What you say in therapy stays in therapy. That's the beauty of it. Except, however, in the case of three close friends, who tried out text therapy and decided to share their sessions with the entire internet, baring their souls for all the world to see.
Robyn Kanner, Akilah Hughes, and Timothy Goodman hit publish on their text therapy sessions in December 2018, baring their trauma and innermost private thoughts for all the world to read. It was a scary thing for each of them; a moment that caused them sleepless nights, and concerns about the reception their sessions might garner from readers.
That's how the Friends With Secrets project was formed — a project that allows readers to scroll through a series of conversations between Kanner, Hughes, and Goodman and their respective online therapists. As you read through the conversations, you read the stories that have shaped these three humans' lives, the trauma they have endured, the thoughts they don't share with most people in their lives. Witnessing these messages passing back and forth makes for raw, vulnerable, and incredibly moving reading. Their sessions not only are an insight into the personal struggles faced by millennials, they also explore how race, gender, wealth, and class intersect with mental health and can limit people's access to mental healthcare. They picked five sessions which best told the "general story" of their four months of text therapy and published them online.
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So, why text therapy? Goodman tells Mashable that during their conversations about the things happening in their personal lives, the topic of text therapy had come up because it's "kind of trendy" currently. Text-based therapy is a form of talking therapy which uses messaging instead of in-person conversation.
Online therapy — which often involves the use of video chats — has been studied extensively. Researchers in one 2012 large-scale study found that "telemental health services" decreased patients' "hospitalisation utilisation" by around 25 percent. But, as Wirecutter notes, "peer-reviewed studies on text therapy are small" so it's currently difficult to assess the efficacy of this particular form of therapy. A 2013 peer-reviewed study of 30 patients of text therapy found patients reported strong relationships with their text therapists. John Torous — director of the digital psychiatry division at Beth Israel Deaconess Medical Center — told Wirecutter that "text therapy is really unknown" and "there are a lot of assumptions being made." Talkspace is a popular text therapy provider, which matches individuals up with an assigned licensed therapist, who they'll speak to every session. The structure of the sessions really depends on the provider — sometimes therapists respond once or twice a day, others message patients back and forth in real-time. In the case of Friends with Secrets, the online therapy takes the form of asynchronous messaging.
"Sharing personal stories is a very intimate way to connect to other people, other lonely people in the world, human beings."
The nucleus of the idea formed in January 2018 when all three friends were going through a lot of different things in their personal lives, says Goodman. "We're all creative people and artists, the three of us, so I think we have a strong desire to express ourselves and share stories and so we wanted to create something that was meaningful and powerful for us but also for other people," says Goodman.
In an age where companies collect and share data about our lives, sharing stories about mental health online can come with a real risk. But Goodman and Kanner — who are both self-employed — say that they are accustomed to putting themselves in their work, and that they don't know what they'd do if they weren't able to express themselves. "I work for myself, and I have been putting my "self" in my work for 5 years now," says Goodman. "With Instagram and Twitter, so many of us put our personal lives out daily, I don't see the big deal. Maybe it's generational." For privacy reasons, they have changed the names of the therapists they spoke to and not shared the brand of the text therapy service they used.
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"Sharing personal stories is a very intimate way to connect to other people, other lonely people in the world, human beings," says Goodman. "A lot of things that the three of us talk about are painful, but they're the reality for millions of other people so by publishing them it, it takes a lot of the stigma away." Not only that, Goodman has found the process of sharing his stories publicly therapeutic and says it has made him feel less alone when other people connect to it. "I think that's a really powerful tool," he tells me.
Rather than sharing screenshots on social media, the text sessions have been published on a website — a deliberate choice given the intimate nature of the stories being told. Kanner says that Twitter and Instagram are a "hard place to have a conversation" like this.
"A lot of things that the three of us talk about are painful, but they're the reality for millions of other people so by publishing them it, it takes a lot of the stigma away."
"They're wonderful platforms but they can be garbage to dive into the nuance of a relationship, or other experience, or other trauma," says Kanner. "Some of the stuff that I say in the first couple of sessions, if that was a Twitter thread, like, I'd be ruined."
