Free professional therapy on the internet

No, seriously. It's largely thanks to podcasting.

Apr 10, 2023

It’s just a regular stressful day in March and you log in to Twitter and the first thing you see is someone retweeting this into your timeline

It’s good to be reminded, no? Nicole LePera is just one of a number of psychotherapists and psychologists who are using social media to offer free unpersonalized therapy, but few have achieved such massive readership. I should add, while also maintaining professional standards. Remember the 1990s, when therapy’s mad cousin, psycho-babble, was everywhere on network television? Dr Phil? The Oprah confessionals? It’s only recently that the mass-media-distributed free therapeutic advice managed to back up from that particular dead end to a significant degree, and enter a more enlightened, “it’s complicated” era.

And this has been I think largely thanks to the rise of podcasts. Television series and Hollywood created their own share of nonsense about the talk therapy profession, with wildly inaccurate portrayal of what therapy is and what licensed therapists do. (In one of her best known films, The Prince of Tides, Barbra Streisand plays a Manhattan psychotherapist who enters into a relationship with her troubled client, played by Nick Nolte, in order to heal him. IRL, that would be an ignominious end of a career. I also remember reading somewhere Elisabeth Roudinesco’s baffled treatment of In Treatment with Gabriel Byrne, a 3-season HBO effort.) No, it looks like competent talk therapy had to wait for the age of the high(er) brow talk radio, i.e. podcasts, to get even the remotest hang of (any) mass media. Before, I was certain the two were constitutionally incompatible. Another looming problem was, while the cultures of the anglo-world were massively adopting the psycho-babble and the therapy vulgate, actual access to actual therapy became a privilege that comes with a well-paying job with excellent additional health benefits. Society was getting the worst of the therapy age – the self-centredness, safetysim, diagnosis-as-identity – while missing out on the best, which required the demanding work of facing oneself.

(I am aware of a lot of psycho-talk gurus on YouTube, yes. It looks like YouTube is a fertile ground for those. No, I’m actually talking about the practicing, licenced psychotherapists, members in good standing of professional associations.)

I think the first time I’ve noticed competent professional therapy managing to translate itself into successful mass media messaging was some ten years ago, in the BBC Radio 4 series in which Susie Orbach and the producers fictionalized her therapy sessions with several different types of clients into a radio drama. It was anonymized and collaged, but it rang true, and they even had the awkward falling-in-love-with-the-therapist, i.e. the transference episode. Many years later, Philippa Perry created a similar series based on her work with clients for Audible which had some great reviews. (Perry is now the Guardian’s Agony Aunt and has made a complete switch to media.)

During the early days of the 2020 lockdown, wanting to have something to listen to on my long and pointless walks, I dipped my toes in This Jungian Life, a podcast that’s been recommended to me multiple times by pals on social media. I’d resisted, harbouring a prejudice against Jungian mysticism and also a distinct European wariness around myths, but the three Jungian therapists trying to make sense of the planetary crisis turned out to be just the thing for me back then. “The only way is through”… and nigredo as the process of individuation “brought about by the subject’s painful, growing awareness of his shadow aspects”, a “moment of maximum despair that is a prerequisite for personal development” – none of that sounded woo any more. There are some extraordinary episodes in the TJL vaults from the last three years, on projection, on endings, on home, on falling in love (that one was unexpectedly celebratory… which does not happen with the much more circumspect Freudian lot). One of the three Jungians also published her first book during that period: Lisa Marchiano’s Motherhood: Facing and Finding Yourself, a book on how what may feel like an annihilating experience of motherhood can actually be an individuation process, a developmental ordeal that some women are lucky to get to go through. Then one day she was a very eloquent guest on another podcast, The Meaningful Life with Andrew G. Marshall, so I checked it out too.

