6RFLDO,QWHUHVW(PSDWK\DQG2QOLQH6XSSRUW*URXSV +HLGL+DPPRQG The Journal of Individual Psychology, Volume 71, Number 2, Summer 2015, pp. 174-184 (Article) 3XEOLVKHGE\8QLYHUVLW\RI7H[DV3UHVV DOI: 10.1353/jip.2015.0008 For additional information about this article http://muse.jhu.edu/journals/jip/summary/v071/71.2.hammond.html Access provided by Penn State Univ Libraries (21 Feb 2016 10:57 GMT) Social Interest, Empathy, and Online Support Groups Heidi Hammond Abstract The Internet provides a way to connect that transcends the limitation of place and gives rise to communities that vary widely in purpose. This article examines the Adlerian concept of social interest and the related concept of empathy in online support groups. Examining online socialization and expression of empathy can support understanding for how social interest can be developed in a virtual environment. Keywords: Individual Psychology, online support, Adlerian, groups, empathy, social interest Individual Psychology, with its emphasis on social interest and community feeling, is an appropriate framework for examining the Internet and the seemingly endless number of virtual communities that have developed within that domain. It is my contention that the Internet can only mirror the complexity of communal feelings that are within human beings. Therefore, it is important to understand both how online communication can shift the way people interact and how that change can affect online relationships and communities. Examining some of these subtle shifts, such as the potential difference in online expressions and experiences of empathy, may shed light on how social interest can be encouraged in online interactions and communities. The Social Implications of the Internet In anticipation of the 25th anniversary of the World Wide Web, the Pew Research Center (2014) examined Internet users’ perceptions of the Internet and reported overwhelmingly positive results. According to the Pew report, 87% of people in the United States use the Internet, and the vast majority of Internet users (90%) consider the Internet a “good thing for them personally” (Pew Research Center, 2014, p. 7). When examining Internet users’ perceptions of online social connections, 67% of people reported believing that “online communication with family and friends has generally strengthened those relationships” (Pew Research Center, 2014, p. 5). Of particular interest The Journal of Individual Psychology, Vol. 71, No. 2, Summer 2015 ©2015 by the University of Texas Press Editorial office located in the College of Education at Georgia State University. Published for the North American Society of Adlerian Psychology. Social Interest, Empathy, and Online Support Groups 175 is that people reported the same general social benefits across age, gender, education, economics, and experience. The Pew Research Center (2014) asked people to describe how they had been treated by other people online. Most Internet users stated that they had witnessed online encounters that were “mostly kind” (76%) and that they themselves had been treated kindly (70%). Focusing on Internet communities, most Internet users had “seen an online group come together to help a person or community solve a problem” (56%) (Pew Research Center, 2014, p. 7). These results all point to a generally positive view of online communication, interactions, and communities. Yet there is another side to this story. The Pew Research Center (2014) reported that 25% of people stated that they had been “treated unkindly or been attacked” in online interactions (p. 7). When discussing online groups, 25% of respondents stated that they had “left an online group because the interaction became too heated or members were unpleasant to one another” (Pew Research Center, 2014, pp. 7–8). When describing the Internet’s effect on personal relationships, 18% stated that it “generally weakens those relationships” (Pew Research Center, 2014, p. 7). Although people seem to generally view the Internet as a positive development, it is important to remember the malleable nature of relational media, including the Internet. Social Interest Alfred Adler’s foundational concept of Gemeinschaftsgefühl has been translated into English as “social interest,” “community feeling,” “social sense,” and “social feeling,” among other translations (Ansbacher, 1978, 1992; Stein & Edwards, 1998). Ansbacher (1992) noted that “community feeling” is the closest translation of the term, embracing a broad sense of affinity between people that, Adler clarified, can also extend to animals, the environment, and the cosmos. Yet the translation “social interest” captures another important aspect of Gemeinschaftsgefühl, namely its “motivating” and “activating” nature (Ansbacher, 1992, p. 404). Social interest is a way to describe how community feeling can be expressed through behavior and can guide people to act in a socially useful manner (Ansbacher, 1992). This article uses the term social interest with the understanding that the overall concept is based on feeling, action, and—as Adler stated in 1928—“an evaluative attitude toward life” (as cited in Ansbacher & Ansbacher, 1956, p. 135). The ongoing debate regarding an operational definition of social interest underscores that it is a layered concept (Bass, Curlette, Kern, & McWilliams, 2002). Stein and Edwards (1998) observed that social interest can be expressed on affective, cognitive, and behavioral levels. Adler (1928/1979a) described social interest in terms of constructs such as identification, 176 Heidi Hammond empathy, understanding, fellowship, cooperation, reason, common