mudcat.org: BS: Research paper! (finally)

COMMUNITIES ON-LINE

Can the internet help take up some of the slack left by inadequate

ÿmental health resources in our society?

ÿÿÿÿÿÿÿÿÿÿÿ According to David B. Goldstien (pp. 1-6), the ability of our society to adequately address the mental health care needs of its members has been severely compromised by the profit driven HMO industry.ÿ In the absence of quality mental health care, to what other alternatives are people turning in order to get their mental health needs met?ÿ This paper seeks to look at ways in which the internet is being used to compensate for this lack, particularly with regard to mental health issues that are not specifically related to major clinical disorders other than depression.ÿ This paper takes, as its focus, one particular on-line community.ÿ It examines what types of issues are being addressed, and in what way.ÿ It looks at current research on the subject of the internet and mental health to see how the activities of the individuals in this community fit into existing mental health paradigms, both on the internet, as well as in the "3D world.

"The goal (of psychotherapy) is to strengthen defenses, restore previous psychological homeostasis, reduce anxiety, and increase the tolerance for unalterable situations".ÿ Hollender and Ford (pp. 145-147) examine several approaches that can be used to accomplish these goals.ÿ In the context of supportive psychotherapy, the therapist can assist with the promotion of therapeutic optimism, assist with the promotion of reality testing, and help with problem solving.ÿ The therapist can also provide advice, provide an opportunity for catharsis, or ventilation, help to reduce feelings of loneliness and isolation, and to help promote the reduction of stress.

ÿÿÿÿÿÿÿÿÿÿÿ

The internet is such a new phenomenon that research into its possible benefits and/or drawbacks is still in its infancy.ÿ Questions are being raised about whether or not psychotherapy can be conducted on-line.ÿ The general consensus can be summed up in the words of Robert L Gluckauf, Ph.D. in Lisa Rabasca's article "Taking Telehealth to the Next Step: "We continue to lack basic information about how and under what conditions telecommunications-mediated services lead to positive psychological and health-care outcomes."ÿ Clearly, this is an area in the field of mental health that deserves scrutiny.ÿ In the meantime, while we await the results of current and future scientific research on this issue, we can explore the possibility that emotional and psychological benefits are currently being derived from Internet use by examining anecdotal reports.

ÿÿÿÿÿÿÿÿÿÿÿ This paper takes as its focus one particular on-line community called "The Mudcat Caf‚" (referred to in this paper as the Mudcat).ÿ The Mudcat is, ostensibly, a web site and on-line forum for people who share a mutual interest in certain kinds of music.ÿ However, a careful examination of the behaviors exhibited by those participating in this web site/forum reveals much more than just shared musical interest.

ÿÿÿÿÿÿÿÿÿÿÿ There are several levels of participation in the Mudcat.ÿ The most casual level of involvement is what is described as "lurking".ÿ Lurking is the practice of reading the contents of the web site and/or forum, but not communicating or participating in any way.ÿ The next level of involvement is the "casual poster".ÿ Casual posters are not members, and although they may post occasionally, they do not form bonds or establish relationships with other participants.ÿ One step up from the casual poster would be those who are members, but who behave, for the most part, like casual posters.ÿ Among members, there are many levels of involvement.ÿ Some people form casual acquaintances or close friendships, and some even carry the relationships that are formed within the Mudcat into their "3D" world, by getting together and socializing with other members in person.ÿ Conversely, some members carry some of their "3D" relationships into the Mudcat by influencing people they know outside of the Mudcat to join up as members.

ÿÿÿÿÿÿÿÿÿÿÿ As a means of gathering anecdotal information about what benefits, if any, the participants of the Mudcat might derive from their activities there, a "thread" (an ongoing conversation taking place outside of "real time") was started.ÿ The thread posed the question: "Do you feel that you are helped in any way, either emotionally, or psychologically, by your activities in the Mudcat?"ÿ Respondents were invited to elaborate on their answers if they wanted to.

Mudcatter #1 was a singer/guitarist who had lost confidence in his ability to perform before strangers and groups of people.ÿ He stated that he "had hardly even picked upÿ (his) guitar for nearly ten years.ÿ He reported that, after a year of participating in the Mudcat, he began making stage performances again after not having done so for twenty years.ÿ A little more than a month after his first performance, he:

"made a road trip covering thousands of miles with another Mudcatter.during which we each played for, as well as with, small groups of Mudcatters and made one coffeehouse performance and one large stage performance..Later we performed on the Mudcat Radio Show before a huge, international cyber-audience.

