Help is just an e-mail away

People are using the Internet to find answers to their problems. But does cybertherapy work?

"Dear Angie, I am in a super mess. I have been married for 25 years and I have fallen head over heels in love with my married secretary. I don't know what to do. It is miserable. I think about her all the time. I haven't said anything to anyone about this, but it is driving me insane."

"Dear In A Super Mess, you will be driven more insane by the problems that would be created for the both of you should you venture into an affair. I can tell already that this behaviour is not congruent with your values. Let your feelings go and soon you will move beyond this."

We have no idea who Angie is, except that she is part of the latest trend on the Internet - cybertherapy. The unhappy user goes to one of several new sites on the World Wide Web, sends off an e-mail message about what's troubling them and back comes a personal reply straight to his or her computer's mailbox.

Angie, who sounds as if she might have done time on a newspaper agony column, is certainly no nonsense - a lovesick adolescent is warned off a long-distance relationship, a single mum is encouraged to date, and she has a startlingly pragmatic approach to problems in general.

"Spring brings new promise and it's time to spring clean," she declares in her introduction. "Shed those friends and duties that bring us down. If something brings you down, get rid of it." If only it were that simple.

But at least she's free. Shrinklink, a US outfit that "helps people to develop informed judgements and choices concerning human behaviour, allows direct e-mail access to a staff of top clinical psychologists and psychiatrists" will set the user back $20 for each question.

Here is one of the Shrinklink clients who seems to be asking for help for the wrong person: "I think my daughter, now eight, may be too attached to her mother. We have tried over the years to accustom her to being alone, but our attempts have always resulted in rages of fear and anger on her part. How can we do it gradually." What? This is a problem? But instead of urging instant counselling for the parents, the "top clinical psychologists" solemnly reply thus:

"Many children have difficulty separating from their parents, particularly their mothers. Some are afraid that their mothers will not come back once they are out of sight. I don't know what you mean when you say you tried to 'accustom her to being alone'. If you mean by herself, isolated, or sent to her room, this can be a fearful situation for a child who is having trouble separating. You might try doing something gradually, such as five minutes for a stretch of time, perhaps once a day for a week."

There is an unreal, soap opera quality to these sites that can make them compulsive viewing. "Help! I think I am going crazy. I keep having horrible thoughts about stabbing my husband and daughter. I have thrown away some knives and don't even want to cut food because I feel like I might go mad and start stabbing them." How do you solve that over the Internet? Is it not time to alert the police, take the children into care?

But the reply from Helpnet ($20 a question to a US panel of PhD psychologists) is breathtakingly calm and assured. "What you describe is obsessive compulsive disorder or OCD, which is quite common and highly treatable. The people who suffer from OCD and who have thoughts about harming people or acting in other unacceptable ways don't do it and are not a risk to anyone." How can anyone be so sure?

British psychotherapists are dismissive of the idea of Internet counselling. "A waste of time and money," comments Neil Crawford, a senior consultant at the Tavistock consultancy service in London. "It has nothing to do with psychotherapy, which involves a face-to-face relationship."

To be fair, most of these sites declare that what they offer is not therapy. Instead, what they provide is telephone helpline-type information about classic problems such as impotence, depression, and difficult relationships - at a price. It's rather like buying an Armani T-shirt when the Marks & Spencer's one looks identical.

In fact, for someone who wants help on any mainstream problem - abusive partners, anxiety attacks, manic depression, divorce, eating disorders, loneliness and a host of others - a free, warmer and often better informed source are the Internet newsgroups. Plenty of them deal with specific psychological and emotional difficulties.

"My name is Peter and I am depressed," ran one recent posting in alt.support.depressed newsgroup. "At least my psychologist insists that I am depressed. I am very frustrated because I live in constant pain from my stomach. I just wish my suffering would come to an end."

Back immediately came a number of caring and thoughtful replies. One declared that antidepressants had enabled him to lead a normal life. Another was more detailed. "Peter, you don't mention whether you have completely ruled out any physical cause for your stomach pain. I would certainly want to be sure there is nothing that should be treated by a MD. If you have, you might consider a more active type of therapy. Life is definitely worth it. There are answers out there, but you have to go after them, not wait for them to drop in your lap. Good luck."