alt.psychology.help

Long-form reference · 6,456 words · about a 28-minute read

Four control messages, and what the first one said

The Internet Systems Consortium keeps a public archive of Usenet control messages — the small administrative articles by which newsgroups are asked into and out of existence — filed one compressed file per group name. The file for alt.psychology.help holds four messages. Three of them ask the world's news servers to create the group; one creates it inside a single site. There is no Request for Discussion, no Call for Votes and no published result, because the alt.* hierarchy had none of those. What stands in their place is the founder's own statement of purpose, sent to every news administrator who took the feed in the body of the article that made the group.

The first message is dated Thursday, 18 November 1993, and left a machine at Nova University in Fort Lauderdale, Florida. Its sender was John M. Grohol, and the signature block at the foot of it places him at the university's Center for Psychological Studies. The body begins by locating the group in the hierarchy's customary procedure and then says what the room was for.

As per discussion on alt.config, this newsgroup's purpose will be for the discussion of psychology on a personal basis. That is, people who are suffering psychological problems, or have significant other or families that suffer psychological problems, who are looking for help, explanations, or advice on what to do, therapies available, psychopharmacological treatments, side effects of medications, etc.

A second paragraph gives the administrative reason, which is a different thing from the human one and is stated with equal directness: the group's intended purpose, it says, is to alleviate the improper posting of articles regarding such requests for information on groups such as sci.psychology and alt.psychology.personality. The message then closes with a line worth quoting for what it concedes about the whole mechanism — As a favor to all your users, please create this group. Thank you. A newgroup control message is grammatically an instruction and practically a petition; each administrator decided, machine by machine, whether to act on it, and the polite imperative is the only enforcement the sender had.

The signature is the ordinary furniture of a 1993 Usenet post and happens to be informative. It records the sender as reorganiser of comp.sys.ibm.pc.hardware and creator of alt.sys.pc-clone.gateway2000 and alt.fan.laurie.anderson, and it signs off with the exhortation to talk to your news admin today. Whoever else was involved in the group later, it was begun by somebody who already knew how the namespace worked, and who had done unrelated namespace work in two other corners of it.

The booster, the local copy and the 1997 reissue

The second message, dated 16 May 1994, is what its own text calls a booster: a re-issued newgroup aimed at administrators who had missed or declined the first one. Its organisation line reads Nova Southeastern University rather than Nova University, the institution having merged with Southeastern University of the Health Sciences in 1994 and taken the combined name. The message reports its own propagation with a modesty that is almost a genre convention — the group, it says, was originally created approximately one year ago and enjoys decent propegation, misspelling included — and restates the purpose in one sentence: to provide a common forum for individuals seeking information about mental health questions they may have about themselves or others.

It also supplies, under the standard heading For your newsgroups file:, the description the sender wanted administrators to install against the group's name:

Questions & answers on psychological problems.

The third message is a curiosity that illustrates the mechanism better than any amount of explanation. On 18 July 1994 an administrator at a site in Vineyard Haven, Massachusetts, issued a newgroup for alt.psychology.help carrying a Distribution header limiting it to one local feed, with a body reading in full: minimal newsgroup creation, update uhog's active file. Creating a newsgroup and creating it everywhere were never the same act, and the archive preserves one instance of the difference.

The fourth and last message is dated 18 December 1997 and came from a host at cmhc.com, its organisation line giving the name Mental Health Net and a web address. Its entire body is another for-your-newsgroups-file line, proposing the same description the booster had proposed more than three years earlier. One detail of it is worth recording, because it bears on the section that follows: the heading in that message reads For your newgroups file:, with the word newsgroups misspelt, and the string ISC's current policy document requires in that position is exactly For your newsgroups file:. That is the whole of the archived administrative record for this group: one creation, one booster, one local copy, one reissue, and no removal attempt of any kind.

The description that stuck, and where it did not come from

ISC also publishes the master files that news administrators install so that a reader sees more than a bare group name. In the newsgroups file as it stands on the day this page was written, among 45,003 entries, the description carried against this group's name is six words long:

An alt.support group away from home.