The point is that the Mudcat, (which is to say the people of the Mudcat), has given me the self-confidence and assurance to do all of those things.

ÿÿÿÿÿÿÿÿÿÿÿ The psychological and emotional benefits that Mudcatter #1 experienced could be put into the categories listed by Hollender & Ford (pp.145-147) as strengthening defenses, restoring previous psychological homeostasis, and reduction of anxiety.ÿ In supportive psychotherapeutic terms, Mudcatter #1 would appear to have received assistance with the enhancement of his self-esteem, the promotion of therapeutic optimism, and possibly some help with a reduction of feelings of loneliness and isolation.

Mudcatter #2:

During a time of not even high tragedy but only a sort of vicious loneliness, this has been a cyber-hearth of quiet good humor for me.ÿ Even those not tempest-tossed need to get out of the rain now and then, and I love the rain.

The supportive psychotherapeutic benefits that Mudcatter #2 may have derived from his activities in the Mudcat could be categorized as assistance with therapeutic optimism, and help with the reduction of feelings of isolation and lonelinessÿ (Hollender and Ford pp. 145-147).

Mudcatter #3:

Our innermost stresses and strifes can often be held in check, but at one point or another, to maintain any semblance of sanity, those feelings must be released..So we bring our lives here to share.ÿ We laugh, cry, complain, scream, worry.ÿ We express all those things which bring us both joy and sorrow.

Mudcatter #3 reported a period of hospitalization during which his wife received emotional support from her activities in the Mudcat:

She had fine, close friends and relatives surrounding her, but the first thing she told me when I was able to listen, was of the support she got from a group of people that neither of us had ever even seen pictures of.

ÿÿÿÿÿÿÿÿÿÿÿ In psychotherapeutic terms, Mudcatter #3 and his wife could be said to have received help with the restoration of previous psychological homeostasis, a reduction of anxiety, and an increase in tolerance for unalterable situations.ÿ The supportive psychotherapeutic benefits could be categorized as empathy, assistance with the promotion of therapeutic optimism, catharsis or ventilation, and assistance with the reduction of stress (Hollender and Ford pp. 145-147).

ÿÿÿÿÿÿÿÿÿÿÿ Mudcatters #4 and #6 both experienced crises involving family members.ÿ Mudcatter #4 "started a thread..not only did I get support to back up my (family member), but I got ideas & information as to how to go about it..armed with the love and prayers of countless Mudcatters in various states and countries".ÿ Mudcatter #6 reported that Mudcatters "literally saved my sanity..the support I received was unbelievable.ÿ It kept me going through 3 months of serious depression."

ÿÿÿÿÿÿÿÿÿÿÿ The supportive psychotherapeutic benefits experienced by Mudcatter #4 could be categorized as empathy, promotion of therapeutic optimism, promotion of reality testing, problem solving, providing advice, and reduction of stress.ÿ Mudcatter #6 could be said to have experienced an increase in tolerance of an unalterable situation.ÿ In terms of supportive psychotherapeutic benefits, this Mudcatter could be said to have experienced empathy, promotion of therapeutic optimism, and a reduction of stressÿ (Hollender and Ford pp. 145-147).

Mudcatter #5 was the victim of workplace bullying

Regardless of how stressed, how low my health and emotional wellbeing was, how much I thought I was going to break into tiny pieces there were two emotional/social contacts which kept me going: my fianc‚e.and the Mudcatters.ÿ I kept checking in here every day..gradually I started to unfreeze my sense of disconnectedness from other people.ÿ So, as I was starting to fight back against my tormentor I was being buoyed up by a bunch of people, the majority of whom I may never meet in person.

In psychotherapeutic terms, Mudcatter #5 could be said to have experienced strengthened defenses, and a reduction in anxiety.ÿ The supportive psychotherapeutic assistance could be categorized as enhancement of self-esteem, empathy, promotion of therapeutic optimism, promotion of reality testing, reduction of feelings of loneliness and isolation, and reduction of stress.

