Eric Legras … THEDOCTORFACTORY … Health & Wellness Strategic Marketing


PharmVille: Dr. Bob’s Web Site by The Doctor Factory

The New York Times – Virginia Heffernan

Say you start to find social encounters terrifying. Your doctor proposes a medication called phenelzine. Now you have a question: What does phenelzine feel like?

Put the question to Google, and you’ll soon land on a Web site called Psycho-Babble. There are plenty of enlightening and nutty answers about phenelzine there, but Psycho-Babble is likely to prove entrancing for other reasons. A vast and trippy symposium about the human mind has been under way on the site for almost 12 years. The nominal subject is pills. But, overseen by a brilliant and reticent Web mastermind, the conversation mixes technology, neurology, poetry and madness.

One Psycho-Babble poster, Rocket Jackson, complaining that his current prescription drug “has lost its once appealing ‘bang,’ ” writes, “I’m finally willing to take the plunge” with phenelzine. Rocket Jackson wonders, Will phenelzine really kindle the “urge to actually initiate a conversation,” or will it just relax him in groups? “Before I pop that first pill, I just want to be sure.”

Zeitguest, another poster, assures Rocket Jackson that phenelzine — brand name Nardil — can make you convivial. Others point out fearsome side effects. Psycho-Babble posters sometimes sound less like fellow sufferers looking to share than connoisseurs involved in collective critique of psychoactive medication — as other groups critique art or wine. “I’ve tried more than 35 different combinations of medications,” Jedi writes. “The first couple of times I took Nardil, it was like ‘seeing the light.’ ”

Psycho-Babble, which given its subject and tone can seem like one of the Web’s more gonzo enclaves, is actually the exceedingly conscientious experiment of Robert Hsiung, an associate professor of psychiatry at the University of Chicago with degrees from Harvard and Northwestern. Intrigued by online therapy but wary of forming authoritarian doctor-patient relationships online, Hsiung developed his own elegant message-board software and founded Psycho-Babble in 1998 as an online support group for patients. Under Hsiung’s gentle stewardship, Psycho-Babble has flourished. Posters have collaborated with Hsiung at academic conferences; they have volunteered to do administrative work on the site. Psycho-Babble has more than 23,000 registered members and has garnered more than 940,000 posts.

Psycho-Babble has a twisted lyricism to it. If Nathanael West captured the rhythms of Depression-era misery in the letters of “Miss Lonelyhearts” — “I cry all the time it hurts so much, and I don’t know what to do” — Psycho-Babble comparably captures how we suffer now. In ornately detailed paragraphs, posters try to use their brains to micromanage their brains. They also keep their heads up. Not long ago, Frustratedmama encouraged a longtime poster to hold out for “an acceptable quality of life.” “Exceptional may be out of reach,” Frustratedmama continued. “Although I would like to think that this is possible someday for all of us.” As Hsiung told me, “I’m continually humbled by the wisdom, determination and caring that they show.”

In an effort to keep this often eccentric group wise and caring and, above all, civil, Hsiung created a range of tools for the community, including one designed to prevent addiction to the site. He also published the formula he uses in sentencing posters he deems repeatedly uncivil to periods of exile from the site. The formula conveys his seriousness about online governance:

B = 1 + (SD – 1) * exp(-P/r)

B = block length

S = severity

D = duration of previous block

P = period of time since end of previous block (in weeks)

r = 24 / ln 2 ~ 35

Despite Hsiung’s caution and control, weird threads pop up all the time, including, not long ago, one about how to love your family more — through a pill. After voicing a traditional complaint — Why am I not sad when I should be sad? — the original poster lurches into clinical language. “My grandmom is in the intensive-care unit of the hospital. . . . I don’t feel the need to cry. . . . I am interested in hyderzine and deprenyl.”

This medical speak might appall drug-therapy skeptics, but for this site’s users, at least, the shift in idiom from storytelling to neurochemistry is often a way for suffering people to shore up faith that they will feel better while at the same time supplying a pretext for confiding fear, sorrow and lonelyheartedness to strangers.

Hsiung’s F.A.Q. includes a section called, “How should I decide what information to trust?” Compiled entirely from board posts, it’s a masterpiece. Above all, it empowers Web users and psychiatric patients alike to be strong readers, to mediate between dictatorial commercial culture and the radical factionalism and individualism of Web communities. One answer came from a poster called Daveman: “The search for truth reminds me of Hegel. It is neither the ‘thesis’ (the claim by the manufacturer that the medication is some sort of wonder drug) nor the ‘antithesis’ (the claim by someone who blames all their problems on the medication) but rather a ‘synthesis’ (a sober analysis of both positive and negative aspects).” Very sanely put.


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