, I’m not positive myself yet, thus I’m looking to share my journey with you.

Amy Pearson has a wonderful website and coaching practice where she trains people to give up the need for external validation, and that’s where I myself am going to start.

I think most people with this issue can recognize it immediately; however, Amy has a post where she describes 10 Signs You Might Be Addicted to Approval. Most importantly, she provides reality checks for each point. I recommend it as a starting point.

10 Signs You Might Be Addicted to Approval

10 Signs You Might Be Addicted to Approval (see full blog post)

 

What I find particularly interesting about Amy’s stance is that she sees the need for external validation as an addiction. Those of us with the addiction race from validation high to validation high, slumping in the middle while we seek more approval. She refers to a term from Martha Beck’s book Steering By Starlight, “fake joy”, to describe these temporary highs, which “take you to a place of ecstasy, then drop you off the edge of a cliff”. I can relate and find this a very useful way to think about things (despite being slightly skeptical of self-help books, ack).

Lastly, as I mentioned in my last post, knowing things in principle is great, but actually changing one’s behaviour is much harder. Amy’s reality checks are a good start, but I don’t know that I can just flip a switch and stop worrying about other people’s opinions outright. Nor do I think my goal should be to turn this concern off completely. That’s the problem about being a consultant, more than many other careers: your livelihood is completely dependent on what others think of you and your work. If you work at a product company, it’s different: your customers only judge you based on the end product. In consulting, you are the product. A consultant can’t just say, “I don’t care what my clients think” anymore. This is why Karen rightly points out that consultants are particularly prone to this issue. What your clients think about you matters deeply, yet you need to find a way to distance yourself enough from their opinions that you don’t implode.

My personal story has more or less led me to a state of implosion. My body is unhappy with me, and my mind is pretty unhappy with me too. I haven’t had a break-down like Karen describes in her talk, but I’ve been wearing myself down over nine years, and over the past few months I’ve realized that it has to stop. I urge you to reflect on your own situation and figure out if you need to take a similar step.

Resources I have identified thus far:

Self-Compassion Books

Although I don’t think that self-compassion is exactly the answer to solving one’s need for external validation, I do think it’s an incredibly valuable practice, so I’m including some links here.

  • Self-Compassion by Kristin Neff
    I am partway through this book and am really enjoying and appreciating it. Neff’s explanations make a ton of sense and have led to many ‘aha’ moments for me. She also includes exercises to do along the way to put the ideas into action.
  • The Mindful Path to Self-Compassion by Christopher K. Gerber
    After downloading samples of both books, Neff’s resonated with me slightly more, so I started with it. Still, both come highly recommended, so see which one resonates more for you.

Coping With External Validation Issues

  • LiveBrazen.com by Amy Pearson
    Amy is a coach who helps people learn how not to seek external approval as much. Her blog is a great resource, and she also has self-study programs available. Although it requires a newsletter sign-up, her Find Out Your Approval Seeking Personality Type quiz is actually fairly interesting.
  • If anyone has recommendations for books on this topic (or anything else, for that matter), please do leave a comment or contact me. I’m eager to learn more.

Harnessing Vulnerability In Consulting

As a young person, I considered being vulnerable one of my fortes. I was very good about sharing my insecurities and emotions with others in hopes of connecting and bonding. However, once I became a consultant (which for me happened straight out of undergrad at age 24), I lost a lot of my willingness to be vulnerable.

Why did I feel the need to shed this vulnerability? In short, insecurity. I wasn’t sure that I was worthy of the role I was given at such a young age. I was nervous that my clients would be upset that they were given a young, inexperienced consultant. I was terrified of making a mistake, having a client come up with a better idea than me, or (gasp) losing an account because of something I did.

Looking back, the back pain that I developed in 2008, two and a half years into my consulting life, should not have come as a surprise to me. I was putting an immense amount of pressure on myself to completely control the tenor of every client encounter, to smooth over any rough edges, to wow them with my work, and never let them down. It should not have been a surprise that my brain started being unable to store all of the stress and tension, and it started finding a home for that tension in my body.

The trouble for me is that old habits die hard. I am still extremely hard on myself in my role as a consultant. I aim to be everything the client could possibly want, and hold myself to impossibly high standards, aiming never to let the client know I am fallible.

I’ve begun to identify two issues at work in this situation:

  • I have a lot of thoughts that lead to stress, tension and difficult emotions (e.g., “If I’m not perfect my clients will think I’m wasting their money.”)
  • I don’t necessarily cope well with the emotions that are caused by those thoughts (e.g., experiencing anxiety when presenting a new design to a client).

