Psychotherapy in Cyberspace

Marina's picture
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           The internet and its vast connections across the globe have allowed for an unprecedented flow of information, communication, and technology that has never been matched before in terms of speed and volume that these connections operate. As a result, psychologists have begun to explore cyberspace as a viable platform for psychotherapy and clinical work. Cyberspace psychotherapy offers many improvements from face to face psychotherapy. Most obviously, cyberspace would increase the availability of psychotherapy to those who are not physically able to reach a psychologist and sessions over the net would make geographical boundaries disappear, instantly making psychotherapy available to people in countries which lack such psychological services. Cyberspace, however, also leads to many ethical questions regarding psychotherapy due to its insecure nature and lack of regulation. Psychotherapy sessions online would occur via video or voice services over the internet such as Skype or through text communications such as email, discussion forums, or chat rooms. Video conferencing seems to be the most promising of these forms as it provides the valuable face to face experience that is crucial in psychotherapy- subtle facial and vocal expressions may reveal more than any text communication would ever be able to reveal. Additionally, psychotherapy sessions via text are questionable in terms of security and reliability. These emails and discussions that take place between the client and therapist could possibly be accessed by a third party endangering the patient’s privacy and threatening their success in treatment. Additionally, text communications offer little verification of who one is actually communicating with- how does the therapist know the client is who they say they are? How does the client know the therapist is actually a therapist? Is the client presenting their real-world identity in treatment or their virtual identity? These ambiguities of text communication via cyberspace could very negatively affect the efficacy of the treatment (Suler 1). Psychotherapy sessions using text platforms over the internet could possibly be improved by using secure networks, encryption, or even user verification software. However, clients of cyberspace psychotherapy using these platforms still risk their information being accessed by hackers.

           Many psychotherapists are turning to online platforms as an option for effective group therapy. These groups can be formed through mailing lists, discussion boards, instant messaging, or even virtual worlds such as Second Life. Online support groups offer flexibility and the ability for people with similar problems and concerns to come together for group therapy sessions despite their geographical location. The virtual worlds of online communities in Second Life are therapeutic in terms of discovering and altering one’s online identity possibly allowing them to learn more about their own real-world identity and give them a chance to work through these personal issues in a safe, anonymous virtual world. One user cites these virtual worlds as his platform for self exploration, “This community is like training wheels…I try out new ways of being, and then I apply it to my real life” (Suler 1). Online communities also seem to be efficacious in terms of group therapy as the anonymous online forum can help to alleviate the stresses of revealing personal information face to face with strangers. Many people even interact differently and more openly online than they would in person, this is called the online disinhibition effect. This self-disclosure that results from online disinhibition allows individuals to quickly reveal their personal problems, emotions, and fears that would be more difficult to access in a face to face environment thus increasing the group cohesion and bonding in these online communities. However, online disinhibition can also impact group bonding negatively as it can lead to threats, rude language, and harsh criticisms that are experienced much less in a face to face environment.

Online depression forum:

online depression forum

           Physical presence of other people can sometimes be intimidating and result in shyness and lack of courage to speak one’s mind therefore an online community would abolish this phenomenon and could encourage more open and stimulating dialogue among group members. Group members would communicate entirely in text and would not know anything about one another’s appearance which increases disinhibition effect as the group members would not have to focus on how they appear or sound to other members but instead they would redirect that focus onto opening themselves up to other group members.  As John Suler points out, “In everyday relationships, people sometimes avert their eyes when discussing something personal and emotional. It’s easier not to look in the other’s face. Text communication offers a built-in opportunity to keep one’s eyes averted.” (2). Additionally, text communications offer asynchronous communication and delayed reactions that can elicit further disinhibiting effects. Immediate reactions in face to face communication can be inhibiting and difficult to process after a cathartic revelation about oneself.  Immediate, real time feedback from others can often influence how much one reveals about them self. It seems that asynchronous communications through discussion forums and email allow group members to reveal more about themselves and work towards deeper expressions of their emotions as they can post what they want to share and then wait for a response, giving them time to process their own emotions. Once a response is received, they don’t have to answer immediately and can again have time to process the response allowing them to successfully manage their emotions under such highly sensitive conditions of self-disclosure (2).

           Another positive attribute of online group therapy is a phenomenon coined “solipsistic introjection” which is used to describe how one processes text communication in their mind and assigns what they imagine each person they communicate with via text looks like and sounds like. Suler explains, “Another group member then becomes a character within one’s intrapsychic world, a character that is shaped partly by how the person actually presents him or herself via text communications, but also by ones expectations, wishes, and needs.” (2). These identities assigned within one’s head to the other’s in the online group increase disinhibition as the text conversation begins to be an occurrence that is happening within one’s own mind and therefore should be safe to say anything. Solipsistic introjections phenomenon can improve group empathy, bonding, and identification with other group members. Another important feature of psychotherapy in cyberspace is its ability to neutralize status. The anonymity of online chat rooms and forums has no place for the status symbols of the real world such as expensive clothes that may be an inhibiting factor when it comes to self-disclosure. Online therapy provides a platform where everyone is equal, everyone can share, and everyone has access and influence where respect is earned not through one’s education or wealth but through their ability to communicate with other group members and the quality of the advice and ideas they offer other group members.

          Psychotherapy in cyberspace seems to be promising in terms of group therapy for its ability to provide a free, open, and anonymous space for people all over the world with similar concerns and problems. Individual therapy seems to be less successful when applied to the internet as it lacks many of the subtle facial and vocal expressions that are so crucial to therapists when reading their patients. The lack of facial and vocal expressions in group therapy, however, is beneficial as they disinhibit group members since they do not receive the immediate reactions from other group members.

 Suler, John. "Online Therapy and Support Groups." Psychology of   

           Cyberspace. Web. Apr.-May 2011. <users.rider.edu/~suler/psycyber

           /therapygroup.html>.

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Comments

Anne Dalke's picture

Cybertherapy

Marina--
As with your last paper, I'd nudge you, in this one, to locate yourself in relation to the phenomenon you are studying. For starters: have you done psychotherapy yourself? On the internet and/or off? As a patient and/or practitioner?

Your exploration of cyberspace as a platform for psychotherapy is a fascinating one, which gives a particular piquancy to questions we have been asking in this class about the performance of self (or false self, or some variant of self) on-line. I hadn't heard the term "online disinhibition effect" to describe a phenomenon I know very well, and it's interesting for me to think along with you about the ways in which it could both lead more easily to self-disclosure, as well as to dangerous or non-productive forms of expression. I'm also intrigued, along these lines, by the observation that "text communication offers a built-in opportunity to keep one’s eyes averted.” I could imagine, too, that asynchronous communication could be either disinhibiting, as you say it is, or inhibiting; I have colleagues who aren't much interested in the internet, for instance, because of the frequent absence of response to a posting: they need to be more clearly "seen" and "heard."

But I guess the phenomenon that most intrigues here is "solipsistic introjection," or turning others into "characters in our own intraphysic worlds." You say this activity improves "group empathy, bonding and identification with other group members"--which I find hilarious, since such bonding occurs only by shaping others in accord w/ one's own "expectations, wishes, and needs." One bonds, in short, w/ oneself, not with others' troubling "other." I'm curious, too about the claim that the the internet "provides a platform where everyone is equal, everyone can share, and everyone has access and influence." Clearly this is not the case: a basic difference in the ability to communicate (access to English? or to a computer?) quickly destroys any illusion of equity.

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