Social Interest, Empathy, and Online Support Groups [607198]

Social Interest, Empathy, and Online Support Groups
Heidi Hammond
Abstract
The Internet provides a way to connect that transcends the limitation of place and
gives rise to communities that vary widely in purpose. This article examines the
Adlerian concept of social interest and the related concept of empathy in online sup­
port groups. Examining online socialization and expression of empathy can support
understanding for how social interest can be developed in a virtual environment.
Keywords: Individual Psychology, online support, Adlerian, groups, empathy,
social interest
Individual Psychology, with its emphasis on social interest and com­
munity feeling, is an appropriate framework for examining the Internet and
the seemingly endless number of virtual communities that have developed
within that domain. It is my contention that the Internet can only mirror the
complexity of communal feelings that are within human beings. Therefore,
it is important to understand both how online communication can shift the
way people interact and how that change can affect online relationships
and communities. Examining some of these subtle shifts, such as the po­
tential difference in online expressions and experiences of empathy, may
shed light on how social interest can be encouraged in online interactions
and communities.
The Social Implications of the Internet
In anticipation of the 25th anniversary of the World Wide Web, the Pew
Research Center (2014) examined Internet users' perceptions of the Internet
and reported overwhelmingly positive results. According to the Pew report,
87% of people in the United States use the Internet, and the vast majority of
Internet users (90%) consider the Internet a "good thing for them personally"
(Pew Research Center, 2014, p. 7). When examining Internet users' percep­
tions of online social connections, 67% of people reported believing that
"online communication with family and friends has generally strengthened
those relationships" (Pew Research Center, 2014, p. 5). Of particular interest
The Journal of Individual Psychology, \/ ol. 71, No. 2, Summer 2015
©2015 by the University of Texas Press
Editorial office located in the College of Education at Georgia State University.
Published for the North American Society of Adlerian Psychology.

Social Interest, Empathy, and Online Support Groups 175
is that people reported the same general social benefits across age, gender,
education, economics, and experience.
The Pew Research Center (2014) asked people to describe how they had
been treated by other people online. Most Internet users stated that they had
witnessed online encounters that were "mostly kind" (76%) and that they
themselves had been treated kindly (70%). Focusing on Internet communi­
ties, most Internet users had "seen an online group come together to help a
person or community solve a problem" (56%) (Pew Research Center, 2014,
p. 7). These results all point to a generally positive view of online communi­
cation, interactions, and communities.
Yet there is another side to this story. The Pew Research Center (2014)
reported that 25% of people stated that they had been "treated unkindly or
been attacked" in online interactions (p. 7). When discussing online groups,
25% of respondents stated that they had "left an online group because the
interaction became too heated or members were unpleasant to one an­
other" (Pew Research Center, 2014, pp. 7-8). When describing the Internet's
effect on personal relationships, 18% stated that it "generally weakens those
relationships" (Pew Research Center, 2014, p. 7). Although people seem to
generally view the Internet as a positive development, it is important to re­
member the malleable nature of relational media, including the Internet.
Social Interest
Alfred Adler's foundational concept of GemeinschaftsgefuhI has been
translated into English as "social interest," "community feeling," "social
sense," and "social feeling," among other translations (Ansbacher, 1978,
1992; Stein & Edwards, 1998). Ansbacher (1992) noted that "community
feeling" is the closest translation of the term, embracing a broad sense of
affinity between people that, Adler clarified, can also extend to animals, the
environment, and the cosmos. Yet the translation "social interest" captures
another important aspect of Gemeinschaftsgefuh !, namely its "motivating"
and "activating" nature (Ansbacher, 1992, p. 404). Social interest is a way to
describe how community feeling can be expressed through behavior and can
guide people to act in a socially useful manner (Ansbacher, 1992). This article
uses the term social interest with the understanding that the overall concept
is based on feeling, action, and—as Adler stated in 1928—"an evaluative
attitude toward life" (as cited in Ansbacher & Ansbacher, 1956, p. 135).
The ongoing debate regarding an operational definition of social interest
underscores that it is a layered concept (Bass, Curlette, Kern, & McWilliams,
2002). Stein and Edwards (1998) observed that social interest can be ex­
pressed on affective, cognitive, and behavioral levels. Adler (1928/1979a)
described social interest in terms of constructs such as identification,

