Transcript
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As a child, I was told that “a trouble shared is a trouble halved.” People need to discuss their

problems, particularly medical problems. But in this fast-moving, modern society, it can be

difficult to find listeners who understand the problem. Howard Rheingold [17] has shown the

power of online communities in his thoughtful portrayal of the WELL1. Now, with tens of

Empathic Communities: Empathic Communities: Reaching Out Across the WebReaching Out Across the Web

Jenny Preece

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others’ conditions and feelings. The term“empathy” has at least three different mean-ings. It can mean knowing what another per-son is feeling, feeling what another person isfeeling, or responding compassionately toanother person’s distress [12, p. 234].

In a review of more than 100 online com-munities, we found that empathy is a keyingredient in many support groups covering awide range of topics [15]. I therefore refer togroups, in which communication betweenmembers is strongly empathic, as empathiccommunities to distinguish them from groupsthat are primarily concerned with factualinformation exchange. Empathic communi-ties generally have a strong focus on medicalor personal problems, and their memberswant empathy and emotional support. In oneonline medical support group this strongsense of empathy was summed up in com-ments from three participants:

“We’re all in this together, which helps!”

“Thanks for this list – it is nice to know you’renot alone”.

“Dr. S and Dr. B said they were amazed athow well I was recovering and give credit to‘my good attitude and emotional preparationfor surgery’ I thank you all for much of that,thank you for your positive support.”

Characteristics of these groups vary; someof the most strongly empathic groups areclosed or have mechanisms that discourageaggressive or superfluous posting. For exam-ple, they may have joining rules and by-lawson the form and content of messages. Somehave moderators who check all messagesbefore posting them to the community. Oth-ers have mediators who are notified by mem-bers when they observe unreasonablebehavior. The mediator then investigates theproblem. The amount and type of activity andthe demography of a community’s populationdefine its character too.

Design of the supporting software influ-ences community behavior. Most bulletinboards have threading, by which replies totopics are listed below the original message.Some indent messages to distinguish replies

thousands of online communities, new

support groups emerge daily. These

communities encourage learning through

shared experiences. They enable partici-

pants to offer and receive emotional

support in a climate of trust, equality, and

empathy.

The days are gone when doctors had timeto call at patients’ homes to talk. A recent arti-cle in the Guardian, a British daily newspaper,reports that “research has shown patientsenjoy on average 16 seconds to explain theirview of their medical problem to doctors”[24]. Some doctors also think that patients donot need to know details about their condi-tion. Furthermore, patients often fear offend-ing their doctor by seeking a second opinion.

An increasing number of people are look-ing to the World Wide Web to help solve theirmedical problems. A New York Times journal-ist [25] reports how Mallory Marshall and herhusband searched the Web to learn aboutprostate cancer. “We became very wellinformed,” Marshall said. “With the informa-tion I dug up, we went all over the place tointerview different doctors and compared dif-ferent therapies ranging from radiation, diet,surgery and ‘seed’ implants.”

Time constraints can make it difficult forpeople to attend local support groups, somany people are turning to the Web to meetothers. Instead of meeting 5 or maybe 10 oth-er patients with the same problem, it is possi-ble to reach hundreds and to find people ofthe same age and gender. Distance and timeare no longer serious barriers to communica-tion. Comparing stories about diagnoses andtreatments makes patients better informed, sothat they can refine their questions for thoseprecious moments with their doctor.

Talking with other patients is a way of find-ing out what to expect next during illness.Physicians know the facts, but patients whoshare the same experience can empathize with

1 The WELL was one of

the first online commu-

nities. It was started by

a group in the San

Francisco Bay area.

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that it brings for people passionately involvedin sports can be frustrating and depressing.

There are two main ways of treating a bro-ken ACL. The ligament can be reconstructedby surgery, or surgery can be avoided andinstead, the patient can follow an intensiveprogram of physical therapy to strengthen sur-rounding muscles to compensate for the miss-ing ligament. Surgery tends to be the favoredoption by athletic people because for mostpeople it brings nearly full recovery and areturn to sporting activities. However, recov-ery may take a year and be painful.

