Banning pro-ana websites? Not a good idea, as Web censorship might have a ‘toothpaste tube effect’

[Update 05.04.13: A longer version of this post, with revised results, has evolved into a full-fledged article published by the UK Royal Society. To cite the article: A. A. Casilli, F. Pailler, P. Tubaro (2013). Online networks of eating disorder websites: why censoring pro ana might be a bad idea, Perspectives in Public Health , vol. 133, n.2, p. 94 95. As part of our research project ANAMIA (Ana-mia Sociability: an Online/Offline Social Networks Approach to Eating Disorders), the post has been featured in a number of media venues, including The Economist, Libération, Le Monde, Boing Boing, The Huffingtonpost, CBC Radio Canada, DRadio Wissen, Voice of Russia.]

Tumblr, Pinterest and the toothpaste tube

On February 23rd, 2012 Tumblr announced its decision to turn the screw on self-harm blogs: suicide, mutilation and most prominently thinspiration – i.e. the ritualized exchange of images and quotes meant to inspire readers to be thin. This cultural practice is distinctive of the pro-ana (anorexia nervosa), pro-mia (bulimia) and pro-ED (eating disorders) groups online: blogs, forums, and communities created by people suffering from eating-related conditions, who display a proactive stance and critically abide by medical advice.

A New Policy Against Self-Harm Blogs | Tumblr Staff

A righteous limitation of harmful contents or just another way to avoid liability by marginalizing a stigmatized subculture? Whatever your opinion, it might not come as a surprise that the disbanded pro-ana Tumblr bloggers are regrouping elsewhere. Of all places, they are surfacing on Pinterest, the up-and-coming photo-sharing site. Here’s how Sociology in Focus relates the news:

Thinspiration on Pinterest ranges from photos of stereotypically attractive women, quotes about how good it feels to work out, or a combination of both. I found one quote that says, “Nothing tastes as good as skinny feels.” Another one, with a picture of a thin, almost naked woman says, “What you eat in private, you wear in public.” Finally, I saw a picture with another barely dressed, thin woman that says, “It takes 4 weeks for you to notice your body changing, 8 weeks for your friends and 12 for the rest of the world. Don’t quit.” You cannot log onto Pinterest with out seeing these types of thinspiration show up. Not only are these women posting thinspiration to shame their own inadequacies in their bodies but also with Pinterest, these images get repined for all of their followers to see so they know too that their bodies are inadequate.
Alexa Megna, The Pinterest Problem, Sociology in Focus, March 29, 2012.

Albeit the tone of the post might sound genuinely judgemental, it points out the classical toothpaste tube effect of Internet content policing: if you « squeeze » controversial images and comments from one service, they outflow and relocate elsewhere.

Does censorship work?

For the last three years I’ve been serving as the scientific coordinator of the ANAMIA research project, studying online pro-ED websites and their social determinants. One thing we had to face from the beginning of our inquiry is that so-called pro-ana and pro-mia websites have been around since the early 2000 (see our latest article Ten Years of Ana, published in the March 2012 issue of the journal Social Science Information). They have a history of migrating frequently to avoid censorship. Moreover, censorship obtains the paradoxical outcome of multiplying them, mainly because bloggers and forum administrators feel the urge to duplicate and triplicate their contents for backup purposes: they don’t want to lose months of hard work because some Web host’s pulled the plug on the their page or forum.

In the last years, the pressure on pro-ana has increased – both at country and service provider level. The first to ban these web pages were AOL and Yahoo, over the period 2001-2004. Can we quantify the actual evolution of the online community after that? Of course there’s no such thing as a national survey of pro-ana/mia website use. Exploratory webometric analyses might illustrate the rise of related search trends, but they hardly tell us anything significant about the actual number of ED-related blogs and websites (to say nothing about the Facebook groups and Twitter accounts). All they detect are peaks of interest for pro-ana news stories among the general public. Here’s the evolution 2005-2009 (i.e. the period following the first wave of pro-ana censorship) of the search volume index for common ana-mia queries (Source: Google Trends):

