Social media saviours or scourges?
Some people turn to social media for solace and solutions to their mental health issues. But does online therapy cause more harm than good?
If the reader takes a particular source of information very seriously, the content of the source can have a significant impact. Dr Shawn LEE
NORA* has over 120,000 followers on her Instagram account dedicated to “writing about what it means to be a human”.
She actively puts up posts that challenge her followers to evaluate their mental health, providing tips and quotes that encourage self-love.
The comment section on her posts are peppered with replies like “This post really helped me when I was struggling”, “Thank you for helping me find a description for what I’m going through” and “You’ve helped me so much these past few weeks since I found you”.
Some followers even openly share their problems asking for advice, whether from Nora or other followers.
Nora is a psychotherapist and the disclaimer on her profile page states “Instagram is not therapy” and that her posts are used for psychoeducation and marketing purposes.
“I have never claimed to offer therapy on Instagram,” she says via direct message on Instagram, adding that she doesn’t consider her page a source of therapy.
“I understand why that might be confusing. I am a therapist but I don’t operate on Instagram,” says Nora, adding that the use of “therapist” on her Instagram handle is just to identify her profession.
Despite the disclaimer, thousands of her followers still seek advice and help from her page, and to her credit Nora doesn’t seem to openly respond to such comments but sometimes her followers do.
A healthy option?
Nora’s Instagram account is not the only place where people go in search of tips on improving mental health or even to share problems.
Look up “psychologist” or “therapist” on a social media platform – be it Instagram, Twitter or Facebook – and there will be a long list of people offering therapy and help on mental health, as well as those seeking them there instead of in real life.
In a letter by National Institute of Occupational Safety and Health chairman Tan Sri Lee Lam Thye published in The Star, he wrote, “Mental illness is a leading cause of economic loss at the individual, family, employer, health system, and national levels due to direct and indirect health costs, absenteeism, lost productivity while at work, and decreased income – all of which can result in a reduced national economic output.”
He added: “More young workers nowadays are stressed out or experiencing symptoms of stressrelated illnesses such as anxiety or depression due to life experiences or environmental factors. Struggling to cope with work, new financial commitments, family expectations and relationships are among the topics of concern among young adults.”
But are they getting help from the right sources, asks clinical psychologist Dr Shawn Lee.
“I have come across some of these social media accounts, and am aware that some individuals with clinically significant conditions are using these platforms as a source of support,” says Dr Shawn.
While he believes that the platforms can be a great way to make proper information available for people who need it, he is concerned for those who only have social media as a source of support.
“If the follower understands that social media is merely a platform for anyone to interact, and that the information may not always be credible, then the potential for harm is relatively low. However, if the reader takes a particular source of information very seriously, the content of the source can have a significant impact. This is why owners of these social media accounts must be mindful about and be responsible for the messages they convey,” says Dr Shawn.
For Lisa*, such accounts offer stability and help, without even having to spend a single sen. The 30-year-old executive at a multinational company follows a multitude of accounts run by “therapists”, but not via her primary Instagram account, though.
“The first is to keep up with my family, friends and colleagues. The second is for myself, where I only follow people who give out good vibes. When I get stressed from looking at things on my first account – like all my friends getting married or engaged – I go to the second account to read positive things and remind myself that I am not a total failure,” she says with a laugh.
“But seriously though, I have seen some improvement to my mental health, I think. I have started keeping a gratitude journal thanks to a suggestion from one of the Instagrammers I follow, and I feel a lot calmer nowadays.”
Potential danger zone
But sometimes, followers of such “feel good” accounts get more than just a motivational quote. They can also be misinformed, says consultant psychiatrist Dr Muhammad Najib Mohamad Alwi who had an interesting meeting with one of his patients recently.
“She told me that ‘people’ in a social media group had warned her against taking antidepressants for longer than just a few weeks or she would risk getting irreversible kidney damage,” he says.
Such incidents put him on high alert on the possibility that patients with actual need for help may be misled.
“There is no way one could be 100% sure that accounts that offer mental health help and therapy are run by those who they claim to be,” says Dr Muhammad Najib, also a professor at Management and Science University.
He believes that those who operate such accounts or pages must have their own motives.