The choice of treatment is, however, not asstraightforward as itmight seem. If surgeryis chosen, patientsmust choose amongdifferent versions ofthe reconstruction.Furthermore, patientsneed to rememberthat people responddifferently to treat-ments, have differenttolerances to pain, andexperience varyingrecovery times, sowhat works for oneperson may not workfor another. Age, gen-der, body weight, lifecircumstances, andattitude also vary fromperson to person andinfluence the successof the surgery. Ofcourse, the skill of the

physician is also an important variable. Hav-ing made a choice, the patient then has towork through the recovery phases, which maybe tedious and painful. In addition, there maybe stresses associated with changes of life cir-cumstances after surgery and the uncertaintyof whether full recovery will be achieved.

Orthopedic surgeons can answer medicalquestions and may be able to draw on theobservations of hundreds of patients, butmost patients want to know what it was reallylike for other patients. They want to hear first-hand accounts of their experiences. How

and replies to replies. Some support the use ofemoticons and small icons to signal contenttype. Searching by date, name, or topic isbecoming increasingly common. Webresources such as frequently asked questions(FAQs), descriptions of medical conditionsand treatments, and lists of resources influ-ence online behavior. Relationships withphysical communities, such as the BlacksburgElectronic Village [5, 6], and organizationssuch as The National Cancer Institute influ-ence electronic communities. These attributesapply to the case story discussed later andcombinations of some of them feature in mostcommunities [23].

Last year I becameintensely interested inone particular discus-sion group, which, as Idiscovered, is a strongempathic community.I needed to find outmore about a skiinginjury, in which I torethe anterior cruciateligament—or ACL asit is generally known—in my right knee, aninjury suffered bymore than 20,000skiers in the UnitedStates each year, as wellas by numerous bas-ketball, football, andtennis players. Theassociated Web pagesprovided basic infor-mation, but readingthe messages quickly turned me into a knowl-edgeable patient. However, what impressed memost were the support and empathy amongthe members of this community.

Medical Background of the CommunityThe ACL is one of four major ligaments thatsupports each knee. Without it, a knee tendsto slip sideways and may give way. Gettingthis injury is bad news because patients haveto give up sports for several months. Eventhough the injury is common and not life-threatening, the changes in life circumstances

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© 1984 Mark Kostabi, Solace Near a Street Light

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4 males to 1 female. Most posters are between20 and 40 years old and share a strong love ofsports. This provides a clear focus for the groupand common understanding between them,which undoubtedly contributes to the successof the community [23]. The scope of most dis-cussions tends to be narrow and clearly focused.The bulletin board is open to anyone, so theoccurrence of acrimonious posts (flaming) andspamming would not be surprising but suchbehavior is unusual. Bob lightly reviews mes-sages, but he rarely intervenes.

Part of the membership of the ACL commu-nity appears fairly transient. Most of the newpeople on the board have recently sustained theinjury, but there are a few old-timers who keepcoming back. There have been a few postingsfrom people professionally involved in orthope-dic treatment, such as a nurse and a specialist inknee braces, but there is no sign of physicians.The tone of the messages suggests a sense ofequality and trust within the group. Communi-cation between members is helpful, empathic,often altruistic, and sometimes cathartic. Peoplewant to share their experiences, learn from oth-ers, and support each other.

What Do People Talk About?A content analysis of 500 archived messages,from the ACL bulletin board, sampled inbatches of 100 at approximately two-monthlyintervals, was analyzed [14]. Some 312 mes-sages were posted by men, 156 by women,and 32 could not be classified by gender. Twohundred fifty-one different people postedthese messages. The largest number posted byone person (Bob) was 24. Most of his postswere to draw attention to previous posts on atopic of interest. For example, common topicsthat newcomers ask about include Is surgerynecessary? What is the difference between dif-ferent surgical procedures? How long is recov-ery? and so on. At the time of this studyadditional useful information, including avideo of arthroscopic surgery, was available onthe Web site, but FAQs were not included.One hundred fifty messages were single postsby one person. Figure 1 summarizes thesefindings. A detailed discussion of the analysisand the methodology used in this study iscontained in Preece [14].

much did it hurt? How does what I am expe-riencing compare with what you experienced?If I do this, what should I expect? One way ofgetting answers to such questions is to seekother patients on Web bulletin boards, ofwhich there are now several thousand. Someare produced as suites of boards by the sameoriginators, and some, like Bob’s bulletinboard, are the work of caring individuals whowant to share their experience and help others.