I want to speak about how to better cope with emotions in subsequent blog post. But for today, let’s talk about the thoughts themselves, the ones that eventually cause emotions. How can one reduce insecurity and the fear of being seen as fallible? How can allowing oneself to be more vulnerable with clients actually reduce the number of negative thoughts one has to cope with?

I started thinking about vulnerability in a professional context when I first saw Karen McGrane’s talk from the 2013 Dare Conference, “I suck, and so do you!“. In her talk, Karen talks about a common problem amongst many digital workers, but particularly among consultants — deep insecurity. She talks about the loop: “the idea that you’re only worthy if you’re doing things right, … that your value to the world is that you have the right ideas.” She talks about how important it is to have the willingness to be vulnerable and imperfect while consulting, and why self-compassion is paramount.

Karen’s talk made me take stock of my situation a little bit, and how much I was using external validation as a means to derive my self-worth as a consultant. Her stunning display of vulnerability, speaking about her own break-down and her journey towards self-compassion, lit a spark within me to explore being vulnerable again. However, I still didn’t really consider what it would mean to be vulnerable with my clients.

Enter my second step on this road: the book Getting Naked by Patrick M. Lencioni. The book is a fable about how a boutique consulting company uses vulnerability to create authentic, trust-filled relationships with their clients. The principles in the book are based on those practiced in Lencioni’s own consulting company. Specifically, he describes the need to avoid three key fears in consulting:

  1. The fear of losing client business
  2. The fear of being embarrassed in front of clients
  3. The fear of feeling inferior to clients

To do this, he describes a number of techniques, such as:

  • Asking dumb questions
  • Making dumb suggestions
  • Celebrating your mistakes
  • Admitting your weaknesses and limitations

He explains how each of the above techniques (and several more) actually can strengthen the bond between consultant and client:

  • Asking dumb questions: Say you ask five questions and three of them are dumb. Lencioni argues that the benefit of asking the other two good questions is worth it. He points out that the dumb questions will be answered quickly, and that no one will remember them for long.
  • Making dumb suggestions: As with asking dumb questions, the argument here is that  it’s better to make all the suggestions one has and not hold back on the client. It’s better to risk asking a couple of dumb suggestions than to not make any suggestions and miss out on the good ones.
  • Celebrating your mistakes: Making mistakes is inevitable. It’s better to call them out and take responsibility for them, rather than hide or downplay them. Lencioni points out that clients don’t expect perfection from service providers, but that they do expect honesty and transparency. (Not hiding mistakes I’m good with, but I am going to have to take his word on the “not expecting perfection” point.)
  • Admitting your weaknesses and limitations: Says Lencioni — since we all have weaknesses, it’s better to be open about them than to end up in a situation of having to do something we’re not good at.

Essentially, Lencioni is giving me (indeed, all consultants) permission, and indeed, a reason to be real and vulnerable with clients. He basically claims that all of the things I have implicitly been worrying about for my almost-nine-year long consulting career, like making mistakes, are things not to fear but to embrace, and that they will only strengthen the bond a consultant has with a client.

I am eager to test out Lencioni’s approaches for myself, being more vulnerable with clients, and not stressing so much about any dumb ideas / questions / designs I may throw their way during the process. As usual in life, this is something that’s extremely easy to say in principle, but much harder to do in practice. The fact is, however, that being easier on myself is critical to my physical and mental health, and that vulnerability seems to be a significant key to achieving this.

I hope this post may be valuable to some fledging (or not-so-fledgling) consultants out there. I would highly recommend both “I suck, and so do you!” and Getting Naked if you are interested in learning more about the value of being vulnerable as a consultant. Getting Naked is particularly great because instead of writing his ideas in a standard business book format, Lencioni delivers his message through narrative, in the form of a fable. If you do read, please let me know what you think and what implications there might be for your own consulting practice!

For the second in this series, see Coping With An Addiction to External Validation.

“Will you be my mentor?”

It’s time to reconsider formal mentoring relationships and the need to have an official “mentor”. You simply can’t force mentoring relationships. The best relationships are those that grow organically over time and develop into a deep mutual respect.

When I first read Sheryl Sandberg’s book “Lean In”, the chapter on mentorship made me uncomfortable. Entitled “Are you my mentor?”, Sandberg argues that people who want to be mentored should never approach another person and ask them to mentor them outright.

I was pretty sure I had asked at least one person to do this in the past, and had certainly had people approach me with this question, so my first reaction was defensiveness: “Why is that question so wrong?”, I thought.