“Perhaps some of them really want to help people who are in trouble and feel more comfortable to seek help online,” adds Dr Muhammad Najib.
“Others might just want to gain popularity or try to get attention from prospective clients. Most worrying though is that some people might be using these platforms to take advantage of those who are desperate or lonely, who will ultimately fall for all sorts of criminal activities – like extortion to grooming children for sexual motives.”
Legit help available
But not every Instagram therapist is clueless or out to harm their followers. There are those, like Amy Fielder, who look to make the world a better place one Instagram post at a time. Known as Amythelifecoach on Instagram, she has almost 15,000 followers and is a certified Holistic Life Coach and Reiki Master Practitioner.
“I am not a licensed therapist, however I am qualified to do the scope of work I do. I have many ‘offline’ therapists as clients, who also follow my work. I believe the qualified and honest way I approach my work and the professionalism I hold myself to has established trust and respect from other licensed therapists as well as various other professionals,” says Fielder who is also an Ordained Minister and is currently in the process of being
certified in Trauma Informed Care.
She often posts motivational quotes, videos and words of encouragement, introducing her followers to good mental health practices almost every day.
“My goal through my work is to enhance the knowledge we have of human behaviour and emotional wellness within ourselves and each other. The thing about mental health is that there is no right or wrong way to it – there is what’s right for you and what’s right for me. They may not be the same approach, same therapist or same platform – but if it works for you, that is all that matters in you achieving success,” says Fielder in an email interview.
Lisa who follows Fielder on Instagram says that she has picked up many useful tips from the latter.
“One of her recent posts on anxiety really helped me learn how to calm down. Some of the advice I have heard from my own friends, but somehow it hits differently when someone like Fielder tells me instead,” Lisa shares.
Lisa, however, doesn’t think that she needs to seek professional help for her anxiety issues.
“Help is on my phone. Why would I need to get it elsewhere?,” Lisa asks. “Also, this way, none of my friends or family will ever find out.”
Proper channels
In Malaysia, there has been a three-fold increase in mental health problems among the population over the past 20 years, wrote Lee, stressing that mental health in the workplace should no longer be ignored as it could cost employers and the country billions of ringgit if not properly addressed.
Like many other therapists on social networks, Nora’s Instagram page has a link to her website on which her followers can get oneon-one online therapy sessions via email messages or voice calls.
The introductory session, which is 20 minutes, is free. After that a 50-minute session costs CN$140 (RM440) and a 75-minute session is priced at CN$200 (RM630).
Universiti Malaya Department of Psychological Medicine Assoc Prof Dr Muhammad Muhsin Ahmad Zahari believes that ideally, knowledge of good mental health should belong to everyone in society. He strongly believes, however, that it is unethical to give open advice or counselling over public domains such as social media.
“It is very important to have face to face contact. Words alone without meeting face to face are prone to misconception and misunderstanding,” says Dr Muhammad Muhsin.
“More importantly, assessment of one’s emotion is important in therapy and there are no other ways to achieve this other than meeting in real life.
“Therapeutic alliance can only be done when both the therapist and patient meet each other and recognise each other’s emotions.”
This is also a sentiment shared by Dr Muhammad Najib who says that it is healthier to interact with real people “despite the hassle”.
“People would be able to ‘read’ your behaviour and body language and give appropriate feedback or help, if needed, but that’s not possible for online interactions. I don’t think the future depicting client/ doctor relationship with empathetic robots as portrayed in some sci-fi movies is anywhere near yet!” he says.
However, it is not wrong for anyone to simply want to read or hear motivational quotes from their favourite Instagram accounts, these “offline” therapists say.
Dr Shawn also believes that there is nothing wrong with people providing tips on coping with emotional challenges and lending others their shoulders to cry on on social media.
“I believe that ‘tools do not cause harm, people do’. Social media is merely a tool,” he says.
“That said, owners of these social media accounts should always provide their followers with resources for proper help if and when necessary.”
* Not their real names
Words alone without meeting face to face are prone to misconception and misunderstanding. Dr Muhammad Muhsin
People would be able to ‘read’ your behaviour and body language and give appropriate feedback or help, if needed, but that’s not possible for online interactions. Dr Muhammad najib