Bob’s ACL Bulletin BoardThe ACL bulletin board, known eponymous-ly as Bob’s bulletin board, forms part of anACL Web site. The bulletin board (URL:http://www.cnct.com/~bwillmot/knees/wwwboard/) started in April 1996. The num-ber of postings per day increased from about 24in May 1996 to more than 100 in April 1997.By October 1997 there was an archive of about9,000 messages. Messages are threaded so thatthe headers of responses are indented and posi-tioned below the header of the message towhich the reply applies. The bulletin board isrudimentary. Messages cannot be ordered andsearched by date, topic, or sender’s name. Somepeople use log-in names, some use first names,some full names, some just give initials, andsome give a description. There are no guide-lines on how to specify topic lines, so styles varyand some are more helpful than others. Exam-ples of typical topic lines are:

Help … Tomorrow is D-Day! (reference tosurgery)

I don’t know what to do!!! (reference to just dis-covering the extent of his injury)

Man, I AM NERVOUS! (concern not onlyabout having surgery the next day, but also aboutwhether he will be able to play football again)

Although guesses can be made about whatfollows, the topics being discussed are notobvious.

The gender ratio is close to two males to onefemale and is similar to that reported by Pitkowand Kehoe[13] for the general population ofInternet users. In 1996, when the board start-ed, there was a higher proportion of men. In apilot study in March 1997 the gender ratio was

Jenny Preece

Information Systems

Department

University of Maryland

Baltimore County

Baltimore, MD 21250

[email protected]

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changes and so doestheir need for empa-thy. Furthermore,the balance betweenneeding informationand needing empa-thy varies too. Thepatients’ messagessuggest that threemain stages can beidentified along thepath from injury torecovery: from injuryto diagnosis, fromdiagnosis to treat-ment, and from treat-ment to recovery, asshown in figure 2.

Some people gettheir injury diag-nosed very quickly,others need to visit

two or more doctors and may seek the confir-mation of a magnetic resonance imaging test(commonly called an MRI). At this first stage,the factual content of messages is about detailsof diagnosis and the kinds of treatments thatare available. The empathic comments gener-ally consist of people telling their stories,including frustrations about not being able toplay sports and concerns about how long itwill be before they can play again.

The time between diagnosis and decidingon treatment is when the most detailed factu-al questions are asked. Patients want to findout about different treatments, check theirunderstanding of the procedures involved, getestimates of the likely amount of pain and dis-comfort, and check the prognoses for recov-ery. They also want to hear from others whoare further along the path to recovery. Patientsalso get frustrated and scared and seek thesupport of others, but the need for factualinformation seems to dominate at this stage.

After treatment, which for an ACL injurygenerally means some form of surgery, patientsare eager to hear how their experiences com-pare with those of others. This is the timewhen empathy is strongest, especially forpatients who experience pain, who are notsleeping well, and who wonder how long they

The analysis showed that 76.8 percent ofthe posts were empathic to some extent. Somedirectly asked for or offered support, somesimply told their story, many asked oranswered questions by drawing on their ownpersonal context. The side-bar titled “Exam-ples of Communicating Empathy” (pp. 40-41) gives examples of some of the differentways of communicating empathy.

Only 17.4 percent of the postings werepurely factual questions or answers andshowed no empathy or reference to personalexperience, as illustrated by the examples inthe sidebar titled “Examples of Communica-tion without Empathy.” (p. 39) Some 5.8 per-cent fell into the category of “other,” and mostof these were jokes. Occasionally there aresigns of frustration, when newcomers, anxiousto find out more about their recently sufferedinjury, ask basic questions that have been dis-cussed many times before. Usually someonepolitely refers the inquirer to an earlier discus-sion. The community is surprisingly tolerantand annoyance is rarely shown.

