One of the questions I’ve been getting a lot lately is “do you think online therapy is really as effective as in-person?” My answer is this: Maybe not, but the fact that it is reaching people who might never come into an office for in-person therapy outweighs the fact that it might not be as satisfying or relational as if they were in the room with me. I think we have to get over this “ideal therapy situation” concept as therapists – that if we can’t do therapy exactly in the way in which we are most comfortable, it’s not worth it. We are excluding so many people then for our own comfort (and privilege, see this past post for the whole soapbox)!
In my brief experience with online therapy, I am noticing that I get a lot of clients who say, in one way or another, “I don’t want to bother anyone with my problems.” I am guessing that this internalized message of disregard for their own importance would normally stop them from going in to see a therapist – where there is a lot of paperwork and effort required to make and get to an appointment, all the while they are telling themselves they are not worth it. So, the ease of online therapy breaks down some of these barriers and makes the initial inquiry easier and much more likely to occur! Wonderful! If someone can get in the “door” and express to me that they don’t feel worth any time or attention, it allows me to give them some, and to at least start working on those negative messages they have been telling themselves for who knows how long.
Also, I am seeing a lot more marginalized individuals via online therapy – those who identify as LGBTQ+ or of different racial or ethnic backgrounds. Those messages of “I’m not worth it” or “I don’t want to bother anyone” are strong in these groups! Maybe these are messages they have heard from our dominant culture, or have been taught to them growing up as coping strategies to fit in or acculturate. Shame. On. Us. for making whole groups of people feel unworthy of time, love, care, and attention. This is a big part of our jobs as therapists these days – to undo as much of these self-degrading thoughts and messages as we can. (It is much the same job as parenting, a post for another day!) We can do this in our lives as well as in our work – notice where society tells us to be small, invisible, silent, not needy or emotional – and counteract those messages. Take up more space there, amplify the voice and the presence of someone told to be quiet, and feel and show our emotions instead of stifling them.
Be a disruptor out there to make voices heard and emotions felt and mental health okay to talk about!