176 Heidi Hammond
empathy, understanding, fellowship, cooperation, reason, common sense,
and courage. Analyzing the underlying facets of social interest can provide
a direction for how to define and develop social interest. Yet another part
of the process requires stepping back and looking at the fullness of its feel­
ing and movement. According to Adler (1933/1979b), "To us Individual
Psychologists, the whole tells much more than the analysis of the parts"
(p. 30). With an appreciation for holism, this article continues the discussion
of social interest by looking through the lens of empathy, recognizing that
empathy is not a synonym for social interest but one aspect of its expression
(Adler, 1928/1979a; Ansbacher, 1992).
Adler (1928/1979a) offered an understanding of social interest that reso­
nates with empathy and understanding: "To see with the eyes of another,
to hear with the ears of another, to feel with the heart of another" (p. 42).
Further emphasizing the importance of empathy to social interest, Adler
(1928/1979a) observed, "Individual Psychology may claim as its contribu­
tion to have pointed out that empathy and understanding are facts of social
feeling, of being in harmony with the universe" (p. 43). It appears clear from
Adler's own words that empathy is included in the overall experience of
social interest.
Empathy
Batson (2009) described how the study of empathy has inspired debate
and discussion over "why it is important. . . what effects it has . . . where it
comes from . . . what it is" (p. 3). Batson clarified that the term empathy has
been used synonymously with cognitive, affective, behavioral, social, and
imaginative processes. Batson reviewed two questions at the core of empa­
thy. The first asks how people can assess "what another person is thinking
and feeling"; the second asks why people may "respond with sensitivity and
care to the suffering of another" (Batson, 2009, p. 3). These questions high­
light that empathy is a process of both inferring thoughts and feelings and
then responding sensitively to another person's experience (Batson, 2009;
lekes, 1993).
Research is thoroughly examining the neurological processes behind
empathy (Batson, 2009; Preston & de Waal, 2002). Preston and de Waal
(2002) proposed a perception-action model of empathy that describes how
neurological processes of perception can "automatically" activate a re­
sponse in a secondary individual when a primary individual experiences
a particular "emotion or state" (p. 4). Batson (2009) summarized that this
response is possible because "perception and action rely in part on the same
neural circuits" (p. 5). Preston and de Waal (2002) clarified that this response
also depends on the "interdependence or interrelationship" between both

Social Interest, Empathy, and Online Support Groups 177
primary and secondary individuals (p. 5). Preston and de Waal's explanation
of the perception-action model describes how empathy relates to neurologi­
cal, social, and evolutionary processes.
Expressing Empathy on the Internet
An original question for this article is about the expression and experi­
ence of empathy online. The Internet provides a forum for connection and
communication that alters many of the usual processes by which people
develop and communicate empathy. How does the expression and experi­
ence of empathy change when a person cannot see or hear another person
and can communicate only through text? How does the process of empa­
thy change when people are connected through a common experience but
have no other particular social bonds? Examining these questions in full is
beyond the scope of this review. However, the discussion here highlights
research that has examined the role of empathy in Internet communities,
concentrating on text-only online support groups.
Online Support Groups
Barak, Boniel-Nissim, and Suler (2008) noted that online support groups
first started in the 1990s and are therefore fairly new in comparison to face-
to-face support groups. Barak et al. estimated that there are hundreds of
thousands of support groups available online. Topics cover various health
conditions and life situations (Barak et al., 2008; Owen et al., 2010; van
der Houwen, Stroebe, Schut, Stroebe, & van den Bout, 2010). Fox's (2007)
study for the Pew Research Center of online patient groups found that 12%
of people who use the Internet had participated in an "online discussion,
a listserv or other online group forum" dedicated to "personal issues or
health problems" (para. 1). Fox (2007) observed that this percentage may
not include the "giant lurker population" of people who visit sites but do not
participate (para. 3).
In regard to the efficacy of online support groups, certain studies have
not shown significant or differential effectiveness (Freeman, Barker, &
Pistrang, 2008; Hoybye et al., 2010; van der Houwen et al., 2010). Other
studies have discussed potential benefits (Griffiths et al., 2012; Houston,
Cooper, & Ford, 2002; Lieberman et al., 2003). Overall, researchers high­
light the need for further study of online support groups. Van der Houwen
et al. (2010) discussed the importance of conducting randomized controlled
trials. Barak et al. (2008) emphasized the importance of distinguishing be­
tween the purpose of peer support ("relief and improved feelings") and
professional support ("therapeutic change in the emotions, cognitions, or
behaviors") when conducting research on support groups (p. 1868).