The corresponding entry in the active file — the list that tells a server which groups exist and how they may be posted to — is alt.psychology.help 0000000000 0000000001 y. The trailing y is the posting flag, and it is the machine-readable statement that the group was never moderated: articles posted to it went straight to the network. Of the alt.support.* groups in the same file, 290 carry y and 11 carry m. The group described as an alt.support group away from home shares the branch's default setting as well as its subject.

How the description got there is a loose end, and this page will not pretend otherwise. ISC's own policy document explains that the newsgroups file is maintained from the for-your-newsgroups-file lines in the individual newgroup messages, or from the whole list supplied in a checkgroups article, and that in alt.* the moderation status and description will be set to whatever was present in the last control message for that group. The last control message for this group proposes Questions & answers on psychological problems, under a misspelt heading. The phrase that actually appears occurs exactly once in the entire newsgroups file and in none of the four archived messages. Where it came from cannot be established from the archive consulted here, and no author for it can be named.

One boundary can be put on the question. ISC publishes month-by-month logs of every action taken on the active and newsgroups files, and those logs begin in May 2003. The name alt.psychology.help does not appear in any of them. Whatever set the description, it did so before that archive opens, and nothing has changed the entry since.

What can be said is that somebody, at some point, looked at a group whose paperwork described a general room for personal psychological questions and summarised it in six words as a member of a different branch.

How large alt.support.* actually was, and is

The branch the description points at is not a footnote. The ISC newsgroups file lists 301 groups whose names begin alt.support., plus the parent group alt.support itself, described there as being for those looking for support in general. For scale: the same file lists 45,003 groups in all, of which 20,466 are in alt.*; the Big-8 equivalent, soc.support.*, contains ten groups. Whatever else the alt.* hierarchy's open creation rule produced, it produced a family of mutual-support rooms some thirty times the size of the one grown under the Big Eight's formal procedure.

The parent's own creation message survives and is worth reading beside Grohol's, because the two describe the same problem three years apart. It went out on 15 November 1990, sent by Paul Traina at Stanford on behalf of another user at the same institution, whose text he quoted rather than paraphrased:

This news group would be a place where people can openly discuss areas of emotional discovery and support they need to work on.

The rationale that followed named the scattering the group was meant to gather up: threads spread across soc.singles, soc.couples, alt.romance and alt.recovery in which posters were trying to deal with some emotional situation, and whose replies, she wrote, were well thought out and offered a lot of experience and insight. Her last line was a specification: this would be an unmoderated newgroup. The branch that grew from it kept that setting as its default.

That requester posted under the handle shedevil, which signs the 1992 control messages with the name Anne P. Mitchell; the same handle, from Stanford and from machines at vix.com, went on to issue the newgroups for alt.support.diet in March 1992, alt.support.cancer that April and alt.support.big-folks that June, the cancer group on behalf of a third party whose own control post, she wrote, was not getting beyond his provider. The diet group's file also preserves a compact statement of what passed for due process in the hierarchy, written by Paul Vixie when he sent one of the control messages for that group himself:

Annie posted a note about this in alt.config and only got one comment. In the alt.universe, this is as good as it gets. Ergo, here we are.

The branch grew from there without a plan. Of its 301 groups, 116 have four or more name components — the sign of rooms split off from rooms — and 58 carry the placeholder text No description, meaning that nobody ever supplied one and nobody ever had to. Eleven are flagged moderated, and even that count is untidy: five names ending in .moderated carry no moderated flag at all, while four groups that do carry the flag have no such word in their names.

Why the group sat outside the branch it resembled

The anomaly the description records is real, and the explanation available from the record is structural rather than mysterious. alt.support.* was organised by condition or circumstance. Most of its working names are nouns: a diagnosis, a bereavement, a treatment, a body, a habit, a family arrangement. In practice a name in the branch had to say what the room was about before it could be filed there.

alt.psychology.help had no such noun. Its founding message describes an intake rather than a subject: people with psychological problems, or with families who had them, looking for help, explanations or advice, on any of it. There was no condition to put after the dot. The branch did already own the general case — that is what alt.support, looking for support in general, had been created for in 1990 — but a general room in the support branch and a general room in the psychology branch are, from a namespace point of view, two different filing decisions, and the second one is the one that was made.

