Characteristics of the included studies.
\r\n\tThis volume presents the multifaceted aspects and should allow readers at all levels an entry into the exiting world of Chlamydomonas research.
\r\n\t
Social networking sites have become part of twenty-first century people’s lives. From all online social networking sites, Facebook is the most widely used. According to a recent report published by Facebook regarding data for the second quarter of 2016, there is a considerable increase (17% in comparison with last year) in the number of both daily and monthly active users, with 1.13 billion daily active Facebook users for June 2016 and approximately 1.71 billion monthly active Facebook users for 30 June 2016 [1].
\nOnline social networking sites may have a useful role in mental health research (for a comprehensive review of the use of Facebook in social science see Ref. [2]). For instance, Facebook, the most widespread form of online social networking site, can easily be used as a great clinical research tool, as it can provide the recruitment of patients and involve them in programmes [3]. Also, it can be used to guide interventions and in treatment monitoring (e.g. in physical activity or overweight programs [4, 5]). So far, several studies have investigated the role of social media in people with serious illness, and research shows that it is a promising approach in patients with schizophrenia [6].
\nSocial media is a valuable resource for receiving peer-to-peer support. Facebook, Twitter or YouTube can be used by people with several conditions in order to find support or advice from others and to share personal experiences. Naslund et al. [7] proposed a model that illustrated potential benefits for people with serious mental illness, which they can have in an online community on online social networking sites (overcome stigma, seek professional help, receive adequate treatment).
\nRegarding mental health interventions delivered via Facebook, research is only starting to emerge. In an online randomized controlled experiment, a depression awareness campaign delivered via Facebook for adults was associated with enhanced mental health literacy [8]. Facebook allows for establishing and maintaining connections with others, and studies show that there is a positive relation between Facebook use and social capital, with greater advantages for people with low self-esteem and life satisfaction [9]. According to a review on the applications of social media in medicine and healthcare services, it seems that social networking is a promising approach. However, much uncertainty exists in terms of ethics and safety [10]. Furthermore, social media seemed to be an effective method to promote health-related behaviours [11].
\nThere are studies showing that online social networking sites are important factors in youths’ social lives, as in a large sample (N = 3.068) of adolescents (aged 11–14), there were significant positive associations between the use of online social networking sites and several friendship-related variables (friendship quality, face-to-face interaction, bridging/bonding social capital) [12].
\nOnline social networking sites can have benefits in terms of cognitive abilities for older healthy adults [13], as it was shown in a study involving older adults (mean age comprised between 78 and 80), in which participants were randomly assigned into three groups: Facebook training, online diary website and waiting list. The Facebook intervention was delivered over 8 weeks and older adults received weekly training in how to use Facebook.
\nRecent research has associated social media networking with several negative outcomes, both in adolescent populations and in adults.
\nAccording to a report published by the Pew Research Center, adolescents are avid users of online social networking sites, with approximately 71% of them using more than one online social networking site [14] in 2015, and the most widely used online social networking site was Facebook (41%). Frequency of using social networking sites expressed as the amount of time spent on online social networking sites was associated with mental health problems in children and adolescents [15]. Namely, the same study shows that spending more than 2 h per day on online social networking sites is associated with higher psychological distress, poor self-rated mental health, suicidal ideation and an unmet need for mental health support. In another study conducted on a large sample of adolescents (N = 5.126), there were significant positive associations between the use of online social networking sites, psychological distress, suicide ideation and suicide attempts [16]. In this study, cyberbullying victimization served as a full mediator in the relationship between the use of online social networking sites and psychological distress/suicide attempts and acted as a partial mediator in the relationship between the use of online social networking sites and suicidal ideation.
\n“Facebook depression” [17] is a term introduced in a report of the American Academy of Pediatrics to describe the impact of social media on youths’ mental health, according to which depression arises as a consequence of youths spending a large amount of time on social media [18]. When it comes to mechanisms explaining why the use of online social networking sites is associated with negative mental health outcomes, one study shows that negative comparison on Facebook is related with adolescents’ life satisfaction [19]; negative comparison on Facebook predicts life satisfaction, but the opposite relationship is also significant.
\nResearch regarding problematic online social networking sites in adolescents is scarce, and very few studies have investigated the relationship between Facebook addiction and youths’ mental health problems. In a study conducted with adolescents, both personality traits and social influence processes emerged as significant predictors of problematic Facebook use and Facebook use frequency. Problematic Facebook use was predicted by emotional stability, extraversion, conscientiousness and norms, while the frequency of Facebook use was predicted by gender, group norms and social identity [20].
\nWith the rapid emergence of technology, the term “iDisorders” was introduced to define mental health problems related to technology usage. In a meta-analysis including eighteen papers on the relationship between Facebook use and loneliness, it resulted that the two variables were significantly associated and that loneliness predicted Facebook use and not the other way around [21]. Facebook use had a significant contribution to mental health, with Facebook use, impression management and friends predicting mood disorders, with different contributions across disorders (having more friends is negatively associated with major depression and dysthymia, while positively predicting mania) [22]. Social media, operationalized as the total time spent per day, visits per day and global frequency of visits on social media, was associated with depression in a large sample of U.S. young adults [23]. Facebook intrusiveness was correlated with obsessive-compulsive disorder severity and with obsessive beliefs in a sample of young adults (aged 18–24) [24].
\nThere is ample literature on the role of online social networking sites, and Facebook in particular, in mental health outcomes. However, there is high heterogeneity in what online social networking sites and Facebook mean. Facebook is conceptualized and measured differently across studies, given that while several studies investigate Facebook use, others investigate either the number of friends, Facebook disclosure, Facebook activities, Facebook motives or Facebook addiction/intrusiveness/problematic use.
\nDespite the fact that no diagnostic manual recognizes Facebook addiction as a diagnostic category, more and more research focuses on pathological uses of online social networking sites, and Facebook in particular (see Ref. [25] for a complex review of online social networking sites addiction). Online social networking sites addiction is related to deficits in emotion regulation and susceptibility to drug and alcohol addictions [26], somatic symptoms, anxiety, insomnia, social dysfunction and depression [27].
\nOnline social networking sites, and Facebook in particular, can offer great opportunities, in terms of interaction with others, for individuals with social anxiety. Two different hypotheses have been proposed in order to explain why socially anxious individuals use computers [28], which can easily be applicable to online social networking sites. The first hypothesis proposed is the social compensation hypothesis [29], according to which individuals use online social networking sites in order to compensate for deficits in social skills or discomfort in face-to-face situations. The second theory, opposed to the first, is called the social enhancement hypothesis. According to this hypothesis, socially skilled individuals use online social networking sites to find additional opportunities to interact with others. In the existent literature on the relationship between online social networking sites and social anxiety, there is mixed evidence regarding the two hypotheses, as both have received support.
\nIn an experimental study, Rauch et al. [30] investigated whether previous exposure to Facebook attenuates or augments physiological arousal during face-to-face interaction in a sample composed exclusively of adult female students. Participants were randomly assigned to four groups: Facebook exposure only, face-to-face exposure only, Facebook exposure first plus face-to-face exposure second and face-to-face exposure first plus Facebook exposure second. The results indicated that participants who only had seen the stimulus on Facebook had less physiological arousal than participants who had seen the stimulus face-to-face. However, regarding the combined conditions, physiological arousal was higher when seeing the person face-to-face when this preceded seeing the person on Facebook. Social anxiety moderated the relationship between physiological arousal and Facebook exposure so that exposing an individual to a stimulus person on Facebook is related with increased arousal in a face-to-face meeting with that person, and this, moreover, appears in highly social anxious persons.
\nNo systematic approach has been conducted so far investigating the relationship between social anxiety and online social networking sites, or Facebook in particular, despite growing evidence on how socially individuals use online social networking sites. Therefore, the main aim of the current paper is to offer a comprehensive review of the state of the art of existent studies on the relationship between online social networking sites and social anxiety.
\nThe current systematic review has been conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement [31].
\nIn order to be included, studies had to:\n
involve participants with social anxiety symptoms/disorder;
include online social networking assessments;
include social anxiety assessments;
be published in peer-reviewed journals;
be published in English.
There were no age constraint criteria applied and no year of publication limitation.
\nStudies were excluded if there was no assessment of social networking and social anxiety, and they were not published in English.
\nElectronic databases (PsychInfo, PubMed, Scopus, Web of Science) were consulted by two independent assessors up to 20th June 2016. Several terms related to social networking were combined with terms related to social anxiety. No additional records were identified through the manual search in the references of the articles published and meta-analyses related to the subject. The reference lists of relevant papers and meta-analyses related to the subject were screened in order to identify potentially relevant articles. We repeated the search on 25th July 2016 to double-check and identify whether new articles had been published since the first search. The search terms were as follows:
\nSocial network* OR Facebook OR LinkedIn OR Tweeter OR Instagram OR Youtube* OR Myspace OR Social Network Sites OR social media*
Social phobia OR social anx* OR social phobi* OR social* anxious* OR generalised social anx* OR generalized social anx*
1 AND 2
The flowchart describing the inclusion of studies is described in Figure 1. The literature search yielded 673 articles, of which 98 were duplicates. After removing duplicates, the titles and abstracts of 575 articles were screened. Thirty-eight relevant papers were selected for full-text reading. Of these papers, 18 were excluded based on the following reasons: no social anxiety assessments (n = 20), not peer-reviewed articles (n = 2), not published in English (n = 1), no measure on social networking (n = 1), and theoretical reviews or meta-analyses (n = 2). This left a total number of 20 articles to be included in the systematic review.
\nThe following information was extracted from each of the studies included:
\nauthors and year of publication;
sample characteristics (number of participants, mean age, age range, proportion of female participants, type of sample);
amount of time spent using social networking sites per day;
online social networking conceptualization;
concepts assessed in the study;
information regarding the association between online social networking and social anxiety.
Flow diagram of study selection process.
A summary of the characteristics of the studies included (number of participants, age, online social networking sites conceptualization, primary results) is described in Table 1.