Twelve respondents reported emotional and/or psychological benefits as a result of their activities in the Mudcat.ÿ These benefits could be broken down as follows:

ÿÿÿÿÿÿÿÿÿÿÿ Enhancement of self-esteemÿÿÿÿÿÿÿÿÿÿÿÿÿ ÿÿÿÿÿÿÿÿÿÿÿ ÿÿÿÿÿÿÿÿÿÿÿ 2

ÿÿÿÿÿÿÿÿÿÿÿ Empathyÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿ ÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿ ÿÿÿÿÿÿÿÿÿÿÿ ÿÿÿÿÿÿÿÿÿÿÿ 9

ÿÿÿÿÿÿÿÿÿÿÿ Promotion of therapeutic optimismÿÿÿÿÿÿÿÿÿÿ ÿÿÿÿÿÿÿÿÿÿÿ ÿÿÿÿÿÿÿÿÿÿÿ 7

ÿÿÿÿÿÿÿÿÿÿÿ Promotion of reality testingÿÿÿÿÿÿÿÿÿÿÿÿÿÿ ÿÿÿÿÿÿÿÿÿÿÿ ÿÿÿÿÿÿÿÿÿÿÿ 2

ÿÿÿÿÿÿÿÿÿÿÿ Problem solvingÿÿÿÿÿÿÿÿÿ ÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿ ÿÿÿÿÿÿÿÿÿÿÿ ÿÿÿÿÿÿÿÿÿÿÿ 1

ÿÿÿÿÿÿÿÿÿÿÿ Providing adviceÿÿÿÿÿÿÿÿÿ ÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿ ÿÿÿÿÿÿÿÿÿÿÿ ÿÿÿÿÿÿÿÿÿÿÿ 1

ÿÿÿÿÿÿÿÿÿÿÿ Catharsis or ventilationÿ ÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿ ÿÿÿÿÿÿÿÿÿÿÿ 3

ÿÿÿÿÿÿÿÿÿÿÿ Reduction of feelings of loneliness or isolationÿÿÿÿÿÿÿÿÿÿÿ 8

ÿÿÿÿÿÿÿÿÿÿÿ Reduction of stressÿÿÿÿÿÿ ÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿ ÿÿÿÿÿÿÿÿÿÿÿ ÿÿÿÿÿÿÿÿÿÿÿ 3

ÿÿÿÿÿÿÿÿÿÿÿ If we look at these anecdotal reports as being success stories, we might want to try to isolate some of the characteristics of the Mudcat to see what makes it possible for it to be successful.ÿ In his article, "Starting a New Online Support Group", John M. Groholÿ states that:

Unlike anything else in the world, the Internet offers people the ability to connect personally with one another through self-help support groups covering a wide variety of medical and mental health concerns (p.1).

The Mudcat is not, strictly speaking, a self-help or support group, but it does share some important characteristics with such groups.ÿ Support groups are usually fairly specific in terms of the types of issues that they address, such as "depression", "panic attacks", "cancer support", etc. (Grohol, 1997 p.1).ÿ The Mudcat is not specific to anything.ÿ It has a general focus of shared interest in music, but it is an open forum, and people who post are free to discuss almost any subject they choose.ÿ However, as a community of many people with varied interests and experiences, it is not uncommon for many Mudcatters to have a mutual need to discuss a specific topic.ÿ For instance, there were several threads in the six-month period between July, 2000, and January 2001, that were specifically about depression.

Therefore, each thread about "depression" could be viewed as a support group for people concerned with depression, albeit a short lived one.ÿ One of the advantages of this type of setup is the ability of one participant to get many needs met in one site.ÿ One drawback might be that, in the thread at least, it is probably not possible to go into quite as much depth as what might be expected in a single-issue support group.

Cyberspace is great, but let's not underestimate the importance of in-person realities. ÿA healthy online group is one where at least some of the people know each other.ÿ It's one in which at least some of the people know about other peoples' real lives and identities.ÿ (Suler, 1996 p. 3)

In the Mudcat, participants can decide on the degree to which they want to integrate their Mudcat life with their in-person, or 3D reality.ÿ Some people prefer to remain largely anonymous.ÿ However, many participants choose to integrate the Mudcat with their 3D life to the extent that there are Mudcat gatherings happening on a regular basis in locations as far flung as the United Kingdom, Canada, many parts of the United States, and Australia.ÿ Mudcatters often develop friendships over the telephone as well as in person.ÿ It is not uncommon for multiple members of one family to participate together in their Mudcat activities.

