Cyber-Therapy, Driving Therapy, and Counter-Culture:

Finding Help on the Internet

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When the idea of cyber-therapy was first proposed to me, I thought, "What a stupid idea. What about the face-to-face interaction between client and therapist? What about client confidentiality? Won't there be a lot of other people that may have access to private information?" Nevertheless, after examining this concept further, I thought that it may not be that bad of an idea. For those who wish to reach out to others about minor problems in their lives, cyber-therapy may be of some help. I suppose that is why radio advice talk shows are so popular.

There are many different sites these days offering therapy on the Internet, and the idea of cyberpsychology has been under scrutiny by professionals and nonprofessionals alike. I have been asked to examine a few different types of therapy on the Internet, and provide my opinion on what I think as an undergraduate student in psychology. This paper will analyze four sites offering psychological advice via the WWW (three of which are profit-based). Contrasting the concept of pay-as-you-go cyberpsychology, I will examine cyberspace counter-culture as an alternate form of therapy.

I would first like to address the concept of psychotherapy. From my point of view, psychotherapy may be necessary when an individual's situation or behavior is unacceptable either to themselves or to the society within which they live. With this in mind, therapy, therefore, would be necessary only when the individual or society deems it necessary. "When a person's behavior tends to conform to prevailing social norms, that person is not likely to come to the attention of mental health authorities. But when behaviors becomes patently deviant, outrageous, or otherwise nonconforming, then one is likely to acquire a special label."* [Here would could debate the issue of conformity to the norm, however, this is a topic for another paper.] Cyber-therapy would therefore only be able to cater to the individuals who see their own situation or behavior as unacceptable to themselves.

Therapy for a mental illness/problem may involve simply "getting something off your mind" via writing it down or talking to someone or something. It may also involve the prescription of certain drugs or, in some cases, undergoing surgery. The difference here, obviously, being biological. This brings up a point regarding the classification of cyber-therapy. How would the cyberpsychologist know if the individual seeking assistance does not have a somatic disorder? Would it be safe to say that cybertherapists should be required to obtain histories on every e-mail they receive? It is highly unlikely that anyone would put that kind of information over the Internet anyway! Therefore, it would be logical to assume that cyber-therapy should be limited to minor problems, with the brunt of responsibility being on the client and the therapist's common sense.

As part of my assignment, I was asked to examine two sites which offer cyberpsychology as possible therapy. The first one, On-Line Emotional Fitness, written by Tom Raymond, MSW, "relies on Participation Theory". This theory is based on social learning principles, and therefore can be categorized along with those such as Bandura, Mischel, Rotter, Dollard & Miller, etc. I found nothing really "new" in reading this theory, but it was easy to read and understand. The semantics involved, however, were rather confusing. For example, 'Participation Theory defines intimacy as the closeness and camaraderie that's created when partners are able to satisfy each other's needs. While partners who are intimate may "love" each other people who love each other are not necessarily intimate.' [taken from this article] Why is there not a definition for "love" included as well? What am I to compare intimacy to? Basic themes, however, are prevalent throughout this theory, and good advice is apparent such as, "Coordination is just as difficult a skill to master...partners must provide each other with constant feedback in order to avoid collision." [also taken from the article] Once again, communication is essential in any relationship, including those between the self, family, partners, and the therapist. It is not at all harmful for one to communicate basic problems to cybertherapists such as Tom Raymond, however, as a student of psychology I know that certain types of therapy are more effective than others in the treatment of various problems/disorders.

As indicated earlier, the topic of on-line therapy has been under scrutiny -- especially those which charge for advice. The following are examples taken from public e-mail sessions:

THE GOOD

"The above paragraph from Laurie really hit home with me. I think the popularity of all types of on-line communication has much to do with the disembodiment issue....especially for women, who strive unsuccessfully) to be accepted for who they are, not what they look like...With on-line communication, all the "undesirable" physical attributes are removed whether they be physical infirmities or visual imperfections."

"...while on-line psychotherapy may or may not be good for various types of problems, I think there would be a great benefit for those who have negative body images for whatever reason. So that the patient would learn ways of interaction that are not tainted by the physical impression he or she expects to make. It is a difference, I think, between seeing oneself as a subject rather than as an object. People with poor body images, I think, tend to see themselves as the objects of another's critical gaze rather than as the subject looking out."