\nStudy name | \nN (% F) | \nMage (SD) Age range | \nSample | \nTime spent in social media per day (SD) | \nSNSs construct | \nMeasures | \nPrimary results | \n
---|---|---|---|---|---|---|---|
Aladwani and Almarzouq [45] | \n407 (54%) | \n20.04 (1.16) | \nStudents | \n1.86 h (0.99) | \nCompulsive SM use | \nInteraction anxiousness Self-esteem Problematic learning Media complementarity | \nSignificant positive associations between compulsive SM use and SA r = 0.26, p < 0.05 | \n
Antheunis et al. [12] | \n3.068 (53.7%) | \n13.46 (0.56) 11–14 | \nAdolescents | \n7.27 h (8.54) | \nSNSs use intensity | \nSocial anxiety Quality of friendships Bridging social capital Bonding social capital Offline interaction with friends | \nSignificant negative associations between SNS and SA r = −0.08, p < 0.001 | \n
Bodroža and Jovanović [32] | \n804 1st phase 445 (79.1%) 2nd phase 359 (79.4%) | \n26.95 (6.35) 15–62 21.29 (2.96) 18–44 | \nStudents and general population | \nCombined sample: ½ of the sample uses FB 1–3 h/day, 27% <1 h, 15% 3–5 h and 8% >5 h Student sample: FB 1–3 h/day, 35% <1 h, 11% 3–5 h, 3% >5 h a day. | \nPsycho-social aspects of Facebook use (PSAFU): Compensation Self-presentation Socialization FB addiction Virtual self | \nSocial anxiety personality Sensation seeking | \nSignificant positive associations between FB and SA r between 0.11 and 0.58, p < 0.001 and 0.05 in both samples Significant positive associations between FBA and SA r = 0.19, p < 0.001 (FB users sample) r = 0.17, p < 0.001 (Student sample) | \n
Casale and Fioravanti [46] | \n400 (51.8%) | \n22.45 (2.09) | \nStudents | \nNot reported | \nGeneralized problematic Internet use | \nSocial anxiety Satisfaction with the needs through SNS: -The need to belong-The need for self-presentation -The need for assertiveness | \nSignificant positive associations between problematic Internet use and SA r = 0.22, p < 0.001 | \n
Clayton et al. [39] | \n229 (74.3%) | \n18.19 (0.43) 18–21 | \nStudents | \n30 min to 1 h | \nEmotional connectedness to FB Facebook connection strategies | \nAnxiousness-social anxiety subscale loneliness Alcohol use Marijuana use | \nSignificant positive associations between emotional connectedness to Facebook and anxiousness r = 0.18, p < 0.001 Significant positive associations between Facebook connection strategies and anxiousness r = 0.23, p < 0.001 | \n
Davidson and Farquhar [49] | \n336 (70%) | \nNot reported | \nStudents | \nNot reported | \nFacebook intensity anxiety | \nSocial anxiety number of unique groups Role conflict Self-monitoring Religious activities | \nNon-significant positive associations between FB Intensity and SA r = 0.05, p = ns Significant positive associations between FB anxiety and SA r = 0.66, p < 0.001 | \n
Fernandez et al. [29] | \n62 (63%) | \n19 (1.05) | \nStudents | \nNot reported | \nFacebook usage | \nSocial anxiety Depression Personality | \nSignificant negative associations between FB friends and SA r = −0.45, p < 0.001 Significant positive associations between FB usage and SA r between 0.27 and 0.50, p < 0.001 (i.e., number of lines in about me, number of TV shows, number of music interests) Non-significant associations between SA and number of activities, self-reported time spent on FB, No. of status updates, No. of posts by friends, and no of posts by self. | \n
Green et al. [43] | \n306 (65.69%) | \n20.52 (1.45) | \nOnline participants from all around the world | \n2.44 h (2.82)/day | \nFB self-disclosure (public and private) | \nSocial anxiety Controllability Reduced cues Disinhibition Offline self-disclosure | \nNon-significant associations between FB self-disclosure public and SA r = 0.05, p = ns Non-significant associations between FB self-disclosure private and SA r = 0.00, p = ns Non-significant associations between time spent on FB and SA b = 0.11, p = ns | \n
große Deters et al. [33] | \n1st study 153 (60.78%) 2nd study 209 (88.52%) | \n1st study 20.18 (3.24) 2nd study 23.50 (3.24) | \n1st study Students 2nd study General population | \nNot reported | \nStatus updates, No. of likes received per status update No. of individual commenters per status update | \nSocial anxiety personality (extraversion) | \nSA did not predict no. status updates, No. of likes received per status update, No. of individual commenters per status update p = ns | \n
Hong et al. [40] | \n230 (31.7%) | \nNot reported | \nStudents | \n34.3% spent < 1 h; 30.9% spent 1–2 h; 17.4% 2–4 h; 17.4% >4 h | \nContinuance intention to interact with others on FB Online social anxiety | \nGeneral social anxiety Belief in dangerous virtual communities | \nSignificant negative associations between FB continuance intention and SA r = −0.48, p < 0.001 Significant positive associations between OSA and SA r = 0.38, p < 0.001 | \n
Indian and Grieve [41] | \n299 (85.95%) | \n28.35 (10.88) | \nRecruited from | \n30–60 min, 14% with daily usage >3 h | \nFacebook social support items | \nSocial anxiety Offline social support Subjective well-being | \nNo difference in perceptions of Facebook social support in high and low socially anxious, t(297) = 0.14, p = 0.89 FB social support explained a significant amount of additional variance in subjective well-being over and above offline social support for the high social anxiety group | \n
Landoll et al. [34] | \n1st study: 216 (63%) 2nd study: 214 (54%) | \n19.06 (1.28) 15.72 (1.22) | \nAdolescents and young adults | \nNot reported | \nAversive social networking peer experiences | \nSocial anxiety Internet use Social Peer victimization Depression | \nSignificant positive associations between negative SNSs experiences and SA r = 0.37, p < 0.001 | \n
Lee [47] | \n304 (56%) | \n22.45 (6.10) 17–55 | \nCollege students | \nNot reported | \nFacebook addiction | \nSocial anxiety Smartphone addiction Personality traits Multitasking | \nSignificant positive associations between FBA and SA r = 0.25, p < 0.01 | \n
Lee-Won [35] | \n243 (71.6%) | \n19.69 (1.12) | \nCollege students | \nAssessed but not reported | \nAmount of FB use Problematic Facebook use | \nSocial anxiety Personality Need for social assurance | \nNon-significant negative associations between FB use and SA r = −0.03, p = ns Significant positive associations between FBA and SA r = 0.45, p < 0.001 | \n
Liu et al. [44] | \n780 (50.9%) | \n13.94 (0.90) 13–18 | \nAdolescents | \nNot reported | \nPersonally identifiable information (PII) disclosure | \nSocial anxiety Privacy concern Parental mediation Narcissism | \nNon-significant negative associations between PII and SA r = −0.07, p = ns SA indirectly decreases PII disclosure by increasing privacy concern. | \n
McCord et al. [38] | \n216 (85.64 %) | \n32.2 (12.43) 18–69 | \n31.5% undergraduate students, 12.0% graduate students, and 55.6% were not students | \nNot reported | \nFB use FB social interaction anxiety | \nSocial anxiety | \nNon-significant associations between FB use and SA r = 0.01, p = ns Significant positive associations between FB SA and SA r = 0.64, p < 0.001 | \n
Ramirez et al. [42] | \n244 (51%) | \n34.59 (11.19) | \nFacebook users | \nNot reported | \nFB reconnection | \nSocial anxiety Information seeking Uncertainty predicted outcome value Sociability | \nMarginal significant negative associations between SA and FB reconnect b = 0.14, p = 0.05 | \n
Rizvi [48] | \n150 (75%) | \n18–27 | \nDifferent educational institution | \n46% <30 min 32.7% 30 min to 1 h 11.3% 1–2 h 10% > 2 h | \nExcessive FB use (log in) | \nSocial anxiety Personality | \nNon-significant negative associations between excessive FB use and SA r = −0.02, p = ns | \n
Shaw et al. [36] | \n75 (55.2%) | \n19.2 (1.27) | \nStudents | \n2.04 (1.13) Range 1–5 | \nFB time passive FB use FB content production Interactive FB communication | \nRumination Depressive symptoms Mood and anxiety symptoms Content production Interactive communication Social anxiety | \nSignificant positive associations between time spent on FB and SA r = 0.33, p < 0.01 Significant positive associations between passive FB use and SA r = 0.32, p < 0.01 Non-significant associations between content production on FB r = 0.23, p = ns Non-significant associations between interactive FB communication and SA r = 0.21, p = ns | \n
Weidman and Levinson [37] | \n77 (77%) | \n18.91 (1.05) | \nStudents | \nNot reported | \nFacebook profile (no. friends, no. photographs, no. videos, photo albums, relationship status, people in profile picture, status update, quote) Social activity Social inactivity Close relationship quality Self-disclosure | \nSocial interaction anxiety | \nSignificant negative associations between no. friends and SA r = −0.21, p < 0.05 Significant negative associations between FB quote length and SA r = −0.38, p < 0.05 | \n
Characteristics of the included studies.
Note: N = number of participants; %F = percentage of female participants; Mage = mean age; SD = standard deviation; SNSs = social networking site; SM = social media; SA= Social anxiety; FB= Facebook; FBA= Facebook addiction; OSA = online social anxiety; ns= non-significant; no. = number; h = hours; min = minutes.
We included 20 papers in the systematic review, of which three papers [32–34] consisted of two studies/phases each. Most of the studies included were conducted with adults (n = 14), recruited either from university (students), or from the general populations, while several papers were conducted with adolescents (n = 3), and some studies did not report the age of the participants (n = 2). Nine of the papers included reported the time spent on Facebook; one study also assessed this indicator but did not report it, and the rest of the studies did not include reports on the time spent on Facebook. Social media was operationalized differently in the papers included and while few studies reported social media variables, most of the papers included referred specifically to Facebook.
\nWith respect to the manner in which online social networking sites or Facebook were conceptualized in these studies, we have encountered several approaches:\n
Facebook use (n = 7), which in turn can be conceptualized as the amount of time spent on online social networking sites, passive use of Facebook or using interactive Facebook features (updates, comments, likes);
Psychosocial aspects of Facebook use (n = 6), which can also mean Facebook connection strategies, Facebook continuance intention, Facebook reconnection decision, Facebook social support, aversive Facebook experiences or cybervictimization;
Personal disclosure on Facebook (n = 3), which can also mean private or public disclosure, personal identifiable information (profile information and privacy settings) and status/quote update/length;
Problematic use of online social networking sites (n = 6), which can be found as Internet addiction, compulsive social media use, Facebook addiction or Facebook intrusiveness;
Facebook anxiety (n = 3), with different terms such as Facebook-specific anxiety, Facebook interaction anxiety or online anxiety.
Most of the papers included found a significant association between social networking (Facebook) and social anxiety (n = 16), while the rest of the studies included found no significant relationship between social media and social anxiety.
\nThere are mixed findings regarding the relationship between online social networking and social anxiety. On the one hand, there are studies reporting significant associations between the two variables. For example, Antheunis et al. [12] showed that Facebook use was negatively associated with social anxiety in a large sample of adolescents. Lee-Won [35] found evidence that Facebook use, defined as the amount of time participants spend on Facebook on an average day, was associated with social anxiety. Shaw et al. [36] found a significant relationship between the time spent on Facebook and social anxiety in a sample of undergraduate students. The same study found a significant association between passive Facebook use, defined as passive content consumption (e.g. passively viewing one’s Facebook profile) and social anxiety. The relationship between passive Facebook use and social anxiety was significant even after checking for depressive and anxiety symptoms. Weidman and Levinson [37] considered both offline (self-reported indicators) and online indicators (using the profiles of coders for Facebook) of social anxiety. Results on self-reported social anxiety and objective Facebook use indicated significant negative relationships between the two variables, with number of friends, number of photographs and quotes length being negatively related to social anxiety. Regarding the rated social anxiety symptoms observed and objective Facebook signs, there were significant negative associations between social activity composite (number of friends, photographs, videos, photo albums), the number of people in profile pictures and social anxiety.
\nOn the other hand, there are several research papers that show no association between Facebook use and social anxiety. große Deters et al. [33] found no significant relationship between social anxiety and different parameters of Facebook use (status updates, number of likes or individual commenters per like), and none of the prediction models investigated, in which social anxiety was used as a predictor and Facebook as a criterion, were significant. McCord et al. [38] found no significant relationship between general Facebook use, defined as the frequency of using the socially interactive features of Facebook (sending messages, using chat, writing on events/friends walls, sending friend requests, posting comments, updating status) and social anxiety. Fernandez et al. [29] did not find a positive association between the frequency of Facebook usage, operationalized as time spent on Facebook, status updates, number of posts by friends/self and social anxiety, in a sample of students. In this study, several independent coders rated each participant’s level of social anxiety based on viewing their Facebook profiles and associated it with participants’ self-rated social anxiety symptoms. Social anxiety was not associated with an increased frequency of Facebook use, either based on self-report data or based on coders’ reports. However, there were positive associations between profile information sections and social anxiety. The number of activities was not associated with social anxiety. Using multiple regression, the results indicated that social anxiety had a unique contribution, apart from depression and neuroticism, to profile information (excepting the number of movies and activities).
