Busting Mental Health Myths With Joe Nucci

0:02Thank you for joining us for episode 539 of Live Happy Now. What if everything you knew about mental health was wrong? Today's guest is here to bust some myths and share some new truths. I'm your host Paula Felps and this week I'm talking with Joe Nucci, a psychotherapist whose new book, Psychobabble, dismantles 40 popular misconceptions about mental health. Joe's here to talk about some of the most commonly believed myths and explain why this misinformation can be so damaging. He'll also talk about how to navigate the sea of misinformation on social media and take control of your own mental health.

0:40Let's have a listen. Joe, thank you so much for joining me on Live Happy Now. Oh, thanks so much for having me. We're here today to talk about your new book, Psychobabble. I love this book. It really swims against the mainstream flow of a lot of the things that we are hearing about mental health. So before we get into what you're talking about, let's talk about the why. What made you want to write this book? Well, I only have been in kind of the content creation, social media influencing game for like two, two and a half years. And a couple of years ago, when I started to take it a little bit more seriously, I started looking at what other people were posting.

1:18And I was surprised and also concerned because it wasn't just that I was seeing posts that lacked nuance or could easily be taken out of context. It was just sometimes the information was just wrong. Or if it was taken out of context or just a little bit oversimplified because that's what happens when it's just a meme or just a short video, people were using it in a way that I was noticing could actually be harmful to your mental health. I'm pretty sure that was the opposite of what we all had in mind when we started consuming mental health content and we started de-stigmatizing it and branding it and investing in it and talking about it so much.

1:56And so what I tell people is I'm like, listen, the spirit of the book and the spirit of my content is not one in which it's kind of like a finger wagging ivory tower. Like this is not the correct definition of the term you just used. It's actually worse than that. They're being used in ways that I think are antithetical to mental health that are hurting relationships that are actually causing a lot more chaos and a lot less calm? I mean, you tell me, Paula, does it seem like, you know, we've never talked about mental health more. Do we feel collectively mentally well? Exactly. And that's the thing.

2:27These mental health discussions have gone so mainstream. You know, there was a time when if you had anxiety, you didn't talk about it. If you were going through depression, you didn't talk about it. That wasn't healthy either. Now it seems we've kind of done a pendulum swing. And I hear people very openly talking about mental health in a way that hasn't been done and sometimes feels almost like they're being too vulnerable with too many people. Right. Well, I think part of the issue, and this is one of the themes that underscores many of the mental health myths I talk about in Psychobabble, is we can't pathologize everyday life.

3:02There are problems of living that we all deal with, like we all deal with grief and tragedy and disappointment and sadness, but that is very different from dealing with a mental illness. And what I've observed is sometimes people are patting themselves on the back being like, oh, we're so inclusive. You know, we've really destigmatized mental illness. But then someone in your life or someone in the media with like a true mental illness will come on and all of a sudden you actually see the stigma there. So I recently watched that Netflix documentary, Unknown Number. Oh, I just finished that. Yeah, I'd love to know what you think.

3:37But I know that from my view of just the internet and culture is everyone seemed really frustrated by the daughter. So for those of you who haven't seen it or don't know it, this is a spoiler alert. So just like be warned. But basically, this poor teenage girl is cyber bullied by anonymous phone numbers for like two years or something like that. And it turns out that it's the woman's mom. And she still wants to have a relationship with her mom. And everyone was like, oh my gosh, I can't believe what's wrong with her. What's wrong with her? And I was like, what's wrong with her? I'm like, she's a survivor of emotional abuse.

4:08This is actually the expected reaction. For me, it was the sobering moment that it's kind of like, it was like, oh, yeah, like we think that we've destigmatized so much. We popularized so much. But one of my theories that I put forward in the book is like, well, maybe we think we've destigmatized it because we're talking about everyday sadness, like it's depression. And people feel like they can talk about their sadness, which they should. People should be able to feel supported by their loved ones talking about their emotions and stuff. But Feeling a little quirky or having some eccentricities is very different from having autism or dealing with ADHD.

4:43It's like, and these differences I think really matter. And I think people have become rapid to self-diagnose. Yeah. I have a lot of sympathy for people that gravitate towards self-diagnosis because, listen, it's just a supply and demand issue. There aren't enough therapists. And if you need to get diagnosed with something complex, like you need a testing psychologist, like someone that's going to bring you through like a testing battery and like interview your loved ones and really figure out the precise label of what's going on with you. That's super expensive. It's super time consuming. And so I totally get the impulse of wanting to use TikTok or in a lot of ways, this isn't new to right.