"On line psychotherapy may be a really bad thing compared to conventional therapies. Conversely, it could be a really good thing. Anonymity is very high on the internet, and that may bring people to open up to an Net. therapist. However, if someone does not wish to face a particular issue, it is much easier to lie in a e-mail than to lie face to face...it is much more difficult to tell! On-line personas and such may protect the person from making any real progress. However, from my personal experiences on Interacting on IRC, I have made a few friends that I tend to be much more open to...but if I don't wish to talk about something I don't. In person, it is much harder to avoid something without giving some indication that you are indeed avoiding it."

AND WITH THE GOOD COMES
THE BAD

"...thanks for taking the time for taking on this incredibly uncomfortable subject. I, for one, have had an overwhelming uneasiness about providing therapy over the Internet, and especially the thought of charging 'the going rate' for something that is essentially unproven. I am a social psychologist in a school of public health and research the efficacy and usefulness of using technological applications, including the Internet, for providing health education. Knowing how little we know about this medium, I think we are misleading the general public who might truly be in need of therapy by having them assume that Therap-e-mail is effective. I have yet to see any kind of empirical study (or even serious anecdotal comments) that leads one to assume that charging for therapy via the Internet at this point is anything more than a money-making venture."

I wouldn't touch it with a ten-foot pole

I'd say this is a con game.

"Has anyone heard of the Institute of ________ [name & Internet address omitted]? This service charges $100 for a 30-minute on-line consultation in real-time with a "transcendent analyst" (none of whom are mentioned by name). It concerns me because while there is no data supporting the validity of on-line therapy as of yet, promises (or at least implied promises) of results are made... ______ [name omitted] also offers a ten percent discount on sessions with the purchase of a $300 membership to the institute, which brings with it the status of "priority client". This practice of placing a higher importance on the welfare of a client who purchases a product than that of a client who does not seems questionable on ethical grounds."

'Something tells me that the $100 pricetag will take care of itself... I would be *very* surprised if they had any responses... Maybe they should have a disclaimer like the 1-900 psychic lines: "For entertainment purposes only"?!'

"This definitely sounds like a con game. Although, I can think of better words. Can't something be done about this?"

In contrast to the pay-as-you-go cybertherapists, I found Internet Mental Health to be very useful to professionals and nonprofessionals alike. This is a no-nonsense, information-based approach to seeking answers to common mental illnesses. They claim to be a FREE "encyclopedia of mental health information," and with to "freely share whatever information we have on mental health with the world." Beginning as a collaboration between Japan and Canada, Dr. Phillip and Brian Chow have developed a huge database of mental health information including the 50 most common mental disorders, 65 of the most common prescribed psychiatric medications, published articles, diagnoses, etc. This site has also been awarded with 13 Internet awards , including HomePC 500 Best Web Sites, NetGuide Platinum Site, and the Net User 5 Star Award. This is a great site for gathering information regarding almost any type of mental illness, however their diagnosis process may be a little too advanced for many who don't know under what category their illness/problem may lie. Minor problems of a social nature would be better answered in psychological forums or chat rooms.

In discussing these different approaches to on-line therapy with friends and classmates, most agreed that the information-based site would be their choice because of it's objectivity in reporting. Most also agreed that cyber-therapy via On-Line Emotional Fitness was more of a "Dear Abbey" type of site, indicating that his advice was not particularly valuable. A friend indicated, "It makes you feel kinda warm and cozy, but doesn't really offer anything concrete. I am not really impressed by it, and I certainly wouldn't pay for it. Writing to Ann Landers is free." Comments were also made regarding his suggestion of medication as a possibility to a cure for depression, however as he is not a psychiatrist they felt it was wrong. We did not experiment with his site due to it's monetary nature. We did, however, run through Internet Mental Health's diagnosis questionnaire for nicotine addition. We were both impressed by the option of "Self-Diagnosis" -OR- "Therapist Diagnosis" (choosing self-diagnosis), and after answering a few questions we were supplied with a list of possible treatments. Treatments included not only psychotherapy, but medical and psycho-social arenas as well. "This is far more useful, and it doesn't pretend to be any type of real therapy. The first thing it told you was what it is NOT, which is very positive for something on the Internet [referring to their claim that they are not a substitute for professional therapists]."

