Hey check this out. Now we are starting to see some of the realities of the net utilized. Anoymous people with real or imagined problems, entering to “therapy” with virtual therapists. This is cool.Some years ago I was interviewed by Michelle Goldberg–who worked for me for a while–now a senior editor at Slate–about a website for agoraphobics and I was quoted in Wired saying” A virtual life is better than no life at all”, and I think this is still the case. I imagine, and I may be wrong that many of these folks wouldn’t seek “real” counseling, but in this space they can perhaps allow themselves to ask for help, after all no one knows who they really are. Of course it would be good to actually see some research done on the experiences and effectiveness of this space. It would also be useful to know what percentage of these participants are moved to seek real counseling with real people.

Second Life offers healing, therapeutic options for users

Cherilyn Parsons, Special to the Chronicle

Sunday, July 13, 2008
The author’s avatar approaches the Tibetan Buddhist templ… Carolina Keats, avatar for health librarian Carol Perryma… An avatar approaches an anxiety support group meeting.

“Every human being is interested in two kinds of worlds: the Primary, everyday world which he knows through his senses, and a Secondary world or worlds which he not only can create in his imagination, but which he cannot stop himself creating.” — W. H. Auden

In a garden pavilion on an island, I sat with an assortment of human beings – one clad as a teddy bear wearing a Santa hat, another as a brazen vixen, a blue man, a tuxedoed prom king – and poured out my heart from a place of loneliness and grief. Click click went the computer keys, like the staccato beat of my heart. Clack clack went their replies, their empathy and their own tales of triumph and woe. Via my avatar – the persona I’d created to engage here – I was participating in an “anxiety support group” in the free, virtual world of Second Life.

As I write those words, I can hear the scoffing. Pathetic! Escapist! Are you addicted to computer games? Do you have no friends? Second Life? That place is just about weird sex fantasies!

Founded in 2003 as a virtual community built by users, Second Life rose to cultural phenomenon status by 2006 – only to suffer media backlash over its glitches, hype and sex scene. But it continues to grow. By June 2008, more than 14 million people had joined, only 38 percent them from the United States. More people went “in-world,” or participated in, Second Life in the 30 days of June than live in all of San Francisco, which is the home of Linden Lab, the creator of Second Life. If Second Life were to materialize from its server space, the landscape would be four times the size of Manhattan.

A new virtual world, Google’s Lively, was introduced last week with its version of avatar chat rooms. And Second Life just announced a new technology, developed with IBM, to allow avatars to teleport among worlds. No wonder analysts at Gartner, a leading technology research company, predict that three years from now 8 in 10 Internet users will work or play in virtual spaces.

Sure, Second Life has more than its share of sex shops and pick-up joints, where avatars can lure others. You get it on virtually with “teledildonics” and relevant “animations.” In a “sim,” or simulated region, called Jessie, people kill each other for pleasure, albeit to “teleport” back, unwounded. There are financial swindles, pick-up scenes, personal backstabbing, and more attention to elaborate hairdos than Cher in her heyday. According to U.S. intelligence agencies, Second Life might harbor real-world terrorists, scheming in the caves of online anonymity.

It has, in short, all the trauma and pain of real life, and some cautions are in order when it comes to seeking psychological support.

But maybe because it’s a dream realm, hopefulness abounds. Nowhere is that truer than in Second Life’s support groups, which help people cope with everything from cancer, depression, bipolar disorder and autism, to caretaker stress. There are more than 70 such groups, according to Second Life’s Health Support Coalition. Most are secular. While a few groups are facilitated by associations such as the American Cancer Society, peers run most.

As expressed on the Web site, www.supportforhealing.com, associated with Second Life’s Support for Healing Island, “we are NOT and never will replace the help of professionals … but purely hold a safe place for people to come when they need a shoulder.”

A year ago, before I had explored Second Life, I would have laughed at the idea of virtual shoulders. How can a person possibly be “real” via an avatar anyway – much less have a meaningful conversation with a puppy dog, barmaid, elf, or wilder avatar appearance such as a blob or a tree? It’s hard enough to trust someone in real life, much less “second life.” Then again, what better place to connect our yearning selves with other yearning selves than in a space of mutual creation – a place where those very selves can be one’s unconscious made manifest? Indeed, avatar, in its original Sanskrit, refers to the descent of the soul in human form.

Click, clack: When I rose from my hourlong anxiety group meeting, I felt seen and heard in the deepest part of me – more so, in fact, than in some “real life” interactions, where we often put up fronts.