sense, and courage. Analyzing the underlying facets of social interest can provide a direction for how to define and develop social interest. Yet another part of the process requires stepping back and looking at the fullness of its feeling and movement. According to Adler (1933/1979b), “To us Individual Psychologists, the whole tells much more than the analysis of the parts” (p. 30). With an appreciation for holism, this article continues the discussion of social interest by looking through the lens of empathy, recognizing that empathy is not a synonym for social interest but one aspect of its expression (Adler, 1928/1979a; Ansbacher, 1992). Adler (1928/1979a) offered an understanding of social interest that resonates with empathy and understanding: “To see with the eyes of another, to hear with the ears of another, to feel with the heart of another” (p. 42). Further emphasizing the importance of empathy to social interest, Adler (1928/1979a) observed, “Individual Psychology may claim as its contribution to have pointed out that empathy and understanding are facts of social feeling, of being in harmony with the universe” (p. 43). It appears clear from Adler’s own words that empathy is included in the overall experience of social interest. Empathy Batson (2009) described how the study of empathy has inspired debate and discussion over “why it is important . . . what effects it has . . . where it comes from . . . what it is” (p. 3). Batson clarified that the term empathy has been used synonymously with cognitive, affective, behavioral, social, and imaginative processes. Batson reviewed two questions at the core of empathy. The first asks how people can assess “what another person is thinking and feeling”; the second asks why people may “respond with sensitivity and care to the suffering of another” (Batson, 2009, p. 3). These questions highlight that empathy is a process of both inferring thoughts and feelings and then responding sensitively to another person’s experience (Batson, 2009; Ickes, 1993). Research is thoroughly examining the neurological processes behind empathy (Batson, 2009; Preston & de Waal, 2002). Preston and de Waal (2002) proposed a perception-action model of empathy that describes how neurological processes of perception can “automatically” activate a response in a secondary individual when a primary individual experiences a particular “emotion or state” (p. 4). Batson (2009) summarized that this response is possible because “perception and action rely in part on the same neural circuits” (p. 5). Preston and de Waal (2002) clarified that this response also depends on the “interdependence or interrelationship” between both Social Interest, Empathy, and Online Support Groups 177 primary and secondary individuals (p. 5). Preston and de Waal’s explanation of the perception-action model describes how empathy relates to neurological, social, and evolutionary processes. Expressing Empathy on the Internet An original question for this article is about the expression and experience of empathy online. The Internet provides a forum for connection and communication that alters many of the usual processes by which people develop and communicate empathy. How does the expression and experience of empathy change when a person cannot see or hear another person and can communicate only through text? How does the process of empathy change when people are connected through a common experience but have no other particular social bonds? Examining these questions in full is beyond the scope of this review. However, the discussion here highlights research that has examined the role of empathy in Internet communities, concentrating on text-only online support groups. Online Support Groups Barak, Boniel-Nissim, and Suler (2008) noted that online support groups first started in the 1990s and are therefore fairly new in comparison to faceto-face support groups. Barak et al. estimated that there are hundreds of thousands of support groups available online. Topics cover various health conditions and life situations (Barak et al., 2008; Owen et al., 2010; van der Houwen, Stroebe, Schut, Stroebe, & van den Bout, 2010). Fox’s (2007) study for the Pew Research Center of online patient groups found that 12% of people who use the Internet had participated in an “online discussion, a listserv or other online group forum” dedicated to “personal issues or health problems” (para. 1). Fox (2007) observed that this percentage may not include the “giant lurker population” of people who visit sites but do not participate (para. 3). In regard to the efficacy of online support groups, certain studies have not shown significant or differential effectiveness (Freeman, Barker, & Pistrang, 2008; Høybye et al., 2010; van der Houwen et al., 2010). Other studies have discussed potential benefits (Griffiths et al., 2012; Houston, Cooper, & Ford, 2002; Lieberman et al., 2003). Overall, researchers highlight the need for further study of online support groups. Van der Houwen et al. (2010) discussed the importance of conducting randomized controlled trials. Barak et al. (2008) emphasized the importance of distinguishing between the purpose of peer support (“relief and improved feelings”) and professional support (“therapeutic change in the emotions, cognitions, or behaviors”) when conducting research on support groups (p. 1868). 