I Tried Getting Therapy Via Texting and I Think It's a TERRIBLE Idea

TW: Contains ranting, mentions of suicidal ideation, and “The Good Wife” spoilers.
Publish date:
April 5, 2016
relationships, therapy, mental health, texting

TW: Contains ranting, mentions of suicidal ideation, and “The Good Wife” spoilers.

Talkspace is a therapy-via-text app that was launched just over a year ago, of which I’ve only recently become aware, and to which I have to say NO.

When it comes to mental and behavioral wellness, I want us all to have as much of it as possible, and I usually advocate “anything that helps,” and also that something is better than nothing. I generally feel that what works for other consenting adults is not my business, but this is a case where I think it can actually do harm.

Please take my NO with a grain of salt, of course; not only am I not the boss of you, but we are all operating at different levels of resources, and woefully inadequate access to mental health care for many is a matter of fact, not opinion.

Furthermore, there are all sorts of different methods of professional therapy, and it's important to find the practitioner(s) and approach(es) that work best for you. I get that apps are all about convenience and access and using and creating technology to do more and more things each day with our beloved smartphones and devices, and I'm not here to be the stodgy grandmother crowing You kids today, always on your phones…

And that wasn't a sarcastic Twitter “beloved” in the preceding sentence, either. My phone certainly is my beloved, and though I think we could all stand to connect in person more, I don't curmudgeonly blame the rise of the machines for people possibly being disrespectful to loved ones or ignoring them at the dinner table.

Maybe your phone is always in your hand, so maybe it makes sense, in theory, that your fingertips could be your conduit to therapy, but texting your therapy with so few boundaries of time and space, or, as Talkspace boasts, “messag[ing] your therapist anytime and anywhere,” could also just be practice for oversharing on social media with a diminished sense of any potential consequences, and under the comfy blanket of anonymity. The app’s ties to social media are undeniable and, at least in part, intentional, with one of the Talkspace slogans chirping that it’s “therapy, re-invented for how we live today.”

I grant that “how we live today” does largely involve typing things into screens on our devices and then reading things off of them, which is how I wrote this and how you come to be reading it right now. But in terms of personal mental health and wellness, the more you open up a window on your phone and type out your deepest fears, hopes, and secrets, the more you practice doing just that, and the less it could mean each time you do it.

Here at xoJane, we share lots of personal stories, of course, and I know well the catharsis that can come from sharing, even with strangers and online. But that alone can’t be your primary source of therapy.

Talkspace argues that taking away barriers increases access, which of course it does, but does it also obliterate necessary boundaries and structure, thereby diminishing quality?

Texting is, by nature, amorphous and ongoing, which Talkspace touts as a bonus, though I see it as a detriment. Having access to your text therapist whenever you want sounds like an all-you-can-eat buffet type of dream, but buffets often end in a trash heap of half-eaten plates, nausea, and regret.

I’m devoted to open conversations around mental health, so integrating your therapy more into your daily life is a great idea to me. I also don't want to suggest that we need to relegate therapy to one tiny idea of an hour a week on a couch in a small, unmarked room with a white noise machine by the door. Let it be wherever you want, but I do think it should actually be somewhere outside of the digital realm as a primary source of treatment.

On a super basic level, I don’t want something as delicate as therapy being subject to an iffy cell signal. If a text is delayed or is not coming through to you, you have no way of knowing. This is annoying enough when it happens with my friend whose iOS update seems to have gone awry, but in the context of therapy? I don’t want to be sitting anywhere waiting for a text reply on something that serious.

And if you think I’m taking the concept of therapy too seriously, I would ask what casual or non-serious therapy might be for. Committing halfway might be all someone feels capable of, or have time for, or be able to afford, but that could also be a symptom of the issue that sincere therapy could help with in the first place.

There’s also no debating the convenience of texting, but this just isn’t an area where convenience can rule. We’ve all eaten from a convenience store from time to time, but if that’s our constant, we’re missing out on much more nourishing, nutritious, and satisfying experiences. Grab N’ Go therapy can’t be the way.

I would be a fool to rant away at first sight without giving it a try, so I absolutely downloaded the app and created a “nickname,” what Talkspace calls usernames. Within the first text volley, my worst fears were confirmed, when the alleged therapist punctuated her reply with an emoticon.

I say “alleged therapist” because I can’t help but wonder about the authenticity of the pictures, names, bios and credentials of the Talkspace providers. The site has done their due diligence with legal statements about their staff, but it’s still a thumbnail pic on an app.

Here’s where I will attempt to check my privilege as an extroverted in-person person. I understand that we are all on a spectrum with regard to verbal communication in person, and I’m on the far end of loving and preferring it. As such, it makes sense that one of the main selling points of this app that is clearly not for me is that some people express themselves better anonymously and in writing.

That’s great. Do what works for you. But accountability matters in therapy, and just the act of going and speaking what you’re going through can be hugely significant.

Also, your therapist can’t see or hear affect if you’re texting. How many times have you misinterpreted a text or an email? How many times have you been rubbed the wrong way by something you’ve read right here on this site, that might have come across very differently in a real-time conversation with whoever wrote it? How many times has a tweet gotten someone in trouble or even cost them their job?

It is a fact that words in writing can seem harsher than when spoken, especially when dispatched in small chunks, like in a tweet or a text.

For example, “I feel like I’m a burden to people” could be the beginning of a really productive conversation that leaves you feeling lighter and better at the end, or it could be the very last thing someone says before trying to end their life. The cues that a trained professional would need to pick up on in order to know how best to react to those eight words are lost via text, and the back-and-forth needed to suss them out via text could only do more harm, depending on one’s mental state.