178 Heidi Hammond
Pros and Cons. Various pros and cons can be seen in the logistics, com­
munication, and socialization processes of online support groups. Online
support groups offer freedom from the "constraints of time and distance"
(Siriaraya, Tang, Ang, Pfeil, & Zaphiris, 2011, p. 618). Participants are also
free to join or leave the group at any point (Barak et al., 2008; Pector, 2012).
Logistical drawbacks could be the need to have a computer and Internet
access, as well as possible technical issues (Lieberman et al., 2003). Barak
et al. (2008) noted that the number of groups can be intimidating and groups
can vary widely in regard to size, activity level, and culture.
Preece (1999) summarized that one potential benefit to a discussion
board is that people can post and respond to comments 24 hours a day.
Slower pacing can allow more time for reflection (Barak et al., 2008; Preece,
1999). Discussion boards have the benefit of reviewing full conversations
and past conversations, and participating in multiple conversations at once
(Barak et al., 2008; Siriaraya et al., 2011). As a communication mode, writ­
ing also can foster clarity and self-expression (Barak et al., 2008; Preece,
1999). In contrast, Preece (1999) noted that slower response times may be a
drawback for people seeking more immediate support.
Another freedom of online support groups is that participants can
choose to actively participate or simply read the messages from others
(Barak et al., 2008; Freeman et al., 2008). Barak and Dolev-Cohen (2006)
found that more active participation in an online support group was related
to a reduction in distress later on.
On a logistical level, perhaps one of the greatest drawbacks to online
support groups is the challenge of crisis intervention. Pector and Hsiung
(2011) emphasized that anonymity, distance, and lack of education and
training present genuine challenges when someone expresses suicidal ide­
ation or makes threats in an online group setting. Although there do not
appear to be easy answers to this dilemma, Pector and Hsiung (2011) sum­
marized various mitigating steps, such as posting "contact information for
local, national, and international crisis resources, and emergency services
and hotlines" along with providing education on suicidal ideation and refer­
ral information for therapy (p. 217). The issue of crisis management in online
support groups deserves continued attention.
Some of the most intriguing benefits and drawbacks to online support
groups are found on the social level. Suler (2004) described how the Internet
can have a disinhibition effect that leads some people to "loosen up, feel
less restrained, and express themselves more openly" (p. 321). This effect
can result in actions that are "benign" or "toxic" or a combination of the
two (Suler, 2004, p. 321). On the one hand, the disinhibition effect may "ac­
celerate" intimacy and bonding (Barak et al., 2008, p. 1870; Suler, 2004).
On the other hand, it may lead people to foster intimacy too quickly or act

Social Interest, Empathy, and Online Support Groups 179
in hostile and disruptive ways (Barak et al., 2008; Suler, 2004). Suler (2004)
observed that "the distinction between benign and toxic disinhibition will
be complex or ambiguous in some cases" (p. 321).
Another benefit to online support groups is the ability to connect people
who face rare conditions, as well as people who are dealing with situations
that the broader culture minimizes and/or are subject to stigma (Barak et al.,
2008; Gold, Boggs, Mugisha, & Palladino, 2012; Schotanus-Dijkstra et al.,
2014; van der Houwen et al., 2010). Connecting to people in a similar situ­
ation can help normalize experiences and support the exchange of valuable
information (Barak et al., 2008; Gold et al., 2012). Barak et al. (2008) added
the caveat that peer groups can field "misinformation" and develop "blind
spots" (p. 1878).
Identity formation is another interesting and complex facet of the
Internet. Group participants can remain fairly anonymous online, which
may help them feel less vulnerable (Barak et al., 2008; Suler, 2004). Barak
et al. (2008) and Suler (2004) observed that online support groups generally
place people on a fairly even plane, as the shared environment does not
display many status indicators. However, anonymity can open the door for
people to create false identities or present false facts (Siriaraya et al., 2011).
Empathy in online support groups. Ickes (1993) described how the full
experience of empathy includes not only understanding but also expressing
that understanding ("empathic expression") and communicating that under­
standing ("empathic communication"). In face-to-face support groups, one
can see how empathic expression and communication can be conveyed
in both verbal and nonverbal language. What adaptations are necessary to
engage in emotional and empathic communications in text environments?
In regard to general emotional expression, Preece (1999) observed that
people have "creatively" used punctuation and emoticons to communicate
"emotions in text" (p. 81). Emoticons are "a digital icon or a sequence of
keyboard symbols that serves to represent a facial expression . . . to convey
the writer's emotions or clarify intent" (Emoticon, 2014). Ganster, Eimler,
and Kramer (2012) discussed how people also use graphic pictures of facial
expressions ("smilies") to convey expressions.
Certain studies have found that expressions of empathy, support, and
personal narrative are some of the most common types of communication
content in online support groups (Preece, 1999; Schotanus-Dijkstra et al.,
2014; Siriaraya et al., 2011). These studies indicate that online support
groups may provide a forum for certain key types of personal expressions
and social interactions.
The mutual sharing of empathy, support, and personal narrative may hap­
pen by design. Siriaraya et al. (2011) found that certain forms of information