178 Heidi Hammond Pros and Cons. Various pros and cons can be seen in the logistics, communication, and socialization processes of online support groups. Online support groups offer freedom from the “constraints of time and distance” (Siriaraya, Tang, Ang, Pfeil, & Zaphiris, 2011, p. 618). Participants are also free to join or leave the group at any point (Barak et al., 2008; Pector, 2012). Logistical drawbacks could be the need to have a computer and Internet access, as well as possible technical issues (Lieberman et al., 2003). Barak et al. (2008) noted that the number of groups can be intimidating and groups can vary widely in regard to size, activity level, and culture. Preece (1999) summarized that one potential benefit to a discussion board is that people can post and respond to comments 24 hours a day. Slower pacing can allow more time for reflection (Barak et al., 2008; Preece, 1999). Discussion boards have the benefit of reviewing full conversations and past conversations, and participating in multiple conversations at once (Barak et al., 2008; Siriaraya et al., 2011). As a communication mode, writing also can foster clarity and self-expression (Barak et al., 2008; Preece, 1999). In contrast, Preece (1999) noted that slower response times may be a drawback for people seeking more immediate support. Another freedom of online support groups is that participants can choose to actively participate or simply read the messages from others (Barak et al., 2008; Freeman et al., 2008). Barak and Dolev-Cohen (2006) found that more active participation in an online support group was related to a reduction in distress later on. On a logistical level, perhaps one of the greatest drawbacks to online support groups is the challenge of crisis intervention. Pector and Hsiung (2011) emphasized that anonymity, distance, and lack of education and training present genuine challenges when someone expresses suicidal ideation or makes threats in an online group setting. Although there do not appear to be easy answers to this dilemma, Pector and Hsiung (2011) summarized various mitigating steps, such as posting “contact information for local, national, and international crisis resources, and emergency services and hotlines” along with providing education on suicidal ideation and referral information for therapy (p. 217). The issue of crisis management in online support groups deserves continued attention. Some of the most intriguing benefits and drawbacks to online support groups are found on the social level. Suler (2004) described how the Internet can have a disinhibition effect that leads some people to “loosen up, feel less restrained, and express themselves more openly” (p. 321). This effect can result in actions that are “benign” or “toxic” or a combination of the two (Suler, 2004, p. 321). On the one hand, the disinhibition effect may “accelerate” intimacy and bonding (Barak et al., 2008, p. 1870; Suler, 2004). On the other hand, it may lead people to foster intimacy too quickly or act Social Interest, Empathy, and Online Support Groups 179 in hostile and disruptive ways (Barak et al., 2008; Suler, 2004). Suler (2004) observed that “the distinction between benign and toxic disinhibition will be complex or ambiguous in some cases” (p. 321). Another benefit to online support groups is the ability to connect people who face rare conditions, as well as people who are dealing with situations that the broader culture minimizes and/or are subject to stigma (Barak et al., 2008; Gold, Boggs, Mugisha, & Palladino, 2012; Schotanus-Dijkstra et al., 2014; van der Houwen et al., 2010). Connecting to people in a similar situation can help normalize experiences and support the exchange of valuable information (Barak et al., 2008; Gold et al., 2012). Barak et al. (2008) added the caveat that peer groups can field “misinformation” and develop “blind spots” (p. 1878). Identity formation is another interesting and complex facet of the Internet. Group participants can remain fairly anonymous online, which may help them feel less vulnerable (Barak et al., 2008; Suler, 2004). Barak et al. (2008) and Suler (2004) observed that online support groups generally place people on a fairly even plane, as the shared environment does not display many status indicators. However, anonymity can open the door for people to create false identities or present false facts (Siriaraya et al., 2011). Empathy in online support groups. Ickes (1993) described how the full experience of empathy includes not only understanding but also expressing that understanding (“empathic expression”) and communicating that understanding (“empathic communication”). In face-to-face support groups, one can see how empathic expression and communication can be conveyed in both verbal and nonverbal language. What adaptations are necessary to engage in emotional and empathic communications in text environments? In regard to general emotional expression, Preece (1999) observed that people have “creatively” used punctuation and emoticons to communicate “emotions in text” (p. 81). Emoticons are “a digital icon or a sequence of keyboard symbols that serves to represent a facial expression . . . to convey the writer’s emotions or clarify intent” (Emoticon, 2014). Ganster, Eimler, and Krämer (2012) discussed how people also use graphic pictures of facial expressions (“smilies”) to convey expressions. Certain studies have found that expressions of empathy, support, and personal narrative are some of the most common types of communication content in online support groups (Preece, 1999; Schotanus-Dijkstra et al., 2014; Siriaraya et al., 2011). These studies indicate that online support groups may provide a forum for certain key types of personal expressions and social interactions. The mutual sharing of empathy, support, and