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Psychiatry and Society
by Keith Russell Ablow, M.D.
March 1997

The Internet and the Id

Mind not the burgeoning sales of Prozac, Paxil, Effexor and Zoloft, the 1990s are Freud's decade. As the year 2000 approaches, we are watching a battle the doctor would have relished-between one vision of man as a machine, a set of neurons plugged into the World Wide Web and powered by Prozac, and another of man as a soulful being with burgeoning passions that will not be denied. It is the decade of human drives versus disk drives, and the id is casting a long shadow, especially over the Internet.

The id turns out to be a little like a water balloon, just the way Freud described it. Squeeze the balloon tight at one point, it swells at another. So as technocrats offer up voice mail with endless digital options but no real voices, mice that point instead of squeak, and the option of going to work or going food shopping without really going anywhere, the id's stock is rising like Coca-Cola. It's the real thing.

Cigars are back. Big, thick ones that are routinely finding their way into women's mouths as well as men's. Strip clubs are sprouting up everywhere and business is booming. Cosmopolitan magazine has rededicated itself to exploring the female orgasm. Drugs, an unfortunate, artificial and cowardly flirtation with one's mind, are the rage. I'm told a decent bag of heroin can be had for four bucks (down from twenty) in some towns. Larry Flynt, publisher of Hustler, the first large-circulation man's magazine to photograph women's genitals without any fuzzy lenses, is being depicted as a hero in a major motion picture. Sports Illustrated has gone with an all-bikini swimsuit issue. Fashion includes piercing body parts-noses, tongues, lips, even parts of the vagina and penis-as if to confirm the existence of the corporeal, to anchor our flesh in moments of pain and loops of stainless steel. Extreme fighting, in which bare knuckles replace padded gloves, is cutting into boxing's popularity.

Movies about disasters are the only ones Hollywood will really gamble big on. People want to see a tornado or volcano or asteroid bust everything up. They want to see how much more powerful Nature is than the stuff we build on it.

Sex is one of the biggest Internet products, with groups on sadism and masochism generating interest no psychopharmacology chat room ever will. The id is snaking everywhere through the Web.

Watch for other predictable triumphs of id: Prostitution will skyrocket, violence in movies and television and print will reach a fever pitch. The death penalty and abortion and euthanasia-gripping dramas rooted in organic viability-will be even more vigorously debated. We may even conspire to make war, to kill together, in order to know we are alive together. Strangely, this is all good news for psychiatry, at least the human version of it that seems now to be at death's door, the version in which people's emotions have meaning beyond the synapse. Because I predict more and more Americans will be fed up with simplistic explanations of their life experiences that reduce their psychological worlds to serotonin and norepinephrine and dopamine (which makes about as much sense as equating the meaning of this article with electrical impulses in my laptop). Those of us interested in the truth and helping people find it will see our stock start to rise with the id's.

I can't wait to watch managed care try to manage what's brewing just under the surface, in that place my patients keep telling me their Prozac doesn't seem to reach.

Keith Russell Ablow, M.D., born in Marblehead, Massachusetts in 1961, is a psychiatrist, author and journalist. Dr. Ablow graduated from Brown University, the Johns Hopkins School of Medicine and the Tufts/New England Medical Center with a Residency in Psychiatry. Dr. Ablow's book, Without Mercy: The True Story of a Doctor Who Murdered,  is now available in paperback at most bookstores. Dr. Ablow's first novel, Denial, will be published by Pantheon Books in July.