Why telling people to 'go to therapy' isn't as enlightened as some think
On Twitter, there's an all too simplistic line being drawn between morality and therapy.
Everyone on social media needs to go to therapy, or so we keep being told. When England lost the Euros, the "get some therapy" crowd were out in full force. Men, it was suggested, could be less racist, violent or drunk if only they'd give it a try. It has also been touted as a solution to social problems as varied as QAnon, vaccine misinformation, and liking Donald Trump. But this is a way of thinking which ignores the reality of therapy. All forms of treatment are flattened into one, and questions over effectiveness and accessibility are pushed to one side. Therapy is reduced to a question of willingness, a thing people might avoid because of stigma or pride. But the "go to therapy" demand, which takes on a hectoring tone one notch away from "pull yourself up by the bootstraps", is often functionally useless: lots of people are unable to access a therapist regardless of whether they can be scolded into visiting one.
But before we dive into the problems with "therapy discourse", let's clarify what we're actually talking about. According to Dr Natalie Hendry, an academic at RMIT, Melbourne, who is currently researching the link between therapy and social media, the more image-based memes often focus on a particular kind of therapist and a particular kind of setting; namely, an old white man in a room with a patient reclining on a sofa. In this sense, they present a limited view of therapy that ignores different modalities, such as group sessions or somatic therapy (related to the body). Perhaps the most common strand, though, is the idea that men need to go to therapy. This particular discourse has become so cliche and ubiquitous that it has inspired an ironic spin-off: "Men would literally rather (x) than go to therapy", which proffers ever more elaborate and absurd excuses. But it's still not at all uncommon to see it expressed in earnest.
A number of articles have been written, for example, from the perspective of people who only want to date men who've had therapy. Michael Schneider, an Instagram artist who poses next to quotes written out in balloon writing, once wrote: "Fuck nudes. Send me a dated invoice from your therapist so I know you're working on yourself." Of course, only wanting to date someone with a therapist is anyone's prerogative, but it can veer uncomfortably close to choosing a partner based on how well-off they are, ending up as a slightly more progressive version of assortative mating.
I can empathise with the impulse behind this way of thinking, though: while I have no experience dating straight men, as a gay guy, I am all too aware that men can be terrible. Male violence is a social scourge, and the world would be a better place if its effects were mitigated. Wanting bad men, or anyone who has hurt us, to go to therapy is also a more charitable impulse than wanting them to go to jail. But I worry the idea that therapy makes men better is not entirely true, or at least not in the way that's being suggested.
“The way we talk about therapy online, as though it were a silver bullet, can also obscure the larger social factors which cause people to seek therapy in the first place, problems that also require collective solutions.”
As many of us know, waiting lists for NHS therapy are notoriously long, but when you do finally get an appointment, you will most likely receive a short-term course of CBT. This is a form of therapy focused on changing thought patterns, which has been criticised for being overly structured and unsuitable for more complex mental health problems. Although it is possible to get psychoanalysis and talking therapy on the NHS, it's nonetheless harder to enter into a ponderous Dr Melfi/Tony Soprano-style relationship on the government's dollar. Demanding better-funded services is important, but if we want to provide people with meaningful and sophisticated ways of understanding their mental health, then we need to be more specific than "y'all need to go to therapy".
The way we talk about therapy online, as though it were a silver bullet, can also obscure the larger social factors which cause people to seek therapy in the first place, problems that also require collective solutions. For instance, there is a wealth of evidence to suggest that the most common mental health disorders are related to poverty. If you go to a therapist because your job or your living situation is making you anxious or unhappy, they might be able to help you to cope, but they are unlikely to prescribe you a new home or a life without working. This isn't even a criticism of therapy: a good therapist understands that some problems are beyond their scope, and there are traditions of radical psychotherapy that explicitly foreground these kinds of considerations. But this nuance gets lost in the 'go to therapy' hectoring we see on social media, which seems to position it as a catch-all solution to unhappiness.
