Therapy speak at its peak - Harper's BAZAAR September 2023
As we reach peak therapy, Alexandra English wonders whether our mental health hyperawareness is making us feel any better
The therapist’s consulting room is one of the last genuinely private spaces left in our always-on, always-oversharing, extremely online culture. Behind closed doors, what’s said on the couch stays on the couch. At least until recently, when therapy-speak and the therapists themselves began creeping into our real lives, sneaking into everyday conversation, infiltrating pop culture and taking over our social media feeds and television screens. Now, without moving from our own couches, we can see exactly what’s happening on the therapist’s.
There’s been an influx of therapy-related television series, documentaries and podcasts recently. Esther Perel, the wildly popular psychotherapist and author, launched her podcast, Where Should We Begin?, in which listeners eavesdrop on real couples’ therapy sessions, in 2017 and returned for a fourth season in July. In 2019, the fly-on-the-therapist’s-wall concept was expanded for the screen in Couples Therapy, in which private sessions with Dr Orna Guralnik are filmed reality-TV-style, following couples on their redemption arc (or lack thereof), and in the 2022 documentary Stutz, Jonah Hill profiles the renowned psychiatrist and his own therapist, Phil Stutz. In 2021, the true-crime podcast The Shrink Next Door was adapted into a miniseries of the same name, with Paul Rudd playing an unconventional psychiatrist who worms his way into the life of a longtime client (played by Will Ferrell). There’s fiction, too: in this year’s Shrinking, Jason Segel plays a grief-stricken therapist who gives up on trying to lead his clients to breakthroughs and starts telling them exactly what to do.
Therapy has also taken over the media. In July, two major American publications — The New Yorker and New York Magazine’s “The Cut” — were dedicated to therapy. The latter teamed up with Perel to celebrate the release of the new season of her podcast, with a dedicated category called the “Esther Perel Universe”. It featured a crash course into the Perel canon (fittingly subtitled “Where should you begin?”), a list of her top 10 erotic films and a reflection on maintaining desire in a long-term relationship, among other articles. The New Yorker’s digital “Therapy Issue” expanded during the month to include features on growing up with a psychoanalyst father, writers musing on whether we had reached “peak therapy TV”, and rebranding MDMA as a therapeutic drug. “If our current moment has a defining impulse, it’s the drive to feel good again … Perhaps our fixation on therapy is as much a symptom as it is a cure,” the editors’ letter read.
NOT SO LONG AGO, you’d hide that you went to therapy. Now, having a therapist is pretty much standard among the other professionals you collect as an adult: a dentist, a regular GP, a personal trainer, a hairdresser, an accountant. You might go to therapy more than you go to the gym.
So acceptable is therapy now that for an increasing number of single people on dating apps, the thought of matching with someone who regularly schedules time to work on themselves is a turn-on. Forget tall, dark and handsome: the new holy trinity of attraction is self-aware, vulnerable and goes to therapy.
Tinder’s Future of Dating 2023 report, based on a survey of 4000 18- to 25-year-olds in the United States, United Kingdom, Canada and Australia in April this year, found that 75 per cent found a match more attractive if they were open to working on their mental wellbeing. Mentions of therapy in dating profile bios are up 38 per cent year on year. “Some examples are: ‘Swipe right on therapy,’ ‘Swipe left if you’ve never been to therapy,’” says Kirsty Dunn, a spokesperson for Tinder Australia. “Young people are not only looking for love, but a deeper connection
… It’s not taboo to be in therapy; it shows that you’re self-aware and committed to bettering yourself. Other generations should definitely take notice: therapy is sexy.”
The same trends are being seen at Hinge. The app’s most recent user survey found that 91 per cent preferred to date someone in therapy. “Talking about mental health has gone from being an ‘Oh no,’ to a must-have in modern dating,” says Logan Ury, Hinge’s director of relationship science. “People have been working on themselves and want to be with someone who’s done the same.” The app also offers therapy-related prompts, such as: ‘Therapy recently taught me …’; ‘My therapist would say I …’; ‘My last journal entry was about …’
In May, Bumble also introduced profile prompts and badges to inform potential matches that mental health is a high priority. A recent study found that a third of Australian Bumble users shared that they were either going to or considering going to therapy. “Dating is an experience that requires a certain level of vulnerability, and [since the pandemic], the majority of single people are more focused on emotional maturity than physical requirements,” says Lucille McCart, Bumble’s APAC communications director.
