|Title||Discourse of support: Exploring Online Discussions on Depression|
|Source||Wageningen University. Promotor(en): Cees van Woerkum, co-promotor(en): Hedwig te Molder. - [S.I.] : S.n. - ISBN 9058087751 - 240|
|Publication type||Dissertation, internally prepared|
|Keyword(s)||discussiegroepen - depressie - psychologie - communicatie - menselijke relaties - sociale interactie - groepsinteractie - zelfhulp - zelfzorg - internet - discussie - discussion groups - self help - self care - communication - depression - human relations - social interaction - group interaction - psychology - discussion|
This study aims to explore the everyday talk of people who take part in an online support group on depression. Although the popularity of online support groups has increased over the years, illustrated by a growing number of people -both patients and family members-, who turn to the Internet to join these groups, little is known about their daily practices. This study aims to explore these conversational practices based on a detailed examination of participants' talk within such groups.
The conversational materials that are collected are analysed with the help of discursive psychology, a perspective developed by the British social psychologists Edwards, Potter and Wetherell. The view on language that is favoured within this approach can best be illustrated by considering its three main concepts: construction, action and non-cognition.
With the notion of construction, discursive psychology puts forward the view that through language people construct different versions of reality. It is pointed out how these versions are themselves also rhetorically designed. The view that language is oriented towards action draws attention to the fact that people do things with language rather than merely describing the world as it is. This view runs counter to the perspective that language is an abstract system of reference that describes how things essentially are. Discursive psychology considers language an instrument in the hands of participants, which enables them to accomplish different kinds of interactional functions, e.g., blaming, complementing or inviting someone, taking responsibility or presenting a particular state of affairs as factual.
The view that language is oriented towards social action implies a non-cognitive view on reality. That is to say, cognitively inspired notions like hoping, wanting but also emotion words like anger or jealousy are not taken as expressions of particular states of mind or feelings, nor are they considered as explanatory concepts per se. Rather, discursive psychology considers them a topic of study and examines the ways in which these concepts are employed by participants to fulfil different kinds of interactional goals. To give an example, a study of marriage counselling sessions by Edwards has shown how the husband and wife define jealousy both as an enduring character trait, as well as a warranted reaction to flirtatious behaviour of the other. The study shows how offering these descriptions enables the couple to manage issues of responsibility and blame for their marital problems.
The theoretical concepts that typify a discursive psychological approach are closely related to the way the conversational materials are collected and analysed (see Chapter 3). Starting point for the analysis is to consider how participants themselves take up a particular utterance. This point of view, also described as the next-turn proof procedure, argues that participants themselves determine whether a particular utterance counts as an accusation or a description, rather than any informed guesses made by the researcher. Apart from this validation procedure, there are a number of other principles that discursive psychology considers helpful in analysing the data that are collected. First, there is the variation in descriptions that offers a starting point to examine the discursive work that particular utterances accomplish. A second principle is the rhetorical organisation of talk that draws attention to the fact that every description is designed in such a way so as to counter an alternative description. A third analytical lever that can be helpful is the so-called accountability feature which illustrates participants' orientation to the normative accountability of their behaviour, thereby pointing to the discursive business that is locally accomplished.
To further contribute to the quality and validity of the analysis, discursive psychology attempts to integrate the findings with existing studies and presents the integral materials to the reader, who is thereby in a position to judge the interpretations made by the researcher.
At the centre of attention in this study is an online support group for people with depression. For quite some time, communication via computers has been studied from the perspective of Reduced Social Cues, as developed by Sproull and Kiesler. The findings that were reached within this tradition have been influential in that they have described this type of communication predominantly as anti-normative and leading to polarised and extreme outcomes. Recent theoretical models like the SIDE model, developed by Spears and Lea, and the SIP perspective, developed by Walther, have countered this largely negative view by propagating that normative influence can very well be transmitted in online environments, depending on whether a social or personal identity is salient. Although both models do not consider medium characteristics to determine the process of communication nor its outcomes, they do provide a rather mechanistic view of the communication process, and of the way in which people construct identities. This is partly caused by the fact that these studies are based on experiments.
Other studies, predominantly from a sociological or ethnographic point of view, have redirected their focus of attention to the diverging ways in which people actually use the different options this medium offers. However, these types of research have not taken into account the everyday talk of people who interact online, which is an area of attention that is also overlooked in studies which focus on online support groups in particular.
The current image of computer mediated communication processes is therefore still to a large extent determined by the assumptions put forward by the Reduced Social Cues perspective. Communication via the Internet is in this view taken to be largely unproblematic and straightforward, because it is argued that the interaction is not hindered by so-called status effects, e.g., the alleged influence of factors like age or gender in face-to-face conversations. Online interaction is also typified as transient, because any tangible effects of the communication process are lacking: there are only messages that appear and disappear on a computer screen. Also with regard to interaction in online support groups, an image is put forward of a straightforward and easy exchange of experiences and advice among those who are 'like-minded'.