These figures are far from being a satisfactory approximation of reality. But they explain one important feature of the pro-ana-mia phenomenon: the first wave of censorship of 2001-2004 seems to have prompted not only a migration to other services but also a relocation to other countries. If at the beginnig of the 2000s, the pro-ED websites were mainly known in the US, by mid-2000s they had gone global. Let’s focus on France and UK, two countries that since then have been actively trying to put into place restrictive legislations on pro-ana (respectively in 2007 and in 2008). Providers have increasingly denied domain hosting, blogging platforms have shut down individual pages, Facebook has unplugged groups and Google has ostensibly limited pro-ana search results. As a consequence, after the spikes of 2007 in France and of 2009 in UK, the search volume index for « pro-ana » in the countries was soon reduced to a crawl in the following years (Source: Google Trends):

Mapping ‘ana-mia’ networks

This doesn’t mean that the pro-ana-mia blogs, forums and online groups have disappeared. If, instead of trends we focus on the structures of online networks, we see a different picture. It seems censorship doesn’t affect the size, but rather the shape of the social graph of the online ana-mia community. To illustrate this, using Navicrawler we explored the French ana-mia blogosphere at two different dates (March 2010 and March 2012). The idea was to try and understand where so-called pro-ana Web pages are located and how much they are interlinked. Here is a visualization obtained with Gephi:

Mapping pro-ED websites (France, 2010-2012) – ANAMIA Research project

How can we read this graph? First of all, despite the legal pressure to ban ana and mia websites the network has not become smaller. The number of nodes (referenced pages) was 559 in 2010. It is 593 in 2012. Again, these figures are crude approximations. Assessing numerically this ‘invisible Web’ is highly problematical. Plus, crawling is a tool meant to explore, not to produce exhaustive representations or statistically representative samples. Let’s just say that the network is certainly consistent from year to year – and comparable to the figures of the English-speaking Web ten years ago.

Sizable clusters are discernible at the top and at the bottom of the two graphs. These are communities hosted on popular blog platforms and rallying around influential individual blogs that act as hubs (the bigger nodes). The main difference from year to year is that there are fewer and fewer links bridging the gap between the top and the bottom of the graphs. Accordingly, clusters gain strength: a brand new one adds up, as the other two become denser, larger, more interlinked and they attract isolated Web pages.

This is a clear illustration of the toothpaste tube effect: it seems that legal pressure has « squeezed » the network in its middle, like one would do with a toothpaste tube. As a consequence, blogs are extruded to the margins (top and bottom) of the graph. All censorship does is reshaping the graph. But not always the right way.

Why pro-ana censorship is bad news for public health policy-makers

By forcing blogs to converge into one of the bigger clusters, censorship encourages the formation of densely-knitted, almost impenetrable ana-mia cliques. This favours bonding, but also information redundancy – meaning that pro-ana-mia bloggers will tend to exchange messages, links and images among themselves and to exclude other information sources. Imagine you are a medical institution trying to put in place an information and awareness campaign on the risks of extreme fasting or exercise. Because of the toothpaste tube effect, it is clearly more difficult to reach out to ana-mia bloggers now than two years ago. If in 2010 a public health information campaign would target the Web sites in the middle of the graph and hope they relay the message to the margins, in 2012 the middle is virtually deserted. The only option is to cut through the dense clusters and hope your message will reach one of the more central influencers. But this is clearly a long shot. Ana-mia Internet users are constantly putting in place new strategies to elude general public visibility. Websites use cryptic language, password protections, and special software applets to circumvent search engine indexing. For these sites, censorship is a risk they have to constantly manage by fine-tuning their visibility.

Because of the toothpaste tube effect, we can conclude that all censorship does is to relocate ana-mia forums and blogs, moving them onto other platforms or to other countries, remodelling their social network in denser and more disconnected clusters. Those who actually suffer the consequences are healthcare professionals, public decision-makers, families and charities providing information and support for people affected by eating disorders – but not for ana-mia online communities. They know how hard it is to reach out to ana-mia online communities, and they know that it will be increasingly hard if these communities become more suspicious, secluded and inward-oriented.

