Zodiac Sign · May 21, 2024

Dr. Julie Smith sits behind a spectrum of five Post-it notes, each symbolizing one of the "Top Five Indicators of High-Functioning Depression." These indicators resonate with those familiar with perusing social media for mental health advice: "You fulfill societal expectations effortlessly, concealing the emptiness within," loss of enjoyment in previously pleasurable activities, exhaustion from social gatherings. Maybe you identify with Number 3: "You resort to scrolling through social media, binge-watching TV, and indulging in unhealthy snacks to numb emotional turmoil."

The British psychologist and author is an omnipresent figure on TherapyTok, where a multitude of mental health professionals, including psychologists, psychiatrists, and licensed therapists, alongside a plethora of "coaches" with varying degrees of credibility, create concise videos to educate the public on understanding their own minds. With a staggering following of 4.7 million, she doesn't just simplify mental health topics into 60-second spoken-word lists; she also employs vividly colorful gimmicks to captivate viewers who might otherwise expect to watch something like the satisfying crushing of an object. Before delving into topics like "3 Ways Past Trauma Can Manifest in Your Present" or "5 Signs of a Highly Sensitive Person," Dr. Julie employs a visual allure—whether it's pouring out a bucket of candy, flipping over a massive hourglass, or standing next to a towering stack of dominos (like any adept content creator, she strategically saves the final topple for at least halfway through) to maintain viewer engagement. Does it matter that terms like "high-functioning depression" and "highly sensitive person" aren't recognized diagnoses? Perhaps. Or maybe not.

These clips resemble "get ready with me" videos more than they do actual mental health treatment. In a time when therapy fatigue may be setting in, it appears that some therapists are also losing interest in traditional therapy methods. This is evident in the growing number of therapists who spend less time with clients and more time creating content, hoping to reach millions of viewers. While most therapists working full-time and relying on insurance-set rates typically cap their earnings at around $100,000 per year, therapists who dedicate themselves to content creation, either full-time or part-time, can earn significantly more. For instance, @TherapyJeff, whose real name is Jeff Guenther and who works as an individual and couples therapist in Portland, Oregon, claims he can earn eight to nine times that amount through social media via brand deals, merchandise sales, and direct subscriptions. When asked if he's making close to a million dollars, he responds, "It's been an especially good year."

Although he still maintains a caseload of about eight to 10 clients on Mondays and Tuesdays (a full-time therapist typically sees around 20 to 25 clients weekly, he notes), Guenther is most renowned for his candid TikTok videos on dating and relationships. In these videos, he addresses his audience as "anxiously attached babes" or "relationship girlies" who are "still in their healing phase but horny AF." With a staggering following of 2.8 million and an upcoming dating advice book set to release this summer, Guenther epitomizes how to become a therapist influencer by establishing rapport with his audience and making them feel understood and supported.

Therapists have always had influence, whether through writing books, public speaking engagements, or product endorsements. However, to gain fame on TikTok, they must adhere to the platform's unique rules. What resonates on TikTok are simple, visually captivating videos that seem destined to land in your feed (the comments often echo sentiments like "my For You page really said 'FOR YOU.'"). Therapists perform cute dances alongside charming graphics depicting experiences like living with both ADHD and PMDD. They lip-sync to popular songs while discussing how to identify signs of depression in clients who may have suicidal thoughts. They also seize on memes to critique parents who haven't sought therapy.

The most successful TikTok therapists often don't directly advertise their individual therapy services. Instead, they focus on selling products that position them as mental health authorities while also potentially yielding influencer-level incomes. Many offer digital courses akin to those offered by other educational influencers. They promote their books, merchandise, or, in the case of Dr. Kojo Sarfo, his comedy tour, where he occasionally engages the audience about their mental health diagnoses. Tracy The Truth Doctor also provides specialized mental health coaching services tailored to fellow influencers.

They also foster a validating bond with their audience. Guenther, for instance, has denounced those who label others as "too sensitive" as "emotionless turds" and expressed a desire to craft "psychologically lethal" messages on behalf of his clients, albeit acknowledging the unprofessionalism of such actions. "I've been accused of being a toxic validator," he concedes. "Imagine if your ex-boyfriend stumbled upon my content. Someone might come across one of my videos and use it to feel better about themselves, instead of doing the necessary work and taking accountability." Ultimately, however, TikTok's algorithm determines who sees his videos, beyond his control.

Similar to many therapists on TikTok, Guenther is remarkably open about his own personal struggles, a departure from the approach favored by previous generations of therapists. He candidly discusses going no-contact with his mother, who is also a therapist, and his experience as the "scapegoat of the family." (His advice for fellow scapegoats: Wear a T-shirt emblazoned with the words "Official Family Scapegoat" and tell your mother she's "constantly hijacked by shame" before requesting the potatoes.) Likewise, counselor KC Davis of "Struggle Care" recently admitted to a period of hyperfixation on romantic novels so intense it led her to neglect basic self-care tasks like showering; Therapy Jessa has shared videos of herself crying, while Courtney Tracy, better known as Courtney the Truth Doctor, creates intimate "get ready with me" videos and discusses her experiences with borderline personality disorder and autism as a therapist.

Despite experiencing tremendous success as a content creator, Guenther acknowledges that his current career trajectory is not sustainable. He confides that dedicating so much time to TikTok has taken a toll on his own mental well-being. "It's draining. There's burnout. It's an unpleasant place to be," he admits, citing the relentless demands of the algorithm, negative comments, and the peculiar parasocial relationships that develop among viewers who feel they have direct access to him simply by consuming his content. "I want to step away from this because the Algorithm is my boss, and I receive a performance evaluation every single day based on a mysterious algorithm that makes no sense," he laments.

If the content feels somewhat superficial and therapists don't derive satisfaction from creating it, what purpose does it serve? One could argue that by transforming mental health topics into TikTok engagement material, influencer-therapists are diminishing the stigma surrounding mental illness and motivating individuals to seek treatment, or at the very least, offering a temporary solution for those unable to access direct care. However, it also appears to serve as a temporary solution for therapists who are exhausted by the daily grind of individual client sessions, with limited opportunities for professional advancement and salaries largely beyond their control. And who can blame them? Even if viewers understand that consuming therapy content isn't a substitute for actual therapy, when a licensed therapist appears on their feed to provide precisely what they need to hear most — reassurance that they're worthy, that things will improve, accompanied by a charming visual hook — they'll continue watching.

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