For two days last September, a 30-foot-long mirror sculpture stood at the center of a busy New York City plaza, reflecting the last of the summer’s harsh sun. Almost as though they couldn't help themselves, sweaty passersby stopped in the brutal heat, pulled their phones from their pockets, and snapped photos. Most stood in a line at the far end of the mirror to capture their normal reflection, which was labeled, "This is what you really look like. (And you look awesome)." Far fewer took selfies in front of the display’s long walls, which were built with bent, rolled funhouse mirrors that made their bodies look like swirling pieces of abstract art. "This is what Facebook makes me feel like," read one caption. "Social media engagement can trigger anxiety symptoms."
The display promoted Talkspace, an online therapy company that connects more than 300 licensed therapists with 200,000 clients via its smartphone and desktop apps. Circling employees handed out flyers detailing the startup's latest offering: a 12-week, $400 "social media dependency therapy" package. It was, the card explained, "the first program of its kind designed to help you manage your use of, and response to, Facebook, Instagram, Twitter, and more."
Like most people passing the giant, blazing-hot mirror, I was skeptical.
Unlike most of them, I had already signed up.
My interest was mostly journalistic. The last few years have produced a conflicting batch of studies about the impact that social media has on our well-being. Among their findings: The more we use Facebook, the worse we feel. Facebook ruins relationships. Facebook makes us feel bad about ourselves. Facebook contributes to eating disorders. Positive emotions spread faster through social networks than negative emotions. Facebook use correlates with "life satisfaction, social trust, civic engagement, and political participation." Being active on Facebook can make us feel less lonely.
You get the point. We're far from a consensus on the exact impact of social media on mental health, let alone the appropriate therapy for any negative side effects. I wondered what a treatment program would be like, especially one that required checking an online app, which seemed oddly close to the behavior that I imagined such a program would be designed to control.
My Talkspace-assigned therapist, whom I had first met online, was Nicole Amesbury. Back in September, at the giant mirror, I found her sitting under a nearby umbrella.
Nicole is also Talkspace’s head of clinical development (and very frequently the therapist assigned to journalists, it seems). She explained that Talkspace created the social media program after she and other therapists noticed social media often came up with clients: People found photos of friends living seemingly perfect lives to be anxiety-provoking, or said they had trouble living up to the curated versions of themselves they project online.
Although I’d like to treat my therapy earnestly, I told her, I’m not sure I have a problem. I mean, of course I use social media all day as part of my job. Of course I’ve been the subject of a few less-than-polite tweets. And of course I’ve noticed that my Instagram feed is a constant parade of engagements, new babies, and vacations. But it's not like I’m addicted.
"What’s interesting," she told me, "is that everyone who has walked by here has told me that everyone else they know has a problem, or they have a friend who has a problem."
At which point it dawned on me that, in classic pre-first-step fashion, I had just told a therapist that I don’t have a problem. I started social media therapy the next day.
I had imagined that social media therapy would be something like Alcoholics Anonymous, with a step-by-step plan that promised to lead me to a substance-free (or I guess, in this case, "social media moderate") life. My vision included worksheets, resolutions to resist posting for certain periods of time, and guidelines for how to use sites like Facebook in a way that created the purported side effects of life satisfaction and contagious positive emotions while avoiding the depression, eating disorders, and other negative correlations.
What I found instead felt more like an interactive journal. Nicole and I shared a chatroom that I could access 24 hours per day, seven days per week, but it wasn't a continuous chat like the one you might carry out over IM with a coworker. Instead, the pace felt more like that of the notebook I exchanged with my girlfriends in grade school. I would write a few paragraphs to Nicole, and within a few hours, Nicole usually responded with another few paragraphs. We exchanged messages about once a day at first.
Nicole asked me whether I’d thought any more about my concern that I’m not really a good fit for social media dependency therapy, and wondered if anything came up for me. I responded with a list of potentially less-than-healthy ways in which social media had impacted me, and she told me I did something right by just thinking about it a little further.
Over the next few weeks, I told Nicole about my life on social media: The story of the first time an angry commenter rallied a Twitter mob to harass me, how I occasionally spend time on old high school friends’ Facebook pages, the constant churn of Twitter and email, and the anxiety of waiting for a text message after a good first date.
Most of the time, these stories about my life on social media led to questions about my life. It’s hard to untie the anxiety of waiting for a text message after a good first date from the general anxiety of dating, or to define the difference between unwillingness to engage in Twitter debates and a general unwillingness to enter conflict. Being a sarcastic asshole on Twitter, after all, is not so far removed from just being a sarcastic asshole.
