Elias Aboujaoude M.D.

Compulsive Acts

Psychotic Websites

Does the Internet encourage psychotic thinking?

Posted Jul 20, 2009

We are accustomed to people allowing the less attractive features of their personalities to blossom online. Lewd, impulsive and antisocial behavior becomes irresistible when potential perpetrators are shielded by secrecy and online anonymity. That is how many cyber communities devolve into mudslinging, making a mockery of etiquette or even netiquette as their members compete in eviscerating one another. But online forums can also serve as examples of the opposite process, an arguably equally unhealthy state of blind, mutual agreement.

"Groupthink" was defined by psychologist Irving Janis as "a mode of thinking that people engage in when they are deeply involved in a cohesive in-group," and "when the members' strivings for unanimity override their motivation to realistically appraise alternative courses of action." Groupthink sacrifices reasonable dissent and counterpoint in the interest of group solidarity and the single agenda. Especially when it comes to Internet communities that coalesce around a narrow cause, as opposed to large, open, communities like YouTube or Flickr, silence is often preferable to voicing an opinion deemed threatening to the group's homogeneous fabric.

A twenty-four-year-old patient I treated for schizophrenia introduced me to a dangerous form of groupthink on display in a number of overtly psychotic websites. There, individuals who, like my patient, believe they are victims of mind control, share stories of harassment and tips on how to break free. "Gang Stalking is a systemic form of control, which seeks to destroy every aspect of a Targeted Individuals life," warns the banner on gangstalkingworld.com, one of several such websites. "The Target is followed around and placed under surveillance by Civilian Spies/Snitches 24/7." The perpetrators of abuse include "Royal Canadian Mounted Police" using a "telepathic amplifier that works with microwaves," "Freemasonic intelligence agencies" using "frequency weapons," "bad guys" using "psychotronics," and "Warsaw Pact" researchers using "hypnosis and electromagnetic waves." My patient, who after five years of denying his illness was finally starting to accept that medications might be a good option, found confirmation of his odd experiences on these websites in a way that "justified" his paranoia and hallucinations. Once again, he believed the CIA really implanted a chip in his brain and that he didn't need antipsychotic medication, only a neurosurgeon who can take the chip out.

A British study from 2006 by Dr. Vaughan Bell was among the first to examine this phenomenon. As part of the study, three independent psychiatrists were asked to evaluate 10 online mind-control accounts identified through a simple Google search. Their task was (a) to determine whether the poster was psychotic based on his writing and (b) to analyze the hyperlinks within each post to look for evidence of social organization among posters and visitors.

The three psychiatrists were in high agreement that "signs of psychosis are strongly present" in the 10 accounts, indicating that posters were very likely to be schizophrenic. (Because the psychiatrists were blind to each other's assessments and to the purpose of the study, no "groupthink" process can be blamed for their consensus!) Furthermore, the links embedded within the posts showed "evidence of social organization and community, based around the content of these experiences and beliefs."

Social networking around pathology carries the worrisome risk of normalizing an abnormal experience, as like-minded individuals share their stories without any outside input to raise the possibility that the unusual experiences they are describing may actually be the product of a serious illness. The study authors point out that the end result may be that the very diagnosis of schizophrenia is questioned. As stated in the DSM, the "bible" used by mental health professionals for psychiatric diagnosticating, an unusual belief is not considered psychotic, and therefore is not pathological, if it is "accepted by other members of the person's culture or subculture." With cultures and subcultures of all stripes proliferating online, it is easier than ever to find a virtual place where some people's eccentricities, or in this case, hallucinatory experiences, are considered the norm. Who are we to call them schizophrenic or ask them to "conform," when everyone around them partakes in the same delusion?

Precisely when we need someone to confront us and loudly disagree with us, a form of groupthink sometimes takes over homogenous online circles, in a way that can be very self-defeating. In my patient's case, it helped convince him that he was entirely normal. That is the exact opposite of a support group.

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