Touching on the unavoidable

On being a therapist and a regular person during election season.

Hello Testers! I’m back after a week away from writing. Vibes are challenging these days. Reminder to myself and to anyone reading that you do not have to know what the polls are saying every second, and if you haven’t made plans to distract yourself on election night, do it now. 

It’s a tough time to be a therapist. It’s not so often that I find myself experiencing such a similar emotional reality to so many of my clients. With just a few days until the election, we’re living through a moment where political stress is overwhelming and inescapable. I’ve been seeking out supervision and advice in order to better understand how to show up for clients during this season when I, too, am trying to keep my head above the water of my own existential dread. 

I’ve been noticing how various influencers and media outlets are addressing the mental health of it all, too. There are articles titled something like “How to cope with your election anxiety” that list strategies such as practicing mindfulness, limiting media exposure, exercising, and being in community. 

These are evergreen suggestions, and they’re good ones. When faced with overwhelming structural issues, it’s always a good idea to focus on what we can control. And for all the people who are googling “how do I deal with my election anxiety oh god make it stop,” I’m glad that there are some resources out there. 

But doesn’t it all feel kind of…trite? Of course it’s not enough. There’s no getting around the fact that whatever happens over the next however long will be painful, and the fear that accompanies that is real. 

My intention is not to be negative or hopeless. As a therapist during this election season, things are out of my control. I don’t have any information that my clients don’t. I’m aware of the very material dangers facing my clients in varying ways. As a therapist and as a person, I hate how helpless this all makes me feel.

I received a good piece of advice earlier this week: The role of the therapist in this situation is supportive, not curative. We can’t make election anxiety go away (no one can). But as therapists, clients, friends, people, we can all be a reminder to each other that no matter what, life on earth continues. Whatever happens on Tuesday, I’ll be on time for my appointments on Wednesday. And so on and so forth.  

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Drugs to order

Friend of the newsletter Andréa Becker wrote an excellent article for Business Insider about the rise of cisgender men taking supplemental testosterone despite being in generally good health. The article frames the trend as a way for men to be more “manly,” perpetuating and affirming existing norms of traditional masculinity. From the article:

“This trend tells a story of a new kind of gender-affirming care, but for cisgender men. Testosterone is prescribed to treat a set of vague symptoms for men hoping to feel ‘better,’ though it’s not exactly clear what it does or who needs it. In his 2007 analysis of the testosterone market, the legendary medical sociologist Peter Conrad said: ‘Testosterone became a drug in search of a disease to treat.’ Nearly two decades later, the search continues, with male insecurity as a stand-in condition.”

The trend fits into a broader phenomenon of an increasingly fractured physical and mental healthcare environment catering to affluent people with money to invest in specialized treatments with varying levels of scientific support. From men’s health clinics, where you can drop in and start a regimen of testosterone in between eating fruit snacks and watching sports (and for cis men *only*, it should be mentioned), to virtual platforms like Hers, where you can take a quick survey and exchange a few DMs with a text box psychiatrist (who I’m not entirely convinced is not a chatbot) in order to start a course of SSRIs, to a site like Mindbloom where you can place an order for sublingual ketamine to be consumed at home without supervision, the market is thriving for hyper specific, out of network treatments that you may have read about online or heard about from a friend and decided that you need it, too. (Hers has recently added Wegovy and other weight loss drugs to its menu of offerings.)

google ads flooded with sponsored posts.

Taking any kind of medication is a personal decision, but it is also *ideally* a collaborative one. But when the only thing standing between you and a medication is a virtual order cart, without getting any input from a real live human professional interlocutor, there are risks. A survey alone is not enough for a diagnosis (see Skill Gap for more of my thoughts on standardized assessments), and providers are not always adequately explaining adverse side effects or long-term consequences. There’s no space to explore the nuances of the complex issues being dealt with: How do you define your problem? In the case of testosterone, what if the problem is that you don’t feel you adhere closely enough to a socialized idea of masculinity? How do we differentiate between a problem that requires medicating and an insecurity that requires processing and deeper emotional work? And when you are paying a private clinic or company for a treatment, how do you trust that your well-being is being considered as much as their potential to profit off your problem? 

This is not a new phenomenon and the solutions aren’t simple. When it comes to psychopharmacology, between medical gaslighting, overprescription, and pill-mill doctors, psychiatry is a particularly difficult field to navigate as a patient. There’s validity in our need to have more agency over our healthcare and what medications we take; these companies are not all the same and they are not all bad. But I remain skeptical of the businesses that profit off the exhaustion, anxiety, and feelings of unwellness that follow so many of us for so many complex reasons. 

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This week in armchair overpathologizing

Or you just have a crush. :)

Thanks for reading! As always, please send any suggestions or feedback my way. Go vote, go outside, look at leaves, hang out with your friends, and buy some Halloween candy on sale. See you next week.