\nBodroža and Jovanović [32] constructed a scale in order to measure several psychosocial aspects of Facebook use. Five factors emerged for the structure of the scale, namely: compensation (use Facebook in order to compensate for personal insecurity/inadequacy), self-presentation (concern related to impression on others), socialization (striving to acquaint new friends/intimate partners), Facebook addiction and virtual self (Facebook adequately represents one’s personality). Social anxiety had positive associations with each of these factors. Clayton et al. [39] found a positive relationship between anxiousness (public and private self-consciousness, social anxiety), emotional connectedness to Facebook (integration of Facebook in one’s daily life) and Facebook connection strategies (reasons to use Facebook, use Facebook to learn more information about people, to maintain current relationships). Anxiousness was a significant predictor of both emotional connectedness to Facebook and Facebook connection strategies. Hong et al. [40] investigated the relationship between the continuance intention to interact with other people on Facebook and social anxiety and found a significant negative relationship between them. Social anxiety predicted the continuance intention to interact with other people on Facebook and, together with online social anxiety, accounted for 44% of the continuance intention. Indian and Grieve [41] found no differences between low and high socially anxious individuals in Facebook social support. There were significant association in both groups between Facebook social support and subjective well-being, as well as between Facebook social support and offline social support. Finally, Facebook social support was a significant individual predictor of subjective well-being for highly social anxious individuals. Landoll et al. [34] developed an instrument that assesses negative peer experiences on social networking sites. There were significant associations between negative online peer experiences and social anxiety and depression. Ramirez et al. [42] investigated factors related to the decision to reconnect on Facebook with a past contact in a sample group of adult participants. Using hierarchical logistic regression, they found several predictors that accounted for almost 40% of the variance of the decision to reconnect on Facebook, in which social anxiety was also included and has a marginally negative contribution to it. There were other factors (e.g. relational factors and information seeking factors) that have a greater contribution to the decision to reconnect than social anxiety.
\nThere was no significant evidence stemming from the papers included of an association between Facebook disclosure and social anxiety. Green et al. [43] found no relationship between Facebook self-disclosure (public and private) and social anxiety. Two hypothesized pathways from social anxiety to Facebook self-disclosure considered online attributes (reduced cues, controllability) and feelings of disinhibition. Results showed that the model accounted for 23% of the variance in Facebook private self-disclosure and 7% of the variance in Facebook public self-disclosure. Liu et al. [44] did not find any relationship between Facebook disclosure and social anxiety in a sample group of adolescents aged between 13 and 18. Disclosure in this study referred to personally identifiable information, a composite score computed by adding a measure for attitudinal information disclosure (profile information on Facebook page and personal photographs) and a scale assessing behavioural information disclosure (items actually posted on Facebook and privacy regarding photographs). There was only an indirect relationship between social anxiety and Facebook disclosure through the role of privacy concern, defined as concern related to the security of the personal information presented online. Namely, by increasing privacy concern, social anxiety indirectly decreases disclosure. Using a path analysis approach, parental mediation had only an indirect effect on disclosure through privacy concern, and no direct effect. Self-disclosure, defined as the presence or absence of status update/quote and length of status update/quote, was also considered in Weidman and Levinson [37] as a measure of social inactivity. Status update was unrelated to social anxiety in both self-reported and observer-rated social anxiety and objective Facebook signs, while the length of the quote was related to social anxiety only in self-reported and not in observer-rated social anxiety.
\nMost of the papers included sustained the relationship between problematic use of online social networking sites or online social networking sites addiction and social anxiety. For instance, Aladwani and Almarzouq [45] found a significant positive association between interaction anxiousness and compulsive social media used, which finally has a significant effect on learning outcomes. Bodroža and Jovanović [32] found a significant relationship between social addiction and social anxiety both in a sample of Facebook users recruited online and in a sample of students. Casale and Fioravanti [46] considered the Self-Determination Theory in the context of Facebook use and proposed that the satisfaction for unmet needs through social networking sites should be a viable candidate in the development of problematic use of Internet communicative services. Results showed that social anxiety had a significant effect on generally problematic Internet use for both women and men, in a sample group of undergraduate students. They also considered several needs for using social networking sites, such as the need to belong, self-presentation and assertiveness. Problematic use of Internet communicative services was significantly associated with all the three needs considered. However, only the need for self-presentation was a significant mediator in the relationship between social anxiety and problematic Internet use only in the case of males. Lee [47] investigated the relationship between Facebook addiction and social anxiety in a sample group of African American students and found a significant positive relationship between the two variables. Using hierarchical multiple regression, the results showed that approximately 19% of the variance of Facebook addiction was explained by eight predictors, of which age, social interaction anxiety and multitasking were the most related to Facebook addiction. Finally, Facebook addiction was significantly associated with smartphone addiction. Lee-Won [35] found a significant association between problematic Facebook use and social anxiety, with the latter being a noteworthy predictor for problematic Facebook use. Furthermore, the results indicated that a significant moderator in the relationship between problematic Facebook use and social anxiety was the need for social assurance. Rizi [48] found no relationship between social anxiety and excessive Facebook use in a sample of 150 young adults; there were no differences in Facebook use according to high vs. low social anxiety levels. However, the majority of the participants from this study logged on to their Facebook accounts few times a day (47%) and spent less than 30 min on Facebook (46%). The only parameter regarding Facebook usage that was considered in this study for the association with social anxiety was the frequency with which participants log onto Facebook, with no other variables considered.
\nThree of the studies included that assessed online social networking sites anxiety indicated significant positive relationships with social anxiety. Davidson and Farquhar [49] investigated the relationship between social anxiety, religion and Facebook. They developed a Facebook-specific anxiety scale, an adaptation of a social anxiety scale related to Facebook and found a strong association with social anxiety. Online social anxiety and social anxiety were positively associated in Hong et al. [40], with general social anxiety being a significant predictor of online social anxiety. McCord et al. [38] used a Facebook social interaction scale and found a significant association with social anxiety in an adult sample group. Using multiple regression results indicated that social anxiety and anxiety on Facebook predicted Facebook social use. There was a significant interaction between social anxiety and Facebook social anxiety, which is in line with the social compensation theory. According to this theory, highly socially anxious individuals tend to use Facebook in order to compensate for the discomfort associated with face-to-face communication. A second regression model was also significant, with anxiety on Facebook and social Facebook use predicting social anxiety; again, there was a significant interaction between the two predictors.
\nOnline social networking sites are widespread means through which people can interact with others. There are many advantages of online social networking sites; however, recent research focuses mainly on the negative impact they have on mental health. Terms like “iDisorders”, “Facebook depression” and “Facebook addiction” abound in the literature on online social networking sites and mental health, proposing new disorders that are determined by the use of online social networking sites/Facebook. Moreover, their particularities in terms of manifestations make some advocate their inclusion in current diagnostic nosologies.
\nThe present review aims to synthetically present the existing literature on the relationship between social anxiety and social networking. Twenty studies met our inclusion criteria. Most of these studies referred to a particular online social networking site, Facebook, and assessed different related parameters. Overall, most of the papers reported significant associations between online social networking and social anxiety, with four papers reporting no relationship between the two variables. There were mixed results on the relationship between Facebook use and social anxiety, as there were both studies sustaining a significant positive association between the two variables and those that found no association. Several psychosocial aspects of Facebook use were significantly related, both positively and negatively, to social anxiety. There was no relationship between Facebook disclosure and social anxiety in any of the papers included that assessed this construct. With one exception, there was a significant positive relationship between online social networking sites addiction/problematic use and social anxiety. There was evidence of a significant association between Facebook anxiety and social anxiety.
\nThis results should be interpreted in the light of the fact that there was a high heterogeneity of Facebook conceptualizations, as in several studies, the amount of time spent on Facebook was assessed, while other studies assessed Facebook/ Internet/ social networking problematic use/intrusiveness/addiction, or psychosocial aspects related to Facebook use, or Facebook disclosure, and in fewer studies, Facebook anxiety was considered. Therefore, one cannot conclude that online social networking sites have a negative or a positive effect on social anxiety without carefully taking into consideration what they mean. An important limitation of the current review was the fact that although we aimed to investigate the relationship between social media and social anxiety, most of the papers included referred only to social networking sites such as Facebook and we cannot generate findings pertaining to other social networking sites, such as Instagram, Tweeter, Youtube, LinkedIn or Myspace. Future studies should also investigate the role of these other social networking sites in mental health problems and in social anxiety per se. Another limitation of this paper refers to the sample groups. As most of the participants included were students, this does not enable us to extend our to other populations. Involving more heterogeneous samples of participants, adolescents, young and older adults can help us to find significant moderators in the relationship between social networking and social anxiety. As all the studies included were cross-sectional, we cannot conclude that there is causality between social networking media, namely Facebook, and social anxiety. Does social media (time spent, pathological use, number of friends, activities) contribute to social anxiety symptomatology or do socially anxious individuals tend to use more social media? According to what we currently know, no directionality can be assumed. However, much like in the meta-analysis on Facebook and loneliness [21], in this case, social anxiety can predict social media use rather than the other way around.
\nFuture experimental studies manipulating independent variables would be useful in order to draw more conclusions on the relationship between social networking and social anxiety. Longitudinal studies would allow us to test bidirectional relationships between the two variables and investigate time-related patterns in social networking use and social anxiety. Up to this moment, it remains unclear whether social anxiety leads to more online social networking use, or whether the relationship is opposite, with more use of online social networking predicting social anxiety. Bidirectionality between the variables could also be an important aspect to investigate, as there is preliminary evidence for both directions.
\nThe findings of the current review have important clinical implications regarding social networking use for individuals with social anxiety. The benefits/advantages of online social networking sites should be used and investigated in order to overcome existing barriers in clinical practice. Testing interventions delivered over social networking sites in randomized controlled trials would have great implications on the development of evidence-based remote interventions.
\nFunding for this study was provided by a grant from the Romanian Executive Unit for Financing Education Higher Research, Development and Innovation (the “Effectiveness of an empirically based web platform for anxiety in youths”, grant number PN-II-PT-PCCA-2011-3.1-1500, 81/2012) awarded to Dr. Anca Dobrean.
\nIn international Tibetan Buddhist seminar-, meditation-, and retreat-centers, patterns of violence and exploitation have developed over the past decades. Recently, economical, psychological, and physical abuse [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12] was reported. It has evolved against the background of structures that systematically devalue and control the feminine. Such structures effect on the individuals of the respective groups and engrave into their bodies and minds. Thus, in a cultural-insensitive, unreflected transfer of knowledge of Buddhist philosophy and respective training techniques, the culturally ingrained ways in dealing with the feminine and its unconscious attitudes were absorbed. A visualization concept of females merely forming the passive counterparts to male characters, their devaluation in comments and acquired behavior patterns as well as misunderstood visualization techniques leading to narcissistic self-aggrandizing patterns contribute to confusion. This disorientation in turn not only forms the basis for developing self-devaluation and uncertainty regarding the individuals social positions in the groups, but also causes a double bind-based inability to act. Thus, one option seems to be the proximity to the spiritual master, the identifying of women with the male master, which somehow is supposed to define their position and seemingly would enhance their spiritual progress towards enlightenment as well. The undefined social positions of women in such groups, which encourage projecting undesirable aspects onto them, and sexualized aspects, such as the role of a secret lover, pose a cultural challenge for them. However, besides uncertainties due to a lack of cultural socialization, and the opportunities for honest communication on this issue, usually prevented by vows of secrecy, damage to group members is incurred by those regarding themselves as Vajrayāna practitioners, even preaching Vajrayāna, for whom gender equality ought to be standard in their training. Thus, in neglecting individual and institutional betrayal trauma [13], the implicit traumatization of people, despite being undeniable injuries, has been successfully silenced for decades. And control of the feminine has also been achieved by projecting the shadow, one’s own unwanted aspects, at the women.