Against the backdrop of this research, this study attempts to undertake a detailed exploration of participants' everyday talk in an online support group on depression. The conversational materials that are collected are the contributions written to this support group during a period of two years. A first gloss of the data has resulted in the identification of three broad areas of attention, which are explored in greater detail in chapters 4, 5 and 6 (see for a detailed overview of how these areas have been identified, Chapter 3).
This study focuses on the way people describe themselves and their illness, and the kinds of interactional functions that are accomplished in doing so. In particular, this study aims to examine how participants:introduce themselves in this group by attributing particular identity categories to themselves and other people;interactionally manage to ask for support and provide 'support' to others;interactionally manage to request advice and offer 'advice' to others.
Chapter 4 shows how participants present themselves when they visit this support group for the first time. Exploring these first fragments demonstrates how people do not start addressing their feelings and problems in relation to depression straightaway. Remarkably, participants begin their messages by providing extensive explanations of how their depression has come about.
The chapter demonstrates how these explanations, which are most of the time presented as external from the speaker, enable participants to explain for their depression on the basis of objective and factual causes. In this way, participants resist the claim that their depression is an illness that merely resides in peoples' heads, on the basis of which it could be considered an imaginary disease. It also works to show their ability to take into account the reasons behind their depression, which enables them to stress their personal competence.
Maintaining a sense of personal competence is also an important concern when participants present themselves vis-à-vis other participants in this group. By presenting themselves as being positively different form others (e.g., 'sensitive', or 'intellectually demanding') participants are able to address their depression, without suffering a lack of personal competence. Also when they address their depression while emphasising that they have continuously tried to improve their situation, participants are offered an opportunity to portray themselves as depressed but competent. In this way, participants are able to address their illness, while countering the impression that depression can easily be overcome if the person who is depressed is willing to do something about it.
Chapter 5 describes how participants show a pervasive concern with accounting for their request for help. Contrary to what one might expect, talking about one's feelings and asking for help in a support group for peers is far from straightforward. This chapter demonstrates a number of discursive 'strategies' that participants employ and which illustrate their awareness as to whether their request for support is appropriate.
It was shown how participants may describe their depression as a result of emotions, which operate autonomously from themselves. Participants may also describe their request for support as an expression of honest feelings, which is as such, hard to refute. Two other discursive resources that participants may draw on is to describe their problems in relation to the troubles other participants are having and attend to the consequences of posting their down feelings for the well-being of the group. This chapter thus shows how calls for help are not automatically considered 'appropriate' in this support group.
Remarkably, this chapter simultaneously demonstrates that participants present talking about their feelings of depression as a moral obligation. As such, participants find another discursive 'strategy' to account for their call for help.
Chapter 5 shows that what counts as a 'norm' is not clearly defined, nor can its meaning be determined at the outset. On the contrary, what counts as an 'appropriate' request for support is subject to continuous negotiation. The chapter also illustrates how participants refer to normative expectations that ostensibly contradict each other , and also, how they render different normative expectations applicable in different situations. Thus, we have seen how participants attend to their call for support as something to account for, while at the same time defining talking about your feelings of depression as a moral obligation.
Chapter 6 draws attention to the ways in which participants interactionally manage to ask for advice and provide advice to others. It was shown how advice was given by defining it as a 'technical matter', which made available the suggestion that offering advice is an uncomplicated matter. At the same time however, we see that participants in this group collectively define 'advice' as a general category, as inappropriate. The fragments that are presented in this chapter show how participants reject advice, since it makes inferentially available that they are depending on others to offer advice to them. In those instances, participants resist this claim by presenting their contribution as merely 'venting' or 'unloading', which can happen relatively autonomously from others.
This chapter also demonstrates how personal experience in this group does not automatically count as a relevant basis to provide advice. Interestingly, when we consider that we are dealing with a group for peers where we may expect sharing experiences to be an important aspect that constitutes such a group, what we see is that participants continuously emphasise their individually different circumstances as a discursive 'strategy' to reject advice.
Chapter 7 provides an overview of the findings and formulates recommendations for practice and future research. An important conclusion this study draws is that next to providing and asking for support and advice, this support group offers participants the possibility to construct 'adequate' and 'appropriate' identities, by offering descriptions of who they are and how their depression has come about. The latter may serve as a better illustration of the possible value this group holds for its participants than the mere fact that this group provides an opportunity to exchange advice and support.
Another important issue this study demonstrates is that presenting oneself as depressed but competent poses an important concern for participants, and it has shown the different ways in which participants orient to this concern. One of the ways in which participants portray themselves as competent is by offering extensive explanations of how their depression has come about. This offers insight in the possible themes of conversation that participants of these groups consider relevant.
Future research may draw attention to whether the kinds of concerns that are demonstrated to be important for participants in this support group, e.g., constructing 'adequate' and 'appropriate' identities, might also prove to be important for participants who take part in other support groups.
This chapter also formulates the recommendation that user-centred research offers an important contribution in exploring the possibilities of this new medium. The added value of this type of research can be further illustrated when we compare it with the kinds of studies that consider media characteristics such as anonymity to determine the type of communication and its outcomes, without considering the ways in which the medium is put to use by its users. The chapter thus states that paying attention to participants' actual uses of the medium is an important route for future research.