Between that first discovery and the present day, I’ve spent countless (walking) hours with Andrew and his guests in my ears. While not all guests are equally convincing (there’s the odd bit of oddness, as with a guest who assured the host that he communicates with his dead son on the regular), the majority are episodes bursting with good advice and context. It’s hard to choose a handful. Kathryn Mannix was a guest twice, to talk about her books With the End in Mind: How to Live and Die Well, and Listen: How to Find the Words for Tender Conversations, and those are always up there. The episode with Dr John Kaag on William James (“Be not afraid of life. Believe that life is worth living, and your belief will help create the fact.”) Dr Anna Colton: How to Sit with Anxiety. Malcolm Stern: Slay Your Dragons with Compassion. There was a brilliant episode on depression a while back… and another one with a therapist who learned how to become a sexual person in middle age.

Then, via the very well known podcast How to Fail, which I also used to listen to (it’s now mostly celebrities who come on so I’ve abandoned it), I discovered Best Friend Therapy, with Elizabeth Day and her best friend psychotherapist Emma Reed Turrell. There are some great episodes here, especially in earlier seasons (how to date in today’s world and survive with your sanity intact is one of those).

Sam Harris’ Making Sense podcast will usually contain a lot of psychology stuff (in addition to philosophy, Eastern thought and practice, and brain science) and his recent conversation with Aristotelian ethicist Martha Nussbaum was quite a ride. He’d often have neurologists on (Lisa Feldman Barrett), comedians (Ricky), AI experts, and artists.

I walk much less these days and listen to the podcasts less, but still check these out periodically to see if there’s something there I’ve never heard before (there often is). Just as I was thinking I was done expanding my pool of psy pods, I happened upon Ten Percent Happier, apparently legendary among the mindfulness and CBT types (hello, you know who you are). Jerks at Work with Amy Gallo is a spectacular episode, as is the one with social psychologist Jonathan Haidt.

Those of you who have a personal or cultural resistance to the notion of psychotherapy might find this a good way in. I come from such a background. Now I think Freud was a genius, and also a flawed human actor and a total ignoramus on certain topics. He and his practice have become essential for the conversation of the humankind – but equally essential is the criticism of them. (Deleuze: We are not constituted by a lack; desire is fullness. Also Deleuze: It’s the adults who pathologize their kids, psychoanalysis is a perverse middle class pastime by mommy and daddy. Also alas Deleuze, with anti-psychiatrist Guattari: [insert any old mad anarchic nonsense here]).

One of the best books that I remember reading about the birth of psychoanalysis is Lisa Appignanesi’s Freud’s Women, in which she argues that the talk therapy practice emerged thanks both to the brilliant articulate neurotic women who were its earliest subjects and Freud, Jung et al. (One of the reasons I like Cronenberg’s 2011 film A Dangerous Method is that it suggests as much: it was a pas de deux.) I have veered on the topic of psychotherapy this way and that multiple times in my life, though a constant is that I could never once afford it for any length of time. This has become now a feature of the thing, its comparatively exorbitant expense (in terms of time as well as money) and a relaxed attitude about practical goals. For this reason and others, CBT has become very popular: it’s shorter, it gives you practical things to do and it’s about observable behavioural change. That it works only for some people and some type of affliction only, and often short-term, is usually lost in the chatter.

I’m hoping to revisit this topic and look at the situation in Ontario. I am also curious about the big switch to online communication in the psychotherapeutic profession, as if the presence of human bodies is now too much of a risk for psychotherapists. (It’s such a fascinatingly blind spot, it almost calls to be psychoanalyzed.)

And on the TBR list, this: one fairly hostile history of the early days of the psychoanalysis (left) and one exploring the lives of the (now literary) characters “Dora”, “Rat Man”, “Little Hans”, the “Young homosexual woman”, and “Elizabeth von R.”

Meanwhile I’m hoping someone does This Winnicottian Life podcast or something. If anyone needs a revival, it’s Donald Winnicott. Such a great guy. Alison Bechdel did her lion share for the cause in Are You My Mother?