While going to therapy may be the new high water mark for attractiveness, it also brings with it a specific type of therapy-speak to relationships. In the past few years, first date questions expanded beyond “What do you do for fun?” and “How many siblings do you have?” to include “What’s your star sign?” and “What time were you born?” Now, it’s: “What’s your love language?” and “Do you know your attachment style?”
WE HAVE REACHED PEAK pop psychology. But how did we get here? And is all of this mental health hyperawareness making us feel any better?
We are living through a mental health crisis and therapeutic services are increasingly difficult to access. Gen Z and younger millennials are much more likely to seek mental health help than older generations, according to the Australian Psychological Society (APS), but they’re also more likely to experience mental health challenges. In March, a global survey by the non-profit Sapien Labs found that not only did the pandemic completely rock young adults’ mental health, but they’ve also not yet bounced back. More than 400,000 participants from 64 countries took part in the study, which found the average ‘mental health quotient’ score (regarding family relationships, friendships and overall wellbeing) had dipped by 33 points in the past two years.
Dr Catriona Davis-McCabe, the president of the APS, explains to Harper’s BAZAAR that mental health services are also harder for young people to access. While the Australian government increased the number of Medicare-subsidised therapy sessions available to people during the pandemic from 10 to 20, in December 2022, it scaled back to 10 sessions. “Gap fees [about $90] are much harder for younger people to afford than older Australians, which makes resorting to social media for mental health support more likely,” she says.
With limited access to professional one-on-one services, people have begun turning to the internet for help. Where older millennials, gen X and baby boomers are likely to use Google (where search rates for the terms ‘toxic’, ‘trauma’ and ‘gaslighting’ have all steadily increased in the past five years, with ‘gaslighting’ and ‘love bombing’ showing huge spikes in early 2023), younger millennials and gen Z do their research on Instagram and TikTok.
The hashtag #TherapyTok on TikTok has 1.7 billion views, and #MentalHealth on Instagram has 49 million posts. On social media, therapy-speak is spewed out by a mix of qualified and armchair therapists to their patients (read: followers). Many of these therapist influencers reduce complex therapeutic concepts into 30-second soundbites — posting reenactments of sessions they’ve had with clients or pointing to a list of signs of intergenerational trauma while dancing to whatever song is currently trending — in the hopes of creating viral content.
THE BOOM IN social media therapy began in 2017 when a number of therapists began to use Instagram to gain more clients. In 2019, The New York Times declared ‘Instagram therapists’ to be the new ‘Instagram poets’. “Instead of posting free verse in typewriter font, they deal in pithy announcements about embracing imperfection, self-care, ‘growth mindset’, mothering oneself, imposter syndrome and trauma,” Sophia June wrote.
The issue is that it can be tricky to discern the qualified from the un. Anyone who has selfie mode on their smartphone can post life advice online. A study published in The Journal of Medical Internet Research (JMIR) last year analysed the first 100 TikTok videos to appear under the hashtag #mentalhealth. It was the most viewed hashtag in the space at the time, with 25.3 billion views. (That was March 2022; it’s now 96.7 billion.) Almost half of these videos reported or expressed symptoms of mental distress, and the top three most-viewed categories were videos that offered support or validation, videos that described mental health issues or other struggles, and videos that shared coping strategies. Most of the top 100 videos under the #mentalhealth hashtag were posted by consumers, not mental health professionals.
In some cases, posts that describe a set of symptoms someone is experiencing can lead them to get the help they need. In other cases, the person watching may incorrectly label themselves with a condition they don’t have and decide they don’t need professional help because they have solved their problem themselves.
“We are encouraged by the growth of mental health awareness on social media and the decreasing stigma surrounding such issues,” Davis-McCabe says. “However, self-diagnosis is no match for seeing a professional and getting a proper diagnosis. Young Australians diagnosing their illness on social media platforms such as TikTok should really think twice before doing so.”