Upon much more reflection, I’ve figured it out: you can’t force a mentoring relationship. Unfortunately, many start out in this way, and therefore I encourage you to start off slow and grow your mentorship relationships organically.

The reason? Mentorship relationships involve humans, and humans are messy. To have a successful mentoring relationship, there has to be a strong bond between the two participants. They have to find each other intellectually stimulating, have compatible temperaments, and be genuinely interested in each other’s wellbeing.

I have had this fail in both directions. I have asked people to ‘be my mentor’ and later realized that we just weren’t compatible — it felt like their advice was coming from their place of truth, but wouldn’t translate to me. Likewise, I’ve had people ask for me to mentor them that I didn’t really gel with or see much potential in. Unfortunately, it’s incredibly hard to invest in a ‘mentee’ when you aren’t genuinely interested in their career development.

My point is this: if you’ve only seen someone speak at a conference, or met them briefly at an event, or have only seen what they produce online, you can’t possibly predict whether a bond will form between you. So why would you commit to having a certain type of relationship before you know if you’re compatible?

This isn’t to say that you shouldn’t reach out to people you find exciting and interesting. Not in the least! What I’m saying is that you shouldn’t try to formalize something too early (or perhaps, ever) before you actually know if you two are a good match.

My recommendation is this: consider starting — and keeping — things casual, until they potentially evolve into something more. If you’re interested in learning from someone, great! Approach them and ask them:

Would you be willing to go for coffee with me (or meet online) to discuss X topic?

It’s as easy as that. It’s best to give a specific topic so that the potential mentor can decide whether they have something of value to share.

Once you meet and start getting to know each other, that’s when you can start deciding whether this is someone whose opinion you’d like to call on again. But stop — this doesn’t mean you ask them to be your mentor at the end of the meeting! This is just where you gauge your mentor’s reaction. Ask them if they might be willing to do this again sometime. If the answer is yes, fantastic. This means that you should just file away a note in your brain that says, “Hrm, that was really helpful advice. Perhaps I will call on ________ to help me out next time I need assistance.”

Really, there is no need to formalize at this point. In fact, I would argue that there might never be a need to formalize. As long as you’re clear about whether the person you’re asking advice of isn’t feeling imposed upon, and is willing to continue giving their time, that’s all that matters.

The fact is that if you start calling on this person for advice periodically as you move through your career, and over time you develop a professional closeness and investment in one another: that person is your de facto mentor anyway. The more close you become, the more time the person will be willing to invest. There’s no need to ever even call them a mentor, necessarily. Doing so might put unnecessary pressure on a fragile human relationship.

Simply reach out to people you think you can learn from, whether they are ‘peers’ or people more senior to you, and see where the relationships evolve. I think you’ll be happy with the results!

(An aside: the key here is actually reaching out. Speaking as someone who has struggled with self-confidence and shyness in the past, I know how difficult this can be. But the more I’ve moved in user experience circles, the more I’ve realized what fantastic and giving people work in this field. Everyone is always on the look-out for new people entering the field who are motivated and bright. Know that if you reach out, you will almost always be welcomed with open arms. Try it!)

 

Toronto User Experience / Interaction Design / HCI Groups

All of IxDA Toronto‘s email comes to me, and I’d say a good 75% of it is from newcomers to the city, recent grads, or people investigating a career change. Everyone wants to know what UX resources are available in Toronto.

I respond to each query personally, but it has occurred to me that it would be good to have this kind of information up on the web – who knows how many people don’t think to email me, and go on unaware of all the great groups that meet in the city? How tragic.

So, here’s the list:

  • IxDA Toronto – the Toronto chapter of the Interaction Design Association

    (Since I help run it, I get to put it first.) :)

    IxDA Toronto meets roughly every month. We have no formal membership (absolutely everyone is welcome, whether they are an interaction designer or not), and events are always free. We try to have a nice mixture of workshops, panels, lectures, social events, and weird things like “Mentorship Speed Dating”.  We try to focus more on the design side of UX, but we really cover the full spectrum. After each event, we invite everyone to carry on the conversation at a local bar.

    To join: Register on the IxDA website, go to the IxDA Toronto page, and click “Join This Local” to get email notification of events, or follow us on Twitter.

  • TorCHI – the Toronto chapter of the ACM‘s special interest group on Computer-Human Interaction (SIGCHI)

    TorCHI runs a monthly lecture series focused on HCI topics, and they occasionally bring well-known UXers into town to run workshops. TorCHI’s presenters are a combination of leaders from industry as well as academia. They usually meet at the Bahen Centre at the University of Toronto.