Different Needs at Different TimesNot surprisingly, patients’ needs changebetween the time of their injury and theirrecovery. The kinds of questions asked

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will feel like this. The lucky ones want to checktheir progress with others who have gonebefore them. Some people count the days untilthey can resume their favorite sports— biking,football, skiing, and so on—and want infor-mation about the best physical therapy work-outs to get them back playing again.

People vary enormously, but in general thetime before treatment is when most fact findingoccurs, with the time just after diagnosis beingthe most intense of all. The same questions fre-quently get asked again and again. Empathicmessages are sent at all stages, but the need forempathy is often strongest just after surgery.

The messages sent to Bob’s bulletin boardillustrate the important role of empathy in thiscommunity. People want to make contact withothers, tell their stories and be heard, offer andreceive support, as well as get factual informa-tion about their problem. Learning the medi-cal facts is only part of the communication onthis board. Even those who ask or offer factualcontent usually do so in the context of theirown injury, recovery, and broader life circum-

stances. These messages are from patients con-cerned about their condition and it is commonfor them to talk about their own experience.Messages from other patient support groupsalso show a high level of empathy [15]. Wom-en’s health groups are often the most stronglyempathic, particularly those that have joiningrequirements and rules and are moderated.

Research in psychotherapy [7, 9] informsus that empathy is present in most communi-cation, but in many work situations it may besubtle. Much of the research in computer-sup-ported co-operative work (CSCW) and com-puter-mediated communication (CMC)focuses on performance in formal tasks, whereempathy is usually not obvious. The dramaticincrease in empathic communities providesexciting opportunities for researchers to take anew perspective that acknowledges the role ofempathy in informal online communication.

Design Implications The ACL bulletin board, like many bulletinboards, has little structure and is an example

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Figure 2. Injury-Diagnosis-Treatment-Recovery Path

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of the ad hoc evolution of bulletin boarddesign [8], which is just beginning to changeas designers become more conscious of com-munities’ needs. Basic tailoring facilities andemoticons are examples of change. As thenumber of people online increases, users willrequest better usability. For example, they willquestion why they cannot do seeminglystraightforward things, like easily search previ-ous messages and archives. Some ACLpatients wanted to contact others similar tothemselves. Another issue discussed was thefrustration experienced when newcomers askquestions that have already been discussed atlength. In addition, ways of dealing with well-known problems, like flaming, continue to beimportant for all communities.

Figure 3 shows some key design require-ments for empathic bulletin board communi-ties. At first glance these issues appear likethose needed by any online community.Empathic communities are at the extreme

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end of the empathic–non-empathic spectrumof communities. The difference lies in thedegree to which supporting empathy isemphasized. In order to support the high lev-el of empathy that makes empathic commu-nities function, their requirements need to bemet in ways that do not threaten empathiccommunication. There may, therefore, betimes when efficiency has to be balancedagainst supporting empathy and trade-offsmade. For example, FAQs are efficient butmay affect empathy among patients, as dis-cussed later. Similarly, a balanced approach isneeded to developing techniques for informa-tion searching and other key user activities(see Figure 3, center of diagram). Ways ofdealing with concerns such as privacy (left ofdiagram) may require more human involve-ment than in other communities. People indistress also tend to be vulnerable, so guard-ing against misleading information (particu-larly medical information), impostors, and

Figure 3. Design Requirements For Empathic BBC Communities

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dent, time since surgery, and so on. Searchingstrategies can be adapted on the basis of visu-al feedback to enable users to target specificindividuals.

Research on recommender systems mayalso be useful in this context. Recommendersystems are like collaborative filtering, but theterm is broader and includes systems that maynot explicitly collaborate with recipients [16].Some of these systems enable users to entertheir preferences directly, in addition to thesystem tracking choices from past user behav-ior. Using such systems, it might be possibleto alert members of communities to posts thatmight be of interest to them. Users could thendecide whether they want to follow up on therecommendations. GroupLens [11], for exam-ple, performs a similar service for Usenet read-ers. Studies of GroupLens indicate that thatthe service is useful. However, it was difficultto get adequate ratings upon which to basefuture searches because of the small number ofarticles read by each Usenet user. The narrowfocus of many empathic bulletin board com-munities may be a successful avenue forexploring such systems.