[This post was made possible by the help of the fine people at the ANAMIA research team: Paola Tubaro (SNA coordinator), Fred Pailler (graphs and analyses), Débora de Carvalho Pereira and Manuel Boutet (webcrawling). The research project is funded by the French Agency for National Research (ANR) under grant agreement n. ANR-09-ALIA-001. ]

—
[↩] ADDENDUM April 5th, 2012: Upon reading this post, French academic blogger @affordanceinfo (Olivier Ertzscheid) asked whether there is a difference between the toothpaste tube effect and the Streisand effect. In both cases, information censored on one Web site or service is mirrored elsewhere in an incontrollable manner. There are, nevertheless, two main differences. The first one is the role played by the source of the information. The toothpaste tube effect concerns documents (texts, images, etc.) willingly put online by a source and censored by a third party. On the contrary, the Streisand effect concerns contents that are leaked by a third party, against the will of the source that actively tries to censor them. A second – and most important – difference is the outcome. By making contents and sources converge to specific zones of the Web, the toothpaste effect produces network density and bonding. Ultimately, censorship creates or reinforces a common identity. On the contrary, the Streisand effect produces virality, i.e. an ephemeral circulation of information in sparsely knit, dispersed networks. Given the perfunctory nature of the information exchange, the Streisand effect, is unlikely to create or reinforce a common identity.

avril 4, 2012 | Filed Under body, social capital, social networks

Comments

16 Responses to “Banning pro-ana websites? Not a good idea, as Web censorship might have a ‘toothpaste tube effect’”

Ollie on avril 6th, 2012 4 h 32 min

Immediate connections to Foucaults « repressive hypothesis » come to mind. Attempts to censor these groups rallies people around the identities that empower them
Julien Couvreur on avril 6th, 2012 6 h 45 min

This is not censorship, as the information is not and cannot be prohibited by Tumblr. Only government claims such a power.

This is analogous to my not allowing alcoholics to a party at my house.

Maybe socializing more would help the alcoholic, and maybe some parties will aim towards that goal, but the decision rests with me as owner of the house.
Maybe those rules will seem cruel and push some of my guests towards more open and inviting parties.

Similarly, some of Tumblr’s competitors may advertise a policy of openness and draw good souls with those better features.
Neuroskeptic on avril 6th, 2012 9 h 00 min

Is it also possible that censorship aimed at (say) the term « pro-ana » could lead the same content to appear but under a different name?
Antonio A. Casilli on avril 6th, 2012 9 h 19 min

@ollie indeed. Would be interesting to dig deeper into the meaning of group identity and empowerment in this case. It is clear ana-mia Web culture challenges many of the categories post-stucturalism and cultural studies have made us used to. More on this to come…

@julien: not sure about the alcoholics/anorexics comparison. I would say that is censorship, as content regulation happens after several country-level laws have been proposed and discussed in Parliaments. Your analogy should probably go: it’s like *your landlord* had told you not to allow a certain category of people to your party, and to make sure you comply he/she had labelled them as “alcoholics”.
Antonio A. Casilli on avril 6th, 2012 9 h 39 min

@neuroskeptic Well, search result moderation is actually a pretty complex issue here. As of today, Google and co. actively filter queries revolving around pro-ana and pro-mia (which is why our Google trends analysis works better until 2009-10). As a consequence *anti-pro-ana* results score better in search engines and actual pro-ana websites tend to appear towards the last search pages. Eli Pariser would say that’s a « filter bubble », and I would agree. But ana-mia Web users are everything but passive victims of this process: they constantly invent new jargon terms, distinctive expressions and ‘shibboleths’ (inside jokes, images, songs, phrases to spot outsiders) and to be circumvent search engine filtering.
Cletus on avril 6th, 2012 12 h 49 min

Tumblr refusing to host your content is NOT censorship. You are perfectly free to find another avenue to disseminate your material. No one is stopping you. And if I were in their shoes I would stop permitting you to post your content for no other reason than the legal liability it opens them up to. A « free press » doesn’t mean people are obliged to publish your views.
Antonio A. Casilli on avril 6th, 2012 15 h 08 min

I am sorry, but I don’t seem to understand who is the « you » this comment refers to. It would be a mistake to conflate the views of the researchers studying anamia communities with those expressed by bloggers and forum members. Your remark seems to personalize way too much the stakeholders. Tumblr, as a publishing and sharing platform, does not hold views. Yet it conveys the views of political actors who act as moral entrepreneurs to push their political agenda.
MIke on avril 6th, 2012 16 h 48 min

I have to wonder if eating disorders such as anorexia and bulemia harm more people than the obesity epidemic in this country. And, do photos of curvaceous women contribute to more people becoming less overweight, and therefore healthier, or to more eating disorders? Or, both?
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Thomas on avril 8th, 2012 2 h 36 min

I hope that this means that they are also going to ban all blogs related to smoking, eating fatty foods, and participating in overly dangerous activities, seeing as how these can also be viewed as causing or leading to self harm.
Matt Cornell on avril 8th, 2012 12 h 11 min

Interesting essay on a troubling issue. I wonder how you feel about the recent ban on « child pornography » on Reddit, and if you would apply a similar analysis in that case. Specifically, the forums that were shut down at Reddit were for the circulation of « legal » pedophilic images– mostly anime and captioned nonsexual photos. I can only imagine the toothpaste-tube effect would work in much the same way. But I have yet to see anyone argue against efforts to root out pedophiles.