Moreover, the narrative of Buddhism being a panacea for mental health not only misinterprets its spiritual methods to be psychological or medical ones. Damage is also caused by seducing and misleading sick individuals and by misinterpreting any trauma of those severely injured by the leadership or group members. Thus, the shadows behind the devaluation of females and seducing some of them into neglected social positions reveal a blind spot in Tibetan Buddhism and its seminar-, meditation-, and retreat-centers in the West, where it has continued to grow over decades. In rationalizing misconduct of the leadership and their helpers to be ‘crazy wisdom’ [1, 2, 5, 8] or even so-called ‘karma purification’ [1, 2], it was possible to even cover the injury to individuals and structural defects.
Due to the ongoing efforts to whitewash, denigrate those concerned, and silence the required discourse on leadership responsibility and accountability in the respective international contexts and head organizations, it is now crucial to broaden the perspective and consider the societal impact of such offences which, even as Buddhism and spirituality, have already been injuring and traumatizing many people. In the following subchapter, the descriptions of eleven probands are presented.
Qualitative data of the research project TransTibMed from eleven participants in different international Tibetan Buddhist groups are presented covering the following eleven questions: Which kind of abuse or violence have you experienced in Buddhist groups; how did you react to abuse or violence; how have your experiences in Buddhist groups had an impact on you; which kind of indoctrination, abuse, or violence against others have you witnessed; how have you reacted in the face of this indoctrination, violence, or abuse towards others; how did the experiences in Buddhist groups change you; how did the experiences in Buddhist groups change your relationships and your ways of relating to others; how did your experiences in Buddhist groups change the way you work; and have you parted with one or more Buddhist groups or teachers? If so, why?
The questions when you think of abuse in Buddhist groups - the abuse of people who have been manipulated and of minors, including sexual abuse - how do you think and feel about it? How do you evaluate the responsibility in the group? Who is responsible for what and why do we allow male Buddhist teachers to not only denigrate but also exploit women for their own (mostly hidden) agendas in the name of spirituality were replied to by others and one person who also replied to the above.
Probands were recruited through information at university, the German Buddhist Union (DBU), and indirectly through (former) group members informing others at social networks.
All probands presented wrote about their experiences in international Tibetan Buddhist organizations. Some of them were in several groups. All together, these statements refer to eleven different international Buddhist organizations. In order to protect the individuals, the names of the respective organizations are not provided here.
The following results are structured as follows: All answers of one person are presented in one subchapter. The first nine questions were replied to by #1, #2, #3, #4, and #8 and the last two questions were replied to by #3, #5, #6, #7, #9, #10, and #11. The first six persons (#1–#6) are female and #7–#11 are male.
Questions are written in italics and the replies in straight letters. All answers of probands in German were translated by the author.
Which kind of abuse or violence have you experienced in Buddhist groups?: “Psychological abuse - gaslighting (stating everything is simply in my mind), manipulation to accept abuse by the abuser himself stating that he was my teacher, that everything ‘is empty’ therefore he couldn’t be an abuser. Psychological abuse through an email attack to my workplace claiming I am having a nervous breakdown” (#1).
How did you react to abuse or violence: “At the time of the individual abuse within […] I felt inadequate, I did not acknowledge that the perpetrator should be able to take some responsibility for their behaviors. I felt abandoned and inadequate because of the way the group reacted to the abuse - they did not acknowledge it had happened and when I disclosed it they did not view it as abuse. I was minimized by the ‘spiritual director’ when I disclosed it to her - she said that my ‘practice was enduring suffering’. At the time this made me feel more inadequate. Later I understood this as a minimizing activity, and I became very angry about six months later after reading testimonies of other former members. Following my workplace receiving an email from […] management using a fake identity I experienced rage, could not concentrate, my boundaries were poor, I turned to alcohol to cope, I experienced suicidality. I felt paranoid, I did not understand how much danger I might be in or not. I did not know who could help, I felt abandoned by people who did not understand and could not help me. I had digestion problems due to the anxiety and shame for several months. I had little energy and could not exercise, experienced stiffness and rigidity in my face, I had slow speech and slow processing speed. I dissociated frequently e.g. not remembering where I had put things, where I had parked my car. I had nightmares about being murdered by the leadership” (#1).
How have your experiences in Buddhist groups had an impact on you: “Severe post traumatic stress, anxiety, shame, and post traumatic growth. I am now connected to people who I find kind and who listen to me and appreciate my perspective on the groups. I therefore feel heard and understood, and no longer gaslighted” (#1).
Which kind of indoctrination, abuse, or violence against others have you witnessed: “I witnessed long term members so highly indoctrinated that they repeated teachings verbatim all the time, they did not have vocabulary from outside the group anymore. I saw people force the teachings on each other to invalidate the other persons feelings and dismiss their needs. I have read testimonies and seen evidence of threats against former members - threats to ruin peoples reputations and livelihoods. I heard people with mental health problems be spoke about disrespectfully” (#1).
How have you reacted in the face of this indoctrination, violence, or abuse towards others: “At the time I believed what was said about former members - that they had ‘lost patience in their spiritual path’ or had ‘developed an angry mind and were blaming the centre’. When I came to realize that this was gaslighting of whistleblowers (after leaving) I became very distressed that the centre could avoid taking responsibility for people’s wellbeing by blaming their ‘mind’ for everything. When I saw the threats and character assassination of former members I went into shock, and then experienced righteous anger” (#1).
How did the experiences in Buddhist groups change you: “I now understand spiritual abuse and am very sensitive to coercion. I am suspicious of all spiritual teachers. I only trust survivors of abuse and a few friends and family. I have more highly developed critical thinking skills and enjoy being disobedient. I now struggle to follow rules I believe are unnecessary, I trust my intuition more” (#1).
How did the experiences in Buddhist groups change your relationships and your ways of relating to others: “I recognise my needs and when someone is not good for me, I do not automatically put other people first. I do not practice accepting everything, I feel more in touch with righteous anger. I try to communicate my emotions more. I trust few people, especially religious people” (#1).
How did your experiences in Buddhist groups change the way you work: “I am suspicious of meditation and mindfulness, I read all about the under reported adverse effects. I understand abusive systems of power and abusive group dynamics. I don’t trust cognitive therapies so much anymore, I only trust interventions that are also systemic” (#1).
Have you parted with one or more Buddhist groups or teachers? If so, why: “Yes both […] after reading testimonies of abuse and reading cultic studies literature, I understand that they are personality cults and that they do not understand trauma. They claim to help you with stress and teach you mindfulness when they actually believe you should be practising dissociation from your emotions. They have obscured and whitewashed serious abuse, appointed only internal safeguarding officers who are invested in the continuation of the movements, and who are interested in saving their reputations” (#1).
Which kind of abuse or violence have you experienced in Buddhist groups: “Sexual assaults, however without violence, we were servile, so there was no need for it. Men were instrumentalized, delegated by relocation, assigned as secretaries of centers, to work for the Lama was an honour, sometimes for little or no payment, many did not longer pursue their own lives, partnerships were interrupted, separations and uniting were arranged” (#2).
How did you react to abuse or violence: “I did not perceive it as such. It was only when my best friend revealed herself to me that I could see it as abuse on her and then on me as well” (#2).
The questions how have your experiences in Buddhist groups had an impact on you and which kind of indoctrination, abuse, or violence against others have you witnessed were not answered by #2.
How have you reacted in the face of this indoctrination, violence, or abuse towards others: “later I also learned about sexual assaults against very young women” (#2).
How did the experiences in Buddhist groups change you: “have become more suspicious, but also more adult and autonomous” (#2).
How did the experiences in Buddhist groups change your relationships and your ways of relating to others: “Sometimes one gets arrogant, considering oneself as something better, but one also becomes more compassionate. That we are all essentially the same and can simply be on equal level with each other has reached me and I have internalized it to this day. In a therapeutic context it has helped to make encounters on equal level, but also endangered for much closeness and confluence” (#2).
The questions how did your experiences in Buddhist groups change the way you work and have you parted with one or more Buddhist groups or teachers? If so, why were not answered by #2.
Which kind of abuse or violence have you experienced in Buddhist groups?: “spiritual, psychological, emotional” (#3).
How did you react to abuse or violence: “Anger, helplessness, eventually some deference to my teacher for survival and to maintain my position in the group. Basically you have to tell him he is right and you are wrong to preserve your standing as a student” (#3).
The question how have your experiences in Buddhist groups had an impact on you was not answered by #3.
Which kind of indoctrination, abuse, or violence against others have you witnessed: “Gaslighting, shaming, slander, emotional manipulation, violation of confidentiality, outright lies, telling the Executive Director to fire someone because ‘she was too neurotic’, psychologizing every single student, punishment sending people away from group retreats into solitary or banning people from retreats” (#3).
How have you reacted in the face of this indoctrination, violence, or abuse towards others: “I was often not aware or stood by quietly and watched” (#3).
How did the experiences in Buddhist groups change you: “Sustained attention, strength to do multi day ritual, I am not afraid to be alone in the woods, I accept pain and negative experiences as just part of life. I feel a tremendous union with the divine available in my body. I regularly experience space that feels between life and death, no self, and primordial. I will also never ever become a student of a male spiritual teacher again. I will never give my power away to any human teacher ever again. I have learned a lot about this and still feel very hurt” (#3).
The questions how did the experiences in Buddhist groups change your relationships and your ways of relating to others, how did your experiences in Buddhist groups change the way you work and have you parted with one or more Buddhist groups or teachers? If so, why were not answered by #3.
When you think of abuse in Buddhist groups—the abuse of people who have been manipulated and of minors, including sexual abuse—how do you think and feel about it? How do you evaluate the responsibility in the group? Who is responsible for what: “Angry. Sad. Helpless. The teachers are responsible for the abuse, the board of directors is responsible for not intervening and for allowing a spiritual director who is also paid employee to have veto power over the board (absolute control of the whole organization, which is legally questionable and the board knew it)” (#3).
Why do we allow male Buddhist teachers to not only denigrate but also exploit women for their own (mostly hidden) agendas in the name of spirituality: “We all participate in patriarchy. Tibetan Buddhism encourages mind control, submissiveness, and patriarchal hierarchy. I believe that we allow it because we are so disconnected from our own power that we are willing to let some guy and some exotic tradition tell us what to do. We are eager to hand the reigns over, and Tibetan Buddhism in its sleek ways explains why we should. I believe that men have been suing the tradition for their own agendas for so many centuries that perhaps it has only become a vehicle for patriarchal abuse and I seriously question if the Vajrayana is of benefit in the world now” (#3).
#4 did not answer the question: which kind of abuse or violence have you experienced in Buddhist groups?
How did you react to abuse or violence: “I got super angry with myself, blaming myself very badly for not being good enough” (#4).
How have your experiences in Buddhist groups had an impact on you: “Lack of trust, no direction in life, I cannot see my future, I’m afraid of making decisions, I feel helpless and good for nothing” (#4).
Which kind of indoctrination, abuse, or violence against others have you witnessed: “Later on I heard for a community member that the senior teacher had sexual abuse on different women. Even one of the women contacted me and [was] telling me her story. Also I saw people leaving abruptly and getting very confused. Some left with anger. And I heard in the community that there was a woman who got crazy and left. Whatever that means. I guess mentally ill” (#4).
How have you reacted in the face of this indoctrination, violence, or abuse towards others?: “I was blaming myself and asking help from others. I saw everyone else right and I thought they are the best people on Earth, I wanted to get back to the community. I was scared of my family. The community members were immaculate and wise. They even sent me pictures, messages, poems I couldn’t understand because I so much wanted to figure out the messages behind” (#4).
How did the experiences in Buddhist groups change you: “I doubt myself, I had better periods but I keep falling back. I lost trust in life, I lost trust in myself and others, I have a lot of tension and fear in me. I cannot imagine to be capable of anything. Study or move away from my parents” (#4).
How did the experiences in Buddhist groups change your relationships and your ways of relating to others: “I can be still opened but deep down I have fear, doubt and it is not easy to trust people in a deeper level. I feel alone” (#4).