5:23Like how many of us have gone on Dr. Google? You know what I mean? And it's like, what's this little bump for? I totally get it. But I think the danger with mental health, unlike kind of trying to diagnose that mole by yourself, is that a lot of these things, they can become self-fulfilling prophecies. They can become performative. If you start telling yourself that you have some sort of disorder, you may start not just training yourself to believe that, but training others to treat you like that. And the thing about diagnosis, I write about this in the book, is that diagnosis is not But diagnosis is not the destination.

5:56It's the start of the journey. It informs a treatment plan. So you then do not meet the criteria anymore. Like that's the point of the diagnosis. A lot of people are kind of treating diagnosis like it's an identity or it's like a personality trait or something. And I think that there's some risk in that. That was actually something I wanted to ask you about because I do have people in my life that have built their identity around a diagnosis. and in a recent discussion talking with someone and she was talking about like her ADHD and all these other things. I'm like, when did that diagnosis come about?

6:29And it's like, well, she had basically found it online and now she was kind of recalibrating her life to accommodate this new identity of ADHD. And I'm not a therapist. I don't play one on TV. I can't, I cannot help her with that, but it really struck me that she was altering her life for something that we don't even know is genuine. Right. So it's kind of funny, Paula, do you remember five or 10 years ago, there was all these documentaries and all these news stories being like, we're over diagnosing our children with ADHD. Like we're, we're putting them on medication. And now it's like this, this weird shift where now it's like everybody and their mother has ADHD and like everybody needs medication.

7:15I think I have a few things to say about it. I think the first thing is one of the dangers of self-diagnosing yourself with something like ADHD is that you may have the symptoms. You may be able to correctly identify the symptoms, but knowing what the criteria is because you looked it up online or maybe you bought a copy of the DSM, the Diagnostic and Statistical Manual of Mental Disorders, does not make you a diagnostician. Two-thirds of Americans have disordered sleep, right? I don't know about you, but as someone with ADHD, when I don't get my sleep, when I'm not like taking care of my body, like my vessel, my symptoms are way, way worse.

7:51And then I like require my medication, like just to be functional. I try to stay on top of that lifestyle stuff because I think it decreases my need for medication. But for the everyday person without ADHD, if you're getting poor sleep on a continuous basis, you're going to be more distractible. You're going to be more impulsive. You know, you're going to be more scattered and disorganized. And so the danger is people are diagnosing themselves. Maybe they're even improperly diagnosed and maybe they get a hold of like an Adderall prescription, like let's just say, for the sake of argument. But what's really happening is disordered sleep.

8:20You haven't fixed the underlying cause and now you're covering the symptoms with what is essentially time-released cocaine. Like that is what Adderall is. And it's not exactly like it. It's like it's in a much lower dose and it's extended release and it can be hugely beneficial for people with ADHD. And it'll certainly mask your symptoms, right? But it's like, that's not helpful in the long run. Other health problems are going to come up if your sleep is disordered. And you probably want to know that. And a good therapist, a good diagnostician will be able to rule that out when they're trying to figure out what's wrong with you.

8:50So with so many people leaning into social media, how is that creating and spreading misinformation that is harming our well-being? Well, one of the things, if you work in social media or you come to study it and learn it, one of the things you'll learn about social media is there are certain types of things that go viral, right? There's certain things catch on. And so one of the things, of course, is like outrage. And there's plenty of that in today's society. But there's also something that we would call things that are like surprises, things that are kind of like new. It's like, oh, I haven't heard this before.

9:26And so I think one of the dangers is that the things that will get a lot of people talking in the comments and will get a lot of shares, it's not because it's right or wrong or even good or bad. It's mostly just, oh, you haven't heard that take before. And so because of that, I think social media is slanted towards misinformation or towards things that are maybe worded in a way that you haven't quite heard before, but it has this implication that might not totally be true. And this is true of any subject. I also think it's, you know, therapy is a bespoke service. It's super individualized. Like I said, you come in because you're feeling distractible and you have ADHD-like symptoms.

10:04I'm sitting here and I'm like, is it ADHD? Is it distorted sleep? Is it dietary? Is it lifestyle? Is it bipolar? Is it borderline? Like there's so many other diagnoses that share those symptoms that are important to rule out. You just can't do that on a video or a meme. And so part of it, it isn't even anyone's fault. It's just kind of like what the system is. Now, having said that, we all need to remember that when I say it's become popularized, people are kind of doing it as a personal brand. There was a phenomenon over COVID. Did you catch this? Where I believe it was mostly adolescents, but people were pretending to have mental health diagnoses like Tourette's or ADHD, getting huge followings and then being like, just kidding, I made it up.

10:47How did I miss that? I mean, we all had extra time during COVID. I can't believe it. It's true. There was a lot going on. I was tracking it, you know, because I'm in this space, but I just, I share that to remind people that like, you know, this is like stuff like that is happening and it's not, and I'm not saying it's like, oh, they get like a few thousand followers. Like I'm saying they get like hundreds of thousands of followers and reach like millions of people. And so I'm not blaming kids. Kids are experimenting and kids are just kind of trying to figure themselves out. And so it makes sense to me why someone would do that, but there are still consequences to that culturally.