Jeff Guenther, a therapist who posts on TikTok as @TherapyJeff, is one of a growing cohort of qualified therapists taking to social media in the hopes of counter-acting misinformation and mis-self-diagnosis. Before the pandemic, Guenther ran his private therapy practice in Portland, Oregon. When the world shut down and therapy sessions moved online, he found himself looking for ways to help people who couldn’t access individualised therapy. He never set out to be a TikTok star; he was posting straightforward, relatable videos about what he knows best: relationships. He covers the first stages of dating, long-term love, cheating, breaking up, getting back with your ex (or not), how to stop crushing on someone, and self-esteem in relationships. He also aims to dispel relationship and therapy myths. He’s funny, straight to the point, he doesn’t mime or dance, and — for a generation who has grown up online — he gets it. (Take this recent post: “10 questions to find out if your new love interest has worked on themselves because you know what they say: the road to relationship hell is paved with sweet and charismatic people who haven’t done any emotional work.”)
“[During the pandemic], I spent a lot of time scrolling through TikTok, and I saw that mental health was trending because we were all feeling traumatised,” Guenther says over Zoom, wearing one of his signature plaid shirts. “I thought it could be a fun challenge to get online. I’ve been a therapist for almost 20 years, so I have a lot of therapy one-liners that people can maybe relate to. I’m not giving therapy; I can’t do that because it’s not ethical, so it’s mental health takes, relationship advice, different ways to look at things and to validate people.” With 2.7 million followers and more than 70 million likes on TikTok and more than 850,000 followers on Instagram, his approach seems to resonate with people. His comments section is full of in-jokes and topic requests.
“[I had noticed] more life coaches and people start chiming in, talking about their mental health journeys and experiences, and that’s when it started feeling a little funky for me,” Guenther says. “I was like, I have lots of training and continuing education that never ends and almost 20 years of experience in the field, and I have a pretty good understanding of what I’m talking about. I worry that the life coach might be on there not to be helpful but because they want to be famous online. It’s hard to tell who’s qualified and who’s just like, somebody spewing bullshit.”
Dr Jodie Lowinger is a clinical psychologist and the founder of Sydney’s The Anxiety Clinic, a team of registered and clinical psychologists dedicated to treating stress, anxiety and mood challenges, and Mind Strength, her performance and resilience consultancy business. (She’s not on TikTok.) She emphasises just how important it is that the people offering therapeutic information are qualified and well-intentioned. “If you are delivering scientifically supported tools that can help people in an evidence-based, responsible way, that’s phenomenal. The bottom line is, we are in a mental health crisis, and if people can help, then they should help,” she says. The key message is to be conscious of responsibility in this space. It needs to be helping, not harming.”
(Jed Horner, a spokesperson for TikTok, tells BAZAAR: “At TikTok, we encourage people to connect, share their experiences and be part of a supportive community. We aren’t the go-to place for medical information, and we would always advise users to seek professional medical advice if they are in need of support. To identify and limit the spread of misinformation and disinformation, we collaborate with fact-checkers around the globe, including AAP in Australia. In addition, we also have over 40,000 safety professionals who monitor the platform and ensure that our Community Guidelines are enforced.”)
THEN THERE’S THE THERAPY-SPEAK. Just like babies learning to talk, followers repeat the language they’re exposed to on social media and bring it into everyday conversations or pass it on through their own social media posts.
In the real world, therapy parlance — such as self-care, boundaries, toxic, narcissist, gaslighting, love-bombing, “a little bit OCD” — are pervasive in everyday conversations, whether it’s about wanting to cancel plans, refusing to answer calls from unknown numbers, breaking up with friends, recounting weird dates, describing your boss or telling people that you like to colour-code your bookshelf.
It’s “an explosion of diagnostic language”, as Carolina Bandinelli, an associate professor at the University of Warwick who studies romance and digital culture, told The New York Times.
The good news is that the infiltration of therapy-speak has destigmatised conditions such as anxiety and depression. People can name their experiences, or something close to it, and others will understand what they mean. Therapy-speak helps to put the messiness of our feelings and experiences into neat boxes and has given us a new cultural lexicon with which to explain ourselves to others. It also allows us to talk about heavy topics with a touch of humour. Take the term ‘menty B’, short and cute for ‘mental breakdown’, and, according to Dictionary.com, coined in Australia. It’s less serious than a mental breakdown but still lets people know you’re struggling (in a fun way, lol).
