I will present to the Email and Mental Health discussion some reflections derived from experience with the Psychomedia email discussion list "Psicoterapia" [PM-PT], that I coordinate together with Marco Longo and Salvatore Manai.

This list is young, having been born only a few months ago (June 1997). Therefore it is difficult to make an assessment of this experience. In Italy we are still in a period of pioneering this field, and is not surprising that two of the list owners are themselves among the pioneers in psychology and psychiatry Internet discussion groups: Marco Longo is the founder of Psychomedia) and manages several other discussion lists, and Salvatore Manai is the founder of Psychology Notes and manages the psychology discussion list.

As for me, I am the Editor of the "Psicoterapia" area of POL-it, the most important online review of Italian psychiatry. One might say that the email discussion group "Psicoterapia" was created as a link between the major Italian professional organizations in the Internet in the field of mental health, trying to span the various disciplines involved, and also overtly aimed at encompassing the various theoretical approaches.

This latter aspect, in my intention and that of the other two owners, is certainly the most important: our ambition or, if you will, our dream, for the "Psicoterapia" list in fact is over the years to establish an advanced perspective, yet one that incorporates the views of individual list members. We wish that the list will be valued by workers in various schools of thought and in particular that it would address the historical development of concepts in the field of psychotherapy.

Use of electronic mail is one of the more interesting aspects of the Internet, particularly in the extent to which the Internet permits exchange of information and documents all over the world in real time. Within the area of electronic mail, discussion lists have the advantage of the contemporaneity of messages distributed to all list members, yet giving everyone the option of responding in their own time, an advantage lacking in telephone conferences.

But I would like to comment on a second, and perhaps more important, aspect of email: the replacement of spoken communication by writing. Some describe a grand return of the era of belles lettres that unfortunately was extinguished by the advent of the telephone; but in truth email has in common with handwritten or typed letters only one feature: the fact that one must take the time to spell out one's thoughts. The slowness of this activity induces a contemplative and emotional mood (this contrast from communication by speech is stronger in the case of handwritten letters, as writing by keyboard is far faster than by hand). The major differences that characterize email (beyond, as it has been noted, the maximal speed of communication-- nearly real-time) involves the fact that in email, transmitting in ASCII code, there is little possibility of transmitting more than the content of a communication; content is emphasized at the expense of nonverbal communication. One's facial expression cannot be seen and the various gradations in tone of voice are not heard. These negative features are shared with snail mail, but futher lacking in email are italicization and underlining. There is ittle beyond the ability to use capital letters to emphasize some words (indicating they are to be uttered in a loud voice), as well as some symbols (faces that grin or express sadness, etc.) and other little tricks available within Internet tradition and approved by netiquette.

What does this imply for the psychological aspects of a discussion list, and in particular for a list like "Psicoterapia"? We know that ideas are communicated in extremely personalized ways in psychotherapy; and that various schools and trends of thought often have arisen through affective ties based on the attractive force of historical figures or charismatic leaders, where not very rarely the analogic components of the communication (the nonverbal communication and the metacomunicative aspects in general) were preponderant over the content or the "rationality" and logical coherence of the ideas that were transmitted from the "masters" to the "students." This very much resembles the essence of curative factors in psychotherapy, where impact of the "person" of the therapist (personality and emotional heat, tone of voice, etc.) goes beyond all the "specific" therapeutic factors that are perennially the target of ever more sophisticated yet frustrating research. In this light, current experiments of conducting psychotherapy through email are interesting, practiced especially when patient and therapist are widely separated geographically.

The specific characteristics of electronic mail therefore offer a new way to debate and to discuss, where the communications are relatively lacking in emotional or personal aspects which, as it has been noted above, are important in maintaining one's adhesion to one particular theory. Of course, it is not possible to draw definitive conclusions, but we can say that is worthwhile to pursue experimentation in a field characterized by new and interesting developments. One of the more interesting aspects of a "Psicoterapia" discussion list, for example, is the concrete possibility of a splitting-off of the kind of groups that unfortunately have characterized psychiatry, a field composed of mutually alienated cliques or psychotherapeutic schools whose impact often is directly proportional to the isolation they manage to maintain. Electronic transmission facilitates sending anything that comes to mind immediately to colleagues of the most diverse orientations. Already cross-orientation alliances and mutual enrichment have occurred (colleagues who appreciate the ideas of the exponents of schools contrasting with them request bibliographical references, etc.) This "cross-cultural" process fundamentally defies the logic of the "schools" that - given the institutional mechanisms in which they are all involved - extends to suppressing comparisons of ideas that diverge from dogma, holding the students in thrall lest their too-rapid development might make them too independent of their school, which therefore inevitably would cease to exist. (Paradoxically, a true school is that one that works to eliminate its divisions in order to make the "students" more and more independent from its "masters").

And for that reason I think that having too many diversified lists within the field of psychotherapy is not indicated (it can be a serious error, for example, to separate psychotherapy from psychoanalysis and perhaps psychotherapy from psychiatry), because this goes against to an aspect of Internet philosophy, even though it's impractical to eliminate certain specialized lists.

One characteristic cause of controversy on many discussion lists is that they contain debates and divergent opinions on several issues (and the debates and the clash of various ideas become mitigated by virtue of the fact that the discussion is an opportunity for moderation and reflection): these discords are healthy, because they constitute the spark that ignites discussion. The "Psicoterapia" discussion group is no exception, where, as was said, differences of opinions have always been valued. Examples are some debates that have happened on the 'Net, such as one on IPT (Klerman and Weissman's Inter-Personal Therapy for depression) between myself, Giovanni de Girolamo and other colleagues (this debate, actually, took place on the "Psichiatria" list of POL-it coordinated by Francisco Bollorino, before that the "Psicoterapia" list was born), or that more recent one on the criticism of phenomenology that followed the contribution of Mauro Fornaro, with the interesting participation of Andrea Angelozzi and Salvatore Manai. Because of their validity these debates have been then published in the "Psicoterapia" area of POL-it. Other interesting debates that have developed in the list during its first six months of life have concerned such topics as the relationship between the idiographic model and the nomothetic (that is, psychotherapy as science and the problem of the research empiricist), the issue of the self-disclosure (personal revelations by the therapist), the problem of the conscience (beginning with a contribution by Mark Solms in the Journal of the American Psychoanalytic Association issue #3 for 1997), and so on. Our hope is that this is only the beginning of a long and stimulating path.