Sometimes Nicole was encouraging. "I am not so sure why you are saying it is not mature," she told me, after I confessed to a somewhat nefarious social media act. "You know, human behavior is fascinating. You certainly are not the only one to do this type of posting." Sometimes she acted like a coach. "As far as being efficient with email and checking, have you tried to schedule email and checking to just certain times during the day? If so, what was that like for you?"
At her suggestion, I tried. It was like trying to hold my breath for several hours or willing myself to grow a couple of inches taller. Which is to say, it didn't work. "One of the benefits of therapy," Nicole assured me, "is that when you make a plan for change, and then things don't go according to plan, then you have someone to talk with about it."
Typing to Nicole (Talkspace offers both video and audio options, but I chose to write) made me think about how social media intertwines with my general anxieties and habits. But after a few days, typing my thoughts began to feel like an assignment. I started posting just two or three times per week. Eventually, an entire week went by when I didn’t respond to Nicole. And then, I dropped off entirely.
I know Nicole would not put it this way, but I failed social media therapy.
It turns out I wasn’t alone.
"We aren’t getting a lot of addicts, and even if we’re getting them, they drop early on," Roni Frank, the software developer who cofounded Talkspace with her husband, Oren, tells me in late November, after I’ve finished the 12-week program.
Though everyone says they’re addicted, she says, they aren’t necessarily motivated to solve the problem. She compares it to cigarettes. "In the early years, people were smoking like crazy," she says, "and at some point, everybody started to be aware of how harmful it is. I think the same thing will happen with social media, and how it is basically promoting poor mental health."
Social media therapy is not the only aspect of Talkspace that has yet to be fully embraced by the mainstream. The idea that therapeutic help can come from an app, in general, has been met with some skepticism. "Developing a relationship with your patients in online therapies can be a problem, because you can't see emotional cues," Madalina Sucala, a clinical psychologist at the Icahn School of Medicine at Mount Sinai who has researched how clinicians feel about e-therapy, told The Verge, "and sometimes you can't convey empathy."
The other perspective is that apps like Talkspace make therapy more accessible and affordable to people who need it. A depressed person who can't get out of bed may still log into an app. Someone who is unemployed might not pay hundreds of dollars an hour to see a therapist in person, but they might pay the $25 per week that Talkspace charges for unlimited messaging therapy."We are basically doing the same thing as traditional therapy," Frank says. "We are not inventing a new treatment. We’re taking the same therapy, to build the same therapeutic relationships with clients, that are using the same techniques."
A preliminary study found that text-based therapy delivers similar results to traditional therapy. It was, however, funded by Talkspace and had a tiny sample size of 58 people. In December, Talkspace announced a partnership with the Teachers College at Columbia to run a more extensive study on the effectiveness of messaging therapy.
After I hang up my phone call with Frank, I call Nicole. I’m about to interview my own therapist, which is a bit surreal.
I tell her I’m still not sure that I actually ever had a problem with social media. After all, part of the reason I didn't follow through on my treatment was because I didn't feel like checking into the Talkspace app after a long day of checking email and social media. She tells me that whether or not I have an addiction is not exactly the point.
"As therapists we see problems, all the time, every day, with someone coming in, and as they’re telling us about what they’re struggling with, they’ll bring up a social media piece. [They'll say] ‘And then I saw him post this on Facebook.' Or 'I didn’t get invited to this,'" she says. "But some people don’t think of that being a part of their overall mental health. When people come to therapy, they usually come with a thing that they need to work on—a relationship, a habit, a fear—and they pop it in there and say, this is my problem, and it seems very well defined. But of course, you’re a whole person. And whatever this problem is, social media is woven into our lives, so usually it’s part of the person."
This makes sense to me. It can take several decades of research for an addiction to make its way into the official diagnostic manual for mental disorders (gambling addiction, for instance, just made the cut in 2013), and just as it's too soon to say that Talkspace is effective therapy, it's too soon to say that Social Media Dependency is a legitimate disorder. What I can say after 12 weeks of messaging (and failing to message) Nicole is that thinking a little more consciously about social media—which plays out in a digital format, but is as real as any other aspect of my life—made me feel better about my interactions there. Even so, as long as I’m interviewing my therapist, there’s still one more thing I really want to know.
"I don’t think that you have a really horrible problem, no," Nicole tells me. "I think you try your best to manage it. I’ve seen far, far worse."