Persons who regularly record their thoughts are increasingly reaching for a mouse instead of a pen and paper.
Web logs, or “blogs,” are public online diaries that represent an emerging trend in self-expression and networking. Blogs cover everything from health care and current events to finding Mr. or Ms. Right, and the medium could become a powerful communication tool for mental health professionals and their patients as it becomes more mainstream.
Blogs are similar to personal home pages and newsletters, except that the content is updated more frequently-daily in many cases-and usually focuses on a single topic. The blog of Alex Chernavsky, a critic of psychiatry and the pharmaceutical industry, is one example.1
The medium has emerged as part of the consumer empowerment trend that has characterized the Internet age, and is borne of a philosophy that embraces the exchange of information in cyberspace. Blogs have been employed most extensively in the news industry, where columnists use them to extend their communication with readers.2 More companies today use blog software to collaborate on product development and post updates on market conditions, among other uses. Even the CIA is using Traction Software, an enterprise-based blog software package.3
Blogs are a hybrid form of communication, combining elements of individual and group psychotherapy with a public journal. Blogs not only are an outlet for the writer’s thoughts and feelings, but also provide a forum for ongoing discussion.
For example, one person with schizophrenia and bipolar disorder posts a blog at www.h13.com. Reading his poetry and reflections on his illness is bound to change one’s perspective on how a patient perceives his or her mental illness. The comments by visitors who provide support, find a shared experience, or describe their triumphs and setbacks are equally revealing.
In another blog (www.crazytracy.com), a registered nurse at a psychiatric hospital vents about her experiences in life and at work. Her outrageous rants and raves appear to have attracted a cult following.
A ‘blogring’- a group of blogs identified by a central theme, such as ‘depression’ or ‘self-loathing’-can also promote a sense of belonging for the user. When signing up for the ring, a specialized code on the user’s site will identify the viewer as belonging to that blogring and allow him or her to visit other blogs within the ring. Users select blogrings, visit each other’s blogs, and post comments,4 thus creating a community of support through Internet connectivity.
Many blogs also include specific links to the online diaries of friends or to other blogs or Web sites of interest. Technology such as blogLinker (www.bloglinker.com), myMediaList (www.mymedialist.com), and Blogrolling (www.blogrolling.com) facilitate this process.
Creating a blog once required knowledge of hypertext markup language (HTML), the code commonly used to create a Web page. Now, however, anyone with Netscape, Internet Explorer, or another Web browser can devise a blog using such services as Blog*Spot (www.blogspot.com), Xanga (www.xanga.com), or LiveJournal (www.livejournal.com).
Blog*Spot, Xanga, and CrimsonBlog (www.crimsonblog.com) provide free blog service, but may place ads on your site at their discretion. For users willing to pay for premium service, the ads are removed and additional features are available. The Developer’s Corner (http://fahim.razorsys.com/Blog.htm) is suitable for users who want to use their own site but need software.
Blogs in psychiatry
Blogs can be useful for patients who keep a journal. The patient and therapist can review an online diary and more quickly address issues outside of regular sessions. Postings can also be followed across a historical timeline-a function that e-mail does not offer. What’s more, each user can review comments from other viewers and post responses. For the patient who misses a group session, blogs can help him or her catch up on the current discussion.
Psychiatrists can also use blogs to exchange information with other members of a patient’s multidisciplinary care team. Such communication often is impeded, especially in hospitals that lack an electronic medical records system or do not have the central chart readily available. A blog on the hospital’s Intranet, however, can bridge the communication gap by providing links to articles and reports.
But use of blogs in psychiatry has its drawbacks, with potential lack of privacy the most obvious among them. Most blog software offers password protection, however: Either the entire site is blocked from public access or specific messages can be hidden.
Further, although blogs can be a useful adjunct to therapy, they are not a replacement. For fmany patients, the social interaction and non-verbal cues associated with traditional psychotherapy are crucial to treatment. Blogs may also frustrate therapy by allowing a patient to avoid direct ‘confrontation’ in an interpersonal setting.