The founding message gives its own administrative reason, and it is not about the support branch. The group was to relieve two named groups of traffic they did not want: sci.psychology and alt.psychology.personality. It was named after the rooms whose overflow it was catching rather than after the branch whose work it would end up doing, and the record shows that choice being made in as many words.

There is one further oddity of chronology. When alt.psychology.help was created in November 1993, the group alt.psychology did not exist; it was brought into being, by accident, on 2 December 1994, in the course of a sender's repeated attempts to create alt.psychology.nlp. For its first year the group was a child of a parent that had not been born — an ordinary condition in a hierarchy where a name is only a string, and one that the wider story of that branch, told on the alt.psychology page, covers in full. What matters here is that the taxonomy nobody was enforcing produced a support group filed under psychology, and that the master description file eventually recorded the fact.

Peer support online becomes a research subject

The honest bulk of what can be said about a group like this comes not from the group but from the literature about the thing it was. Online mutual support attracted formal study from the mid-1990s onward, and the papers of that first decade are specific enough to attribute precisely. What follows reports what those researchers concluded; none of it is asserted here.

One of the earliest of the widely cited empirical studies is a small one. Nancy Weinberg, John Schmale, Janet Uken and Keith Wessel published Online help: cancer patients participate in a computer-mediated support group in Health & Social Work in February 1996. They followed six breast cancer patients who used home computers for three months to read and post messages on a bulletin board. The patients, the authors reported, had no difficulty learning to use the computer and used it an average of one hour a week; they discussed their medical conditions, shared personal concerns and offered support; and the authors concluded that the online approach provided many features of traditional face-to-face support groups.

Barbara Sharf's Communicating breast cancer on-line: support and empowerment on the Internet followed in Women & Health in 1997, a participant-observation and discourse study of an on-line discussion list. Sharf identified three major dimensions in the traffic — exchange of information, social support and personal empowerment — compared computer-mediated support with face-to-face groups, and concluded that the list fulfilled the functions of a community, while flagging future concerns about information control.

Two further 1997 papers took the subject up in their own disciplines. Deborah A. Salem, G. Anne Bogat and Christina Reid published Mutual help goes on-line in the Journal of Community Psychology in March, at volume 25, pages 189 to 207; Salem and Bogat published Characteristics of an On-Line Mutual-Help Group for Depression in the International Journal of Self Help and Self Care in 1999. Andrew Winzelberg's The analysis of an electronic support group for individuals with eating disorders appeared in Computers in Human Behavior in August 1997, at volume 13, pages 393 to 407. The abstracts of those three were not available to this page, so no finding is attributed to them here; they are named because their dates and titles are part of the record of when the subject was taken up.

What the studies said participants got

By the end of the decade researchers had begun coding the messages themselves, and the resulting inventories are the closest thing the literature has to a description of what such a room contained.

Paula Klemm, K. Reppert and L. Visich published A nontraditional cancer support group. The Internet in Computers in Nursing in 1998. They content-analysed 300 messages from an internet cancer support group and sorted them into eight categories: information giving and seeking; personal opinions; encouragement and support; personal experience; thanks; humour; prayer; and miscellaneous. Their assessment of the format listed the advantages as twenty-four-hour availability and accessibility to the homebound, and the disadvantages as the cost of internet access and the lack of a professional facilitator.

J. Finn's An exploration of helping processes in an online self-help group focusing on issues of disability appeared in Health & Social Work in August 1999. Messages were downloaded and coded by raters into helping categories covering both task and socioemotional functions. Finn reported that the group provided many of the processes used in face-to-face self-help and mutual aid groups, with an emphasis on mutual problem solving, information sharing, expression of feelings, catharsis, and mutual support and empathy.

M. White and S. M. Dorman analysed 532 messages posted to a public Alzheimer mailgroup over twenty days of 1998, publishing in Computers in Nursing in 2000; members, they found, used the mailgroup to find and proffer information, share experiences and opinions, and provide encouragement. The following year, in Health Education Research for December 2001, the same authors reviewed the development of health-related online support groups as a field, and set out the standing structural comparison: such groups had benefits for people unable or unwilling to attend face-to-face sessions, and difficulties arising from the absence of the visual and aural cues that face-to-face communication supplies.