One problem with these suggestions is thatthey have implications for individuals’ privacy,which must be protected. A second is thatthey involve substantial software develop-ment. In the short term improved ways of tai-loring bulletin board displays and book-marking would improve usability. Some

scams is a serious issue. Good resources onthe Web (top right of diagram) are also need-ed, with ways of accessing them within a bul-letin board (right of diagram). For example, itwould be helpful to click on a term in a mes-sage and call up a Web browser. Tailoring thebulletin board display and keeping personalfiles is useful too.

Finding Facts and Others Like Yourself …Most people join Bob’s bulletin board soonafter their ACL injury. They want to find outas much as possible about the various treat-ment options available. Sometimes, peoplealso want to find others with whom they canclosely identify in terms of gender, age, life cir-cumstances, sports preferences, level of sportsactivity, and body mass to see what choicesthey made and how successful they were. Forexample, a patient might want to find womenover 40 years of age weighing around 120pounds who are moderately active. Thepatient might want to gauge where the wom-en are in the recovery process, to review theirmessages and others in the same thread or onrelated topics. Now the only way to do this isto scan the list of names for those that lookfemale or post asking people who fit thedescription to identify themselves. Havingfound potential candidates, the next stagemight be to contact them directly.

Providing this functionality raises privacyas well as technical issues. People may notwant to receive e-mail from strangers, so mak-ing this easy would not be desirable. Othersolutions need to be found. For example, peo-ple could be invited to complete a simple on-line form that would be active for a limitedperiod of time and then be either renewed ordiscarded. There could be a facilitator whoensures that requests for contacts are honor-able and agreeable to the person being asked.The facilitator would then initiate an intro-duction.

Information visualization techniques, likethose used in the FilmFinder [2], could enableparticipants to visualize data from communitymembers collected via forms. It would be pos-sible to use such techniques to visualize therelationships between combinations of vari-ables such as age, gender, time since the acci-

E x a m p l e s o f C o m m u n i c a t i o nw i t h o u t E m p a t h y

Fewer people asked straight factual questions or gave answers inwhich there was little or no reference to their own personal situation,such as the comments from Gerry and Rob.

Hard to say if she has a problem or not. Just make sure that when she’snot rehabing it all her spare time is spent trying to straighten the leg.

Gerry

Well isometrics are a good way to exercise the legs without puttingundue stress on the compromised ACL. . . . Straight leg lifts — lay onyour back and while keeping your knee straight lift your leg 10 to 30degrees, Hold. Repeat. Once again the amount of time you hold the legwill determine the amount of work the quad will do.

Rob

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nication have not been borne out and I hopethey will not.

A balanced approach to supporting effi-cient information exchange and empathy isneeded, and the solutions may vary from onecommunity to another depending on thenature of the community, the topics of discus-sion, and the structure and usability of thesupporting software. For example, Ackermanand Palen [1] observed a different solution intheir study of the Zephyr system, which is aconferencing system used by students at theMassachusetts Institute of Technology to dis-cuss programming problems. They concludedthat there was no need for a system memorybecause the users did not mind answering thesame questions again and again. Of course,discussions of technical issues are likely to beless empathic than personal health. In a studyof the general use of e-mail in a professionalsetting, Whittaker and Sidner [22]point outthat many e-mail conversations are multi-

agreed formats for message headers (e.g., top-ic lines and user names) would also help.

Same Questions Again and Again When I joined the ACL community I won-dered why there were no FAQs on the associ-ated Web pages. Later, as I used the boardmore, I realized that, as with many obvioussolutions, there could be a serious problemwith this one. Providing concisely writtenanswers in FAQs may inhibit people from ask-ing questions in case they are thought unnec-essary and a nuisance by others. FAQs mightencourage intolerance and abruptness. Com-ments like: “you should check the FAQs firstbefore posting” or “don’t waste people’s timeby asking questions that are already answeredin the FAQs” could reduce or even eliminateempathy and change the nature of the com-munity. Since I conducted the study, FAQshave been added to the Web site. So far, myconcerns about destroying empathic commu-

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In the sequence of postings that follow, Debbie

directly asked for support and Ken, Kath, and Mike

responded by empathizing with her situation and

suggesting ways to cope. Notice also the expression

of warmth and encouragement to “hang in there,”

an invitation to come back and tell how she is pro-

gressing, a note that she is welcome to contact the

other “veggies” at any time, and wishes of good

luck. Considering these people only know each oth-

er through this bulletin board, the warmth, caring

and empathy conveyed in their postings is remark-

ably strong.