You’re not alone, the group told me.

Nor are you.
Virtual safety net

The anonymity of Second Life can make all the difference in opening up to share within a support group.

Somewhere in small-town America, a wife and mother of about 40 – she could be your neighbor or relative – suffers from serious depression. She loves animals, so within Second Life, as Fionella Flanagan, she’s a big gray dog with a shaggy white mane. She attends the depression support group. Why does she do it? “I don’t have to worry about what I say in the group coming back to bite me in my home town.”

She also suffers from fibromyalgia, one of those crippling, invisible diseases that some doctors say is “all in your head.” In Second Life, Fionella doesn’t “have to overcome real life prejudice when I say I’m sick. There’s none of that, ‘but you look so good’ junk.”

When anxiety support group avatars were asked whether they were more honest as avatars than in real life, a wild-haired blonde, Galvana Gustafson (in real life an American dancer and bassoonist with a master’s degree in psychotherapy), put it this way: “My avatar is more honest than myself because the rejection won’t hurt as much.”

No one would guess that the person behind the avatar Morgana Shi, a redhead knockout DJ at Second Life’s Heavenly Rose nightclub, suffers from bipolar disorder as well as back pain so disabling she often can’t leave the house. “This is my only outlet really,” she told me via private instant message while she was DJ’ing.

I’ve never done an interview while I was gyrating on a dance floor (click the floor, and a dance animation takes over your avatar). “Hallelujah, it’s raining men,” the song raged, and I whirled with other avatars as Morgana and I chatted.

“All of Second Life is my support group,” she reported. “My first week here, I walked onto the land that Heavenly Rose Night Club was on, and ran into Rose Kenzo, the owner, and she took me under her wing. She has been there for me for the last two years every day since.”

Morgana later discovered the Support for Healing Island “because I was going through a major relapse with my bipolar and needed help from people who understood. I personally like to be in groups that are survivors, sufferers, and caretakers and loved ones, supporting one another. The best help and advice I have ever gotten are from people who have experienced firsthand.”

She now leads a bipolar group on the Support for Healing Island and raises funds for the National Alliance on Mental Illness Walk in the real world.
Remaking the world

One of the most beloved community members in Second Life was The Sojourner, a multiple stroke survivor who created the “Shockproof Dreams” sim for stroke victims, people with autism and Asperger’s syndrome and the people who care for them. In real life, she once worked as a speech pathologist and her son has Asperger’s. A sweet, empathetic-looking avatar with auburn hair, in real life she died suddenly in May 2008, provoking an outpouring of in-world mourning.

The Metaverse Messenger – one of the virtual world’s newspapers – reprinted an interview with “Soj” as she was known, from June 2007. Second Life “isn’t just a game,” she emphasized. “It is a widely diverse opportunity to explore every aspect of life, if you choose to. If you are disabled in any way, this is a way to move beyond the disability.” Before her own strokes, she had worked professionally with stroke survivors. “I quickly realized that Second Life was a good rehabilitation tool. … It helps with memory, planning things, using math, making friends, developing self-confidence, using skills you thought lost to stroke.”

Soj created not only support groups but a “sandbox,” complete with tutorials and classes, where people can freely create objects out of “prims,” the core building material (think molecules) of Second Life, and thus create clothing, homes, entire landscapes. “A farmer/landscaper may not be able to use a plow in Real Life, but can landscape or have animals in Second Life,” she said in her last talk, now posted at her memorial on the Shockproof Dreams sim.

People with autism or Asperger’s especially seem to appreciate Second Life. The literature welcoming visitors to Brigadoon, a community within Shockproof Dreams, describes how the virtual world lacks “the richness of expression and gesture found in Real Life,” so people who become easily overwhelmed by real-world stimuli face “fewer distractions to worry about.” The Web site www.autistics.org sponsors a group of “activist autistic people” called the Autistic Liberation Front, who engage in discussions, workshops and conferences. They have a museum and library and hang out in a social area called Porcupine.

Researchers of autism use Second Life as a laboratory and tool. At the in-world SL-Labs and Teaching and Research facility, at the University of Derby in England, Simon Bignell, a lecturer in psychology, studies how Second Life can “enhance first life social-communication skills in people” with autistic spectrum disorders. The Center for Brain Health at the University of Texas, Dallas, offers a therapy in Second Life for people with Asperger’s that helps them practice interviewing for jobs.