The list is stable across studies, populations and years. None of the studies cited here reported discovering a mechanism unknown to the older literature on mutual aid; what they reported was the same mechanisms operating through a text file.

Who used them: the finding about stigma

One widely cited finding of the period is about selection rather than effect, and it comes from a study that was not primarily about the internet at all. Kathryn P. Davison, James W. Pennebaker and Sally S. Dickerson published Who talks? The social psychology of illness support groups in American Psychologist in February 2000. They measured support group participation across twenty disease categories in four metropolitan areas — New York, Chicago, Los Angeles and Dallas — and on two on-line forums.

Their result was that support seeking was highest for diseases viewed as stigmatising, naming AIDS, alcoholism, and breast and prostate cancer among them, and lowest for less embarrassing but equally devastating disorders, of which they gave heart disease as the example. The authors framed the finding in terms of social comparison theory and its applications in health care.

That is a general result about support groups, arrived at partly from online data, and it bears on the room this page is about only in the way that a general result can: it says that the populations who assemble in such places are selected by embarrassment rather than by severity. What the 301 rooms of alt.support.* were sorted by, and what the four archived control messages for alt.psychology.help say the group was for, are consistent with it. Consistency is not evidence, and no study of this group exists.

Anonymity, disinhibition and the missing cues

The property of the medium that the period argued about most is the one a support group depended on: that nobody could see you. Usenet asked for no registration, verified no name and issued no credential, and the accounts of online support written in these years treat that as a central variable rather than an incidental one.

One formulation of it arrived at the end of the era. John Suler, of Rider University, published The online disinhibition effect in CyberPsychology & Behavior in June 2004. Suler's argument was that people online self-disclose or act out more frequently or intensely than they would in person, and he set out six interacting factors behind it: dissociative anonymity, invisibility, asynchronicity, solipsistic introjection, dissociative imagination and minimisation of authority. He was explicit about what the effect is not: rather than treating disinhibition as the revealing of an underlying true self, he proposed conceptualising it as a shift to a constellation within the self-structure. The online disinhibition effect has since been conventionally divided into benign and toxic forms, and both halves of the division describe things that happened in unmoderated support groups.

Running against the optimistic reading was a widely reported negative result. Robert Kraut, Michael Patterson, Vicki Lundmark, Sara Kiesler, Tridas Mukopadhyay and William Scherlis published Internet paradox: a social technology that reduces social involvement and psychological well-being? in American Psychologist in September 1998. Following 169 people in 73 households through their first one to two years online, the authors reported that greater use of the internet was associated with declines in participants' communication with family members in the household, declines in the size of their social circle, and increases in depression and loneliness. Kraut, Kiesler, Bonka Boneva, Jonathon Cummings, Vicki Helgeson and Anne Crawford published Internet Paradox Revisited in the Journal of Social Issues in 2002, returning to the question with further data. The debate those two papers frame — whether the medium that made a room like this possible was on balance good for the people in it — was live for the whole of the group's active life and was not settled during it.

The absence of professional oversight

The studies cited above return, sooner or later, to the fact that nobody was in charge. Klemm and colleagues put it in a list of disadvantages in 1998, in five words: lack of a professional facilitator. It is a plain description of the arrangement rather than a criticism of it. In an unmoderated newsgroup there was no screening of participants, no follow-up, no duty of care and no way for anyone to know that a regular poster had stopped posting.

The question of what a clinician should do about that — whether psychologists could or should take part in public online discussion, and under what rules — was a professional controversy of the period, and it is documented in its own right; Keith Humphreys, Andrew Winzelberg and Elena Klaw's Psychologists' ethical responsibilities in Internet-based groups: issues, strategies, and a call for dialogue, in Professional Psychology: Research and Practice for October 2000, is one documented opening of it, and the debate and the professional bodies' guidance of those years belong to the sci.psychology.psychotherapy page and are not restated here.