11:18What kind of harm is being caused to someone who is taking their advice through social media and then probably digging a little deeper, going to chat GPT or something like that and saying like, okay, I have this. Now, what do I do? Well, something I write about in the book is sometimes people believe this myth that getting a diagnosis is the worst thing that can happen to you. And I say, that's not actually true. a worse thing that can happen to you is that there's not a label like we can't actually name what's going on with you because like no psychologist or no therapist has ever seen it before so you need to get like referred to specialists and stuff like that i would say that that is worse than having something like depression or something very standard that people can treat but the other thing this brings it back to your point is that getting the wrong diagnosis means you're getting the wrong treatment plan, which means you're actually staying in your suffering or staying in the disorder behavior for longer.

12:17I'm a big fan of this guy. His name is Dr. Alan Francis. He has actually written and edited large chunks of the DSM. He came out with this book in 2013. It's called Saving Normal. And his message is not dissimilar to mine. He was saying, stop pathologizing in everyday life. This is a bad idea. It's going to lead to social contagion. It's going to overwhelm mental health resources. This was in 2013. So all these years later, I'm looking at what's happening and his words feel pretty prophetic. One of the things he says is a mental illness is not something that just gets better with time. It requires professional support.

12:55And the longer you go without professional support, the worse it's going to be. Regular problems of living that we all go through, right? Things that aren't mental illness are going to get better with time. They're going to get better with time and just support and patience from your loved ones while you figure life out because I'm still figuring a life out. I'm sure you're still figuring life out. Like it's just part of. Yeah, exactly. It's part of the journey. The issue with the turning to TikTok or something like ChachiVT and then attempting to do all of this yourself is that if it's the incorrect diagnosis and you are right that you do have something diagnosable, it's going to get worse with time without that support.

13:35We'll be right back with more of Live Happy Now.

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14:36And now let's hear more from Joe Nucci. Now, personally, I think that we all need to remember there just simply aren't enough therapists. This is like a supply and demand issue. And so one of the things we're also seeing, and for me, it's an issue of social justice, is if everyone needs to go to therapy because everybody has something wrong with them and everyone has ADHD and there's only a few hundred thousand therapists in the United States, what's going to happen? Well, therapists are going to stop accepting insurance and we're going to treat the people that want to pay us the most. We're scarce in terms of supply compared to the demand.

15:09And so that is what's happening. And I mean, don't you hear it from everyone? I can't find anyone good. Everyone has a waiting list. Everyone is so expensive. And listen, for those listening, it's like, I am part of this problem, but look, I live in Manhattan. It's expensive. I got to make a living too. And so I'm not faulting any therapist. I'm not saying that it's bad to get paid what you feel like you're worth. I'm not faulting anybody else. I'm just saying we've branded it so aggressively, and we didn't have the supply to meet the demand. So I think that there is a role for coaching for AI.

15:41It needs to get better, obviously. It's a hot mess right now. But I'm hoping that we catch up because people need treatment, even if it's only one in four. And that is what the statistics say. One in four have a diagnosable mental illness. That's still tens of millions of people going without treatment every week. Right. Right. And I do like the idea of coaching. I know there are so many great experts out there who will deal with specific things that are going on in your life. And like you say in the book, which I found so interesting, I don't normally hear someone within the industry saying, not everyone needs therapy.

16:15That's like a pharmacist saying, not everyone needs drugs. But I love that. And you present it beautifully. So tell us why not everyone needs therapy and then also how you know if you do need therapy versus a coach or you just need some time. Yeah. Well, I would say I'll answer it in reverse order. The first thing is if you're curious about therapy, if you think it might help, go talk to your therapist or talk to your doctor. Medical doctors are trained in kind of the basics of understanding, like, is this a mental health concern or is it not? The consult can't hurt and better safe than sorry.

16:52Like, of course. I think that where the problems can start to come up is people think that they're benefiting from something is the same thing as needing it. I have treated patients in my practice who came in, we did excellent work. They worked really hard on themselves. They're better people for it, but they were relatively fine when they came in. They weren't experiencing overt dysfunction. They were meeting all of their goals. They had good relationships. They had a good job. They were checking a lot of boxes. I've also had patients who came in and it's kind of like, you know what? If you didn't come to see me or another qualified professional, you would not be okay.

17:30Like I said, this would not have gotten better with time. This would have gotten much worse. And so we have to think about what it is that we're working on. If you want to go to therapy and you want to like self-actualize and just become more self-aware, I think that's great. I have patients like that. I think that's fine. But I think as a culture, as a mental health community, we all have to consider what that means if so many people are doing that. Because think about it from my perspective as a therapist. Do I want a bunch of patients that are going through a lot and require a lot of attention and energy and the stakes are really high?