Participants frequently remark upon the sense ofÿ "community" that they feel characterizes their experience of the Mudcat, and many even report feeling a sense of extended family with the Mudcat community.ÿ Perhaps, in such an environment, it becomes easy to share the kinds of personal experiences that foster a sense of feeling supported and helped.

While the Mudcat appears to have been very helpful for some people in getting some of their emotional and/or psychological needs met, this type of setup is not without its pitfalls.ÿ As an open forum, the Mudcat is susceptible to "trolls" and "flamers".ÿ These types of people prey upon emotionally needy, or vulnerable people.ÿ Some people have reported intensely upsetting experiences as the result of being victimized by trolls and flamers to the extent that they have felt the need to stop participating in the open forum.

Suler (p.2), describes people who: Act out in cyberspace - who are in some way hurting or violating the rights of others, or hurting themselves - are usually discharging some negatively charged aspect of their psyche.

In an open forum, it is not possible to screen out these types of people, so an on-line community like the Mudcat may be a very counter-productive setting for people with some kinds of emotional and/or psychological issues.

ÿÿÿÿÿÿÿÿÿÿÿ

Some mental health professionals are concerned with the possibility of "Internet Addiction".ÿ Therefore it would be appropriate to include some discussion on this issue in this paper.

What IAD is is difficult to define at this time.ÿ Research to date has been composed exclusively of exploratory surveys, which cannot establish causal relationships between specific behaviors and their cause.

Do some people have a problem with spending too much time online?ÿ Sure they do.ÿ Some people also spend too much time reading, watching television, and working, and ignore family, friendships, and social activities.ÿ But do we have TV addiction disorder, book addiction, and work addiction being suggested as legitimate mental disorders in the same category as schizophrenia and depression?

Since the aspects of the Internet where people are spending the greatest amount of time online have to do with social interactions, it would appear that socialization is what makes the Internet so "addicting".ÿ (Grohol, 1999 pp. 1 & 4)

In her article, "Is Internet Addiction Real?", Tori DeAngelis (p.1) Quotes David Greenfield, founder of the center for Internet studies, as saying that the internet is "a socially connecting device that's socially isolating at the same time".ÿ Greenfield adapted criteria for compulsive gambling, not a socially interactive activity, to use as his criteria for Internet addiction.ÿ This has caused some discussion about the legitimacy of his findings.

ÿÿÿÿÿÿÿÿÿÿÿ "But for now, this and other questions about internet use will remain unanswered until more controlled studies are done, critics say"ÿÿ (DeAngelis, p.3).

ÿÿÿÿÿÿÿÿÿÿÿ It is clear, from the amount of interest that has been generated in the mental health profession, as well as the general public, about the benefits and pitfalls of the internet, that much research needs to be done.ÿ It is also clear that some people are using the internet to get emotional and/or psychological needs met.ÿ The Mudcat Caf‚ presents a very interesting, and possibly enlightening subject for researchers who would want to establish the possible legitimacy of the internet as a way for people to fill in the gaps left by the scarcity of adequate mental health care in our society.

Goldstien, D.B. (1999, September).ÿ The Starvation of Our Mental Healthcare System.ÿ Psych Centralÿ (Internet Mental Health Directory).

Grohol, J.M. (1997, September).ÿ Starting a New Online Support Group. Psych Centralÿ (Internet Mental Health Directory).

Grohol, J.M. (1999, February).ÿ Internet Addiction Guide.ÿ Psych Centralÿ (Internet Mental Health Directory).

Hollender, Marc H. & Ford, Charles V. (1990).ÿ Dynamic Psychotherapy: An Introductory Approach.ÿ Washington, DC: American Psychiatric Press.

Rabasca, L. (2000, April).ÿ Taking Telehealth to the Next Step.ÿ Monitor on Psychology, 31, p.1.

Suler, J. (1996, May).ÿ Identity Management.ÿ Psychology of Cyberspace.

Suler, J (2000, July).ÿ Maximizing the Well Being of Online Communities.ÿ Psychology of Cyberspace.