But as words hit the zeitgeist, their definitions morph. The linguist Valerie Fridland calls this ‘semantic bleaching’ (for example, “literally” now means “figuratively”). Therapy-speak has quickly become a cyberspace-wide game of telephone, and when diagnostic language seeps into conversations to describe normal human tendencies and emotions, serious medical conditions are diluted into a personality quirk or a joke.
You don’t become close with your colleagues because you’re ‘trauma bonding’; the term refers to the emotional attachment that can develop between an abuser and a victim that’s more akin to Stockholm Syndrome than having to manage up. Likewise, when gaslighting is used to describe the strange behaviour of someone you’ve been on a couple of dates with, it takes away the seriousness of a manipulative tactic whereby the abuser wears their victim down to make them lose their sense of reality to the point that they don’t trust their own thoughts.
“It’s diminishing to the people who actually could be diagnosed with that, and it’s making it so the word or the label doesn’t mean as much as it did before, and you don’t even know what you’re talking about,” Guenther says.
He does believe, though, that this mental health hyperawareness is a net good. Social media can be helpful in moments that are tough but don’t warrant an emergency face-to-face appointment, and can also give lonely people a sense of community. “Therapy is a privilege in most places,” he says. “If you’re looking at TikTok therapists for five to 10 minutes, that feels like something. And if you’re lonely, when you’re on TikTok, you feel like you’re connecting with actual people, even if they are parasocial relationships.” The data backs him up. The JMIR study signified the “importance of TikTok as a just-in-time source of social support and personal validation that is made available without the need for planning, scheduling and financial remuneration.”
“All this language is good, but I want you to use it as a way to connect, use it as a way to explore different concepts, use it as a way to express what your emotional experience is so that other people can understand it,” Guenther says. “I think it’s great that therapists are online, on TikTok, on Instagram or YouTube, and they’re giving away all this free, really interesting information. And it’s also important for people to remember that TikTok isn’t therapy; YouTube is not your doctor. I encourage my clients to go ahead and learn about it through Instagram, TikTok, WebMD, Google, collect all the data and bring it in, and we will talk about it together, and I’ll bring my professional medical opinion.”
So, think you’re an anxious-avoidant narcissist with insecure attachment and OCD? Prove it — to a professional.
THERAPY-SPEAK GLOSSARY
What it all really means
GASLIGHTING
It’s not simply a way to accuse someone of lying to you. It’s a manipulative form of psychological abuse aimed at making a victim question their very perception of reality, their sanity and their memories. Victims start to mistrust themselves and often feel confused and anxious. They can also doubt their experience of abuse, which in turn can lead to sustained abuse.
PTSD
You can have a negative reaction to a situation based on a previous experience without it being post-traumatic stress disorder (PTSD). In reality, it occurs after someone has survived a life-threatening situation, significant injury or sexual violence — an experience that leads them to believe the world is not safe. People can experience debilitating flashbacks, nightmares and mood changes, and are often diagnosed if symptoms persist for more than a month.
TRAUMA BONDING
This phrase doesn’t describe going through a traumatic or stressful event with another person or group. It refers to the emotional connection between an abuser and their victim that can occur from cyclical abuse that includes periods of remorse, during which the victim might start to feel compassion towards or dependent on their abuser.
LOVE-BOMBING
Being showered with attention and swept off your feet in the early stages of a relationship isn’t necessarily love-bombing. But if the displays of love are too full on, too soon and generally disproportionate to the stage the relationship should be at, it could be early signs that your partner is ultimately vying to control and manipulate you, and isolate you from friends and family.
BOUNDARIES
Setting a boundary does not mean giving another person an ultimatum in a request to control their autonomy or the situation (“If you do this, I will break up with you”). A boundary can be a guideline you set for yourself about what you are willing to put up with, or it can be a request (“Can we come back to this argument after I’ve had some time to think?”).
The National Sexual Assault, Family & Domestic Violence Counselling Line – 1800RESPECT (1800 737 732) – is available 24/7 for any Australian who’s experienced, or is at risk of domestic violence and/or sexual assault. Lifeline 13 11 14.
This article originally appeared in the September 2023 issue of Harper’s BAZAAR. Artwork by Kubi Vasak.
