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“For a while,” says Jeff Guenther, a licensed professional counselor with a warm, affirming demeanor who shares mental health information on TikTok, “I was in it for the likes and views.” And he certainly got them: @Therapyjeff has amassed 1.1 million followers and more than 22 million likes.
Then, another TikTok therapist posted a video expressing frustration with “trauma-dumping clients.” (Trauma dumping is sharing traumatic experiences, often unexpectedly, with someone who hasn’t agreed to hear them; the TikToker later explained she’d been using the term colloquially, to connect with people and be “cute.”) Therapists across the internet quickly rejected the idea that you can “trauma-dump” on someone whose job is to help you manage trauma. The therapist deleted her account and told BuzzFeed News she’d lost two clients over the debacle.
“That really shook me, in a good way,” says Guenther. The very public incident made him rethink his approach to mental health content creation and the kind of information he chose to share.
Guenther’s not alone.
Since the dawn of the pandemic, mental health content creators have flourished across social media, especially TikTok and Instagram. But they aren’t all equal. Creators with questionable qualifications and intentions have proliferated too, sharing dubious information, outlining symptoms, suggesting that various behaviors indicate all manner of DSM diagnoses, and at times even proffering treatments. Experts advise people to avoid mental health mis- and disinformation by seeking out credible sources.
But those credible sources face their own challenges. Therapists are trying to share information widely without compromising their professional ethics, and the questions they encounter aren’t easy to answer. How much should they reveal about themselves? Should they try to be trendy, or stick to basics? Would dancing to Lizzo’s “About Damn Time” diminish their credibility? And how do they handle people reaching out for help via DM or comment section?
There are as many approaches to these quandaries as there are kinds of mental health practitioners on social media. Some avoid trends like dances and viral sounds, while others lean into memes and the opportunity they provide for exposure. Some eschew direct interaction or stick to answering follower questions, while others go viral weighing in on current events, as is most recently exemplified by TikTok therapist participation in the inexorable wave of content—much of it highly misogynist—related to the Depp v. Heard trial. Therapists find themselves searching for the best trends to hop on to discuss trauma, puzzling through creating pastel Canva carousels outlining anxiety-management tips, and learning to stitch and duet, all with varying levels of enthusiasm and skepticism. “It takes a toll,” says Guenther. “There have been a dozen times where I’ve been like, ‘Fuck this, I’m not doing this anymore.’ ”
Many say that, one way or another, they have a mandate to figure it out. Ben Miller, a psychologist and the president of Well Being Trust, feels therapists “have an obligation to evolve” and “meet people where they are.”* (He once organized trainings for practitioners on the benefits of using platforms like Facebook but admits he’s spent little time on Instagram and TikTok.) Psychologist and Hopelab chief science officer Jana Haritatos says mental health content on social media is particularly key for helping young people. Conversations about the importance of destigmatizing mental health issues often point to increased awareness, including on social platforms, as a key piece of the puzzle.
Considering the inaccessibility of traditional mental health care, especially for members of marginalized communities, this perspective makes sense. Trauma therapist and licensed professional counselor Yolanda Renteria (@thisisyolandarenteria on TikTok and Instagram, whose combined follower count is more than 250,000) is galvanized by the size of the audience she can reach. She’s especially interested in connecting with Latino communities, where therapy is often particularly stigmatized, and assisting others in breaking out of the same generational cycles of trauma she openly discusses working to overcome herself. At the same time, she is careful to ensure that when she does choose to share her own experiences, it’s beneficial for her client. As she explains, they should never “feel like they have to carry your emotions.”
Research demonstrates that social media encourages self-disclosure, and this is as true for therapists as for anyone, particularly as they deal with the isolation of the pandemic and the sense of loneliness that’s common among private-practice mental health professionals.
