PROFESSIONAL ISSUES ONLINE E XPANDING THE P ARADIGM (WIIFM? PX!)
PROFESSIONAL ISSUES ONLINE E XPANDING THE P ARADIGM (WIIFM? PX!)
(What’s in it for me? Please explain!)
The profession of mental health is online: conducting research, testing, communicating with and counseling patients, supervising, teaching, consulting, and conducting the business of psychology. Is this a good thing? We now have 10 years of data, lots of discussion, many questions, but few answers. The Internet has not only amplifi ed the way we communicate but changed who we are online. To quote Turkle (2005), “in cyberspace your words are your deeds, your words are your body. And you feel these word-deeds and this word-body quite viscerally” (p. 1). Before venturing into the digital age professionally, we need to be able to interpret the exchange of “word-deeds and word-bodies” as they manifest at light-speed in cyberspace discourse. How do we feel about communicating this way? How does it change our patients and us?
For clinicians, the fi rst steps into a new arena are usually ethical and legal ones. At this point in time, terra fi rma legal and ethical guidelines for mental health professionals can be cautiously applied to cyberspace (see the California Psychological Association’s “Tips for Telepsychology,” 2005), and the fi t is not perfect. Problems exist when applying psychological theories, jurisprudence, and assumptions about behavior to the vastness of cyberspace communication. Further, the Internet encour- ages a multiplicity of ways of being that challenge theories and systems of psychology. For example, offl ine models of psychotherapy lean heavily on an accurate assessment of a person’s stage of development, identity, affi liations, and soundness of reality test- ing in order to craft interventions. Online, however, these constructs are mutable and
10 Cyber Shrinks: Expanding the Paradigm
highly sensitive to technological interference or interaction effects, perhaps due to the archtexture of the Internet itself, they are even resistant to classifi cation entirely.
Haraway (1991) believes that the Internet has upset social hierarchy and political power, especially the status of gender, race, sexuality, and class. She urges us to analyze the human-computer, the cyborg,
a hybrid of machine and organism, a creature of social reality and fi ction…a condensed image of both imagination and material reality … transgressed boundaries, potent fusions, and dangerous possibilities which progressive people might explore as one part of needed political work (pp. 149–151).
Everything online is mediated by the cyborg. It is not human-to-human discourse but human-machine-human, and the machine keeps changing its stripes. Online is not like face-to-face. There are heightened similarities and exponential differences. First, everyone has a voice. Second, no one is in charge (Voice Over Internet Protocol, 2005). We have cyberqueer theory, which now applies to all of us. The Internet allows projec- tions of alternative sexualities and makes it easy for the straight to bend a little (Plant, 2001). In concert with who we are on ground, cyberqueer theory applies to all of us because we can now be out in any way we want to be, Dicey or poignant admixtures of fantasy and realism are the norm. Everyone can lie or express their true identities online. This freedom makes it even more diffi cult for clinicians to understand the cyborg and navigate their psyches (and ours) in cyberspace.
One cannot simply upload psychology (or anything else, for that matter) to cyberspace without a radical shift in perspective (British Association for Counseling Practitioners, 2005; Grohol, 1998; Jones, 2000; 1998; Turkle, 2005). Radicalism begins with the status quo, questions that challenge existing epistemologies and power:
1. Who’s in control online?
2. How technologically competent should clinicians be?
3. What is good and bad “netiquette”?
4. Where does etherapy take place?
5. How does privacy, confi dentiality, and anonymity online compare to offl ine?
6. How do the following manifest online: diversity, culture, identity, rela- tionship, sexuality, discourse, power, body, emotion, competency, effi cacy, harm, and contraindications?
7. How do we know what we know about practicing in cyberspace?