The problem with text therapy

You’ve probably seen the ads for Talkspace, Betterhelp, and other digital therapy services meant to “disrupt” the therapy world. Maybe they even sound good to you — a bargain price, and access to your therapist whenever you want instead of at a set appointment time each week.

But with anything, there’s a shadow side, a catch. There are a lot of problems with these services, including issues with privacy and confidentiality for clients, and serious concerns around professional ethics and compensation for therapists. On top of all that, I seriously question whether any effective therapy or personal growth work can happen via text.


Getting Out of Your Comfort Zone

Text therapy probably sounds pretty comforting, easy. Less intense and nerve-wracking than face-to-face interactions. You don’t have to make eye contact. You can just stop responding for a while if you feel overwhelmed or annoyed or done. You don’t have to see the impact your words, tone, or energy have on another human being. All the same reasons you probably prefer to text friends or romantic partners instead of talking on the phone or seeing them in person. It’s easy, and you don’t have to get outside your comfort zone.

The thing is, therapy is meant to a place to grow, heal, and change. And by definition, you can’t do that if you stay in your comfort zone. If therapy is easy, comfortable, and allows you to wiggle out of uncomfortable feelings and situations, then you aren’t getting what you need out of the process.

Therapy isn’t meant to be horribly uncomfortable either. There’s a productive window, just outside your comfort zone but before you get flooded with anxiety and become unable to think. Negotiating that place with your therapist is part of the process, part of the important job of getting to know yourself better, knowing when you are getting overwhelmed and how to calm yourself down. This is a very useful skill to have in life, in job interviews, talking to strangers at parties, and a million other situations. If you are always avoiding getting uncomfortable, you never learn how to do this. You stay stuck.


Words Are Only Part of the Picture

Text makes it hard for you to do your work, and makes it hard for us therapists to do our work too. Text is a very limited form of communication. As a therapist, I am looking at ALL the ways you communicate with me, not just the words you choose. I’m listening to your tone of voice, the pace at which you are speaking, the energy behind your voice. I’m paying attention to your body language, eye contact, and the way you gesture and move. I put all this together to form a complete picture of what’s going on for you in every given moment.

I can’t tell you how many times someone’s words said something very different than their body was saying, and being able to call my client’s attention to that and explore leads to huge breakthroughs and changes. That can’t happen over text. The truth is, therapists need to actually see your body language, hear your tone of voice, to be able to diagnose you and to provide effective treatment.


A Time and a Place

Without a doubt, for some people in some situations text “therapy” can be a good thing. If you are unable to access any other form of mental health care for instance, or if you truly are only looking for someone to just listen. Peer support text programs provide a wonderful service, a way to be understood and feel less alone.

But if you are actually looking to address real mental health concerns (for example, depression, anxiety, or disordered relationships to food, drugs, sex, etc.), text therapy is not going to cut it. And if you are looking to actually push yourself to grow as a person, change unhealthy patterns in your relationships, work, and life, texting someone is not going to do the trick. Texting is easy, and easy does not bring about change.