Second Life’s Health Support Coalition (a collaboration between Soj, the avatar Gentle Heron and Carolina Keats, who in real life is a medical librarian) has won a grant from the Annenberg Foundation to create an Ability Commons, for 40-plus smaller health and support groups. “Imagine a paralyzed 23-year-old lying in his family’s back bedroom,” the coalition wrote, “yearning for contact with age peers in similar situations. Second Life offers people with serious physical and cognitive disabilities opportunities to socialize and get information.”

They needed a grant because hosting takes money. Though Second Life itself is free to access, people pay a monthly rent for “land” and prim space.

The large, lush Support for Healing Island, which has more than 850 members, ran into just that problem: The island’s founder, Zafu Diamond (in real-life Englishman John Palmer), couldn’t sustain the fees. This lovely garden isle with mountains, moving streams, flowers, flying butterflies, shrines and buildings, offered the widest array of peer support groups in-world. Featured on British TV, there’s even a Medicine Buddha Tibetan temple, where avatars could sit in meditation, chill to the sound of mantras, or share quiet conversation.

According to its monthly newsletter, Support for Healing was “a group of people that believe that recovery from depression, emotional trauma, and mental and physical illness can be greatly enhanced by loving kindness and friendship.” A Listening Ear service had offered “one-to-one support for those who have a need to talk to someone between the times regular meetings are scheduled.”

But fundraising efforts by the island’s stalwarts came to naught. Appeals to Linden Lab did no good. Groups ceased. The Listening Ear closed. The island teetered on the edge of digital disappearance – and at the last minute, an energy healer who’d been offering group meetings on the island stepped in to take over as owner. Most of the groups have restarted, though the depression support meeting, which had moved to The Centering Place sim, will be shared by both locations. The Listening Ear remains shut.

The avatar who saved Support for Healing is named Tong Ren Writer, after the Tong Ren therapy he practices. (In real-life he’s a patent lawyer in Boston.) He intends to welcome more support groups and also continue his free, energetic healing group twice a week.

Committed volunteers

Group leaders like avatar Glenn Oud, who has facilitated the weekly anxiety group for more than two years, take great care to not mislead. An East Coast IT professional in his 30s, who once had considered psychology as a career, he opens each meeting with disclaimers: “Please do not let these meetings take the place of professional help,” he typed to us. (Most support groups operate via typed chat.) “Please be kind . . . both listening and sharing are important.”

The weekly groups are an enormous volunteer commitment. “I keep thinking I’ll take my Thursday nights back,” he told me (the anxiety groups are 7 to 8 p.m. Thursdays, though they often go longer). “But hearing people tell me every week that it’s helping keeps me doing it.”

Specky Zaftig, the administrator for the Support for Healing forums, and the avatar of a 28-year old British woman, donates dozens of unpaid hours each week. It “allows many of us to offer something back to others from our own experiences. Many of us have struggled with depression, etc. To find a safe place where people understand you and support you because they want to can make a real difference to some people. … I like to know that somehow I’ve made a difference, no matter how small.”

A lot of altruism, free giving, plenty of warnings. Isn’t there any digital snake oil here? No fake therapists?

One in-world psychologist, Dr. Craig Kerley from Georgia, who was profiled on CBS’s “Early Show,” has hung his shingle for “cybertherapy” at $90 per hour. This work, he says, “can be valuable for those who have limited choices in their geographical region, have limited time to drive to regular in-person appointments, have limited mobility, and have limitations in their lifestyle that make traveling to a brick and mortar office difficult.”

Still, Dr. Peter Yellowlees, a professor of psychiatry and behavioral sciences at UC Davis and a specialist in virtual worlds, cautions about therapy in Second Life, even with professionals. He advises using it only as “a potential adjunct to face-to-face therapy,” and to “use passwords or other cues in Second Life to make sure you’re talking to the right person” – the real therapist, not scammers posing as one.

Yellowlees uses Second Life as a teaching tool, not for therapy. His Virtual Hallucinations sim gives “the lived experience of schizophrenia – to hear voices and see visions” so his students (and the rest of us) can “get inside the head, just a bit, of someone who’s psychotic.”

It certainly sparked empathy in me, much more richly than a mere clinical description of the disorder would have done.

Empathy: There’s that word again, an odd one to associate with impersonal bytes and modems, but the right one. Second Life is a hot, humming thing of wire and light, a “server” – spiritual teachers would like the metaphor – that can carry community and genuine human sympathy.

Cherilyn Parsons is a freelance writer and fundraising consultant to journalism organizations. E-mail her at style@sfchronicle.com.