by Amber Trotter, Psy.D.

THERAPY CULTURE AND ITS DISCONTENTS 

Psychotherapy is culturally ascendant. Therapy speech permeates modern culture. Everyone, it seems, is doing the work and holding space for others. Celebrities and nobodies alike vulnerably share their mental health challenges on social media—the New York Times recently quipped that going to therapy has become a dating ploy. Mental health-focused tech companies receive exponentially expanding VC funds.

Ostensibly, heightened awareness about mental health is a good thing reducing stigma and shame about mental illness, and increasing treatment options, access, and ultimately usage. But is all this talk about mental health actually making things better? There are myriad approaches to this question, but I will limit myself to one concern: heightened emphasis on mental health may be leading people away from professional therapy. Full disclosure: the de-skilling of mental health professionals directly affects me and biases my judgment. From my perspective, while there are real and incredibly valuable gains from increased concern about mental health, online therapy culture—now including AI—and workplace pseudo-therapy often have inadvertently deleterious effects. There is a new level of money at stake in mental health care. Companies are competing to capitalize on the expanding mental health market, while also being motivated to save money when it comes to paying for employees’ mental health care.

One of the perennial paradoxes of Silicon Valley is that cutthroat capitalists come off as the good guys—in this context, championing mental health. Into the shambles of the American mental health care system walk tech barons in shining armor, to make it all better. Or so the story goes. The reality of course involves glitzy and initially inexpensive products, marketed until usage reaches the point at which prices can be increased swiftly. Not only do digital forms of therapy divert people from licensed professionals, they often breed misinformation, leading to inaccurate self-diagnosis and ineffective alternative treatment. TikTok informs people of their psychological condition and explains what it means. AI therapy offers a simulacrum of human connection and empathy just convincing enough to dissuade people from reaching for the real thing.

Meanwhile, in efforts to reduce costs, companies offer paltry alternatives (think lunch break yoga classes) and partner with mental health care companies with far too few practitioners to respond to demand—or soon, in all likelihood, with AI therapists. Middle managers are also increasingly converted into makeshift therapists. The pressure to hold weekly one-on-ones and process negative emotions has escalated rapidly. It’s a tall ask for someone with no formal training, not to mention a full-time job. And again, this practice diverts people from traditional talk therapy, potentially to negative effects.

While of course there are innumerable helpful strategies in treating mental illness, traditional human psychotherapy has a particular and important role to play. I think that has been obscured, paradoxically, by therapy culture. I hope we, as professionals, can advocate effectively for what we have to offer.