What the evidence established, and what it did not

A systematic review of the accumulated results appeared just as the news2mail gateway was closing. Gunther Eysenbach, John Powell, Marina Englesakis, Carlos Rizo and Anita Stern published Health related virtual communities and electronic support groups: systematic review of the effects of online peer to peer interactions in the BMJ in May 2004. Searching eleven databases, they identified 45 publications describing 38 distinct studies, including 20 randomised trials.

Their central difficulty was one of study design rather than of outcome. Only six of the studies evaluated what the authors called pure peer-to-peer communities; 31 evaluated complex interventions bundling peer support with psychoeducational programmes or one-to-one contact with health professionals, which made it impossible to attribute any effect to the peer-to-peer component. The outcomes measured most often were depression and social support measures, and most studies did not show an effect. The review also recorded a negative finding that is easy to overlook: the authors found no evidence to support concerns over virtual communities harming people. Their conclusion was that no robust evidence existed either way for consumer-led peer-to-peer communities, and that research was needed to establish under which conditions and for whom electronic support groups were effective.

Two later results, both clearly postdating the gateway, are worth recording because they show where the question went. Kathleen M. Griffiths, Alison L. Calear and Michelle Banfield published a systematic review of internet support groups and depression in the Journal of Medical Internet Research on 30 September 2009. From an initial pool of 12,692 abstracts, 31 papers describing 28 trials met their criteria. Sixteen of those used a design in which the support group's own contribution could be separated out — a single-component intervention, a design controlling the non-support components, or a cross-sectional analysis — and ten of the sixteen reported a positive effect on depressive symptoms; but only two of the ten employed a control group, and studies of lower design quality tended to be the ones reporting more positive outcomes. Their conclusion was that there was a paucity of high-quality evidence.

Griffiths and colleagues then supplied some. In a randomised controlled trial published in PLoS ONE on 28 December 2012, community volunteers with elevated psychological distress were assigned to one of four twelve-week conditions: an internet support group, an automated internet training programme, both together, or a control website. There was no change in depressive symptoms relative to control after three months of exposure to the support group; at six and twelve months, both the support group alone and the combined condition showed significantly greater reductions than control. The authors described internet support groups for depression as promising and warranting further empirical investigation. Nineteen years after alt.psychology.help was created, that was the state of the evidence about the form it belonged to.

Norms in place of moderation: the instruments available

On Usenet, moderation was a piece of routing rather than a temperament: articles posted to a moderated group were diverted to a human being, who either discarded them or injected them into the network with an approval header attached. That mechanism, and the reasons hierarchies adopted it, are described on the soc.* hierarchy page; the working procedure of a particular moderated group is set out on this directory's page for soc.culture.singapore.moderated. Neither is retold here. What matters for this group is the negative fact: it never had any of it. The posting flag in the active file reads y today, and no control message in the archive ever asked for anything else.

Nor was there a route to acquiring one by argument. ISC's policy document states the position for the hierarchy flatly: in alt.* and free.*, all properly formatted newgroups are automatically executed, and all rmgroups are ignored. A group in alt.* could be created by anyone and could not be deleted by anyone; the only body that ever decided whether it existed was the set of news administrators who chose to carry it. RFC 1855, the Netiquette Guidelines of October 1995, defines the hierarchy for its readers in exactly those terms: alt is so named, it says, because creating an alt group does not go through the same process as creating a group in the other parts of the hierarchy.

What an unmoderated group had instead was three instruments, all of them voluntary.

• The periodic posting. The convention of re-posting a standing document at intervals, so that newcomers arriving mid-stream had somewhere to start, reached Usenet from the ARPANET mailing lists: the acronym FAQ was coined by Eugene Miya of NASA for use on the ARPANET SPACE list between 1982 and 1985, for exactly the problem of questions being asked again by people who had not read the archive, and Jef Poskanzer is credited with posting the first weekly FAQ on the Usenet graphics groups. The genre spread across the network and became one of its characteristic artefacts.
• The answers groups. As FAQs accumulated they acquired their own moderated repositories. The alt.* hierarchy's, alt.answers, is still in the newsgroups file, described there as a repository for periodic USENET articles and flagged moderated — a moderated address where an unmoderated group could deposit a document that would keep, cross-posted from the group itself.
• The regular. The person who has been in the room longer than the person asking, and who answers the same question again. Nothing in the software recognised this role and nothing conferred it.