    To join: Purchase a membership online. Says the website: “One year membership is CAD $20 and gets you free admission to our monthly events.  ACM Members can join for $15/year and students for $10.”

  • UXIrregulars – a long-running social group for UX professionals

    UXIrregulars is currently run by Kaleem Khan. It meets the second Tuesday of every month (a little less frequently when Kaleem gets busy) at a local restaurant / bar. Everyone is welcome – it’s a great place to chat with people in the Toronto community. I love pointing out that I got my first job through UXIrregulars!

    To join: Find out about events through the Google Groups mailing list.

  • UX Practice Group – an interactive UX training series

    Brad Einersen founded the UX Practice Group a year or two ago. He takes fledging (and more experienced) UX designers through a series of free tutorials about practical UX skills, like usability testing and creating personas. Events are held at Brad’s offices at Klick.

    To join: Sign up for the UXPG LinkedIn Group to be notified of events.

 

Any of these groups would be pleased to have you attend an event – please don’t be shy. If you have any questions (or ideas of any groups I’ve missed), let me know in the comments!

Omnigraffle Annotation Scripts Posted

After much delay, I finally got around to prettify-ing and posting the scripts I created to help me adjust my wireframe annotation dots in Omnigraffle.

Rather than copying yet another Usability Matters blog post over here, I’ll simply point you to the blog post:
Annotation (“Wireframe Dot”) Applescripts for Omnigraffle

I still have yet to write scripts for better managing the textual half of annotations in Omnigraffle… whenever I think I have an approach, Applescript throws up a barrier. But if people find these useful, perhaps I’ll prettify the ones I wrote for Visio back in the day as well (they are numerous).

I’d love any feedback you have – hopefully they are not too difficult to use. I may do a video tutorial at some point if they are tricky.

Apple’s Checkout: Credit Card Flaws

(Originally posted on the Usability Matters Blog on December 22, 2009.)

Every week I collect a bunch of recommended reads in my browser tabs, hoping for a few spare minutes to skim through them. This week, one such article was Luke Wroblewski‘s blog entry, The Apple Store’s Checkout Form Redesign.

I really enjoy how straight-forward Luke is with his analysis in this article (and everything he writes, his book being no exception). He includes fantastic examples from Apple’s previous checkout form and its new checkout form. However, having just purchased a MacBook online, I have to disagree with his positive assessment of Apple’s new credit card form.

The form is as follows (note I’m using the Canadian form here so it’s missing the Discover card):

As Luke explains, Apple no longer asks users to identify their card type (Visa, MasterCard or AmEx) up front. Because we can infer a person’s card type based on their credit card number, all we really need is that number.

This is absolutely true. We have been asking people to enter unnecessary information for years. However, the problem is exactly that: people are used to entering this information.  So when we get to Apple’s form, we eagerly look for a place to identify our credit card.

My brain while using the form: “Lo! Look at those shiny images showing card types! I will click on Mastercard, for that is my card type.

A re-enactment, in pictures:

And then:

Then, the loud sigh. I gave up and started typing my credit card number in. And then the form did this:

All other cards are greyed out, and my card type was magically highlighted.

I am sure that Apple included the card type images as a way of telling users what cards they accept, but the images seem clickable because they are a) images and b) in a place where the user would normally expect to interact.

If I were to redesign this form, I would let users interact with the images if they want to. Let them select MasterCard up front if it makes them happy, but switch to Visa in the end if that’s the type of card number they enter. Users who choose to identify their card up front will be happy, and users who don’t identify their card up front won’t know what they missed.

Anyone else have an opinion on this?

(Thanks to LukeW for the inspiration to write about this issue.)

Designing Online E-Book Readers

(Originally posted on the Usability Matters Blog on November 6, 2009.)

I have heard more about digital books in the past six months than ever before! CBC’s Spark (one of my favourite radio shows) has recently discussed the future of booksthe concept of open text books, Harlequin’s approach to e-books, and the Toronto Public Library’s Digital Bookmobile, which promotes the library’s e-book collection. CBC’s Ideas also recently ran The Great Library 2.0, a documentary about Google Books’ massive digitization project as well as its “competitor”, the Open Content Alliance. I’d highly recommend a listen.

