What all those BetterHelp ads say about ourselves

Podcasting and therapy alike scratch our itch to be inquisitive about things, even our own inner worlds.

Jamie Mulvaney

Jamie is Vicar of St Michael's Chester Square, London.

A podcaster speaks into a mic before a screen.

Soundtrap on Unsplash.

There's one dominion Amazon hasn't conquered. Jeff Bezos famously chose his company's name, in part, because it's the largest river in the world and he wanted to create the world's largest bookstore. And Amazon has flooded the market. But as the world of podcasting is taking over our commutes and leisure time, Amazon isn't taking it over. That top spot belongs to BetterHelp.

Now that I've mentioned it, you probably know what I'm referring to: the ubiquitous ads offering online therapy, often reassuringly read by the podcast hosts themselves. Although Amazon is the second largest ad buyer on podcasts, BetterHelp spends more. A lot more. In the US, BetterHelp spent $22million in the second quarter of this year, followed by Amazon with $13million. . BetterHelp has pretty much been the top spender on podcasts Clearly, BetterHelp thinks the demand for therapy is right up there with the convenience of getting stuff delivered to your door.

The message of online therapy, and the medium of podcasts makes for a neat match. It seems our wants and needs are more and more solo endeavours. Our desire for entertainment and help are becoming something we access alone, behind headphones and closed doors.

Overhearing people talking about their therapist in a metropolitan café is now as as common as the extra-hot flat whites themselves.

I was stunned when I heard recently that Saturday Night Live celebrated fifty years on TV. It was a reminder of an age when families and friends would diarise prime-time weekend entertainment together in front of the glow of the screen. But common experiences are diminishing. Harvard fellow Flynn Coleman highlights that the third spaces where we have customarily congregated, found community, and ourselves, are vanishing.

She is, of course, right. We are just beginning to scratch the surface of the damage our atomised online worlds have created. But where the CDC health report last year tragically detailed the harm social media causes teenage girls, the online space is not without hope. Krish Kandiah writes, 'Instead of demonising new technology as the problem, perhaps we need to find ways to turn it into the solution.'The online world isn't going away, so it must be at least part of the solution. Teletherapy is now available on the NHS, and while there are questions over the affordability and availability of online mental health care, and I cannot vouch for BetterHelp, making therapy more accessible by taking it online plays an important part in winning the battle of declining mental health.

Far from an echo chamber, an online therapist can challenge presumptions at right angles and enable clients to access worlds they previously only dreamed of. And, any good therapist wouldn't encourage you to isolate yourself. We still need community.

Therapy isn't as much a solo endeavour as we might first think. Of course, the therapeutic relationship itself is between two people, however objective one party might be. And just as the old adage goes, 'a problem shared is a problem halved', overhearing people talking about their therapist in a metropolitan café is now as as common as the extra-hot flat whites themselves. Therapy is losing its stigma, and the benefits of it are shared just as we want to share a podcast that's stimulated or amused us.

That elusive arrival at contentment, of happiness, of satisfaction is quite the claim for an online service provider to make.

Some things are sacred, though. James Marriott recently argued in The Times that the burden on those in the public spotlight to overshare isn't always helpful. How, where and with whom we share our inner thoughts matters. The Christian tradition sees that growth happens through relationship, rather than through broadcasting. Spanish mystic St Teresa of Avila wrote almost half a millennia ago about a journey inward, inside of ourselves to a space where only God dwells, if we choose to let him enter. On that journey, she wrote ‘It is a great advantage for us to be able to consult someone who knows us, so that we may learn to know ourselves.’

On that journey of self-knowledge, the online world can enhance our lives, but not replace it. Just as The Rest is History podcast can give you details about ‘greatest monkeys' that your friend can't, specialist help from an online therapist will help you in ways friends won't. But BetterHelp wants to be your friend. The main heading on their website mimics what we've probably all heard from someone we know: 'You deserve to be happy'. They've learnt from the Steve Jobs school of marketing: don't sell the product or service; sell how it will make them feel. That elusive arrival at contentment, of happiness, of satisfaction is quite the claim for an online service provider to make.

Podcasting and therapy alike scratch our itch to be inquisitive about things, even our own inner worlds. Where podcasting has challenged the old powers that sought to control the flow of information, we also do well to listen to external expert help. In this age, the online stream can flow information to us which, like the Amazon, might overwhelm us. It’s worth us asking: is there an external source of even better help available? One that will overwhelm us too – but instead overwhelm with the love we crave in our deepest selves?

Article

Assisted dying

Care

Comment

Death & life

Suffering

27 November 2024

5 min read

Why end of life agony is not a good reason to allow death on demand

Assisted dying and the unintended consequences of compassion.

Graham Tomlin

Graham is the Director of the Centre for Cultural Witness and a former Bishop of Kensington.

