I subscribe to and read an enormous amount of e-mail on a daily basis, in order to keep abreast of the many areas of interest to me. This includes computers, Web design, Webmastering, programming, psychology, psychotherapy, policy and legislative debates, online research and online therapy. Having been using computers to communicate with others for 15 years, I have formed certain expectations regarding my online communications. These expectations include the simple misconception that if I write e-mail to a single person, it is meant only for that single person to read, save or destroy. Not to publish.
In the past two months, however, those expectations have been blown out of the water through two incidents. Both of these incidents illustrate the dangers and unresolved problems which still remain regarding online communication. And both incidents involved fellow professionals, both of whom also had a great deal of online experience.
Both incidents involved people who I have communicated previously with online, one a psychiatrist and one a graduate student. These are people who are in the field to help others and to uphold the trust and confidentiality of their patients. On both occasions (which had nothing to do with one another), I had written what I had believed to be private e-mail to the individual. On both occasions, the recipient of the e-mail, without first asking me, shared that e-mail with two separate mailing lists.
On the face of it, it doesn’t seem like such a big deal. I wasn’t ashamed of anything I said in either e-mail. But the principle remains — they were intended for one person’s eyes only and written only for that person, not for public dissemination and publication. Imagine writing a letter to someone you disagreed with and then seeing that same letter appear in the “Letters to the Editor” column of your local newspaper two weeks later!
What is even more disturbing to me in these cases, though, is the professional conduct of the people involved, and the implications for other areas of online communication.
There is an expectation built upon years of experience and mores online that one simply does not share private e-mail with others unless one has express permission to do so in advance. Naturally there are exceptions to this rule, such as being in receipt of an illegal scheme or knowledge of a person’s imminent death or harm to another. But in day-to-day interactions, imagine the chilling effect such a behavior would have. If you knew that every single word you wrote to another colleague or friend could be widely disseminated and published, you would not only be more careful about what words you wrote, but it would also cause you to censor yourself and your own viewpoint. Instead of expressing your disappointment with a colleague, you just keep your mouth shut. After all, who needs the additional harassment? If everyone intended private e-mail to be read by everyone else in the first place, the original author (not the recipient) would have sent it to the mailing list. It is the author’s choice and decision, not the recipients’s.
These instances illustrate to me how far we still have to go before people will fully embrace online therapy via e-mail or any other modality. Psychologists, psychiatrists social workers, and licensed counselors all have ethical guidelines to uphold within their respective professions when doing face-to-face therapy. But now many of these same professionals are trying to squirm out of calling what they do online “therapy,” for fear of having to uphold the same exacting standards online. If they succeed in their word games, they would not be responsible if e-mail sent to them gets published elsewhere in the online world. It is clear to me that if professionals can so easily violate ethical conduct between one another, they will just as easily violate it in other areas of their lives. After all, the research has taught us that the most valid predictor of future behavior is past behavior.
I’ve been online in one form or another since 1981, on the Internet since 1991, and this is only the second time in all that time where I had this happen to me. It is sad, though not surprising, that it was initiated by two other professionals in the same field as I am. I think it speaks volumes on how much farther we still have left to go to ensure privacy online.
If you want the whole shi-bang of over 10,000 separate resources that have to do with psychiatry and mental health online, then you might want to visit Psych Central. It’s the largest and most comprehensive site of its kind in the world and we’re looking to build upon it in the upcoming years, acting as a super guide to mental health online. If you didn’t find what you needed here, look there next!