How did your experiences in Buddhist groups change the way you work: “I cannot imagine myself to have a job with responsibility. I don’t work much a week and sometimes I just sleep for the whole day” (#4).
Have you parted with one or more Buddhist groups or teachers? If so, why: “Yes, two groups, because I had psychosis and got sick” (#4).
When you think of abuse in Buddhist groups—the abuse of people who have been manipulated and of minors, including sexual abuse—how do you think and feel about it? How do you evaluate the responsibility in the group? Who is responsible for what: “I think leaders of Buddhist groups are individuals and it is unavoidable to find some ‘black sheep’ among them. Certainly I regret such incidents and would feel a serious betrayal of trust if I were to experience this from someone at the centre where I frequently visit. Once someone in the group hears about such, I believe it is their responsibility to communicate to stop it” (#5).
Why do we allow male Buddhist teachers to not only denigrate but also exploit women for their own (mostly hidden) agendas in the name of spirituality: “I would not allow this, but have not had any experience with it, usually I would take action or at least distance myself in case this would not be possible” (#5).
When you think of abuse in Buddhist groups—the abuse of people who have been manipulated and of minors, including sexual abuse—how do you think and feel about it? How do you evaluate the responsibility in the group? Who is responsible for what: “Abuse is unethical and illegal and we always have an obligation to stop it. I don’t think most groups are capable of policing themselves. They are too insular and secretive and outside law enforcement should be contacted. I tried to contact the Dalai Lama and other leaders repeatedly, but they never respond” (#6).
Why do we allow male Buddhist teachers to not only denigrate but also exploit women for their own (mostly hidden) agendas in the name of spirituality: “Because some people actually believe these men have special rights and powers and don’t have the balls to stand up for people being exploited. People are blinded by robes and spiritual authority and it’s dangerous” (#6).
When you think of abuse in Buddhist groups—the abuse of people who have been manipulated and of minors, including sexual abuse—how do you think and feel about it? How do you evaluate the responsibility in the group? Who is responsible for what: “This should not happen at all and ought to lead to an immediate criminal report. The person abusing is responsible, however, depending on the circumstances, also the group involved and the structures prevailing within it. The veneration of the teacher in Tibetan Buddhism unfortunately also creates conditions for abuse, be it physical or authoritative, even if the teachings clearly do not provide for that. In my opinion, Tibetan Buddhism needs some effort towards adjustment to at least make abuse more difficult” (#7).
Why do we allow male Buddhist teachers to not only denigrate but also exploit women for their own (mostly hidden) agendas in the name of spirituality: “Teachers are often held sacrosanct, and criticism of them is mostly unwanted. Sometimes a strong relationship of superiority/subordination can be seen, which facilitates abuse” (#7).
Which kind of abuse or violence have you experienced in Buddhist groups: “Humiliation, exposure, psychological violence, repression, deprivation of healthy self-esteem, intrigues, defamation campaigns, systematic manipulation and lies. Theft: do not take what is not given = misuse of tied donations” (#1) [cited in 2].
How did you react to abuse or violence: “denial, reality negation, rationalization, first insights, perception, evaluation, attempts to communicate, departure” (#8).
How have your experiences in Buddhist groups had an impact on you: “I no longer conform to any group consensus I consider inappropriate. I insist on discussing openly without individual participants manipulating others first. I advocate transparency and truthfulness, even if this is not popular, including financial issues, and try to convey democratic values. My position is that ethics could make a difference, before talking about philosophy and religion” (#8).
Which kind of indoctrination, abuse, or violence against others have you witnessed: “Anyone at […] should have seen quite a lot. For me, these subtle constant manipulations have been the worst, and that behind the scenes the violence was brutal” (#8).
How have you reacted in the face of this indoctrination, violence, or abuse towards others: “First I rationalized. I found many ‘old students’ so unpleasant that I considered more drastic measures to possibly be an option. Today I look at it differently. I do not count the eight letter writers among the ‘old students’, nor all students of […]. After realizing that all of this at […] is a dead end, and being frustrated to find out my fellow sanghaists lacked understanding, I left. They were in a ‘tunnel’. Particularly the many people afraid of losing their ‘dzogchen’, whatever that might mean to the individual” (#8).
How did the experiences in Buddhist groups change you: “Now I look at the world more openly, in its entirety, with all of its problems and opportunities” (#8).
How did the experiences in Buddhist groups change your relationships and your ways of relating to others: “I live quite isolated, beyond my professional and family life. I keep considerable distance from Buddhists” (#8).
How did your experiences in Buddhist groups change the way you work: “I take care of myself and my environment as much as I can. People who want to preach to me, I send away” (#8).
Have you parted with one or more Buddhist groups or teachers? If so, why: “Of all of them. My disgust with Buddhist groups is an impulse way too strong to be ignored. It either will subside or it doesn’t. I am a Buddhist who pretends he is not” (#8).
When you think of abuse in Buddhist groups—the abuse of people who have been manipulated and of minors, including sexual abuse—how do you think and feel about it? How do you evaluate the responsibility in the group? Who is responsible for what: “I feel angry and a huge sense of injustice about it, because it totally goes against the spirit of Buddhism, which is compassion, kindness, and bringing people to enlightenment. The teacher and the Buddhist institution the teacher is affiliated with is responsible” (#9).
Why do we allow male Buddhist teachers to not only denigrate but also exploit women for their own (mostly hidden) agendas in the name of spirituality: “It is an issue to do with the dominant patriarchal society we are part of today, where men are in positions of authority. This, unfortunately has extended to religion” (#9).
When you think of abuse in Buddhist groups—the abuse of people who have been manipulated and of minors, including sexual abuse—how do you think and feel about it? How do you evaluate the responsibility in the group? Who is responsible for what: “Every single person has his share of responsibility, even if he acted in blind trust. These are mitigating circumstances, of a sort. In […]: The higher the position, the greater is the degree of blindness. And the fish is always stinking from its head. Those at the top of an authoritarian structure, and who, due to their position as lama per se are endowed with particular abilities, ought to take responsibility for the consequences of their actions. Responsibility in groups is usually given to older students, who might have been accordingly indoctrinated and bring the relevant skills. Sociological studies might show 80% of leadership in Western Buddhist groups are female, except for the top positions. A psychologist and Buddhist, who I know well, even claims that women are more susceptible to manipulating behaviors in these positions” (#10).
Why do we allow male Buddhist teachers to not only denigrate but also exploit women for their own (mostly hidden) agendas in the name of spirituality: “Ignorance, lack of awareness, lack of ethical conscience. This is true for all genders, although it is mainly women who are currently victims of male offenders. Mostly all is well, as long as one isn’t victimized oneself” (#10).
When you think of abuse in Buddhist groups—the abuse of people who have been manipulated and of minors, including sexual abuse—how do you think and feel about it? How do you evaluate the responsibility in the group? Who is responsible for what: “Disgusted and annoyed. Everyone is responsible in particular the people who know directly about it and keep silent. However I know some people did try to bring abuse to light in the group I knew many years ago. Everything was ignored. They kept files they later gave to an investigation. Yet the group or the lama has still not admitted abuse” (#11).
Why do we allow male Buddhist teachers to not only denigrate but also exploit women for their own (mostly hidden) agendas in the name of spirituality: “Because it happens behind closed doors and unless the women themselves speak out it is difficult to prove. Also Tibetan Buddhism like most religions use fear of hell and damnation to silence. Also women are told they are dakini and as such special with special merit when they die” (#11).
The current issues in so-called Buddhist centers unfold against the background of oversimplifications of terms and concepts of Buddhist philosophy as well as of damaging neologisms. In particular, however, traditional application-oriented learning processes crucial for understanding and teaching are missing. The individual effects of these substantial and structural deficiencies are evident as health damage, specifically mental health, and traumatization of group members. Unreflected decontextualized use of Buddhist terminology and concepts and the neologisms in these contexts thus negatively impact on group dynamics and the health of a group and its members. Since the indoctrination described by the testimonies and the traumatization is still attempted to be denied by the mainstream within these organizations as well as the victims silenced [2], the latter are not compensated in any ways by precisely these organizations which have often previously enriched themselves on them. Furthermore, by propagating Buddhism a panacea for mental diseases, even persons with mental disorders are misled in highly irresponsible ways. Although oaths of secrecy associated with seemingly Buddhist concepts render it difficult for those affected to talk, testimonies regarding indoctrination and systematic abuse causing trauma and mental illness are available now. However, a high number of unrecorded cases of those, who for various reasons are unable to communicate, ought to be assumed.
The kind of abuse described by the probands covers psychological abuse (#2, #3), especially those aspects of the students’ submission, which serve as a basis for sexual assault (#2), the indoctrinative interpretations that are suggesting the abuse itself would take place in the mind of the student (#1) only, as well as psychological violence (#8). This questioning of one’s own autonomous understanding of situations and even one’s perception leads to a continuous state of disorientation, which initially may contribute to psychological damage and is particularly important to consider in later processes of treatment. By means of neologisms such as ‘karma purification’ and ‘crazy wisdom’, which serve to rationalize any misconduct of group leaders and entourage towards the goal of the students’ enlightenment, a form of dependence is constructed, in which they even bind themselves to the insulting leadership. In such ways their identification processes [14] are enhanced and self-reliance and autonomy reduced.
Emotional abuse (#3) was presented as humiliation (#8), exposure (#8), and repression (#8), which explains the very reduction in self-esteem (#8) of students in such groups. However, by using misunderstood visualizations of the Vajrayāna, also narcissistic tendencies get encouraged, resulting in severe arrogance, particularly among those seeking to establish themselves in positions of authority in such contexts, and in such ways forming a kind of spiritual narcissism. This, in turn, may explain their lack of empathy and compassion towards the victims, even whilst still proclaiming Buddhist compassion.
The abuse of authority for slandering any current or former students was reported as interfering with lies even at the workplace, outside the so-called Buddhist organization (#1). The lies (#8), intrigues (#8), and defamation campaigns (#8) mentioned have a huge impact on the individuals, particularly when used to irritate or destroy their reputation, social networks, and income. Since one has grown accustomed to such situations in these contexts, it seems necessary to emphasize that such is far from the basic ethical values taught within traditional Tibetan Buddhism.
The indoctrination saying the abuser would be allowed for the abuse, because of being a spiritual teacher (#1) already indicates an utterly inappropriate way of defining spiritual authority. Groups propagating such dangerous concepts concerning their spiritual teacher, devoid of ethics and adherence to national legislation, together with any authorities imposing their authoritative rules at will, endanger group members as well as visitors.
Any manipulation of students, interpreting the work for a lama, who is regarded a spiritual authority in the group, being an honor (#2), which in turn meant sexual abuse of servile (female) students (#2) and the instrumentalization of men for all kinds of little or unpaid services (#2), as well as systematic manipulation (#8), were also described as abuse (#2). Interpreting work for a spiritual authority as honor already indicates narcissistic group dynamics, where autonomous authentic training of Buddhist ethics and meditation has been replaced by rivalry over physical proximity to the leadership, which in turn has been redefined and also implies power over the group through identification processes. Thus, such concepts shape not only the group’s structures and behavior patterns but also its economic handling, that is expecting donations for certain group members. Furthermore, manipulation is not only for complying with financial and other service expectations, but often people are played off against each other and exchanged after their exploitation at will. Over the years of affiliation, however, these kinds of interactions, which are accompanied by psychological and financial dependencies as well as mental identification processes, can cause serious damage. Theft in the sense of misuse of tied donations (#8) was also mentioned to be abuse. And the manipulation with the conceptual distortion of the Buddhist concept of emptiness used to explain away abuse and abuser (#1) severely devaluates Buddhist philosophy and undermines sound and informed terminological and conceptual discourse.