RFC 1855 is candid about the standing of all three. Its moderator guidelines instruct that the group's FAQ be posted at regular intervals with the guidelines for articles included, and that newsgroups should have their charter or guidelines posted regularly. The document's own status paragraph says that it does not specify an Internet standard of any kind and that distribution of the memo is unlimited. It is a set of manners, published as a request, by a working group with no power to enforce anything — which describes the standing of the norms an unmoderated group had.

How a norm was transmitted, and how fragile that was

The directory's own summary of this group, which stands above this article, says that regulars steered acute cases toward professional help and that the group enforced this culturally rather than by moderation. That is a claim about a form, and it should be read as one: no thread from alt.psychology.help was consulted for this page, and none is described below. What can be described is how such an arrangement worked in general, and what it rested on.

It rested on repetition by people who happened to be present. A norm in an unmoderated group has no text unless somebody writes one, no distribution unless somebody re-posts it, and no application unless somebody replies to the article that breaches it. Each of those is a discretionary act by a volunteer. The alt.* creation record itself shows the same machinery at work one level up: Grohol's message opens by citing discussion on alt.config; Paul Vixie's, quoted above, notes that a single comment there was as good as consensus ever got; and when Tim Pierce re-created alt.support.depression on 3 February 1994 he justified it by saying that recent threads on alt.config indicated widespread support for the newsgroup. In each case the authority invoked is that some people talked about it and nobody objected loudly enough.

The fragilities follow directly and were not secret at the time. A norm carried by repetition survives only while the people who repeat it keep reading, so a group could lose its manners simply by losing three or four regulars over a summer. It has no appeal and no separate record: a disagreement about whether a reply crossed a line is itself just more articles in the same flat sequence, indistinguishable in the newsreader from the thread it is about. It cannot be applied to anyone who does not care, which in a public group with a global feed is everybody who arrives to be unpleasant on purpose, and — after the mid-1990s — every advertiser. And it is invisible from outside: the door that admits an anonymous newcomer at three in the morning is the same door, with the same lock on it, for everyone else.

Some of the support groups of the period took the other route, and the file records how few. Eleven of the 301 alt.support.* groups carry the moderated flag, and seven of the eleven are names formed by appending .moderated to the name of a group that already existed. This group is not among them, and eleven out of 301 is a small enough fraction that going without was the ordinary outcome.

The branch around it, jokes included

alt.support.* is one of the larger accumulations in the hierarchy, and it is worth being precise about how it accumulated, because it was not by organisation. Nobody designed the branch. Its 301 rooms came into being because the creation rule cost nothing and because a great many people independently wanted a room for one condition; the research summarised above offers the standard account of why such rooms filled up, which is that the conditions people seek company for are disproportionately the ones they find embarrassing. This directory preserves two of them in detail — alt.support.ocd and its moderated companion alt.support.ocd.moderated — and what those groups discussed, and how the pair divided the work between them, belongs to those pages and is not taken here.

The same rule that produced them produced everything else in the branch, and the newsgroups file does not sort the two. Filed alphabetically among the rooms for chronic pain, hearing loss and grief are the parody support groups, whose names were the entire joke: this directory keeps one of them, alt.support.jock-strap, whose page covers the parody form and the fact that jokes and real support groups shared a namespace. There are others of the same kind in the file. There are also, less comfortably, long chains of names — six to nine components deep, several of them simply repeating the last component over and over — created to attach an accusation or an insult to a named individual in a namespace from which it could not be removed, since rmgroups in alt.* are ignored. Those names are not reproduced here. And 58 entries carry no description at all, having been created by somebody who never came back.

None of this is a paradox; it is the same fact stated twice. A hierarchy in which nobody can refuse to create a support group is a hierarchy in which nobody can refuse to create anything else either, and what the branch is used for and what is dumped in it have precisely the same cause. That trade-off is the standing argument between alt.* and the Big Eight, and this branch is where both halves of it sit on the same page of the same file.

