In Russian, the word “friend” has a more intimate meaning than other words used for people we know personally. There are acquaintances, there are comrades, and then there are friends. Of the latter it is said, “A friend is someone with whom you have eaten a pound of salt,” meaning that it is a person who has been with you through thick and thin. I often think of this meaning of the word “friend” when someone mentions that so-and-so is his “friend on Facebook.”
The social media phenomenon has become very popular in the past decade, and it has brought about a new way of relating to others. Social media services such as Facebook and Twitter allow simultaneous communication with multiple people, a kind of communication that is rarely possible in physical circumstances—after all, it is not every day one finds himself a speaker in front of a crowd of listeners.
It has been suggested that psychiatrists should embrace social media as a “new and exponentially growing form of communication.”1 However, rather than encouraging social media use, a closer look at this form of communication suggests that there are many good reasons to stay away from social networking, both personally and professionally.
For most of our history, contact and relationships between human beings have involved physical proximity. Although remote communication such as letter writing has existed for thousands of years, it was understood to have a secondary role to that of communicating in person. Under conditions of physical proximity, communicating with others has necessarily involved the use of special senses: sight, hearing, touch, and smell.
Indeed, the degree of intimacy between people may be said to reflect how many special senses they use when they are together. How close people feel to one another may determine the physical distance between them when they get together, how loudly or softly they speak, whether they make physical contact, etc. In how we consciously or unconsciously manipulate these aspects of communication, we necessarily discriminate between people, establish degrees of specialness, and declare how private or public the relationship is.
Letter writing was traditionally a form of communication that existed in parallel to—but not as a replacement for—a physical relationship. In addition to conveying informa-tion for its own sake, a handwritten letter necessarily bore a unique imprint of the individual writing it. As a physical object with some permanence, it could be made particularly personal or unique in any number of ways. Letters took on scents; bore the stains of tears or spilled ink; and often contained other physical mementos, such as a lock of hair.
In the early 20th century, communication by telephone became possible, and by the middle of the century, most households in developed countries possessed a telephone. Technical matters and cost considerations meant that for at least the first 50 years or so after the invention of the telephone, this device was used to communicate with those who were not a great distance away and for short periods of time.
Even though several households may have shared the same “party line,” telephone conversations were generally understood to take place between two individuals and were, in principle, if not always in practice, a private matter for them. Private telephones were to be found in private spaces, such as homes, whereas public telephones in the community were protected by the confines of a booth that ensured privacy from within and shelter from the noise without.
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Individual advice, counseling, or treatment needs to take place in the framework of a face-to-face clinical encounter. In turn, physicians who have a need to make a public statement can do so in any number of ways that do not involve social media.
–Boris Vatel, MD
As telephone communication became less expensive, more accessible, and finally available in the portable form of cellular phones, people started spending more time using it. A curious phenomenon began to take place. Although the two-way nature of conversation continued, the portable nature of cellular telephones has resulted in a merging of a space that was previously considered private with a space that was clearly public.
Where once people separated themselves from others to speak on the telephone, they now began taking phone calls while surrounded by others. The person who chose to use the cell phone in the public space became a de facto public speaker who violated all rules of social conduct in that he addressed himself to no one who was actually present. In fact, an observation has been made that those who have cellular phone conversations in public resemble psychotic individuals responding to auditory hallucinations.
Whereas public cell phone behavior involves talking to one remote person while in the physical proximity of many, social media behavior involves communicating with many remote persons even when one may be physically alone. Both types of behavior occur in apparent ignorance of social rules in the physical world and rely on technology that makes such communication appear normal.
Dr Vatel is staff psychiatrist, Evansville State Hospital, Evansville, Indiana.
1. Peek H. Social media: an opportunity for psychiatrists. Psychiatric Times. July 9, 2014. http://www.psychiatrictimes.com/blogs/couch-crisis/social-media-opportunity-psychiatrists. Accessed July 28, 2014.