Also, I’m frustrated by the pedantic comments above which imply that the word « censorship » can only be used in reference to state suppression of free speech. Clearly, your essay is about censorship by a private corporation, not a government. And as you point out, state morality is often brought to bear on so-called private institutions.
AnaGirlEmpath on avril 13th, 2012 7 h 57 min

Thank you for sharing this article! I have been researching the ProAna Movement for the past decade and have been following the ANAMIA Study with great interest. Several Members from my website have participated, as have individuals from the YouTube ED Community who saw my video promoting and encouraging participation in the ANAMIA Study:
http://www.youtube.com/watch?v=Ey4Ugmm-tC4
I just read the abstract of the March 2012 ANAMIA research review article this morning, and I wish I were still at an institution where I could have access to the full article!
My own research, though considerably less formal, echoes the conclusions of the Author and data above. Three years ago, I inherited full ownership of Project Shapeshift, the birthplace of Ana’s Underground Grotto — the most infamous and extensively-analyzed body of works written from inside the ProAna Movement to date. In recent years, we have refocused and redefined our Community Ethos, which is geared toward Optimal Wellness — Living WITH, not FOR, one’s ED; and finding a workable balance between overt ED pathology and perfect health. We are a diverse group of adults who strive to make the best of Living with an insidious, rarely-if-ever curable illness. 60-75% of long-term anorexics will never recover fully, and 20% will ultimately lose our Lives to this disease.
Why ProAna?
ProAna provides a critical niche for those for whom treatment is and/or was either: 1)Inaccessible; 2) Of insufficient duration; 3) Ineffective; or 4) Unwanted. It should be noted that the last is the smallest group.
Many patients have either been forced into; traumatized by; have otherwise sustained negative treatment experiences; and/or did not find traditional approaches to Recovery beneficial — if they had access to treatment in the first place.
Regarding negative psychological sequelae resulting from nonvolitional treatment: Investigations into efficacy and outcomes are clear on this point: Recovery rarely works if one is forced. No one can recover for us; we must want it — and even then, it is a very difficult fight. Additionally, forced and/or rapid refeeding only reinforces the pathological impeti of an ED in the first place.
Regarding access and duration of therapy: The extremely prohibitive weight standard for official diagnosis (and therefore treatment coverage by health insurance providers in the U.S.) precludes many of us from obtaining adequate, effective and/or lengthy enough treatment to be of any significant therapeutic benefit. Further, treatment protocols at individual institutions are not standardized because no one approach has proved universally efficacious.
To summarize:
Access is one problem;
Inconsistency is another;
Treatment which is primarily governed by weight restoration, especially over a relatively rapid period of time (treatment is often rushed due to financial constraints and high demand for placement) reinforces ED pathology; and the fact that
Current treatment modalities afford us rather poor statistical outcomes — as aforementioned, 60-75% of AN sufferers will never fully recover and 20% will ultimately die due to their ED.
All of the above contribute to the dilemmas which those suffering with ED’s must face.
I have often been asked, « Why don’t sufferers just go to traditional ED Recovery sites for support? » The answer? Recovery-focused sites are extremely restrictive in terms of what Members are permitted to discuss. The most popular recovery site does not even allow Journals — a mainstay of psychotherapy — and is intensely policed, allegedly to prevent ‘triggering’ content from being shared. One cannot discuss numbers; e.g., weight or calories, for example.
As a result, the environment of most recovery sites is often silencing, alienating, censoring and/or otherwise unpleasant and ultimately unhelpful for those conflicted or at a non-100%-recovery focused point in their Journey.
IT IS IMPERATIVE that those suffering with long-term ED’s be granted a place to connect with like-minded individuals in a positive support-based environment, FREE OF CENSURE and full of LOVE, ACCEPTANCE, TOLERANCE and COMPASSION. It is very difficult for anorexics to voice their pain and communicate with others regarding their illness. The Internet has proven to be an excellent medium through which ED sufferers can reach out and receive support on their own terms. Silencing them reinforces the notions of deep shame already intrinsic to the illness, and the pathology-perpetuated impetus to isolate completely and remain completely immersed in one’s disease.