In one of the sessions, Kanner — who identifies as a trans woman — describes being sexually assaulted by a trans woman. "I open up talking about a sexual assault between a trans woman and me. Like, that's not a story that's supposed to be told, no one wants to tell the story of trans women hurting each other." "There can be so much bad that comes out of a story about 'this trans woman hurt me,'" she adds.
One particular moment in Kanner's second session was particularly striking. When talking about her adolescence, she tells her therapist Jennifer about the first time she ever talked to someone about gender. "I looked up forums online and saw this post from a trans person about how suicide hotlines were good because they’d let you talk about gender," Kanner tells Jennifer.
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Kanner explains that she would call every single night and would talk to an adviser about gender for as long as they would allow. "Isn’t that so fucked up? The only way I knew how to get people to talk to me about my gender was to act like I wanted to die," she tells Jennifer. Kanner tells me that her story is about one of many "access problems" that trans and non-binary youth face. "For me, that happened about 2005 when I was on the phone with a suicide helpline acting like I wanted to die to talk about gender. That was a very of-the-moment thing," she says. This experience is one that other trans and non-binary teens growing up during that particular era might relate to. Kanner says that, a decade later, the conversation is a little different for young trans kids wishing to talk about gender.
Both Goodman and Kanner have mixed feelings about their experience trying out this form of therapy. Kanner found being able to read back over the sessions helpful in helping her identify her dependence on alcohol, which prompted her to get sober. In Robyn's final session, she writes that she's "got to fucking stop all of this" in reference to her self-harm and alcohol use. Her therapist ends that session stating her hope that Robyn has "noticed the changes" in herself over the course of their time and conversations.
"I know I drink about my trauma, but over time that behaviour has gotten much harder. Now, as a person with a little bit more time in sobriety, I feel like there are so many other healthy coping mechanisms for me to deal with," Kanner tells me. "These therapy sessions, being able to read them, being able to spend time with them, helped me see that all much clearer." For Goodman, who had previously seen a therapist in person for six or seven years after college, this experience prompted him to get back in touch with his therapist and to start back with in-person therapy.
"I like the idea being able to relate to someone in a physical sense when talking about my personal struggles and fears and traumas, that's important," he says. "There were times when I felt disconnected, but there were also times through the process where let my therapist help me despite the fact that we're talking digitally." Because Goodman was going through "a lot of depression" at the latter part of his sessions, he decided to go back to see his old in-person therapist.
As for how the sessions have been received online, Kanner and Goodman say they've received an overwhelmingly positive response. Starting out, they'd been concerned that people might perceive the project as a group of "self-centred millennials whining about their issues," says Goodman. But, people have reached out to tell them that they've related to their stories. "People are really identifying with it because sharing personal stories, I believe, is a form of activism," says Goodman. "People see themselves in us, and I've heard so much it's encouraging people to consider therapy or text therapy or to go back to their therapist or whatever."
Goodman says that in his conversations with people who've reached out to him, he's been asked for advice on what to do when therapy isn't an affordable option. He says he's advised people to double check with employers to see if they cover the cost of therapy. If not, he's advised people to look for support groups or mental health centres in their communities, and to research if any training clinics at universities might offer services. Kanner says others have contacted her to say they've started therapy after reading their sessions.
If you've read the sessions and feel troubled or concerned, Kanner wants readers to feel assured that they are all doing well. Goodman got himself back into in-person therapy as he was living with depression at the time and said he realised he needed to be "more proactive" about his mental health. "Time has been a really good medicine. Anybody reading it right now, be aware a lot of these things are heavy, a lot of them have been addressed in a really positive way," says Kanner. "So, there's hope."
If you want to talk to someone or are experiencing suicidal thoughts, text the Crisis Text Line at 741-741 or call the National Suicide Prevention Lifeline at 1-800-273-8255. For international resources, this list is a good place to start.
If you have experienced sexual abuse, call the free, confidential National Sexual Assault hotline at 1-800-656-HOPE (4673), or access the 24-7 help online by visiting online.rainn.org.
Topics Health Mental Health Social Good