After hearing e-books swirling through my podcasts, it was exciting to get the chance to work on an e-book reader interface. If more and more content is being digitized, it’s going to be critical to have good interfaces to help find these books, and to read through them.  Usability Matters is currently helping Ontario Council of University Libraries (OCUL) design a tool for doing just that. Over the course of the last year, we have helped OCUL run regular exploratory and evaluative user studies to better understand student and faculty needs with regards to e-books as well as online journal articles.

Part of our work has been to look at various online e-book readers (allowing books to be viewed with an internet browser on a desktop computer). Most online readers are nothing special, but when I encountered the Internet Archive‘s newest reader (released in April 2009) I did a double-take. This was the first e-book reading experience that actually felt fairly comfortable to me. The question is: why? I’ll look at an example using an old Eaton’s catalogue to explore more.

ia_ebook_reader_eatons_catalogue

Although there is a lot worthy of discussion on this page (some positives and some negatives, in my opinion) there are two features that stand out:

1. Ease of Paging Through the Book

Moving from page to page in the book is done simply by clicking on either facing page. Click the right page to move forward in the book, and the left back to go backward. This is a huge improvement over other online tools I’ve seen, as it uses direct manipulation, instead of forcing you to use paging arrows in a corner of the interface. (Note that this tool has paging arrows available as well — giving users options, and ensuring users who don’t discover directly clickable pages can still navigate the book.)

This “click to flip a page” mechanism is strong on its own, but is augmented by an animation of the page actually flipping over. One might argue this animation is unnecessary, but I find it provides a very strong sense of place: it is an elegant way of providing feedback to the user that their action was completed correctly.

2. Browsing Through the Book

The trouble with many online book readers is their precision. You must go through the book linearly, page by page, or else enter a page number to jump to directly. For me, however, a key activity when I pick up a book (particularly a non-fiction book) is flipping through it, getting a sense of its structure and content.

This reader is the first I’ve discovered that makes this browsing activity possible on the computer. Note that much like a regular book, you can see the edges of pages behind the pages you’re reading. You can mouse over these page edges, and flip to a different section of the book. You can’t go to a specific page this way, but you could flip roughly to the middle of the book, or close to the end. The lack of precision is the charm here. I of course could type a random number into a “Go to page” widget at the top of the page, but that takes work: both work to type, and work to come up with a random number. In this interface, I just click randomly. I love it.

ia_ebook_reader_eatons_catalogue_flip_pgs

The movement of these pages also helps create a sense of place for the user as they read the book. They can tell at a glance that they are halfway through the book, instead of having to process a series of page numbers (like “page 63 of 194″).

One of the most interesting things about my love for these interface elements is the fact that the eight users we studied were either uninterested in or ambivalent towards a two-page view of a book. This is likely because they are reading in an academic context, whereas my goal with the tool so far has been to browse interesting old books. Still, I am extremely curious how they will react when they see this version, and if it will change their minds about the merits of facing-page e-book designs. I’ll let you know how it goes!

The Design of Personal Security Questions

(Originally posted on the Usability Matters Blog on March 13, 2010.)

Personal security questions on websites have been de rigueur for quite a while now.

You know what I’m talking about. You answer some personal questions (à la “What was the name of your best friend’s aunt’s dog in kindergarten?”) on sign-up. Later on, if you forget your password to that website, you can reset your password by answering those questions.

Let’s stop and think about that for a second. Answers to a few personal questions are a direct path to your password on certain sites. (Is anyone else getting chills yet?)

Like passwords, personal security questions are an area where security and usability collide head-on. Attempts to make something more secure can often result in making it less usable. Unfortunately, all too often, sites fail on both counts, compromising both usability and security.

Let’s review some of the most common problems with personal security questions, and how to improve your use of them.

Usability Problems

Questions are not specific enough.

  • Example: “What is your pet’s name?”
  • How it can fail: Which pet? What if you have three cats, a boa constrictor, and five chickens in the yard?
  • Improvements: Ensure the question is as specific as possible, with only a single possible answer. This is still far from ideal, but one option here would be asking “What is your cat’s name?” or “What was the name of your first cat?”.

Answers to questions change over time.

  • Example: “What is your favourite colour?”
  • How it can fail: Favourites are pretty fluid things. It’s hard to remember what your favourite colour might have been when you signed up for that site. My favourite while I was at university was red, but now I’m quite partial to teal.
  • Improvements: Avoid questions about favourites entirely. If users have already answered questions about favourites, tell them the date when they answered the question.

Users don’t have an answer to the question.

