A Freudian Screening of Group Tours and Internet Etiquette

In conclusion . . . in a moral point of view, the effect ought to be, to teach him good natural patience, freedom from selfishness, the habit of acting for himself, and of making the best of every occurrence.
–Charles Darwin, The Voyage of the Beagle

The people on any of the TCI trips I have gone on so far all have been very compatible. The group dynamic was terrific and the team spirit was high. We rolled with the punches, mixed with the crowds and tried everything we could.
–Helga Berry Jordan, 2008

Many have lamented the etiquette of some Internet communication, including Ronald Pies, MD. on this Web site. In his blog, “The Eight-Fold Path of Internet Ethics: A Primer for Health Care Professionals,” Dr Pies provided 8 important recommendations for ethical online conduct between colleagues.

You would think that those in mental healthcare would have the best online communication, wouldn’t you? Isn’t some of our expertise in communication, in knowing just when to make the carefully worded interpretation? Nevertheless, at least some of the mental healthcare sites that I have frequented still leave much to be desired in terms of Internet etiquette. Fortunately, some sites refuse to take anonymous or hateful comments, so we never see them. On occasion, I have stopped posting or commenting because the comments continued to be conflictual, rather than a constructively critical nature that leads to dialogue. On one site where I tried to blog and construct a dialogue with critics of psychiatry, I received comments from both men and women, such as, “Throw Dr Moffic under the bus” and “Death to all psychiatry.” My wife took that more literally than I did, understandably so.

As far as I know, such mean-spirited comments didn’t adversely affect my spirit. But such comments on healthcare sites seem to pale in comparison to some others. We know that the vulnerable are vulnerable to their negativity. Some would argue that cyber-bullying has led directly to many teen suicides, as has also occurred with homosexuality. More subtle traumatic damage is yet to be researched adequately. Apologies seem rare, as does asking for forgiveness.

If he were still alive, I doubt that Freud would be a bit surprised at this situation. Recall that Freud ideally wanted the analyst to be a “blank screen” to the patient. The analyst would even sit behind the patient’s head, unseen. Nothing much was to be shared about the analyst’s life. The rationale was that it would provide the patient an open and safe communicative space to access the unconscious, especially repressed sexual and aggressive feelings and fantasies. Of course, nowadays much can be learned about a therapist before ever coming to treatment, given online resources, therapist ratings, and open electronic records.

The “blank screen” today may rather be thought of as a perversion of sorts of the psychoanalytic one. If anything, the anonymous posters, or those with pseudonyms, are unknown, a blank screen to other posters. Even the recipients of their communications are relatively unknown as real people. Computer or mobile phone screens are rarely blank. Freud likely would have predicted that this bubble of anonymity, without real-life punishment, would be an ideal space to unleash sexual and aggressive feelings or fantasies. Consequently, I would think that Freud would want society to set up some controls to help-in his language-our egos manage our ids.

Such modern day reflections of Freud’s theory seem to be confirmed in a study of Weibo, the Twitter of China, which found that angry messages spread faster than any other kind of emotionally toned ones. The lack of live face-to-face communication seems to make it easier for many to feel entitled to express aggression.

Take this example. The cover of the January/February issue of the Pacific Standard shows a woman looking at a phone, reading her cell phone:

You are going to die
And I am the one
who is going to kill you
I promise you this.

The story, “Why Women Aren’t Welcome on the Internet,” by Amanda Hess, is laced with threats of rape and other violence to women. Studies indicate that the most threatening online messages are by far disproportionally sent to women. Some (men usually) try to counter that claim, comparing these threats to silly male frat games or blowing off aggressive steam, so that physical violence from such threats are rare. Some will even say that women who are harassed on line should feel flattered with the attention. Freud professed not to understand women, but I’m sure he would not buy such justifications. (It was when his daughter Anna was finally at risk that he decided to try to leave Nazi Germany.)

Despite laws in many states, police seem reluctant to respond. The Internet is predominantly male dominated in a developmental and operational sense. Twitter allows the most anonymity and therefore has the most users who post threats (I do not use Twitter). Ms Hess hopes that there will be more legal solutions to anonymous threats on the Internet and perhaps the issue will even become a civil rights matter. Yet she concludes the piece with this sentence, referring to her own online threats and real-life trauma: “My anxieties are harder to organize.”

Such common psychological distress suggests that this may also be a public mental health epidemic. Internet violence, while not as deadly as gun violence, is much more common.

If we clinicians heard threats like this in a session, we would be ethically bound to contact the police, try to warn the victims, and perhaps try to hospitalize the patient. Outside of our practices, we have to consider cyber-aggression to be a societal problem that needs our ethical response of advocacy, as well as educating the public and being available for psychotherapy of those traumatized.

Given the “Wild West” nature of Internet communication-with no commonly accepted rules-what else might be done? Is there a communication model that might work better? I think so.

For many years, my wife and I traveled alone. In our later years, we started to do more group travel, from brief local architecture tours to longer overseas tours. Although there are occasional individual exceptions, for the most part, the group process on these tours is exactly what I would like to see on the Internet.

People of different backgrounds and ages get together for a common goal. Although the leader will sometimes give ground rules, most know to be on their “best behavior.” That means, among other things, respecting others, sharing information, accepting unexpected problems, socializing with others, being courteous, helping others in need, and not talking too much about politics and religion. In short, the Golden Rule.

Charles Darwin, the co-founder of evolutionary theory, knew the kind of communication necessary for searching for new discoveries among strangers. I’m quite sure he would be disappointed that we have not evolved beyond his recommendations to fellow naturalists, with which he closed his famous book (The Voyage of the Beagle). If anything, communication has devolved, backwards in history toward that of warring tribes.

The potential of the Internet is immense, not only for information, but for enhancing well-being. However, like all technology, this atomic energy of communication can be used for good or bad. The Internet at its best can be a source of self-help, or at its worse, a source of group harm. We can verbally poison and try to mentally blow up people we don’t like, or we can be nurturing and complimentary. The choice is ours. At least in mental healthcare, can we resolve in this New Year of 2014 to pretend that we are on a group tour-with professionals, patients, consumers, and their family members-where so much is to be discovered and enjoyed?