Two sites which are specifically geared toward the act of driving include Dr. Sy Cohn, a.k.a. The Driving Therapist, and Dr. Leon James, a.k.a. Dr. Driving. Here again are two different approaches to therapy on the Internet: (1) transpersonal, and (2) self-witnessing. Transpersonal psychology, for those who are not aware, can be defined as, "...the study of humanity's highest potential, and with the recognition, understanding, and realization of unitive, spiritual, and transcendent states of consciousness." [D.H. Lajoie & S. I. Shapiro, Journal of Transpersonal Psychology, 1992, 24, p. 91] This can be seen in Dr. Cohn's following section:

BNT NOW (Be in the Now)

I call this "whatifitis." We all need to learn to stay in the now. What happened a second ago is gone; what could happen a second from now, may never happen. All we ever have control of is now -- this moment. When you focus on your breathing you can't help but stay in the now. You're doing that every second you are alive but unaware of it, until you stop doing it. The greatest stress the body gets is not receiving enough oxygen when it needs it the most! (when you are under stress)".

Self-witnessing -OR- self-monitoring, on the other hand, comes from social psychology, and involves, "Focusing on one's own behavior in a given social situation."** The differences in the two techniques are apparent in their varying disciplines. For instance, while Dr. Cohn recommends a change in life style (including what type of foods you should eat, etc.), Dr. James recommends simply becoming more aware of yourself through self-observation. I am partial to Dr. James' methods due to the fact that they are logical and involve examining yourself in a rational way. His Nine Zones of Your Driving Personality quotes, "...we need to continue to be involved in driving self-improvement. Traffic psychology is a continual educational effort and a lifelong involvement." This is very true, as once an individual learns how to drive they tend not to think about their driving style and overall driving skills. It has been my experience that drivers tend to be very under-skilled in the physical act of driving, yet highly overconfident in what little abilities they do have (e.g., speeding in the rain, tailgating, etc.). On the other hand, Dr. James indicates in Positive Zone 2 that drivers should mentally rehearse and, "correct action sequences or principles of good driving." This is something that takes professional race car drivers a lifetime of training and instruction to accomplish, and I wonder how complete a result a self-directed driver can actually achieve. People are not in the position to rehearse certain situations on a regular enough basis for their responses to become automatic rather than conscious [for example not touching the brakes if a car wants to spin (despite what your driving instructor may have told you)].

As I haven't heard his self-help tapes (again due to monetary reasons), it is very hard for me to comment on Dr. Cohn's entire program. The Driving Therapist, I believe, was intended to help those individuals who are already suffering from an anxiety or stress related disorder, using words such as obsessing, nightmares, and twitches. His technique is very holistic, requiring not only mental changes, but physical ones as well (even requiring a car "survival kit" for those emergency stressful times). There are obvious things within his brief synopsis which I would NOT recommend. For instance, Dr. Cohn suggests that anxious drivers should, "Imagine a white light of energy inside of you, it feels warm and nurturing, now it's expanding around you and around the car for protection." However, this appears to be a falsehood, as if he is asking the individual to lie to themselves. As we all know, a car is considered to be a weapon (literally and legally), and no amount of assurance will change that fact. Those who drive have been given a privilege, which should be taken seriously.

I should also point out that I DO NOT DRIVE, and I haven't driven a car in well over five years (the reasons for which are NOT psychological in nature). Therefore, I am not a very good analyst as to what problems drivers may encounter today.

Cyberspace Counter-Culture:
The Acquisition of Knowledge Should Be Free

So, who do you turn to when you have a problem you wish to get off of your mind and don't agree with cyber-therapy as a form of treatment -- especially if you have to pay for it? And why not pay for it? My classmate, Marini Singh (who is very intelligent, yet not as thrifty as I), believes that, "...consultations for couples, individuals, and families...are never greater than $60.00" is a good deal. As indicated in my subtitle, I believe that the acquisition of knowledge should be free, and that individuals should have the right to free speech. Steve Mizrach's (a.k.a. Seeker 1) article Technology and Transgression, expounds this further in relation to the radio underground:

"Radio pirates often laugh at the hypocrisy of an agency like the FCC, which sells off the airwaves to the highest bidder (when they are supposed to be public property), yet protests "spectrum scarcity" as the reason for shutting down pirate radio. Ham radio is allowed: it's OK for one-to-one communication using packet or pre-approved bands, etc., but you've crossed the line when you dare to transmit to large numbers of people - then you need to be profitable."