In February of this year, several Website Admins and top Bloggers of ProAna websites in the U.S., myself included, have begun campaigning for educating people about what actually goes on in a responsible ProAna Community (it should be noted that two distinct populations embrace the term, « ProAna », as a genre descriptor: genuine ED sufferers and ‘wanarexics’ (i.e., those who think ED’s are cool, chic and otherwise positive. The former deeply resent the latter). Most would be surprised to find the unconditional love, acceptance and support offered in such Communities. NO ONE is condemned for choosing to strive for traditional recovery, by the way. He or she is loved and congratulated and supported in the fullest. We have a Recovery Forum on site for interested Members, as well. I have yet to come across a single ProAna Community — and as a Member myself, I have been to many since the dawn of the Movement (ProAna actually began in the late 90′s but was not widely known until widespread media attention precipitated the first wave of censorship beginning in 2001).
Sadly, this mainstream media sensationalism, fear mongering and condemnation has resulted in two things: 1) gross stigmatization of an already sensitive population, and 2) attraction of vast numbers of people who come to sites like mine for the wrong reasons; i.e., to promote, glorify and/or attempt to cultivate an ED within themselves; garner diet ‘tips’ or otherwise misconstrue what ProACTIVE ProAna Communities are all about.
NO ONE with an ED would ever wish this plight upon anyone!
Thanks to the increasing controversy and persecution of ProAna sites, blogs and fora, the ‘Wanarexic Phenomenon’ has become an ever-growing and serious issue for us all. Myself and other responsible Admins make every effort to deter non-eating disordered individuals from participating in our Community Fora wherever and whenever possible. My site in particular has a strict 18+ Policy, supporting individuals in all age ranges 18 or older, even several Members aged 50 and beyond.
If it is difficult for youth with ED’s to speak out, it is even more so for adults who have cultivated a Life of secrecy; shamefully hiding their ED’s because these illnesses are popularly misconstrued as sophomoric and that they ‘should not’ still be struggling.
In conclusion, responsible (ProACTIVE) ProAna Fora are populated by individuals seeking Healing on their own terms and are free to discuss their struggles without fear of being judged, censored or otherwise criticized.
As for Tumblr, I oppose their decision. I think their ‘option b’ would have been more prudent. The following article is an excellent illustration regarding the harm and fallacy of censorship, and why Israel’s Israblog has astutely chosen to allow ProAna Blogs: http://advocacy.globalvoicesonline.org/2008/03/12/israel-israblogs-decision-against-banning-pro-ana-sites/
Once again, thank you for sharing about the data from the European branch of the ANAMIA Study! I look forward both to promoting and participating in the expanded (worldwide English Speaking Countries) Study yet to come! :)

Sincerely,
AnaGirlEmpath
Owner/Administrator,
Project Shapeshift
Antonio A. Casilli on avril 13th, 2012 15 h 09 min

Impressive comments – thank you all

@anagirlempath belated thank you for your video. If you want to access the ‘Ten years of Ana’ article in preprint form, here’s the link http://hal.archives-ouvertes.fr/docs/00/68/23/18/PDF/Ten_years_of_Ana_Accepted_version_complete.pdf

@Matt there’s a growing rhetoric of ‘corporations as people’. I would disagree, yet I’d admit that corporations are citizens, and as such are influenced by all the political tensions shaping citizenship (including who and what to ban or censor).

@MIke you seem to refer to « reverse thinspiration » (showing overweight people to inspire dieting), practice observed in anamia communities, although less often than actual thinspo. ps. scientific literature initially
indicated that pro-ED websites viewership might have potential harmful effects (cf. this article http://www.columbiamissourian.com/media/multimedia/2009/02/06/media/Archive__/img/bardone%20study.pdf), but then recognised nuances: for instance active online participation, rather
than passive lurking, can mitigate damages and even be beneficial (cf. this other http://www.sane.org.uk/uploads/pro-eating-disorder-websites—users-opinions.pdf).
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