My new therapist congratulates me in a pre-recorded video. “I commend you for the journey that you are about to embark on for your own wellbeing,” she says, “and the courage to take those initial steps.”
I’ve just downloaded Talkspace, the therapy app that purports to “democratize mental health.” The courageous steps I have taken, so far, include typing in information such as my age and zip code. The congratulations are from Carol, a licensed mental health counselor. Of the matches listed for me, she is the only one who has included a video message, and she has kind eyes. So I’ve clicked select, entered my payment information, and made Carol my therapist.
Talkspace is just one option in the crowded field of e-counseling, which has emerged in the last decade as people have come to value both self-care and being too busy for self-care. Apps like Joyable, BetterHelp, 7 Cups, and Larkr are attempting to merge the convenience of the smartphone with people’s unmet health and wellness needs.
My employee assistance program covers Talkspace, so I’m trying it. I’m hoping to squeeze into my daily routine some of the benefits of in-person counseling: objective advice, emotional support, clarifying discussion. My impetus is your average millennial ennui: I’m generally unsure about my future, existentially speaking, and, very occasionally, experiencing anxiety so acute that it leaves me weepy and short of breath.
I have no idea how to answer this question via text, a medium in which I almost exclusively communicate through Drake memes.
After I complete a Personal Assessment, rating the severity of these emotions and their effects on my everyday life, Carol sends me a few introductory messages. She explains that I can send text, audio, or video to this “room” as often as I’d like. Then she asks:
“Where would you like to begin? ????”
I have no idea how to answer this question via text, a medium in which I almost exclusively communicate through Drake memes. So, I shoot off a stream-of-consciousness series of messages, my worries about a few big life transitions rising to the surface. She responds right away: “It seems you would like some help in decreasing the anxiety around planning the future as well as living your life now. Is this accurate?”
It really is! It already feels great to have someone personally dedicated to absorbing my inner monologue. I’m impressed with her ability to identify the central theme of my rambling anxieties. Actually, the synthesis is so quick and neat, and the language so slightly awkward, I wonder if it could be the product of artificial intelligence. This would make the process feel more like quizzing an AIM chatbot, like I did as a middle-schooler, than engaging in a mature discourse about self-improvement. As if intuiting my doubts about her status as a real person, Carol soon suggests that we “meet” via video chat the following week.
When the time comes, I am running late ending a bike ride and profusely sweating as I answer Carol’s video call. She’s definitely not a bot! She looks very calm, holding a giant ceramic mug and seated next to a lovely window. A single, leafing bamboo shoot extends into the frame on her left. It looks comfortingly like the few therapists’ offices I’ve physically been in. Once we troubleshoot the glitchy video connection, the session is like any in-person appointment — only this initial chat is 10 minutes long.
We agree to do weekly 30-minute video chats in addition to the text messaging, and we talk about using our time together to help me get more comfortable with uncertainty in my life. She suggests a few ways to practice this, including emailing myself three simple things that make me happy each day. In the meantime, I still have an unlimited ability to send her text messages through the app.
At first, I prefer this endless text thread to the video sessions because it’s more convenient: I send thoughts to Carol as they occur to me, sweaty or not, while I’m on the train, watching TV, cooking dinner, or waiting in line. The best part of the app, it turns out, is not how closely it replicates in-person therapy, but how it forces therapy to become something different, to adapt to my spontaneous needs and give me the opportunity to feel my feelings anytime, anywhere.
One morning, I send Carol a frantic text. I have no control over anything, basically everything is out of control, arrghhhh! Before lunch, she sends me helpful tactics for figuring out why I’m trying to control things in the first place (she’s on to me). It’s the balance of encouragement and tough love I need to push through a productive afternoon — one I might’ve otherwise spent in a tailspin of anxiety.
As the weeks go on, though, the accessibility starts to feel like a burden. I find myself deleting paragraphs I’ve texted into the “room,” because I’ve noticed that the act of typing out a passing concern can overemphasize its importance. Handwriting a thought usually helps me purge it; in the app, the text cools and sets like papier-mache, leaving a brittle shell around the emotion even after it dissipates.
It’s a self-defeating cycle. If a week goes by and I haven’t sent Carol any text messages between our video chats, I start to mentally add Think about my problems to the running to-do list in my head, in an effort to come up with something new to send. This proves to be counterproductive to the goal of becoming less anxious.
But we continue our weekly video sessions, and despite the fact that she appears to be booked every half-hour most evenings, Carol is an excellent listener. Our split-screen chats feel like the kind of conversation only a very best friend tolerates semiannually: completely one-sided, with lots of nodding and “mm-hmms,” founded upon the understanding that nothing you say will be held against you when you eventually get over it.
This is what keeps me from deleting the app when, about a month after joining Talkspace, I still haven’t experienced any major breakthroughs. Even if it takes dozens more messages or video calls to figure it out, I don’t have to worry about being selfish. Carol gets paid to respond. It’s up to me to keep talking.