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Elizabeth Bernstein, writing in the Wall Street Journal, astutely observes that the promise of Facebook and Twitter-to bring people closer by putting their lives online, with up-to-the-minute updates-can have the opposite effect. Many people, she writes, use "friending" and "tweeting" as a surface and synthetic way to talk about the fun outings they're planning or the fact that they just closed another sale at work.

"I'm tired of loved ones-you know who you are-who claim they are too busy to pick up the phone, or event write a decent email," Bernstein writes, "yet spend hours on social-media sites, uploading photos of their children or parties, forwarding inane quizzes . . . or tweeting about their latest whereabouts."

That's just the beginning from a psychological point of view. Facebook and other social-media "destinations" not only provide cover from more genuine and intimate human interactions, they can encourage people to present themselves as actors in their own semi-made-up life stories. They can remove people from reality, heightening their narcissism (which we all have, to a lesser or greater extent), making them not only self-obsessed, but intent on projecting a multi-media fictional representation of how happy and successful and social they are.

As Marshall McLuhan wrote, the medium is the message. There is no avoiding the fact that social-media sites call upon members to use a keyboard, hard drive and computer screen, together with photos, video and words to create evolving autobiographies for "broadcast" on the Web. This very process creates a kind of dual existence, consisting of one's real life and one's life on-line. The online version can pull people away from their deepest thoughts and emotions and relationships-from what constitutes their real selves-into the abbreviated or evasive or attention-grabbing kind that can be packaged for mass consumption.

This is more than an academic concern. It's a human and clinical concern. The distance between a person's contrived self and real self is the growing place for anxiety and depression. Today's social-media sites can expand that distance until, distracted too long from the noble and, ultimately, healing battle to understand oneself and others for real, swells of genuine emotion feel like tidal waves.

Indeed, I have already worked with several clients for whom using social media sites has, in and of itself, coaxed them away from the truth about their lives, toward a kind of technologically intoxicated vacation from it. Together, we struggle to take the journey back.

Anatole Broyard, the late and great NY Times book critic, once wrote, "Inside every patient, there's a poet trying to get out." We could now add that behind every Facebook profile, there's a real life story just waiting to be told.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His newest book, "Living the Truth: Transform Your Life through the Power of Insight and Honesty" has launched a new self-help movement. Check out Dr. Ablow's Web site at