On the newsgroups it was evident that there were a few posters who acted as both gatekeepers (Metoyer-Duran, 1993) and cognitive authorities. One individual in particular was a highly regarded and fairly active participant on the depression support newsgroup. He has a PhD (though the subject area of his expertise was never explicitly stated) and he was perceived as a valuable source of information and support. Other newsgroup members posted the following about him:
Response: [name] … wrote a great guide on medication.
Original post: I love it when [name] posts. Truly a stable presence in an unstable environment.
Original post: you might want to check out: [name of Guide]: [url] it was written by someone who posts here… can be very helpful in understanding these meds.
Original post: One of the occasional posters, has written up a good guide on all this. He‘s gone beyond what I did...in that he researched a lot of drugs and I only look into the ones I‘ve taken/taking... [name] even turned me on to a pretty interesting antidepressant that is only now getting publicity again because it‘s available in a PATCH...woo!
Newsgroup postings This poster was a trusted, credible information source for many newsgroup members. Even though this poster‘s PhD was not in medicine and he was not a healthcare
professional, his experiential knowledge of depression and expert qualification (e.g., the PhD) combined with his having a valid reason for trying to influence other newsgroup posters‘ thinking made him a cognitive authority for others on the newsgroup.
Expertise in an area of specialization outside of medicine was also perceived as useful if that expertise assisted with coping. In the following excerpt Dylan recalls an Anglican priest who had a double qualification for helpfulness—he was both an expert at helping people in his role as priest and he was also an AA member with personal
knowledge of the twelve steps.
Dylan: I would say discussions that I have, particularly in the framework of AA meetings, is most helpful…
I used to deal with an Anglican priest; I did about three step fives with him over the years at least [part of the AA 12-steps—admit to God, to ourselves, and to another human being the exact nature of our wrongs]. He is an Anglican priest, he‘s retired now, he‘s about the same age I am; he is also a member of AA. He‘s a person who had alcohol problems and was in AA but he‘s an Anglican priest so there‘s a double thing there. He‘s a clergy person who‘s used to dealing with people and their problems but he‘s also a member of AA so he knows; he also does step fives with people. So that‘s been beneficial to me. When I do it again I think I‘ll do it with our minister at the Unitarian church, at the Unitarian church because although he isn‘t, is not himself an alcoholic being a minister he deals with those things and also his wife is a member of the program because she‘s a drug, recovering drug person. So he‘s quite knowledgeable himself and I think I‘ll try it with him.
Similarly, for the following poster medical experts were not necessarily the only, nor the primary, source of expertise and information for people with depression.
Original post: [name], ... If you‘re talking about the treatment and diagnoses of depression, I don‘t know if it takes a psychiatrist/therapist to be the only specialist considered… If someone is depressed, they may or may not go to a
psychiatrist/therapist. They may go to their clergyman, friends, a spiritual healer, their general physician for meds, a support group, a 12-step group, a holistic medicine clinic, etcetera instead. In other words, there are many routes in the treatment of depression and pdocs/therps are but one.
Newsgroup posting
The help that other experts can provide can be equally as important and useful as the help offered by healthcare professionals.
Family members, friends, and other personal contacts often acted as expert
information sources in that they had ―expertise‖ in knowing what was ―normal‖ behaviour or typical behaviour for an individual. In the message below, respondent 1 invokes her family as a credible, unbiased information source. The message was written in response to the following post about an article in a May issue of Discover Magazine:
Original poster: > Article in the May issue of Discover Magazine suggests nutritional > treatment for Depression, et al. > they might be onto something, maybe not.
Response 1: Oh, I think they very well might be. I know my depressive symptoms have decreased greatly in the past few months from aggressive nutritional therapy... along with diet and exercise. My family says they‘ve never known me to be
functioning so well mentally and emotionally as I have been of late. I think this idea deserves further study.
Respondent 1 draws on her experience to construct a credible explanation of her recent success coping with depression but she also draws on her family‘s evaluation of her mental state as an authoritative information source that bolsters her claims about nutritional
therapy. The poster invokes family members as reliable information sources who can confirm the positive effects of following a diet and exercise plan to treat depression.
Similarly, in the following message, it was the poster‘s family, friends, and boss who alerted her to the possibility she might suffer from depression which, in turn, prompted information-seeking on the newsgroup.
Original post: Hello, I‘ve been having some pretty bad problems with
depression… My family and friends want me to get some help. I tried talking to my doctor but he didn‘t seem interested. What can I do to see about getting some help? Do I need to seek out a ―therapist‖? Should I ask for medication? ... Like I said, my family and friends came to me. My boss at work even mentioned
something. I didn‘t even realize I was showing my emotions.
In this message the poster reports what her family, friends, and boss have said to her about getting help for treating depression. She invokes these people as unbiased information sources who support her claim that she actually has depression and that she needs to get help because the expert source, her doctor, did not validate her suspicions that she suffered from depression. Posters who claimed to suffer from depression but did not receive a diagnosis from a doctor or other healthcare professional often drew on outside sources to provide confirmation that they did actually suffer from depression. Other newsgroup posters, for example, would report the results of their online quizzes or refer to interpersonal sources as evidence confirming that they did suffer from depression.
A final example shows how institutions were constructed as expert sources:
Response: Anyone promoting something that cannot be backed up by scientific tests as rigid as the FDA requires should really be at some new age site, not here where someone who is desparate might latch onto this and the[n] die because they didn‘t get the medical help they needed.
BTW [by the way] - I and my two children are alive only due to the medicines you reject.
Newsgroup posting
In this case, the speaker is using the FDA as an authoritative, expert information source and as the gold standard for scientific testing and evidence. She disparagingly refers to
alternative medicine as ―new age‖ and implies that alternative medicine is ineffective and potentially dangerous, particularly when used in lieu of conventional medical treatment. However, she does not discuss complementary medicine but rather places alternative medicine and allopathic medicine in opposing categories. This poster is using experiential knowledge acquired through the lived experience of herself and her two children to justify her use of allopathic medication. Although the statement ―BTW – I and my two children are alive only due to the medicine you reject‖ is ambiguous—the poster might be
suggesting that medication prevented her and her children from committing suicide or medication prevented her from harming her children—she uses extreme-case formulations by positioning her decision to take medication as a matter of life or death
(extrematization). She uses expert and experiential knowledge to strengthen her claims. Although expert sources were frequently invoked by speakers building credible accounts, experiential and expert knowledge were often used together to further justify claims. Furthermore, biomedical sources and other expert information sources could be countered and undermined. People would contest expert sources when the information they were given conflicted with their experience, beliefs, or other information sources they trusted more. People would frequently draw upon their experiential knowledge and
different expert sources to undermine biomedical information sources.