  • Examples: “Where did you go on your honeymoon?” or “What was your kindergarten teacher’s last name?”
  • How it can fail: Not all questions will be suitable for all users. Many people aren’t married or didn’t honeymoon; others cannot remember their teacher’s name from when they were 5.
  • Improvements: Never force a user to answer a specific question — always give a wide variety of options, and think carefully about how many will be applicable to different sets of people (young people, middle-aged people, older people, single people, married people, people from other cultures, etc.).

Users provide answers that aren’t easily repeatable.

  • Examples: “What street did you live on when you were 10?” and “What high school did you attend?”
  • How it can fail: Although these are nice and specific, users may write an answer in one format when registering, and provide it in another format when challenged at a later date. Did I write “Main St.”, “Main Street” or “Main St”? Did I write “Stoneybrook High”, “Stoneybrook” or “Stoneybrook High School”?
  • Improvements: Try to avoid questions for which you can foresee repeatability issues, and, if you do use them, remind users to pay attention to format.

Security Problems

Answers to questions are easily guessed.

  • Examples: “What is your eye colour?” and “How many children do you have?”
  • How it can fail: Hackers know the most common answers to questions and will try those first. It doesn’t take much to guess “blue”, “brown”, “hazel” and “green”.
  • Improvements: Avoid questions where the answer is likely to be highly guessable.

Answers to questions are easily found online or in other public sources of data.

  • Examples: “What’s your birthday?” and “What high school did you go to?”
  • How it can fail: In the age of blogs, Twitter, and Facebook, a ton of information about you is available online. Beyond the most obvious data like your birth date (which most people would expect to be easy to dig up), it is easy to divulge something you think is private information but is actually easily accessible. This could be because you shared it online and forgot, or because someone else shared it online and you didn’t find out.
  • Improvements: Avoid these kinds of questions.

Improving Your Use of Personal Security Questions

  • Decide whether personal security questions are truly useful for your site. Would emailing a password reset link to an email address be sufficient for your needs? If you feel you must use security questions, try to avoid making them the sole gateway between a user and a password: instead combine them with some other security measure.
  • Always tell users the date they provided answers to their security questions.
  • Yahoo does this well:

yahoo_pvq_date_example

  • For instance, I planned to have my honeymoon in one city, but it got changed to a different city at the last minute. Knowing I answered the question in November instead of October makes all the difference in helping me answer the question correctly.
  • Consider implementing a CAPTCHA to prevent hackers from writing scripts to automatically guess answers.
  • Consider letting users fill in the blanks to make stronger questions. Mike Just describes this in his paper,Designing and Evaluating Challenge-Question Systems. Provide a question such as, “What is _______’s favourite food?” and let the user fill in a person of their choice.
  • Consider using an alternative challenge and response approach. In his paper, Personal knowledge question for fallback authenticationAriel Rabkin describes using images, e.g.  having users upload a picture and asking “What is the first name of the person in this picture?”. Other possibilities also exist.
  • If letting users write their own questions, give adequate guidance. Remind them:
    • To choose something very memorable (something they’ll still remember the answer to in 3 years).
    • To choose something that is fixed over time (favourites come and go, as do pets).
    • To choose something that is not easily guessable, particularly numerical answers. For instance, there is a fairly fixed set of answers to the questions “How many children were in your family?”.
    • To choose something that is not published online or in public records.
    • To try to choose something only they know the answer to. (This is extremely difficult. In lieu of this, encourage them to choose different types of questions, such that no one person knows or can find answers to all of the questions. Remind them that the person trying to get into their account could very well be someone they know.)
    • Why it is important to choose questions with secure answers (i.e. what the consequences are if someone manages to answer the questions correctly).
    • To not panic. Presenting all of this info and instructions can be overwhelming and scary.  Too much detail about security issues might be pretty discouraging. (And here’s the heart of the interaction designer’s challenge in this area – inform, but only enough.)

Sources and Additional Resources

If you’re responsible for the design of a personal security question system, I strongly encourage you to read (1) and (2) below – between them, Ariel’s and Mike’s papers cover everything I’ve talked about and more. (3) and (4) are more general-interest articles.

  1. Personal knowledge question for fallback authentication: Security questions in the era of Facebook (PDF) by Ariel Rabkin(SOUPS, July 2008).
  2. Designing and Evaluating Challenge-Question Systems (PDF) by Mike Just (IEEE Security & Privacy, 2004).
  3. Those Crazy Internet Security Questions by Kate Pickert (Time Magazine, September 24, 2008).
  4. ‘Forgot your password?’ may be weakest link by Bob Sullivan (MSNBC, August 26, 2008).

As always, I’d love to hear your thoughts on this topic.