Many people simply join a counter-culture community and reflect their annoyances, problems, gripes, etc., within these groups. What better source of therapy than having the opportunity to say anything you wish about anything in basic anonymity -- letting those who want to hear/view what you have to say should they wish (or not wish). Would we be responsible as a race to let individuals do and say anything they wish? Mizrach makes a good argument: "...people have sought ways to communicate internationally without filling the coffers of greedy telecommunication monopolies. What should be more free (both in terms of regulation and cost) than the right to hear the voice of another?"

But what about the computer underground -- those "crypoanarchists, hackers, virologist, [and] phreaks" who utilize the Internet sometimes for criminal feats. Virologists (those who create those nasty viruses for no apparent reason) would be assumed to be the worse. Why do they do it? Your guess is as good as mine. However, there are easy ways to get to these viruses even if you don't know how to build one. Those responsible hackers at Hack The Planet, put up a huge disclaimer in the event of legalities, and with 32354 visitors, this site is VERY, VERY popular. From this site, you can download various "Virii", including a virus creation lab, and even "AOHELL" -- the virus we were warned about by Dr. Leon James! Other miscellaneous downloads include The Hemp & Marijuana FAQ, which boldly states "Marijuana is not a Drug". I agree, however, with Mizrach, who states, "...the guiding principle behind the computer underground seems to be the Hacker Ethic of total open access to technology. People have a right to know the ins and outs of the systems they use, whether those systems are the phone network or the underground tunnels of a university."

Freedom of speech is also not limited to those so called "occult technologists" -- those groups which tend to utilize technology for the advancement of fantasy. Mizrach indicates that he is, "...really fascinated by the degree to which these people see no cognitive dissonance between high tech and the occult." I guess I never looked at it that way before, but it certainly gave me a chuckle. "In a century where so many limitations have given way to technology, is it surprising that we are seeing extropians, transhumanists, New Agers, mixing technology and unabashed romantic idealism?" Apparently there is a hierarchy of technological amplification which is allowed within these subgroups as well. For example, the Global UFO Network, with a whopping 2632 visitors since Feb. 97, would like to make sure that individuals visiting their site know the facts about Hale-Bopp (possibly wanting to stave away the bad publicity caused by Marshall Applewhite). "The nucleus of Hale-Bopp is 25-60 miles across and made up of layers of dust and ice. The core is possibly made of silicate dust. The gas given off forms a thin, straight tail, pushed away from the Sun by the charged particles of the solar wind. The dust also forms a tail, in this case its a wide and yellowish colour which is deflected by photons in sunlight and curved because the comet is in motion." No mention of any UFO in the tail -- and these guys are the "experts" on UFO's!

Nevertheless, cyberspace counter-culture does allow individuals the privilege of speaking their mind, even if it is against the "norm". We should not consider these communities to be anything but sources of information to be added to, ignored, or debated. By limiting what can and cannot be said on the Internet, we are limiting ourselves (and this would be a shame). As well, these counter-cultural communities can be very liberating psychologically, and therefore could also be looked at as a form of therapy.

In the end, doing anything via the Internet IS therapy in most instances. As you will recall from my first report, "cyberspace is like the mind -- an endless expanse of thoughts, feelings, and emotions -- and in utilizing it we are considered to be in a virtual reality." However, '"virtual" may be the wrong word to use'; suggesting instead "alternate" or limiting the phrase to more specific on-line interactions (such as going through an AutoCAD rendering of a house or playing an RPG). Whether you utilize cyber-therapy sites, join a cyberspace counter-culture community, or do ANY form of composition on the net or via the airwaves, you are still conveying thoughts, feelings, and emotions to others -- even if no one hears or reads it. These acts alone may constitute therapy. I think individuals should realize that the Internet is simply an extension of reality, and, as in reality, one should use their common sense and intelligence in making conscious decisions regarding the communities they wish to join and the advice they wish to accept.

*Taken from Clinical Psychology: Concepts, Methods, and Profession, E. Jerry Phares, 4th ed., 1992

**Taken from Social Psychology, Irwin A. Horowitz & Kenneth S. Bordens, 1995

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