The testimony of indoctrination, abuse, or violence against others was described as follows: subtle constant manipulations (#8), highly indoctrinated long-term members lacking vocabulary from outside the group (#1), and repeating verbatim all the time (#1). For so-called Buddhist seminar- and retreat-participants the following methods were described: psychologizing every single student (#3), emotional manipulation (#3), violation of confidentiality (#3), gaslighting (#3), shaming (#3), slander (#3), and outright lies (#3). Someone also testified disrespectful speech about people with mental health problems (#1). Furthermore, blackmailing of the management was described, such as telling the executive director to fire someone because of being diagnosed neurotic (#3) by nonprofessionals. Furthermore, there is testimony on punishment in the form of sending people away from group into solitary retreats or banning people from retreats (#3) and brutal violence behind the scenes (#8). Someone interpreted dismissing people’s needs by invalidating their feelings (#1) through forcing what was called ‘teachings’ on them. There is also testimony on threats to ruin people’s reputations and livelihoods (#1) and on sexual abuse of different women by a senior teacher (#4). Whereas sexual abuse of minors is a clearly defined a criminal offense, currently also severely manipulated and indoctrinated adults, who have mostly initially made their way up to the ‘inner circle’ [2, 5] and have then moved on to physical proximity or agreed to the position of secret lovers, claim the same for themselves. Thus, the overloaded phrase of ‘sexual abuse’ in current contextual discourses ought to be further differentiated, taking into account unequal balance of power, indoctrination, seduction, untrue promises, coercive control, self-responsibility of adults, as well as victimizing collaborators and witnesses. Moreover, the dynamics of controlling the feminine, which have been adopted unreflectively from Tibetan Buddhism, manifest in seemingly impersonal attitudes towards the women concerned, which thus results in a high number of victims.
Three successive states of individual reaction to indoctrination, abuse or violence in the respective Buddhist group showed: continuous close affiliation, critical reflection, and departure. For the period of close affiliation to a group helplessness (#3), denial (#8), feeling of inadequacy (#1), not acknowledging that the perpetrator should be able to take some responsibility for their behaviors (#1), feeling abandoned and inadequate because of the reactions of the leadership and group to the abuse (who did not view it as abuse) (#1), oneself not perceiving abuse and violence as such, but only understanding it when seeing it on someone else first (#2) and anger (#3) were reported. One person severely turned against herself and reported getting seriously angry at herself (#4) with putting herself down (#4). Another person in high position in her group and dependent on financial terms told she has taken over the opinion of the teacher to preserve her own standing and maintain her position in the group (#3). Thus, these replies also may show some implications and limitations of holding positions in such groups. In phase two, the period of reflection and doubts, there were communication attempts before departure (#8). In phase three, after departure from the group, there were feelings to be abandoned by those who did not understand and could not help (#1), anxiety and shame for several months causing digestion problems (#1), frequent dissociation (#1), which might have been accompanied by stiffness and rigidity in the face (#1), little energy (#1), and slow speech and slow processing speed (#1). Furthermore, doubts regarding the dangers (#1) with nightmares about being murdered by the leadership (#1), lack of concentration (#1), poor boundaries (#1), turning to alcohol to cope (#1), and suicidality (#1) were reported. Reading testimonies of former members (#1) was reported having caused anger. And the workplace receiving an email from the so-called Buddhist organization’s management, who was even using a fake identity (#1), caused rage (#1).
The above three successive states of individual reaction were reported to be accompanied by two inner processes when observing indoctrination, abuse, or violence of others: the identifying and indoctrinating phase and the reflection phase. These observations show concepts and behavior far from the attitude of traditional Buddhist practice of having the individual’s autonomy, awareness and self-reflection as its basis. At the period of being indoctrinated, identifying and merging with the leadership, management or group expectations reactions such as lack of one’s own awareness of it (#3), standing quietly (#3) and watching (#3), which could be interpreted as a kind of freezing in shock about what was seen, as well as rationalizing (#8) and even believing what was said about former members (#1) were reported. Someone did not respond to the question directly, but stated sexual assaults against very young women (#2). Yet another person told she was even blaming herself (#4) for the above behavior of other group members while regarding everyone else right. At the period of reflection, when interpreting the issues leading to decisions, someone described realizing all of it a dead end (#8) and his frustration about his fellows narrowing their understanding like in a ‘tunnel’ (#8) before he left. Others responded to the manipulation and indoctrination tactics in the group with shock and later righteous anger (#1), because of the threats and character assassination of former members (#1) as well as with high distress about the center avoiding to take responsibility by blaming people’s ‘mind’ for anything (#1).
The question on how the person was changed him- or herself by their experiences in these groups was replied to with some positive aspects such as sustained attention (#3), strength to do multi-day ritual (#3), being not afraid to be alone in the woods (#3), and the feeling of union with the divine (#3). However, the positively connotated aspect of accepting pain and negative experiences as just a part of life (#3) may already endanger this individual in highly manipulative contexts. Aspects with negative connotations, such as doubting oneself (#4), not being able to imagine to be capable of anything (#4), having a lot of tension and fear (#4), as well as having lost trust in oneself and others (#4) and in life (#4), were reported as well. People also described having become more suspicious (#2), particularly of all spiritual teachers (#1), being sensitive to coercion (#1) and understanding spiritual abuse (#1), the latter of which may not only protect the individual but also enable them to protect others from unreasonable nonsense and misuse. The phrase spiritual abuse might be interpreted as people being seduced into giving up their own strength as if dependent on a master providing them access to their own spirituality. Furthermore, with reporting greater autonomy (#2) and trusting one’s own intuition more (#1), an individual process of change was addressed, which is also found in phrases such as becoming more adult (#2), having developed critical thinking skills (#1), and probably even in enjoying being disobedient (#1) after experiencing abuse in highly authoritative structures to some extent. Also, the result of a process, such as looking at the world more openly (#8), was referred to, and decisions were shared such as never becoming a student of a male spiritual teacher again (#3) and never ever giving one’s power away to any human teacher (#3).
The scope of the personal impact of these experiences in Buddhist groups was described with adverse effects such as severe self-devaluation (#4), posttraumatic stress (#1), and feelings of helpless (#4), shame (#1), and anxiety (#1). Furthermore, lack of trust (#4) was described at the interpersonal level, which might impact considerably on future relationships and work decisions. Although the fear of making decisions (#4) and loss of direction in life (#4) may come up in an early period of leaving an abusive group, they sometimes continue for even years. The refusal to conform to any group consensus considered inappropriate (#8) is often part of the separating process and might stay as a lesson learned. Furthermore, there are positive connotations for a time period after having left the group and making new personal and working relationships, which were called new connections to kind people (#1) and posttraumatic growth (#1). Also, the values of the person were described to be discussing openly without individual participants manipulating others first (#8) and advocating transparency and truthfulness (#8), even if this is not popular, including financial issues (#8), as well as trying to convey democratic values (#8) and ethics (#8). The reflection of absorbed values and integration of one’s own value system are aspects of the process of separation, which often occur long after the physical separation. Sometimes this also encompasses referring to traditional basic Buddhist ethics. In therapeutic processes, it takes place in the phase of dealing with introjects and in the phase of integration. The impact on relationships and ways of relating to others was described as getting arrogant sometimes (#2) for the period in the group, which is regarding oneself higher or more spiritually advanced than others. Negative impact of fear and doubt with feeling lonely and difficulties to trust people (#4) was described as well. Furthermore, it was said recognizing one’s own needs (#1), which seems to be a key issue to reconnect to oneself, not practicing accepting everything (#1) and not automatically putting other people first (#1), trusting few people (#1), as well as trying to communicate emotions more (#1), which may show as becoming more compassionate (#2) or feeling in touch with righteous anger (#1). The making of encounters on equal level at a therapeutic context with dangers for too much confluence (#2) was an impact for a professional therapist. Someone also shared keeping a considerable distance from Buddhists (#8) and living quite isolated beyond professional and family life (#8).
The impact on one’s work was described as taking care to the best of one’s abilities of oneself and surrounding (8), understanding abusive systems of power and abusive group dynamics (#1) and also as suspiciousness of meditation and mindfulness (#1). A young person shared a highly negative impact for her life saying she could not imagine herself at a job with responsibility (#4), she would not work much (#4) and sometimes sleep for the whole day (#4).
The following two questions refer to open letters and ongoing investigations widely discussed in the context. They were asked to understand not only the persons’ opinion but also their position in the group and their behavior. Not everyone replied to the questions: when you think of abuse in Buddhist groups—the abuse of people who have been manipulated and of minors, including sexual abuse—how do you think and feel about it? How do you evaluate the responsibility in the group?Who is responsible for what? Whereas someone told abuse to be unethical and illegal (#6) and in this way referred to basic values, another person simply stripped the leadership of its exaggerated superiority saying the leaders of Buddhist groups were individuals and it would be unavoidable to find some ‘black sheep’ among them (#5). #7 judged that it should not happen at all and ought to lead to an immediate criminal report. Someone replied the veneration of the teacher in Tibetan Buddhism unfortunately would also create conditions for abuse (#7). Reports on one’s own feelings range from helpless (#3), sadness (#3), and anger (#3) to disgust and annoyance (#11). Furthermore, someone told to regret such incidents (#5) and feel a serious betrayal of trust (#5). Someone reported feeling anger and a huge sense of injustice about it (#9) and gave reasons for such behavior going against the spirit of Buddhism, which would be defined as compassion, kindness, and bringing people to enlightenment (#9). Regarding the assignment of responsibilities, one woman said people always have an obligation to stop abuse (#6), and similarly another person told it would be the responsibility of anyone hearing about abuse to communicate to stop it (#5). A man told the person abusing is responsible (#7), however, depending on the circumstances, also the group involved, and the structures prevailing within (#7). Another man told that the teacher and the Buddhist institution the teacher is affiliated with were responsible (#9) and someone else that every single person had his share of responsibility, even if they acted in blind trust (#10), and that the latter would be mitigating circumstances (#10). Furthermore, one woman regarded the leadership and its teachers to be responsible for the abuse (#3) and the board of directors for not intervening (#3) and she analyzed challenging power structures allowing for abuse (#3). #6 assumed most of these so-called Buddhist groups would not be capable of policing themselves (#6) arguing them to be too insular (#6) and secretive (#6) and outside law enforcement (#6). This woman also reported having tried to contact the Dalai Lama and other leaders repeatedly without ever having received any response (#6). Someone else told that Tibetan Buddhism would need some effort towards adjustment to at least make abuse more difficult (#7), and #10 analyzed the degree of higher position in the group to positively correlate with the degree of blindness (#10). He continued to elaborate that responsibility in groups were usually given to older students, who might have been be accordingly indoctrinated and bring the relevant skills (#10). He argued they ought to take responsibility for the consequences of their actions (#10). Yet another person replied that everyone would be responsible, in particular those people who knew but kept silent (#11). This person then reported to know some people who were first ignored when they tried to bring abuse to light in the group (#11) and that neither the lama nor his group would have admitted abuse (#11), even after they later have given the files to an investigation (#11). Despite singularizing individuals with shifting the issues on them, the persons in the groups acting in such ways are “agents in violent betrayal” [15].