180 Heidi Hammond
(e.g., self-disclosure, narration, asking for help) appeared to "trigger" an
empathic response. The authors observed that some people served the role
of primarily empathizing and others provided the triggering statements. A
third category of participants communicated both types of statements; this
observation aligns with Batson's (2009) review of empathy research, which
summarized that witnessing distress can trigger a reaction in others.
Demographics are another variable to consider when analyzing the
communication of empathy online. Siriaraya et al. (2011) found differences
in message content when comparing teenagers and adults who posted on
separate discussion boards for people with depression. Teenagers gener­
ally presented in a more personal, informal way; showed more confidence
online; and used more words categorized as "deep support" (p. 620). By
comparison, the messages from adults tended to be more formal, displayed
less confidence, described more technical problems, and contained fewer
words indicating "deep support." Siriaraya et al. (2011) theorized that teen­
agers are comfortable with online communication, whereas some adults
may need to increase their comfort level and adapt their style of communi­
cation to the Internet.
Suler (2004) and Barak et al. (2008) described the phenomenon of so-
lipsistic introjection, which may shed light on what is happening in these
text-only conversations that include high levels of empathy and support.
Suler (2004) described how "text communication can alter self-boundar­
ies" (p. 323). Suler observed that people may internalize another person's
voice when reading text or reading another person's words in one's own
voice. Suler also described how text-only conversation may encourage the
imagination to fill in the gaps and develop a complex mix of reality and
fantasy. Suler (2004) observed that "different modalities of online communi­
cation . . . and different environments . . . may facilitate diverse expressions
of self" (p. 325). Many of these complex processes can also enhance "empa­
thy, bonding, and the identifying with other group members that is critical in
a support group" (Barak et al., 2008, p. 1871).
Fostering Empathy and Social Interest Online
A remaining question for this literature review pertains to how it may
be possible to foster empathy, social interest, and positive group interactions
in online support groups. Researchers have offered various suggestions that
may help support this outcome. Feng, Lazar, and Preece (2004) discussed
how sites can include "advice on writing styles" to avoid contradictory
and nonsupportive messages (p. 105). Preece (2004) suggested adopting
general "netiquette" guidelines, which are "basic, commonsense rules"
that help support successful communication (p. 59). Siriaraya et al. (2011)
summarized that ways to enhance trust could include "ensuring security

Social Interest, Empathy, and Online Support Groups 181
and confidentiality rules, addressing codes of conduct, governance poli­
cies as well as nurturing community culture" (p. 618). To enhance overall
community feeling, these suggestions point to the potential benefits of
establishing a community structure while also providing education on
online communication.
Employing an effective moderator may be another way to increase
empathy and social connectedness. Preece (1999) found that moderated
communities contained "higher levels of empathetic messages" (p. 78). If
moderation is not possible, Preece (2004) noted that role models, mentors,
and general community regulation can also help foster a more empathetic
and supportive communication style.
Various authors discussed using online support groups as an additional
support to existing therapeutic, health-related, or training services (Barak
et al., 2008; Griffiths et al., 2012; Owen et al., 2010; Schotanus-Dijkstra
etal., 2014).
Discussion
Viewed through the lens of social interest, the online world is similar to
the offline world. Online endeavors, organizations, communities, and com­
ments can either fall along the continuum of being socially useful or socially
useless. Online support groups originally formed to offer people another
way to connect and support one another (Barak et al., 2008). Examining
the nature of online support groups can help us identify how these groups
can maximize the potential for supportive interactions and enhance social
interest online. When describing social interest, Stein and Edwards (1998)
observed, "Adler saw the connections among living beings in many different
spheres and on many different levels" (p. 68). Given the continual expan­
sion of the Internet and the myriad ways it connects, affects, and shapes the
lives of people throughout the world, discussing the role of social interest in
a virtual environment is as important now as when Adler first introduced the
concept to a nonvirtual community in the early 20th century.
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Heidi Hammond (heidi.nicole.hammond@gmail.com) graduated from Adler
Graduate School (Minnesota) with a master's degree in Adlerian counsel­
ing and psychotherapy. She is a licensed professional counselor. Hammond
has used various forms of social media at different times of her life. At
this time, she primarily uses social media for connecting to people on a
professional level.

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