It’s been two weeks and five days now. I read other post-ings where others pained over feeling alone. Well, I’m hav-ing my bout with the depression. It’s a battle to entertainmy mind, reading, computer, talk, radio and rarely TV. . . .I suppose not sleeping very well is wearing on me as well assome of you. Not happy with my flexion yet, can’t seem toget that last 1/8th inch. Thanks for listening. : )

Debbie

My feeling is that nobody knows what we are goingthrough. A lot of my friends have had this, and though theyknow it is a terrible time, they can look back on it—we will

be able to do this too, one day but for now . . . I kind of feelalone. For me, I just want to sleep 3 hours straight, just once.I guess what I am saying is that I know what you are saying.We just have to hang in there. Good luck.

Ken

Debbie, . . . I haven’t been sleeping very well either. Justhang in there you are not alone. Keep me updated on howyou are doing.

Kath

While you’re a few days further in than me I feel I havetoo much of a job to do to feel alone (getting better that is) .. . I HAVE watched over a dozen movies . . . mostly of theintelligent variety, . . .You might want to try this. I made alist of 12 movies I’ve been wanting to see (Room with aview, Forrest Gump . . .) Anyway if that doesn’t help, youcan always communicate with us other “veggies” any time.

Warm regards, Mike

The next three comments show empathy about

life circumstances. Dave is frustrated that he can’t

ride his bike in the beautiful weather. Brad and Bill

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ing discussion of different topics, maybeencouraging people to seek expert advice,keeping watch for scams, and so on. In partic-ular, as groups get very large, moderators willneed to create meaningful subgroups for dis-cussion of specific topics. Deciding when todo this could be a sensitive issue for empathiccommunication. It is well known that moder-ators change the nature of online communica-tion [11, 21, 22], and supporting empathyrequires skill. Mediators are becoming morewidespread. Unlike moderators, mediatorsonly take action when called to do so by thecommunity.

As well as ensuring that an empathic cli-mate prevails, moderators need to look outfor people posing as medical experts or coun-selors. It is easy to imagine instances of peo-ple posing as professional medics in order togive, or worse, sell advice. There has been noevidence of this behavior on Bob’s bulletinboard, but it could be a concern. Incidents of

threaded; that is, several conversations aregoing on at the same time, so information getslost and the same questions are asked againand again. The authors do not mentionwhether this is a problem.

Sensitive Moderating, Joining Requirements, and By-Laws Many concerns for empathic communitiescan be restrained by unobtrusive moderationof some form, rules, and by-laws. Several roleshave been identified for moderators of onlinecommunities [e.g., 4] in addition to stoppingflaming and other antisocial behavior. Somemoderators lead discussions and keep them ontrack, but this is less important for empathiccommunities than for many other groups.Moderators may also act as experts, answeringquestions or directing people to previous mes-sages or resources, as Bob does for the ACLgroup. Moderators of empathic communitiesmay need to take more diverse roles, channel-

respond with comments about their own situations,

which they point out are worse but in a friendly,

joking manner which is supportive.

A A A A A A A A A A A A AC C C C C C C C C C C C C K -KKKKKKKKKKKKKK!!!!!!!!!!!!! There, I just had to get thatoff my chest. It’s 50 degrees today for the first time since Nov.and the sun shining. I have a beautiful bicycle waiting to berode and the road is calling. BUT doc says no. Oh well Iknew you would understand fellow bad knees. Thanks for lis-tening to my whining. Now I feel better!

Dave

Before you know it, it will [be] 70-80 degrees out and youwill be out pedaling your ass all over town! I was to have myrecon on 3/3, now I have to wait until 4/4, just think howwarm it will be before I get out.

Brad

Morning Dave, You make me laugh. . . . Don’t you likehour after hour on your trainer . . . be glad you don’t livein Central California where it’s now 70+ degrees, flowersblooming and you can’t hit the road.