The question why do we allow male Buddhist teachers to not only denigrate but also exploit women for their own (mostly hidden) agendas in the name of spirituality was replied to as follows: Someone telling to have no experience with it assumes she would not allow this (#5) by taking action (#5) or at least distancing herself (#5). A man called it ignorance, lack of awareness, and lack of ethical conscience (#10) and elaborated this to be true for all genders, although currently mainly women were victims of male offenders (#10) and that as long as one is not victimized oneself (#10) people would perceive everything to be fine (#10). Another man analyzed the secrecy behind closed doors (#11) telling unless the women themselves speak out, it would be difficult to prove (#11). He described the fear of hell used in Tibetan Buddhism for silencing (#11) and the seduction with calling the women a dakini promising them special merit at the time of their death (#11). Another man analyzed it as an issue to do with the dominant patriarchal society (#9), where men are in positions of authority having extended to religion (#9). A man analyzed that teachers would be often held sacrosanct (#7), telling criticism of them were mostly unwanted (#7). Furthermore, he argued the strong relationship of superiority facilitating abuse (#7). One women responded with participation in patriarchy (#3) accused what she thinks is Tibetan Buddhism encouraging mind control, submissiveness, and patriarchal hierarchy (#3) and interprets people disconnected from their own power (#3) being willing to let someone tell them what to do (#3). She accused men suing the tradition for their own agendas for many centuries (#3) and regards what she has learned to be so-called Vajrayana even a vehicle for patriarchal abuse (#3). Another woman argued with attributing special rights and powers to certain men (#6), saying people were blinded by robes and spiritual authority, judging this to be dangerous (#6). She also attributes lack of courage to protect those exploited (#6).
Thus, the opening of any closed elitist circles to the wider societal discourse, the democratization processes required within the strictly hierarchical structures of Tibetan Buddhist centers and a supervised training of group members in traditional interpretations of Buddhist terms, concepts and ethics as well as the urgently needed cultural discourses are a vital condition for differentiated, linguistically and scientifically sound processes of knowledge transfer and exchange. However, whereas these concerns contribute to overcoming structural and conceptual inadequacies, the view of and behavior towards women remains a key issue. Particularly, the tacit transfer of projecting the shadow onto the female and the implicit mechanisms of their control ought to be reflected and addressed. In this context, the role and function of a teacher’s secret lover and unreflective copying culturally shaped structures and behavior with regards to her are crucial. Given the lack of reference within their own cultural context, this raises questions about the psychological effects of such kind of social isolation of these women as well as about their secret position of power, which is even defined highly desirable in some circles. This issue raises further questions about leadership responsibility with regard to the group dynamics induced by it and the effects on the women concerned and their self-responsibility. The societal challenge of correcting individual damages that have been recurring throughout generations, which negatively impact on the knowledge of Buddhism itself, however, is directly opposed to the current mainstream of secrecy and individualizing these issues as so-called ‘bad karma’ [1, 2] in such contexts. But although those who still draw their individual profits from these structures try to influence their followers with refusing to listen to the victims and authoritative and confusing definitions, such as trauma being even the aggression of the victim, and in such ways continue to manipulate seminar participants and publicly ridicule and slander victims, now the wider social surrounding has started to counteract the strategy of individualizing issues.
Lacking intercultural exchange of scientific knowledge and its integration into the education in Buddhist philosophy and Tibetan medicine resulted in oversimplification and misguided practice.
Furthermore, the collective projection of the shadow onto the feminine reveals through the current individual and structural challenges in these contexts. This pattern being passed down through generations and unreflectively transferred to Western centers has contributed to forming a subculture spreading internationally under Buddhist cover, with its own secrecy rules, use of language in rationalizing neologisms for the silencing of trauma and the traumatized [2] and trauma dynamics. Ignoring the unconscious in teacher-student relationships and group dynamics has led to the superelevation of persons, even loosing ethics, which form the basis of every Buddhist tradition. Thus, based on the demands for identification with the spiritual master and his entourage, mental diseases were induced.
For individuals coming from Buddhist contexts, it is therefore important to replace the convenient ways of handing over responsibility, which are leading to patterns of dependency and serving exploitation, with freedom to autonomy along with self-responsibility regarding their own training and ethics. The autonomy in one’s own spirituality can never be substituted by an intermediary who is regarded as the sole access to one’s own resource. And the role of the lineage holder in Vajrayāna is not meant for such.
Society, which provides care for the shamelessly exploited, diseased, and traumatized people, now faces several challenges. Apart from prevention through dismantling common idealizations and providing information about the circumstances, terminology involved in indoctrination and the dangers in hypnotising techniques or dissociation sold for so-called Buddhist meditation, it is crucial to develop treatment concepts for those with complex diseases to provide therapeutic care. Furthermore, broadening of the perspective is needed to enable improvement of these closed systems with their seminar-, meditation-, and retreat-centers, particularly concerning education as well as conveying human rights and national legislation to those group members who assume their spiritual masters and entourage are above legislation. For preserving the knowledge of Buddhist philosophy and practice, curing the transgenerational patterns of traumatization of individuals, compensating victims and deciding on how to deal with perpetrators, accomplices and collaborators are crucial.
This research was funded by the German Federal Ministry of Education and Research, grant reference number 01UL1823X.
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He was born in 1969 in Naama, Algeria. He received his BS degree in 1993, the MS degree in 1997, the PhD degree in 2007 from the Electrical Engineering Institute of Djilali Liabes University of Sidi Bel Abbes (ALGERIA). He is an active member of IRECOM (Interaction Réseaux Electriques - COnvertisseurs Machines) Laboratory and IEEE senior member. He is an editor member for many international journals (IJET, RSE, MER, IJECE, etc.), he serves as a reviewer in international journals (IJAC, ECPS, COMPEL, etc.). He serves as member in technical committee (TPC) and reviewer in international conferences (CHUSER 2011, SHUSER 2012, PECON 2012, SAI 2013, SCSE2013, SDM2014, SEB2014, PEMC2014, PEAM2014, SEB (2014, 2015), ICRERA (2015, 2016, 2017, 2018,-2019), etc.). His current research interest includes power electronics, control of electrical machines, artificial intelligence and Renewable energies.",institutionString:"University of Béchar",institution:{name:"University of Béchar",country:{name:"Algeria"}}},{id:"99749",title:"Dr.",name:"Abdel Hafid",middleName:null,surname:"Essadki",slug:"abdel-hafid-essadki",fullName:"Abdel Hafid Essadki",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"École Nationale Supérieure de Technologie",country:{name:"Algeria"}}},{id:"101208",title:"Prof.",name:"Abdel Karim",middleName:"Mohamad",surname:"El Hemaly",slug:"abdel-karim-el-hemaly",fullName:"Abdel Karim El Hemaly",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/101208/images/733_n.jpg",biography:"OBGYN.net Editorial Advisor Urogynecology.\nAbdel Karim M. A. El-Hemaly, MRCOG, FRCS � Egypt.\n \nAbdel Karim M. A. El-Hemaly\nProfessor OB/GYN & Urogynecology\nFaculty of medicine, Al-Azhar University \nPersonal Information: \nMarried with two children\nWife: Professor Laila A. Moussa MD.\nSons: Mohamad A. M. El-Hemaly Jr. MD. Died March 25-2007\nMostafa A. M. El-Hemaly, Computer Scientist working at Microsoft Seatle, USA. \nQualifications: \n1.\tM.B.-Bch Cairo Univ. June 1963. \n2.\tDiploma Ob./Gyn. Cairo Univ. April 1966. \n3.\tDiploma Surgery Cairo Univ. Oct. 1966. \n4.\tMRCOG London Feb. 1975. \n5.\tF.R.C.S. Glasgow June 1976. \n6.\tPopulation Study Johns Hopkins 1981. \n7.\tGyn. Oncology Johns Hopkins 1983. \n8.\tAdvanced Laparoscopic Surgery, with Prof. Paulson, Alexandria, Virginia USA 1993. \nSocieties & Associations: \n1.\t Member of the Royal College of Ob./Gyn. London. \n2.\tFellow of the Royal College of Surgeons Glasgow UK. \n3.\tMember of the advisory board on urogyn. FIGO. \n4.\tMember of the New York Academy of Sciences. \n5.\tMember of the American Association for the Advancement of Science. \n6.\tFeatured in �Who is Who in the World� from the 16th edition to the 20th edition. \n7.\tFeatured in �Who is Who in Science and Engineering� in the 7th edition. \n8.\tMember of the Egyptian Fertility & Sterility Society. \n9.\tMember of the Egyptian Society of Ob./Gyn. \n10.\tMember of the Egyptian Society of Urogyn. \n\nScientific Publications & Communications:\n1- Abdel Karim M. El Hemaly*, Ibrahim M. Kandil, Asim Kurjak, Ahmad G. Serour, Laila A. S. Mousa, Amr M. Zaied, Khalid Z. El Sheikha. \nImaging the Internal Urethral Sphincter and the Vagina in Normal Women and Women Suffering from Stress Urinary Incontinence and Vaginal Prolapse. Gynaecologia Et Perinatologia, Vol18, No 4; 169-286 October-December 2009.\n2- Abdel Karim M. El Hemaly*, Laila A. S. Mousa Ibrahim M. Kandil, Fatma S. El Sokkary, Ahmad G. Serour, Hossam Hussein.\nFecal Incontinence, A Novel Concept: The Role of the internal Anal sphincter (IAS) in defecation and fecal incontinence. Gynaecologia Et Perinatologia, Vol19, No 2; 79-85 April -June 2010.\n3- Abdel Karim M. El Hemaly*, Laila A. S. Mousa Ibrahim M. Kandil, Fatma S. El Sokkary, Ahmad G. Serour, Hossam Hussein.\nSurgical Treatment of Stress Urinary Incontinence, Fecal Incontinence and Vaginal Prolapse By A Novel Operation \n"Urethro-Ano-Vaginoplasty"\n Gynaecologia Et Perinatologia, Vol19, No 3; 129-188 July-September 2010.\n4- Abdel Karim M. El Hemaly*, Ibrahim M. Kandil, Laila A. S. Mousa and Mohamad A.K.M.El Hemaly.\nUrethro-vaginoplasty, an innovated operation for the treatment of: Stress Urinary Incontinence (SUI), Detursor Overactivity (DO), Mixed Urinary Incontinence and Anterior Vaginal Wall Descent. \nhttp://www.obgyn.net/urogyn/urogyn.asp?page=/urogyn/articles/ urethro-vaginoplasty_01\n\n5- Abdel Karim M. El Hemaly, Ibrahim M Kandil, Mohamed M. Radwan.