The Internet is a vast place, wonderful and terrible. It has allowed for so many excellent innovations and improvements to modern day life: One of its best original uses was to allow non-monogamous people to find each other early in the 90’s, before polyamory was even remotely part of our cultural lexicon. And it’s allowed young queer people, feeling isolated in locations where it was more dangerous to be openly queer, to find community and solidarity, an experience which can be lifesaving. The Internet – prior to SESTA/FOSTA at least – was integral in helping sex workers stay safe by vetting clients prior to meeting up with them in-person. Many a successful long distance relationship has been sustained via email and Skype, and where would we be, seven months into a global pandemic, without Zoom, in both our personal and professional lives?
In recent months, there’s been a boom in telemedicine and teletherapy, an adaption so new that social workers and therapists are not sure how it’ll shake out in the long term, once laws and regulations catch up with technology. Most of the therapists I’m in communication with express hopes that teletherapy is here to stay: It’s more accessible than traditional in-person therapy, both in terms of getting to and from appointments, for clients who have difficulty getting around, and it allows the possibility of being more affordable by removing the necessity of renting out a full time office space, which can be astronomically expensive. And while there are some aspects of therapy that can be challenging when conducted through a screen (for example, movement and somatic therapy), overall, the benefits that the Internet has brought to therapy seem to outweigh the drawbacks.
But, like anything, there’s also a complicated side of the mental health as it takes place on the Internet. Therapists, rather than being the blank slate the Freud insisted we should endeavor to be while in the room with clients, are people, and most people in this day and age have some type of relationship or another with social media. Just as the rules and regulations of social work practice have yet to catch up with the necessity of teletherapy as an adaptation to mental health practice, so too have the ethics of being a mental health care provider online lagged in catching up to the reality that most people have a social media presence of some kind.
There’s nothing necessarily wrong with this, though it can be jarring for clients and clinicians alike when our social media presences cross paths. And some therapists include a social media disclaimer in their informed consent forms, explaining their boundaries, concerns and safety practices regarding confidentiality, and acknowledging the fact that awareness of each other’s social media accounts may become pertinent in treatment. But it also poses the question of what does it mean to be a mental health care provider who is also a person – and business owner – on the Internet? And what does it mean for clients to see us there?
Take, for example, Dr. Nicole LePera, also known as The Holistic Psychologist, whose work I have at times found helpful, and who has, in recent months, come under fire from other well-known clinicians in the field (The Wellness Therapist, Actual Psychology, and Seerut Chawla, to name a few) for presenting viewpoints that noticeably lack a critical analysis of race and oppression in understanding trauma and healing, and promote instead a seemingly very individualistic concept that LePera has coined “self-healing.” More recently, Azi, The Wellness Therapist, has also drawn attention to LePera’s problematic alleged association with QAnon believers and Trump supporters via @the.holistic.psychologist’s IG follows and likes, bringing to the fore the question of what it means for clients to differ ideologically with clinicians, whether clinicians should disclose their views, and even whether there are some political viewpoints that are incompatible with therapeutic work. When confronted, often by women of color, LePera tends to respond with all too recognizable fragility: deleting comments (and, by extension, the intellectual and emotional labor expended in writing them which, if nothing else, might be helpful to other readers) and blocking critics.
Still, her #selfhealers community is three million strong, though those who are wary of her note that many of the viewpoints expressed in her posts are simplistic talking points that don’t get into the complexity of trauma (the neurobiology of trauma, the ways in which trauma impacts how we experience relationships) and in fact which approach trauma healing in ways that may actually exacerbate anxiety, particularly in clients who are already highly anxious or who are suffering from PTSD. They also note that Le Pera’s definition of trauma is vague and seems all-encompassing, whereas the criteria for post-traumatic stress disorder in the Diagnostic and Statistical Manual for Mental Disorders: 5th Edition (DSM-5) is, by contrast, highly specific, and to become certified in the many trauma modalities (EMDR, trauma focused CBT, sensorimotor psychotherapy, and somatic experiencing, to name a few) often takes years, and is quite expensive.
This illustrates the crux of the problem that is larger than therapy influencers themselves: that training to become clinicians is often prohibitively expensive, particularly for therapists of marginalized backgrounds for whom academia is still often a source of gatekeeping despite the incredible need for more BIPOC queer and trans therapists.
Therapy itself is still, unfortunately, also often prohibitively expensive, with many therapists opting to go the route of private practice in order to sustain a livable wage. Therapists who, by contrast, decide to work in community clinics and non-profit organizations must contend with exploitatively low wages (some recent graduates even report making lower than minimum wage as fee-for-service clinicians with juggling full caseloads) and high rates of burnout, which also inevitably impacts the work they are able to conduct with clients.
Social media, and the educational information presented there, in many ways serves fill in the gaps left by such an imperfect and problematic system, creating greater access to mental health resources and information, as well as normalization of what it means to struggle with one’s mental health. Still, it’s important to remember the function of social media: Most business people on social media (and a therapist in private practice is certainly a business owner) are using that platform as a means of marketing and advertising. Brands and pages are carefully crafted and curated with the specific intention of attracting potential customers, and while a therapist’s social media account may give you insight into their values as a clinician, their page shouldn’t be a substitute for therapy.