At the same time, staying quiet and leaving the talking to your client is practically Therapy 101. Classic practice advises mental health professionals to be a “blank slate,” to prevent specific details from muddying the client’s ability to share with and project onto their therapist. However, many of today’s practitioners—particularly those creating content for social media—feel modernity demands a degree of self-disclosure.
Wale Okerayi, a licensed mental health counselor who shares some content on Instagram at @becomingselfish but is wary of TikTok, credits the shift to the pandemic. “Our realities are correlating with our clients’ realities,” she says, leading to a greater sense of shared experience that creates opportunities for mutual disclosure.
Many also feel the blank slate standard prevents potential clients from seeking help, by making therapists appear unapproachable. Divija Bhasin, who shares mental health content on Instagram at @awkwardgoat3, is a licensed counselor in Delhi, where therapy is particularly taboo. Her page is frequently funny, sad, and personal—with the goal of making therapy appear more accessible, and therapists more human.
And when they’re seen as humans, they’re able to address the full spectrum of humanity. A listing in a therapist directory can capture only so much, while social media paints a fuller picture. Jayne Mattingly, founder and CEO of eating disorder and body image practice Recovery Love and Care, shares her expertise and personal experience with ED recovery, disability, and chronic illness on Instagram at @recoveryloveandcare, which has more than 19,000 followers.
“The boundaries that are put upon helping professionals to be a blank slate are very racist, fatphobic, and ableist in nature,” says Mattingly. “They assume that marginalized communities don’t care about what kind of helping professionals they see, and what life experiences they have.” She says many of her clients who found her through social media say the way her page highlighted the facets of her identity they related to—such as her disability and her experience with ED—made them feel safer reaching out.
But while some boundaries are being broken for the better, other changes are less positive.
Mattingly says her clients following her online has at times affected the therapeutic relationship: They’ve told her that after learning via her posts that she was in the hospital or experiencing other personal issues, they refrained from reaching out when they otherwise would have. In these cases, despite the pains she’s taken to curate her page, she’s had to recommend they unfollow.
She also fields countless DMs asking for resources and sharing painful personal experiences that can catch her off guard: “If I hear about trauma out of a clinical setting, my mind reacts differently. I’m human, and my brain is a brain.” She has prepared a template of sorts for responding in such situations, both offering resources and reasserting boundaries.
Guenther receives frequent messages and comments too. At times they’re inflammatory or hurtful and come from people who seem to feel he is obligated to engage because he’s a therapist. Usually, he does his best to ignore the vitriol.
But turning the other cheek can be a challenge. Therapists making health content are subject to the same bewitching algorithmic forces and brain chemistry manipulation that keep other influencers—and the rest of us—chasing the rush of engagement. Mattingly has begun expanding to TikTok but has found it hard to avoid being swept up in engagement with the more hostile users frequenting the mental health hashtag, or having her purpose in posting eclipsed by the drive to chase virality.
The pressure is always there. Even long after the “trauma dumping therapist” exited TikTok and explanations of the true meaning of “trauma dumping” had caught fire across the internet, videos dissecting the incident and the term proliferated. It was a hot topic, and the promise of engagement made the trend enticing.
Bhasin corroborates the push to stay on trend. “Whenever something related to mental health or therapy is brought up in the news,” she says, “my audience definitely urges me to talk about it.”
It’s no surprise that the new digital frontier of mental health is fraught. For those seeking help, it can be an accessible blessing and a minefield of misleading information. For therapists, it’s blurring boundaries for better or for worse, and challenging the fundamental tenets of the therapeutic relationship.
In October, the American Psychological Association released general guidelines asserting that “the benefits of using social media” to share mental health information “can hardly be overstated.” Yet the guidelines contain more outdated references than they do actionable advice (and don’t even mention Instagram or TikTok). For now, it seems that, except for their followers, therapists on social media are on their own.
Correction, June 27, 2022: This article originally misidentified Ben Miller’s role with Well Being Trust.
State of Mind is a partnership of Slate and Arizona State University that offers a practical look at our mental health system—and how to make it better.