personal narrative may happen by design. Siriaraya et al. (2011) found that certain forms of information 180 Heidi Hammond (e.g., self-disclosure, narration, asking for help) appeared to “trigger” an empathic response. The authors observed that some people served the role of primarily empathizing and others provided the triggering statements. A third category of participants communicated both types of statements; this observation aligns with Batson’s (2009) review of empathy research, which summarized that witnessing distress can trigger a reaction in others. Demographics are another variable to consider when analyzing the communication of empathy online. Siriaraya et al. (2011) found differences in message content when comparing teenagers and adults who posted on separate discussion boards for people with depression. Teenagers generally presented in a more personal, informal way; showed more confidence online; and used more words categorized as “deep support” (p. 620). By comparison, the messages from adults tended to be more formal, displayed less confidence, described more technical problems, and contained fewer words indicating “deep support.” Siriaraya et al. (2011) theorized that teenagers are comfortable with online communication, whereas some adults may need to increase their comfort level and adapt their style of communication to the Internet. Suler (2004) and Barak et al. (2008) described the phenomenon of solipsistic introjection, which may shed light on what is happening in these text-only conversations that include high levels of empathy and support. Suler (2004) described how “text communication can alter self-boundaries” (p. 323). Suler observed that people may internalize another person’s voice when reading text or reading another person’s words in one’s own voice. Suler also described how text-only conversation may encourage the imagination to fill in the gaps and develop a complex mix of reality and fantasy. Suler (2004) observed that “different modalities of online communication . . . and different environments . . . may facilitate diverse expressions of self” (p. 325). Many of these complex processes can also enhance “empathy, bonding, and the identifying with other group members that is critical in a support group” (Barak et al., 2008, p. 1871). Fostering Empathy and Social Interest Online A remaining question for this literature review pertains to how it may be possible to foster empathy, social interest, and positive group interactions in online support groups. Researchers have offered various suggestions that may help support this outcome. Feng, Lazar, and Preece (2004) discussed how sites can include “advice on writing styles” to avoid contradictory and nonsupportive messages (p. 105). Preece (2004) suggested adopting general “netiquette” guidelines, which are “basic, commonsense rules” that help support successful communication (p. 59). Siriaraya et al. (2011) summarized that ways to enhance trust could include “ensuring security Social Interest, Empathy, and Online Support Groups 181 and confidentiality rules, addressing codes of conduct, governance policies as well as nurturing community culture” (p. 618). To enhance overall community feeling, these suggestions point to the potential benefits of establishing a community structure while also providing education on online communication. Employing an effective moderator may be another way to increase empathy and social connectedness. Preece (1999) found that moderated communities contained “higher levels of empathetic messages” (p. 78). If moderation is not possible, Preece (2004) noted that role models, mentors, and general community regulation can also help foster a more empathetic and supportive communication style. Various authors discussed using online support groups as an additional support to existing therapeutic, health-related, or training services (Barak et al., 2008; Griffiths et al., 2012; Owen et al., 2010; Schotanus-Dijkstra et al., 2014). Discussion Viewed through the lens of social interest, the online world is similar to the offline world. Online endeavors, organizations, communities, and comments can either fall along the continuum of being socially useful or socially useless. Online support groups originally formed to offer people another way to connect and support one another (Barak et al., 2008). Examining the nature of online support groups can help us identify how these groups can maximize the potential for supportive interactions and enhance social interest online. When describing social interest, Stein and Edwards (1998) observed, “Adler saw the connections among living beings in many different spheres and on many different levels” (p. 68). Given the continual expansion of the Internet and the myriad ways it connects, affects, and shapes the lives of people throughout the world, discussing the role of social interest in a virtual environment is as important now as when Adler first introduced the concept to a nonvirtual community in the early 20th century. References Adler, A. (1979a). 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Computers in Human Behavior, 26(6), 1519–1525. doi:10.1016/j .chb.2010.05.019 Heidi Hammond ([email protected]) graduated from Adler Graduate School (Minnesota) with a master’s degree in Adlerian counseling and psychotherapy. She is a licensed professional counselor. Hammond has used various forms of social media at different times of her life. At this time, she primarily uses social media for connecting to people on a professional level.
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