As for the idea that men need to go to therapy and that this will make them less violent, manipulative and abusive, this is a pretty big claim — and there simply isn't enough research to conclusively say whether it's true. Feminist-led practices such as the Duluth Model have been shown to be at least somewhat effective in rehabilitating perpetrators of domestic violence. But these are specialist programmes, and these results can't necessarily be extrapolated to therapy as a whole.
Professor Josh Cohen, a psychoanalyst, lecturer and author of How to Live, What to Do: In Search of Ourselves in Life and Literature, tells me that one of the most common reasons people come to therapy is because they have experienced difficulties in forming and sustaining meaningful relationships. "Over time, we discover that the way that they conduct relationships has been shaped by internalised rigid, often defensive modes of thinking about others that they're barely aware of (if at all). So a person can reasonably expect to become more aware of those defences, and with work, modify them and become more open and flexible and less governed by anxiety and suspicion. Therapy cannot 'cure' cruelty or abusive behaviour, but it can certainly make you more aware of your propensity to it."
While there should be a space for therapy in the rehabilitation of perpetrators of domestic violence, we should be careful about putting out unrealistic expectations of what it can do, particularly within a short time frame. This could be the last thing that someone thinking about leaving an abusive partner needs to hear. "It is unreasonable to expect any quick transformation of patterns of relating that have been established and entrenched over a lifetime," Professor Cohen says. "And it is unreasonable to imagine a wholesale transformation of personality and behaviour. Any glib claim that some wholesale change of personality and attitude can be achieved by the mere act of 'going to therapy' is harmful. It promotes the dangerously unrealistic idea that psychic change is an easy business that just needs an 'expert' to 'say the right things' or show you where you're going wrong."
“Any glib claim that some wholesale change of personality and attitude can be achieved by the mere act of 'going to therapy' is harmful.” Professor Josh Cohen
For deep-rooted problems, not all therapy will have a positive effect. Doireann Larkin, the senior tutor on the Understanding Domestic Abuse and Sexual Violence MA at Goldsmiths, University of London, tells me: "The concern with going to therapy which isn't specialised in violence or abuse is that the perpetrator may attempt to manipulate the session to try and get the professional to collude with them. It can also play into the idea that the perpetration of abuse is a mental illness which the perpetrator needs support for as opposed to a behaviour that they choose which they need to address. This can be problematic as a perspective because perpetrators will sometimes use that against victims (e.g. 'I can't help that I attacked you, I have an anger management problem')." Therapeutic language, too, can be exploited as a means of manipulation and control.
Male violence exists within social structures which lie beyond the individual, which means that any attempt to solve these problems solely through solutions like therapy will ultimately be insufficient. Doireann is careful to stress that therapy might be a valuable tool in addressing abusive behaviour. But, she says, "If that's the only strategy we're promoting, then it's preventing us from considering how issues that we need to address such as gender inequality are perpetuating violence and abuse. It individualises the problem which can take responsibility away from some of the wider political and social factors at play."
If online therapy discourse can sometimes be glib or simplistic, this isn't always the case. Some people use therapy memes as a way of making sharp and incisive critiques of their own experiences. According to Dr Hendry, social media provides people with a valuable space to reflect on what they're getting from therapy. "It allows people to talk about therapy, and particularly bad experiences of therapy," Dr Hendry says. "Some of the participants in our research have said complaining about their therapist in a meme has actually helped them realise that they don't need therapy anymore, or that maybe they need to find a different therapist or a different modality or take a break." It's simply not true, then, that all of these memes function as pro-therapy propaganda: TikTok recently went through a phase of slagging off CBT, for example, and lots of therapy memes are explicitly concerned with how strange or awkward the experience can be, along with the feelings of hyper-vigilance that can come with it.
So some of the ways we talk about therapy online are indeed valuable. But as ever with social media, the problem is a lack of nuance, along with a dose of moralism. I also think that our cultural preoccupation with therapy can distract us from how deprived we are of material ways to improve our lives. We all have to make peace with the world that we actually live in, rather than looking ahead to a utopia that may never arrive. There is where therapy can be useful. But it is not an easy fix, an option for everyone, or a re-education camp to which we can send bad men.