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The Search for an Extremely Online Therapist

How can they begin to understand my mental anguish if they have no clue who Shrimp Guy is?

It became clear, after my third therapy appointment, that I was talking a lot — perhaps too much — about Twitter. So many of my anxieties seemed to trace back to the uncanny social gaucheries of digital life. In particular, I couldn’t get over the haunting feeling that everyone I was staring at across the screen was harboring an undetectable resentment for my entire being, summoning up the same sort of existential malaise you might experience after munching on one too many edibles before heading out to a company holiday party. 

I’ve been online since I was 10 years old, and in that time, I’ve accumulated every possible strain of pernicious logged-on neural disorders — the simultaneous thirst and fear of a larger platform; the intractable public dictums of like/retweet/reply verbiage; the ever-present worry that you might annihilate your life with one bad post. 

My therapist is a lovely man who listened with patience and curiosity long after it became clear that he could barely parse what I was saying. Who could blame him? How do you describe to someone what it’s like to panic over a tweet? This was the struggle every session, as I attempted to boil down the psychedelic quagmire of the internet for someone trained to address concerns of the physical realm — breakups, deaths and family trauma. 

It pains me to admit that I desired a Very Online Therapist — or at least someone who could speak the same language as me while recounting the latest grievances on the timeline. This is one of the saddest truths anyone can identify about themself; one that honestly should make anyone hop on Telehealth to book a double appointment. The only solace I take is that I’m not the only one. Yes, in 2022, a generation of anguished Reddit dwellers are looking to consult with an expert who can recall the Shrimp Guy debacle. 

“I just don’t have 35 minutes to lay out my foundational understanding of how online speech works before I can talk about what’s bothering me,” says David M. Perry, an academic and journalist who has echoed my fantasies of a Very Online Therapist. “I need them to understand a baseline of how that works before I get into my specifics. I don’t know how online my therapist is. She nods sympathetically when I talk about the internet. Sometimes I feel like I should stop and say, ‘Can I stop and recount the last 22 years of online discourse surrounding male feminism?’”

Perry, like me, is a little sheepish about this disclosure. Neither of us are able to articulate the precise mechanics of what we want. After all, the thought of a therapist actually stalking our social platforms is truly mortifying, because the relationship between a patient and practitioner must be limited to the crucible of the office in order to protect against a Tony Soprano/Dr. Melfi situation. And yet, in this era of chronic oversharing — where we constantly barrage our followers with innumerable nervous thoughts better left unshared — perhaps it’s necessary, maybe even healthy, for our mental health professionals to retain a smidge of digital fluency. It’s nice to know that my therapist is a human being who has suffered heartbreak, loss and spiraling regret. It’d also be nice to know that he, too, has bombed a few posts.

“It’d be great if I could find someone who knew everything about Twitter and promised to never read anything I said,” laughs Perry. “It could be like an entry level question. I think it’d be important for therapists to learn that online interactions are real and significant, and that they’re as real and significant as things that happen in our work life or lovelife.”

Thankfully, Matt Lundquist, founder and clinical director of Tribeca Therapy, put me at ease. He’s been fielding prospective clients who’ve wanted a splash of internet literacy in their treatment for years. A decade ago, a patient sought his help after dealing with some sort of civil fracas on an ancient political forum, and specifically requested a professional who wouldn’t require any translation as she described the contours of the posting alcove. (Can you imagine what it’d be like to break down the imperceptible semantic differences between all the options on an emoticon menu?) Lundquist found those concerns eminently reasonable, and believes they should be taken seriously by anyone in the industry.

“These spaces have norms and values that can be broken, that one can fail to make inroads in, where offense can be significant but hard to understand,” he tells me. “As a therapist, understanding this is like understanding any culture — an ethnic group, middle school, even the culture of a given family system or an offline community, like skateboarding. And of course, race and ethnicity are sort of social locations where there’s much nuance to understand.”

At the same time, Lundquist cautions against anyone being overly selective with their mental health services. There’s nothing wrong with splitting the same contextual faculty, but therapists are professionals, and good ones should have the ability to bridge the gap between the roaring boil of the internet and the sort of earthly troubles, biases and proclivities that are common among all mortal inhabitants of the universe. After all, there’s no high quite like realizing that a sensitive area of your brain that you once believed was hopelessly esoteric is actually easily diagnosable. 

“There’s a tendency to get distracted by some things that matter less, in particular the idea of specialty,” says Lundquist. “The pickiness really is much more about fit — a sense of confidence that this person is committed to helping you, that they have a plan, even if that plan changes over time, that this is someone you can talk about things that are hard to talk about with.”

Still, I do wonder if digital volubility will become more pertinent as the generation shift continues, and millennials inherit the paramount concerns of society abdicated by the Boomers and Gen Xers. Before long, America will be almost exclusively populated with people who grew up on the internet, and that means Very Online Therapists are going to be everywhere, simply because more people are going to be Extremely Online. That’s a terrifying thought for a ton of reasons, but at the very least, we’ll no longer need to define the edifying nature of a shitpost to the good men and women behind the desk. A little bit of utopia, in the midst of dystopia.

“It seems silly, but when you consider that therapy is really at its heart all about articulating your experience as yourself in the world, it only makes sense that your therapist should understand the world you inhabit, and the pressures you experience there,” says Hillary Brown, another patient in search of a Very Online Therapist. “All that we experience makes you feel as if everything is important, while simultaneously having no meaning at all.”