After Usenet

The news2mail gateway that produced this directory ran from 2000 to 2004, which places it near the end of the period in which a public newsgroup was a plausible first stop. What follows postdates the gateway and is marked as such.

The migration was not to one successor but to several. Its least visible form was the earliest: the same kinds of conversation continued on web message boards, where a proprietor could delete a post, ban an account and set a rule — the three things Usenet had made structurally impossible. Registration, which Usenet had never asked for, is what put both accountability and pseudonymity in somebody's hands.

One line of descent runs directly out of the newsgroups. Psych Central, the mental-health information site acquired by Healthline in August 2020, was founded by John M. Grohol; Wikipedia's article on the site records that he was a Florida psychology graduate student who began by answering mental health questions in numerous mental health Usenet newsgroups, and that before the sale the site ran support forums of its own, which became independent afterwards. That article dates the site to 1995 in its opening paragraph and its founding to 1991 in its history section, so no founding year is given here. The sender of the November 1993 control message and the founder of that site are the same John M. Grohol.

Another line ran through condition-specific platforms built to collect data as well as conversation. PatientsLikeMe was founded in 2004 by the brothers James and Benjamin Heywood together with Jeff Cole, a long-standing family friend, after their brother Stephen was diagnosed with amyotrophic lateral sclerosis in 1998; it launched its first online community, for ALS patients, in 2006, added communities one condition at a time, and in April 2011 opened to patients with any condition. The shape is recognisably the alt.support.* shape — one room per condition — with the difference that somebody was now recording structured outcomes alongside the messages, which Usenet's format made no provision for.

The research literature followed the same path, and the Griffiths reviews and trial described above are its later chapters. The clearest measure of how much changed is procedural rather than technical: by 2012 it was possible to run a randomised controlled trial of an internet support group, because by then somebody owned the group and could assign people to it. On Usenet there was nobody to ask.

What the record does not show

Not one thread, poster, exchange, FAQ, welcome message or charter revision from alt.psychology.help is documented in any source consulted for this page. No participant is named anywhere except in the four administrative control messages, and those name only senders of control messages, not readers or posters. No readership figure, subscriber count, article count or traffic estimate exists for this group at any point in its life; none of the four messages contains a number, and the one propagation claim any of them makes — decent — is the sender's own characterisation, offered in support of a request, and is not a measurement.

Nothing above describes anything anyone said in the group. The account of what an unmoderated support group's norms consisted of, and of how they were transmitted and how they failed, is drawn from the general documentary record of Usenet practice and from the published research literature on online support, both cited by name and date. Where the directory's own summary above makes a claim about what this group's regulars did, this page has treated it as a claim about the form and has said so.

Nor does this page know what became of the group. There is no removal message, no farewell, no final posting and no date of death in the archive; the group simply persists in the master files, unmoderated, with a description whose author is unknown, exactly as it did when the gateway that produced this directory was still delivering it to people's inboxes.

Scope and limits

Three bodies of evidence lie behind this article, and it is worth saying which claims rest on which.

The group's own history — the four control messages, their dates, their senders' organisations, the descriptions they proposed, and the group's present entries in the active and newsgroups files — comes from the Usenet administrative archive maintained by the Internet Systems Consortium, together with that archive's own published policy document and change logs. Every quotation from those messages is verbatim, misspellings included. All counts given for the alt.support.* branch, for alt.* and for the network as a whole are counts taken from the ISC newsgroups and active files as published on the day this page was written, and are therefore a snapshot of a list that is still maintained, not a historical figure for any particular year.

The research literature is cited by author, title, journal and date throughout so that a reader can check it independently, and every finding attributed above is stated in the source's own abstract. Where a paper is named without a finding attached — the Salem, Bogat and Reid paper of 1997, the Salem and Bogat paper of 1999 and the Winzelberg paper of 1997 — that is because the abstract was not available to this page, and its conclusions are therefore left unsummarised rather than summarised loosely.

What remains unresolved is stated as unresolved: the provenance of the one-line description that has stood over this group since before ISC's change logs open in May 2003, which matches none of the control messages that ISC's own policy says the file is built from.