(and the social media circus)
With the advent of the internet, and the rise of social
media, significant and pressing concerns present
themselves as to the average therapist. How should we
promote ourselves to attract bookings? How personally
visible should we be in our use of social media? And how
does that affect the transference?
According to the American Psychological Association,
in a 2010 paper Where has all the Psychotherapy gone?, thirty
percent fewer patients received psychological interventions
in 2008 than they did eleven years earlier. And while talk
therapy has been in decline, Big Pharma has increased its
domination through drug treatments. In 2005 alone, $4.2
billion was spent on direct to consumer advertising and $7.2
billion on promotion to physicians.1
How does a single counsellor or psychotherapist in private
practice compete with that? In particular, in an Australian
context where psychology is subsidised or free?
Many of us were probably attracted to this work in the
first place, at least in part, because of its non-commercial
quality. Now we must think about marketing just to exist,
much less survive.
Theoretically, you could be the best therapist in the world
and no one ever attend your practice. Equal and opposite,
you could be the worst therapist and be busy because your
marketing worked so well. There must be a ‘happy’ medium.
In the US, there is a new specialised industry of branding
consultants who counsel therapists to establish or protect
their livelihoods in the current market.
Did anyone learn how to attract bookings in their
What’s worse is that in the more than 22 years that I have
been practising in Australia, not one patient or enquirer has
asked if I was a member of a professional association, if I
subscribed to a Code of Ethics, or worse still, if I was even
trained or qualified!
To the big question of how to promote ourselves, the
answer must be: any way we can. A website is now as
essential as a business card in the past. Then, we have to ask:
how will people find our website? And what are they looking
Driving traffic to a website is a major science, but what
makes it harder is that the rules change, regularly. For
example, it used to be that key words were key. We needed
to do key word analysis, find what people most searched for
(i.e., ‘depression’, or ‘addiction cure’, or ‘trauma therapy’) and
then load up the page with these words. We were (and are)
slaves to algorithmically-driven search engines. Now, key
words don’t matter, apparently.
I just use local-paper advertising. Old school I know, but it’s
1 From a New York Times article by Lori Gottlieb, What Brand is
Your Therapist?, November 23rd, 2012.
What people are looking for, in my opinion, is a person
they can relate to. They want a therapist who is not too formal
but not too casual, boundaried but not remote, visible but not
naked, caring but not gushy, intelligent but not academic, and
experienced but not a dinosaur. They also want someone who
is confident and authoritative, but not arrogant or superior, too
They want someone who ‘gets it’. We need to think about
how to convey this.
The money often doesn’t matter that much, or if it does, then
they want someone who is affordable, but not cheap. I find it is
better not to advertise fees up-front.
One tip to get below the surface of this iceberg is to check
out Ali Roth, a website consultant for therapists at http://
myshrinkwrap.com. Her tagline is Websites even Freud would
Envy (!) She is Los Angeles-based but even her homepage is
instructive. Her advice: ‘People need to like you when they Google
you. They want to feel an immediate personal connection.’
And what of our use of social media? Along the lines of
personal connection, how far should we take this without
positioning ourselves as ‘friends’?
Social media is an absolute circus these days and we are at
risk of becoming clowns if we use it badly (or use it at all?).
Many therapists shun Facebook. Many don’t care what happens
if you Google McDougal, or you want to tweet Pete. Many won’t
email a female or mail a male, and few want to be in-synch
through LinkedIn. I do wonder though who will be the first
amongst us to open a Weibo account?
That said, a recent Harvard University research paper claims
that self-disclosure on social media sites activates dopaminerelease
in the brain in a similar way to the pleasure we feel from
food, sex or money. Maybe we’re not tweeting enough???
Perhaps most of us were trained that anonymity is desirable,
many of us were instructed to be a blank screen, a ‘tabula rasa’,
ripe for the projections and transferences of patients. We were
told that even our consulting rooms should be as neutral as
possible, nothing that gives away too much of who we really are.
Not even family photos. (My therapist has photos of her dog
which revealed a very great deal about her to me…).
But has the world moved on now? Is this no longer the best
way to work? Are we at risk of being left behind? Is this what
people are seeking when they want a therapist?
Things have changed so much, and quickly. Would anyone argue?
I think Ali Roth is right, people do want an immediate
personal connection. And there is no personal connection
unless we are willing to be a person, and visibly so.
But the question still stands: how visible?
Should we say: Face it, Facebook is a global phenomenon.
And if we want to book ‘faces’ in our practices, we need a
presence there. But should we ‘friend’ clients? Or accept
invitations to be ‘friends’ from clients? How will it be if we
I told one client recently that while we knew some people in
overlapping social groups, and we may well run into each other,
that I thought it wasn’t ideal for their therapy for me to accept
their friend invitation. And how do you feel about that??? Of
course, that was an email exchange.
On the other hand, I wonder how much harm, if any, it
really does to be seen for who we are. Isn’t authenticity still
I am sufficiently visible as to be more transparent than probably
most therapists. But I do not want to reveal my own stance on
politics or religion — even if I do on Facebook. Here, practically
everyone hates Julia and no one at all can stand Tony.
God is such a loaded subject. I am very willing to discuss my
patient’s experience of God, or their views on politics, but here I
am as invisible, personally, as possible. But if you want to know
where I’m going on holiday, or that I spent Christmas writing a
book, I really don’t mind.
Does it affect the transference? Of course it affects the
transference. But there is no uncontaminated space. It just isn’t
possible. I used to try in my London days. One patient came in
and said, “I saw you get out of your car. I never imagined that you
would have a car like that”. She seemed rocked, de-stabilised.
The essential point is that we still need to be alert for
transferences, projections, idealisations and de-idealisations, no
matter how visible we are, or how invisible we think we are. And
they still happen anyway.
The patient’s pattern will unfold. I won’t say ‘regardless’
because our visibility does make a difference. We do need to
be aware of what of ourselves has become visible. Better to
be conscious of it, and think about how this will affect our
Over 28 years ago, the patient who was bothered about my
car nearly had a breakdown (well, she did, actually) when she
found out my wife was expecting our first baby. Even in those
days, it was hard to be opaque. Now, it’s impossible.
The advent of the internet has changed everything. The
geography, demography, psychological ecology, and social
anthropology of the planet have changed and are continuing to
change dramatically. We had better get with the program, reprogram
and change our traditional channel or we will be left
behind. The article quoted at the beginning indicates we already
are. As we said in the 60s, tune in, turn on or drop out (man).
We can worry about the transference, but surely we had
better worry about our bookings or there won’t be any transference.
In that case, see you at the next meeting of Psychotherapists
Anonymous … online.
Jan Resnick, Amygdala Consulting