Bill

Some people use the board to tell their story and

as a way of inviting others to contact them. The

story below from Jimmy is an example of this. He is

not asking questions; he tells his story and pre-

sumes that when he comes back with more details

about his physical therapy, people on the board will

be interested in listening. He also wants to encour-

age and support others.

Well, here is my story. It all started on 1-11-97, I am 26and I have been skiing for 11 years with no injuries untilnow! It all started with the “famous” one last run. . . . Iwas so glad to find out that the pain could be controlled,just take the meds as prescribed, don’t try to be a hero, itWILL hurt. . . . I have been reading all these stories for thelast couple of months and they have been a tremendoushelp, so please feel free to ask any question, seeing I shouldhave some free time on my hands for the next couple ofweeks!! I will be writing back with some PT details as theybecome available.

Jimmy

Jimmy’s story is typical of an indirect request for empa-thy. He does not ask for support or help directly butinstead tells his story, which often has the effect of elicitingempathic responses. In our study we observed that menadopted this approach more frequently than women, whomade more explicit requests for empathy. The men in thisstudy also asked more factual questions than women [14].

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Just as in ecosystems of animals and plants, thenature of the dynamics of human social ecolo-gy is that many variables are interrelated.Change one and there can be a ripple ofchange through the whole system in unexpect-ed ways. The dynamics of online communitiesthat have only text as a medium for expressionmay be even more sensitive because they lackso many of the feedback cues that we are usedto in face-to-face communication. Even quitesmall changes to the physical (i.e., software)and social structures of the community canhave a big impact on the way it functions.

Communities areforming on the Webat a phenomenalrate for all kinds ofpurposes [3, 13]. Bybetter understand-ing the role ofempathy in a cross-section of thesecommunities, wecan investigate anddesign tools to sup-port empathic com-munication as wellas factual informa-tion exchange. Well-designed empathiccommunities willimprove the qualityof life for thousandsof people.

Acknowledg-mentsI wish to thank Bob

Wilmot for answering my questions and fordeveloping Bob’s bulletin board, which is asource of information and comfort to thou-sands of knee sufferers. Kambiz Ghozati didmost of the data analysis for this study andprovided many useful insights. I also thankthe reviewers and editorial staff of interactionsand Ben Shneiderman for their comments.

References1. Ackerman, M. S. and Palen, L. The Zephyr help

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system. Proceedings of ACM CHI’96 Conference, 1996,

people posing as someone else [17] and gen-der swapping have been well documented[18, 20]. Impostors selling expensive homeo-pathic medicine, promising miracle cures,were observed in several empathic groups.Warnings spread through the groups veryquickly but some people made purchasesbefore the scam was exposed. Awareness thatpeople are watching for scams may deterthem, but the problem is likely to increase asmore people come online.

Joining requirements may also become morewidespread to discourage those without bonafide interest. Morepublic explanationsof moderators’ rolesand clear descrip-tions of communityrules might helpdiscourage unac-ceptable behaviorand support empa-thy. Furtherresearch is neededinto the details ofthese issues in rela-tion to empathiccommunication.

Private Communication Private communi-cation channels areuseful for con-tentious one-to-one debate, fordiscussing topics ofnarrow interest or apersonal nature [1]. Furthermore, there arelimits to the amount and kind of informationthat a person will make available to the publicat large, so private forums for communicationare needed [10]. One-to-one communicationis also known to be liked by women and girls[19]. Facilitating private communication islikely to encourage empathy, particularlywhen the topics of discussion are personal.

Balancing Empathy and Factual Information Exchange The social ecology of human groups is delicate.

42 i n t e r a c t i o n s . . . m a r c h + a p r i l 1 9 9 8

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Coming up in the next issue of interactionsSpecial Section on Collaboratories

Guest Editor, Sara Bly

Including:Remote Observing at the W.M. Keck ObservatoryCollaborative Suites for Experiment-Oriented

Scientific ResearchThe Upper Atmospheric Research Collaboratory

Collaboratory Operation in Magnetic Fusion Scientific Research

Also:Changing How People Work: The Time-to-End-

User ValueWeb Page Design Survey: User Profiles, Key Tools

and the Design Process

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