18:02Or is it easier to collect the same paycheck, right? And everyone is fine. And again, I'm not faulting any therapist out there who wants to treat one group or the other. I'm just saying societally, this is a dynamic that we have to talk about. And I'm so glad you are bringing these things up and you do it in a delightful way. The book is truly, truly enjoyable to read. Thank you. And in the book, you break down, like, it's more than three dozen mental health myths that you - There's about 40, I think. Yeah. So first, how did you come up with that list of all these mental health myths that needed to be deconstructed?

18:38Yeah. Well, I think for me, it was, you know, I do practice as a psychotherapist. And so it was like people are calling me up for consoles or coming in like using these terms incorrectly. So I just kind of had that anecdotal experience to draw on. But also, I think the cool thing about writing the book as a social media influencer is that I kind of had this awesome hive mind sounding board that I could talk to at any given time. So if I was interested in writing a chapter about narcissism, just as an example, I could make some videos about narcissism and I could see it's like, do people care about this?

19:10And like newsflash on social media, they do. That is like the word of the year or something. Exactly. That content performed very well versus other times I would put out a video, but I don't even remember because it obviously didn't perform that well. It didn't make it into the book. And it was like, oh, this is really interesting to me, but this isn't interesting to like the public. And I think that in terms of writing nonfiction, I sort of think that this is certainly a way of writing that I'm going to repeat as long as I keep my platform active. Because I think so many people out there, they have interesting ideas, and I'm sure that their ideas are interesting.

19:43But does that mean that this is the right time for you to go publish this book or on this topic, etc.? And so I think that a lot of the myths were kind of like that. just like being in conversation with my community, talking to them in the comments, seeing what performed really well. But then also deeper than that, it's kind of interesting to share. Let's say I post a video about a topic and I noticed that people are very like sensitive about the subject. That meant that when I went to go writing, I was like, I'm going to be like very careful with my words. I'm going to contextualize a lot. Maybe this chapter is a little bit longer versus other people were just kind of stoked about it.

20:19And it was just kind of everyone was in general agreement. I could kind of like be bolder and like let it rip. You know what I mean? And so that's how I wrote the book. It was kind of, it is both with my audience, but also for them. Like these are the topics they wanted to read more about. I love that. I love that. And that probably accounts for the tone where it is so accessible, which you don't normally expect a book about therapy to be that accessible, but it really is. of all those myths, is there one that you think is doing the most harm as a society? I think the one doing the most harm, because it touches so many of the other myths just by the nature of what it is, is myth number 40, which I think the title is something like, Using Therapy Speak Makes You Emotionally Intelligent.

21:06Take it from me, everyone. I mean, here's the thing that I haven't said yet, Paula, and that I need to. You think I wasn't the number one offender of using psychobabble my first year of grad school? Of course I was. Every therapist was. And if they say they're not, they're lying to themselves. I feel very, very strongly about that. The differences though is us therapists, we kept on training. We kept on learning. And at the beginning of our careers, it's very common where it's like, you know, we're bringing up psychology a little bit too often. We're maybe, you know, accidentally analyzing someone who didn't ask for it.

21:35But the truth is like, we're excited and it's what we do. And it's what we think about all the time. And anyone who has been to therapy and has benefited from therapy knows, God bless all those therapists doing the Lord's work, helping people work through whatever it is. And it's easy to, at the beginning, just be so excited and to misapply or not yet fully understand a term. It seems to me that culture, it's like we've all taken Psych 101. So now we're using these terms like gaslighting, narcissist, people-pleasing, neurodivergency, whatever it is. my content, what I'm up to with this book, it's like, okay, here's psych 102.

22:08Here is the skinny on the stuff you need to know. So you don't embarrass yourself inadvertently. And so you also don't actually make decisions that are based on half truths and falsehoods. And so in this chapter, I talk about how people will use therapeutic jargon, but they'll often use it in a way that's not emotionally intelligent. So here's some things that people do. Ready? Number one, people will often use it as an appeal to authority. So if you're talking about your ex and how much you don't like him, being like, oh, well, my ex was self-centered. It's like, okay, some people are self-centered.

22:40Some people are not as much like whatever. But be like, my ex was a narcissist. It's like, oh my God, I am so sorry that you went through that. It adds this punch and you're using the field of psychology to elevate the gravity of the situation. My take is that if someone had a really selfish ex, they deserve your support anyways, even though lots of people are selfish. I don't think that's asking a lot. I think that all this jargon and learning this jargon, it's a little bit like learning to play an instrument. When you first start learning, you want to stay really loyal to the terms, operational definitions, like the rigid kind of proper definitions that you see in the dictionary.