\n Urethro-raphy a new technique for surgical management of Stress Urinary Incontinence.\nhttp://www.obgyn.net/urogyn/urogyn.asp?page=/urogyn/articles/\nnew-tech-urethro\n\n6- Abdel Karim M. El Hemaly, Ibrahim M Kandil, Mohamad A. Rizk, Nabil Abdel Maksoud H., Mohamad M. Radwan, Khalid Z. El Shieka, Mohamad A. K. M. El Hemaly, and Ahmad T. El Saban.\nUrethro-raphy The New Operation for the treatment of stress urinary incontinence, SUI, detrusor instability, DI, and mixed-type of urinary incontinence; short and long term results. \nhttp://www.obgyn.net/urogyn/urogyn.asp?page=urogyn/articles/\nurethroraphy-09280\n\n7-Abdel Karim M. El Hemaly, Ibrahim M Kandil, and Bahaa E. El Mohamady. Menopause, and Voiding troubles. \nhttp://www.obgyn.net/displayppt.asp?page=/English/pubs/features/presentations/El-Hemaly03/el-hemaly03-ss\n\n8-El Hemaly AKMA, Mousa L.A. Micturition and Urinary\tContinence. Int J Gynecol Obstet 1996; 42: 291-2. \n\n9-Abdel Karim M. El Hemaly.\n Urinary incontinence in gynecology, a review article.\nhttp://www.obgyn.net/urogyn/urogyn.asp?page=/urogyn/articles/abs-urinary_incotinence_gyn_ehemaly \n\n10-El Hemaly AKMA. Nocturnal Enuresis: Pathogenesis and Treatment. \nInt Urogynecol J Pelvic Floor Dysfunct 1998;9: 129-31.\n \n11-El Hemaly AKMA, Mousa L.A.E. Stress Urinary Incontinence, a New Concept. Eur J Obstet Gynecol Reprod Biol 1996; 68: 129-35. \n\n12- El Hemaly AKMA, Kandil I. M. Stress Urinary Incontinence SUI facts and fiction. Is SUI a puzzle?! http://www.obgyn.net/displayppt.asp?page=/English/pubs/features/presentations/El-Hemaly/el-hemaly-ss\n\n13-Abdel Karim El Hemaly, Nabil Abdel Maksoud, Laila A. Mousa, Ibrahim M. Kandil, Asem Anwar, M.A.K El Hemaly and Bahaa E. El Mohamady. \nEvidence based Facts on the Pathogenesis and Management of SUI. http://www.obgyn.net/displayppt.asp?page=/English/pubs/features/presentations/El-Hemaly02/el-hemaly02-ss\n\n14- Abdel Karim M. El Hemaly*, Ibrahim M. Kandil, Mohamad A. Rizk and Mohamad A.K.M.El Hemaly.\n Urethro-plasty, a Novel Operation based on a New Concept, for the Treatment of Stress Urinary Incontinence, S.U.I., Detrusor Instability, D.I., and Mixed-type of Urinary Incontinence.\nhttp://www.obgyn.net/urogyn/urogyn.asp?page=/urogyn/articles/urethro-plasty_01\n\n15-Ibrahim M. Kandil, Abdel Karim M. El Hemaly, Mohamad M. Radwan: Ultrasonic Assessment of the Internal Urethral Sphincter in Stress Urinary Incontinence. The Internet Journal of Gynecology and Obstetrics. 2003. Volume 2 Number 1. \n\n\n16-Abdel Karim M. El Hemaly. Nocturnal Enureses: A Novel Concept on its pathogenesis and Treatment.\nhttp://www.obgyn.net/urogynecolgy/?page=articles/nocturnal_enuresis\n\n17- Abdel Karim M. El Hemaly. Nocturnal Enureses: An Update on the pathogenesis and Treatment.\nhttp://www.obgyn.net/urogynecology/?page=/ENHLIDH/PUBD/FEATURES/\nPresentations/ Nocturnal_Enuresis/nocturnal_enuresis\n\n18-Maternal Mortality in Egypt, a cry for help and attention. The Second International Conference of the African Society of Organization & Gestosis, 1998, 3rd Annual International Conference of Ob/Gyn Department � Sohag Faculty of Medicine University. Feb. 11-13. Luxor, Egypt. \n19-Postmenopausal Osteprosis. The 2nd annual conference of Health Insurance Organization on Family Planning and its role in primary health care. Zagaziz, Egypt, February 26-27, 1997, Center of Complementary Services for Maternity and childhood care. \n20-Laparoscopic Assisted vaginal hysterectomy. 10th International Annual Congress Modern Trends in Reproductive Techniques 23-24 March 1995. Alexandria, Egypt. \n21-Immunological Studies in Pre-eclamptic Toxaemia. Proceedings of 10th Annual Ain Shams Medical Congress. Cairo, Egypt, March 6-10, 1987. \n22-Socio-demographic factorse affecting acceptability of the long-acting contraceptive injections in a rural Egyptian community. Journal of Biosocial Science 29:305, 1987. \n23-Plasma fibronectin levels hypertension during pregnancy. The Journal of the Egypt. Soc. of Ob./Gyn. 13:1, 17-21, Jan. 1987. \n24-Effect of smoking on pregnancy. Journal of Egypt. Soc. of Ob./Gyn. 12:3, 111-121, Sept 1986. \n25-Socio-demographic aspects of nausea and vomiting in early pregnancy. Journal of the Egypt. Soc. of Ob./Gyn. 12:3, 35-42, Sept. 1986. \n26-Effect of intrapartum oxygen inhalation on maternofetal blood gases and pH. Journal of the Egypt. Soc. of Ob./Gyn. 12:3, 57-64, Sept. 1986. \n27-The effect of severe pre-eclampsia on serum transaminases. The Egypt. J. Med. Sci. 7(2): 479-485, 1986. \n28-A study of placental immunoreceptors in pre-eclampsia. The Egypt. J. Med. Sci. 7(2): 211-216, 1986. \n29-Serum human placental lactogen (hpl) in normal, toxaemic and diabetic pregnant women, during pregnancy and its relation to the outcome of pregnancy. Journal of the Egypt. Soc. of Ob./Gyn. 12:2, 11-23, May 1986. \n30-Pregnancy specific B1 Glycoprotein and free estriol in the serum of normal, toxaemic and diabetic pregnant women during pregnancy and after delivery. Journal of the Egypt. Soc. of Ob./Gyn. 12:1, 63-70, Jan. 1986. Also was accepted and presented at Xith World Congress of Gynecology and Obstetrics, Berlin (West), September 15-20, 1985. \n31-Pregnancy and labor in women over the age of forty years. Accepted and presented at Al-Azhar International Medical Conference, Cairo 28-31 Dec. 1985. \n32-Effect of Copper T intra-uterine device on cervico-vaginal flora. Int. J. Gynaecol. Obstet. 23:2, 153-156, April 1985. \n33-Factors affecting the occurrence of post-Caesarean section febrile morbidity. Population Sciences, 6, 139-149, 1985. \n34-Pre-eclamptic toxaemia and its relation to H.L.A. system. Population Sciences, 6, 131-139, 1985. \n35-The menstrual pattern and occurrence of pregnancy one year after discontinuation of Depo-medroxy progesterone acetate as a postpartum contraceptive. Population Sciences, 6, 105-111, 1985. \n36-The menstrual pattern and side effects of Depo-medroxy progesterone acetate as postpartum contraceptive. Population Sciences, 6, 97-105, 1985. \n37-Actinomyces in the vaginas of women with and without intrauterine contraceptive devices. Population Sciences, 6, 77-85, 1985. \n38-Comparative efficacy of ibuprofen and etamsylate in the treatment of I.U.D. menorrhagia. Population Sciences, 6, 63-77, 1985. \n39-Changes in cervical mucus copper and zinc in women using I.U.D.�s. Population Sciences, 6, 35-41, 1985. \n40-Histochemical study of the endometrium of infertile women. Egypt. J. Histol. 8(1) 63-66, 1985. \n41-Genital flora in pre- and post-menopausal women. Egypt. J. Med. Sci. 4(2), 165-172, 1983. \n42-Evaluation of the vaginal rugae and thickness in 8 different groups. Journal of the Egypt. Soc. of Ob./Gyn. 9:2, 101-114, May 1983. \n43-The effect of menopausal status and conjugated oestrogen therapy on serum cholesterol, triglycerides and electrophoretic lipoprotein patterns. Al-Azhar Medical Journal, 12:2, 113-119, April 1983. \n44-Laparoscopic ventrosuspension: A New Technique. Int. J. Gynaecol. Obstet., 20, 129-31, 1982. \n45-The laparoscope: A useful diagnostic tool in general surgery. Al-Azhar Medical Journal, 11:4, 397-401, Oct. 1982. \n46-The value of the laparoscope in the diagnosis of polycystic ovary. Al-Azhar Medical Journal, 11:2, 153-159, April 1982. \n47-An anaesthetic approach to the management of eclampsia. Ain Shams Medical Journal, accepted for publication 1981. \n48-Laparoscopy on patients with previous lower abdominal surgery. Fertility management edited by E. Osman and M. Wahba 1981. \n49-Heart diseases with pregnancy. Population Sciences, 11, 121-130, 1981. \n50-A study of the biosocial factors affecting perinatal mortality in an Egyptian maternity hospital. Population Sciences, 6, 71-90, 1981. \n51-Pregnancy Wastage. Journal of the Egypt. Soc. of Ob./Gyn. 11:3, 57-67, Sept. 1980. \n52-Analysis of maternal deaths in Egyptian maternity hospitals. Population Sciences, 1, 59-65, 1979. \nArticles published on OBGYN.net: \n1- Abdel Karim M. El Hemaly*, Ibrahim M. Kandil, Laila A. S. Mousa and Mohamad A.K.M.El Hemaly.\nUrethro-vaginoplasty, an innovated operation for the treatment of: Stress Urinary Incontinence (SUI), Detursor Overactivity (DO), Mixed Urinary Incontinence and Anterior Vaginal Wall Descent. \nhttp://www.obgyn.net/urogyn/urogyn.asp?page=/urogyn/articles/ urethro-vaginoplasty_01\n\n2- Abdel Karim M. El Hemaly, Ibrahim M Kandil, Mohamed M. Radwan.\n Urethro-raphy a new technique for surgical management of Stress Urinary Incontinence.\nhttp://www.obgyn.net/urogyn/urogyn.asp?page=/urogyn/articles/\nnew-tech-urethro\n\n3- Abdel Karim M. El Hemaly, Ibrahim M Kandil, Mohamad A. Rizk, Nabil Abdel Maksoud H., Mohamad M. Radwan, Khalid Z. El Shieka, Mohamad A. K. M. El Hemaly, and Ahmad T. El Saban.\nUrethro-raphy The New Operation for the treatment of stress urinary incontinence, SUI, detrusor instability, DI, and mixed-type of urinary incontinence; short and long term results. \nhttp://www.obgyn.net/urogyn/urogyn.asp?page=urogyn/articles/\nurethroraphy-09280\n\n4-Abdel Karim M. El Hemaly, Ibrahim M Kandil, and Bahaa E. El Mohamady. Menopause, and Voiding troubles. \nhttp://www.obgyn.net/displayppt.asp?page=/English/pubs/features/presentations/El-Hemaly03/el-hemaly03-ss\n\n5-El Hemaly AKMA, Mousa L.A. Micturition and Urinary\tContinence. Int J Gynecol Obstet 1996; 42: 291-2. \n\n6-Abdel Karim M. El Hemaly.\n Urinary incontinence in gynecology, a review article.\nhttp://www.obgyn.net/urogyn/urogyn.asp?page=/urogyn/articles/abs-urinary_incotinence_gyn_ehemaly \n\n7-El Hemaly AKMA. Nocturnal Enuresis: Pathogenesis and Treatment. \nInt Urogynecol J Pelvic Floor Dysfunct 1998;9: 129-31.\n \n8-El Hemaly AKMA, Mousa L.A.E. Stress Urinary Incontinence, a New Concept. Eur J Obstet Gynecol Reprod Biol 1996; 68: 129-35. \n\n9- El Hemaly AKMA, Kandil I. M. Stress Urinary Incontinence SUI facts and fiction. Is SUI a puzzle?! http://www.obgyn.net/displayppt.asp?page=/English/pubs/features/presentations/El-Hemaly/el-hemaly-ss\n\n10-Abdel Karim El Hemaly, Nabil Abdel Maksoud, Laila A. Mousa, Ibrahim M. Kandil, Asem Anwar, M.A.K El Hemaly and Bahaa E. El Mohamady. \nEvidence based Facts on the Pathogenesis and Management of SUI. http://www.obgyn.net/displayppt.asp?page=/English/pubs/features/presentations/El-Hemaly02/el-hemaly02-ss\n\n11- Abdel Karim M. El Hemaly*, Ibrahim M. Kandil, Mohamad A. Rizk and Mohamad A.K.M.El Hemaly.\n Urethro-plasty, a Novel Operation based on a New Concept, for the Treatment of Stress Urinary Incontinence, S.U.I., Detrusor Instability, D.I., and Mixed-type of Urinary Incontinence.\nhttp://www.obgyn.net/urogyn/urogyn.asp?page=/urogyn/articles/urethro-plasty_01\n\n12-Ibrahim M. Kandil, Abdel Karim M. El Hemaly, Mohamad M. Radwan: Ultrasonic Assessment of the Internal Urethral Sphincter in Stress Urinary Incontinence. The Internet Journal of Gynecology and Obstetrics. 2003. Volume 2 Number 1. \n\n13-Abdel Karim M. El Hemaly. Nocturnal Enureses: A Novel Concept on its pathogenesis and Treatment.\nhttp://www.obgyn.net/urogynecolgy/?page=articles/nocturnal_enuresis\n\n14- Abdel Karim M. El Hemaly. 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