Towfiqu Barbhuiya on Unsplash.

Those advocating Assisted Dying really have only one strong argument on their side – the argument from compassion. People who have seen relatives dying in extreme pain and discomfort understandably want to avoid that scenario. Surely the best way is to allow assisted dying as an early way out for such people to avoid the agony that such a death involves?

Now it’s a powerful argument. To be honest I can’t say what I would feel if I faced such a death, or if I had to watch a loved one go through such an ordeal. All the same, there are good reasons to hold back from legalising assisted dying even in the face of distress at the prospect of enduring or having to watch a painful and agonising death.

In any legislation, you have to bear in mind unintended consequences. A law may benefit one particular group, but have knock-on effects for another group, or wider social implications that are profoundly harmful. Few laws benefit everyone, so lawmakers have to make difficult decisions balancing the rights and benefits of different groups of people.

It feels odd to be citing percentages and numbers faced with something so elemental and personal and death and suffering, but it is estimated that around two per cent of us will die in extreme pain and discomfort. Add in the 'safeguards' this bill proposes (a person must be suffering from a terminal disease with fewer than six months to live, capable of making such a decision, with two doctors and a judge to approve it) and the number of people this directly affects becomes really quite small. Much as we all sympathise and feel the force of stories of agonising suffering - and of course, every individual matters - to put it bluntly, is it right to entertain the knock-on effects on other groups in society and to make such a fundamental shift in our moral landscape, for the sake of the small number of us who will face this dreadful prospect? Reading the personal stories of those who have endured extreme pain as they approached death, or those who have to watch over ones do so is heart-rending - yet are they enough on their own to sanction a change to the law?

Much has been made of the subtle pressure put upon elderly or disabled people to end it all, to stop being a burden on others. I have argued elsewhere on Seen and Unseen that that numerous elderly people will feel a moral obligation to safeguard the family inheritance by choosing an early death rather than spend the family fortune on end of life care, or turning their kids into carers for their elderly parents. Individual choice for those who face end of life pain unintentionally lands an unenviable and unfair choice on many more vulnerable people in our society. Giles Fraser describes the indirect pressure well:

“You can say “think of the children” with the tiniest inflection of the voice, make the subtlest of reference to money worries. We communicate with each other, often most powerfully, through almost imperceptible gestures of body language and facial expression. No legal safeguard on earth can detect such subliminal messaging.”

There is also plenty of testimony that suggests that even with constant pain, life is still worth living. Michelle Anna-Moffatt writes movingly of her brush with assisted suicide and why she pulled back from it, despite living life in constant pain.

Once we have blurred the line between a carer offering a drink to relieve thirst and effectively killing them, a moral line has been crossed that should make us shudder.

Despite the safeguards mentioned above, the move towards death on the NHS is bound to lead to a slippery slope – extending the right to die to wider groups with lesser obvious needs. As I wrote in The Times recently, given the grounds on which the case for change is being made – the priority of individual choice – there are no logical grounds for denying the right to die of anyone who chooses that option, regardless of their reasons. If a teenager going through a bout of depression, or a homeless person who cannot see a way out of their situation chooses to end it all, and their choice is absolute, on what grounds could we stop them? Once we have based our ethics on this territory, the slippery slope is not just likely, it is inevitable.

Then there is the radical shift to our moral landscape. A disabled campaigner argues that asking for someone to help her to die “is no different for me than asking my caregiver to help me on the toilet, or to give me a shower, or a drink, or to help me to eat.” Sorry - but it is different, and we know it. Once we have blurred the line between a carer offering a drink to relieve thirst and effectively killing them, a moral line has been crossed that should make us shudder.

In Canada, many doctors refuse, or don’t have time to administer the fatal dose so companies have sprung up, offering ‘medical professionals’ to come round with the syringe to finish you off. In other words, companies make money out of killing people. It is the commodification of death. When we have got to that point, you know we have wandered from the path somewhere.

You would have to be stony-hearted indeed not to feel the force of the argument to avoid pain-filled deaths. Yet is a change to benefit such people worth the radical shift of moral value, the knock-on effects on vulnerable people who will come under pressure to die before their time, the move towards death on demand?

Surely there are better ways to approach this? Doctors can decide to cease treatment to enable a natural death to take its course, or increase painkillers that will may hasten death - that is humane and falls on the right side of the line of treatment as it is done primarily to relieve pain, not to kill. Christian faith does not argue that life is to be preserved at any cost – our belief in martyrdom gives the lie to that. More importantly, a renewed effort to invest in palliative care and improved anaesthetics will surely reduce such deaths in the longer term. These approaches are surely much wiser and less impactful on the large numbers of vulnerable people in our society than the drastic step of legalising killing on the NHS.