How, then, can you keep yourself safe, especially in an increasingly stressful and anxiety-inducing time, when many are turning to the therapy and mental health support for the first time? Here are some suggestions:
Critique Your Idols
A therapist is just a person with a specific type of training, even if they’ve got millions of followers online. We facilitate healing, but I don’t necessarily believe we are “healers” ourselves. The most important aspect of our work is to hold space for a completely unique type of relationship: one that is entirely focused on the person seeking care, offering a place to reflect, to be curious about oneself, and to experience, I hope, unconditional positive regard.
But still, no matter how much a particular therapy influencer’s content resonates with you, moves you, or strikes a chord with you, it’s important to remember that the person behind the infographic is still just a flawed human being in the midst of their own healing journey making sense of life in a chaotic and oppressive world. When we make heroes and idols of people – whether they’re actors, artists, activists, or clinicians – what we really end up doing is giving some of our own agency away. There are many schools of thought and many avenues toward healing, and certainly it’s valuable to have the crash courses for many of them at your fingertips via social media. What better way to get a sense of what’s out there, and how it might be helpful to you? But mental health posts on social media should just be a place to start, not the be-all-end-all of your self-work and healing, and if a therapy “influencer” isn’t upfront about that as part of their social media presence, tread with caution.
Identify Your Therapy Values
You are the most important part of your experience with therapy, and your needs and values with regard to mental health and healing should be central to the ways in which your therapist works with you. Part of that, though, comes from understanding what your values are and how to communicate them when interviewing a new therapist. (I’ve written about some of that here.)
Sometimes, and ideally, prospective therapists will make that easier on you with a well-written and specific bio or website. In mine, for example, I list quite clearly the various certification programs I’ve completed, and am up front about the lens through which I practice as well as who are the writers and activists who have most influenced me. By being so transparent, it’s my hope to make things easier for clients when researching me before reaching out, making the often nerve-wracking process of starting therapy, whether for the first time or with someone new, at least a little bit easier. Which brings me to my next point…
Do Your Research
While it’s certainly the most convenient and ubiquitous format for accessing bite sized and visually pleasing information (you could lose hours scrolling through therapy memes, infographics, and hashtags; I know because I’ve done it), I also suggest taking some of your research off of social media. If you see something that interests you, there are loads of – probably more balanced – summaries and breakdowns of different modalities and treatment styles. Psychology Today, for example, isn’t just a directory where you can find therapists in your area – you can also search them by modality and search easy and accessible articles about those modalities themselves. Another note about directories like this one: They often allow therapists to choose as many “types of treatment” options as we want, so when interviewing a prospective therapist, don’t be shy about asking them directly what their experience is if one or more of those types of treatment stand out to you, or if you have specific questions about their training and experience.
Reach Out Offline
Finally, if a therapist’s social media account really does catch your eye and you think you want to work with them, don’t do it in the DMs. Go to their website, or search them in a directory, and send an email or make a call to their office number. As a therapist, getting DMs from folks looking for help is complicated: I, personally, make the choice not to offer counseling via any social media site, a boundary that I think most therapists also observe. It’s both for my protection, and the protection of the person reaching out – there are just too many variables in play when talking with someone behind an Instagram handle, and mental health crises, certainly, are not something that can be adequately responded to via direct message. At most, I’ll offer referrals to directories or crisis lines that I deem reputable. But you never know someone’s availability via DM, and larger accounts probably receive dozens if not hundreds of messages a day. A safer bet, then, is to reach out through an official contact form on a website, and don’t be afraid to shop around!
None of the above is to say that you shouldn’t follow therapists online, or that you should judge yourself or feel tricked if what therapists post online resonates with you and prompts your in the direction of your own healing work. It’s okay to get a lot of value from the therapy corner of social media! But feeling validated through the psychoeducational sources that are available online, and doing the deeper, embodied inner work of healing, are two very different things. It’s something that I think about each time a client presents me with a conundrum that will maybe feel familiar to you: “I know, logically, rationally, that XYZ isn’t good for me/doesn’t make sense/isn’t what I want…but I keep doing it anyway!” Psychoeducation is one really important step in the direction of healing trauma, and taking care of our mental health. But healing happens in relationships, intentionally and in an embodied way, over the course of our lives. This can be with a therapist, and hopefully it also happens in our communities and amongst each other, especially given how inaccessible therapy can be for many.
Therapy influencers can point you in the right direction, certainly. And it’s a great feeling to scroll through Instagram – so often a stressful place, where we go either to dissociate from our dread, or compare ourselves to others – and see a post that reminds you of your humanity, your resilience, and the hard work you’re doing toward healing. But remember, therapy is about you, your specific needs and goals, and your lived experience and history, all of which matter so much more than any influencer’s popularity or reach.