Even for people who are better at communicating through typing than speaking, your body language and demeanor can communicate so much to a therapist that disconnected words in a text bubble just can’t. I can’t even count the times when non-verbal communication was crucial in my experiences of therapy. Even a phone call is better than texting; the person on the other end can hear shifts in your voice and your breathing, they can sit with you in the silences that say so much, and they can hear you laugh or cry or sigh in spontaneous physical reaction that is absent in premeditated texting.

Is one expected to text their non-verbal responses too? Like “btw I’m crying rn”? Even if one is adept at essentially writing their own stage directions, transcribing visceral responses is a step removed from feeling them, and being your own narrator takes you out of the immediate nature of therapeutic revelations that change shape the moment you step back and evaluate them, and the deeply personal nature of a gut reaction that happens in the moment.

That’s the thing: unless there’s already a deep bond established, texting someone just isn’t personal. And though a bond can begin through texting, if it is not to eventually grow into other means of communication, I don’t think the safe space needed for productive therapy can be created via text. This is someone you’ve never met. Therapy, when it works well, is a uniquely intimate relationship with someone who is initially a total stranger. You’re not dating this person, there’s not necessarily a protracted courtship period, and yet it is necessary to “click” with them in order to reap the most benefits from the experience.

How am I supposed to click with a small picture and a one-sentence bio? Even with online dating, or in the case of deep friendships or relationships forged online that might begin with simply “clicking” both on and with a tiny avi and a one-sentence bio, they progress. They grow. They take advantage of all of our wonderful technology and you would eventually hear this person’s voice at the very least.

I’m sorry to say it, but if you’re in an extended intimate relationship of any sort that’s exclusively made up of texting, you might soon find yourself chatting with Max and Nev in the opening of an episode of “Catfish.” And although they say many times over that your texts are protected and private, Mr. Robot is a really fantastic show that gets one thinking. I can’t imagine divulging deep personal info to someone via text while wondering if they’re even the person in their picture.

This is different from texting with a therapist that you’re already seeing in person. I’m not in favor of that either, beyond informational/logistical texts like “I’m running five minutes late,” but I can see the benefit of text messaging as a supplement to therapy sessions, or in times of extreme emotion with someone you’re already in treatment with.

I don’t see the benefit of further stigmatizing therapy, as Talkspace is doing with sales pitches that imply a benefit to keeping your treatment totally secret via texting, or in demolishing healthy boundaries with such statements as “Just like texting with a close friend, you can now message your therapist every day, for an entire week, writing as many times as you want, for only $25/week billed monthly.”

Of course I believe close friends should be there for us emotionally, and listen and offer support and try to help and even butt in sometimes, but unless they’re a licensed mental health professional, I think it’s inappropriate to actually treat your friends as your therapists.

Hell, even if they are a licensed professional, it’s not fair to essentially ask them to work in their off time, for free. Appropriate boundaries and clear expectations are necessary when asking your beautician friend to do your hair, or asking your dermatologist friend to look at a funky mole, or if you’re hanging out with your licensed massage therapist friend and you mention that you have a knot in your shoulder, wink-wink.

The same applies to behavioral health, except that it can be harder to manage those boundaries, because while not all friends cut each other’s hair or give each other rubdowns, talking about feelings and sharing issues with one another is an integral part of intimate friendship.

I don’t treat my friends like therapists, nor do I treat my therapist like a buddy. My therapist is friendly, and I feel safe and extremely comfortable with her, but it would be inappropriate for me to, say, call her in the middle of the night to help decipher some weird interaction with my boyfriend, or text some long blurb about how The Good Wife has me in my feelings because Alicia was damn near suicidal a few weeks ago and now she’s tossing her cookies at Jason and she doesn’t know her phone is tapped and how is she ever supposed to get over Will omg omg omg.

My friends get those late-night calls, bless ‘em, and I get theirs. And if I want to delve into my obsession with the fate of Alicia Florrick in my scheduled therapy appointment, that’s fine too, but the unscheduled impulsiveness of texting one’s therapy just doesn’t sit well with me.

For an increased fee, one does have the option to send audio or video messages to their therapists, but that’s still static messaging and not in real time like Skype, which I know many use when traveling or otherwise unable to get to their therapist’s office. For people who are homebound, video calling can be an excellent resource, but check out how Talkspace tries to sell you on texting versus video overall:

As against this approach as I am, I recognize the value of texting as a means of reaching out in a crisis or an emergency, because I hope we can all reach out in an emergency, by any means necessary. I particularly love that the Crisis Text Line exists. The cover of anonymity and the ease of texting can save a life in times of extreme crisis, and Crisis Text Line’s mission statement to “help you move from a hot moment to a cool calm, to stay safe and healthy, using effective active listening and suggested referrals,” makes sense via text.

Crisis Text Line is free, and it clearly and aptly states that it “is not a replacement for therapy,” but that they seek to “help our texters find calm and create an action plan for themselves to continue to feel better.” Sending a distress message, or typing a few words as a call for help when you don’t feel able to orally get a constructive sentence out, could save a life.

And eventually provide references for actual therapy that is not text-based.

Text 741741 for the Crisis Text Line, which is open to anyone, anytime.

If you’re looking for a therapist, contact your healthcare provider for mental health referrals, or try the American Psychological Association’s Locator tool, a referral site like Good Therapy, or the multiple resources of Bring Change 2 Mind, or even a Google search specific to your location.