When, more than a decade ago, I was diagnosed with post-traumatic stress disorder, I turned to the internet to learn more about my condition. Back then, the effects of trauma weren’t exactly unknown, but they weren’t making headlines, either. Most of the information I found was on psychology websites, but it wasn’t until I went to the doctor and received my diagnosis that I fully understood what was happening to me. Public awareness of the condition was low – or at least, it wasn’t something that people spoke openly about. I felt very alone. Fast forward to 2021 and the word “trauma” is everywhere. You’re as likely to find references to PTSD on Instagram as you are on a medical website, and mental health memes in particular have been on the increase; in fact, their preponderance has been unmistakable during the pandemic. The most obvious example is the use of the word “triggered”, which was originally used to describe the way the brains of people with PTSD react when re-exposed to something that recalls the original trauma and puts them in fight-or-flight mode. It has now become so ubiquitous that it’s been co-opted by the political right as an example of leftwing oversensitivity – see Donald Trump Jr’s book of the same name. Though I am mostly recovered, seeing words that once were used clinically to describe my illness splashed all over the internet is certainly an adjustment – especially when they are used thoughtlessly. And with this new enthusiasm for mental health memes come questions: Does their proliferation risk watering down the terminology? Should we worry about people self-diagnosing online? And do we risk opening up the mental health conversation to cynical commercial interests? Memes as exposure therapy “I feel so seen,” I think, when I log into Instagram and am confronted by a meme about self-sabotage. Many accounts tend to be knowingly subversive and ironic, such as this meme from mental health meme queen @binchcity: “Being mentally ill is a full-time job and I’m getting employee of the month.” Others are earnest and along the lines of inspirational quotes, for example: “This isn’t anxiety. This is complex trauma,” as posted on Instagram by a “certified trauma recovery coach”. (Some of the people posting advice or encouragement range from dubious “life coaches” with little certification to licensed professionals, and the use of memes in this context has even been called “dangerous” by some.) Some have a DIY collage aesthetic, while othersare more like cartoons. Some strike a more serious note. Erin Taylor, a 25-year-old writer and artist from New York, runs the meme account @atmfiend, which includes memes about narcissism, rape and child sexual abuse. “I used my meme page as an attempt to process what was going on with my life, from cutting out my father to processing childhood trauma,” she says. “The main motivation was healing myself, but I think [it] ultimately allowed others space to heal themselves, too.” “I think it’s beneficial for people to know they’re not alone … often people don’t have friends or family talking about abuse, neglect, domestic partner violence or feelings generally,” says Taylor. At their best, these memes help sufferers process the things that have happened to them in a safe way, helping them to confront difficult issues without being exposed or triggered – like a visual diary, or even a form of exposure therapy. ‘Trauma is about shame and secrecy’ Bessel van der Kolk is laughing. I’m reading memes to the psychiatrist and best-selling author over Zoom, including one that makes reference to his pioneering book The Body Keeps the Score, which explores how trauma reshapes both the body and the brain and has been back in the bestseller charts thanks to the pandemic. Twitter user @sydneyelainexo wrote in March: “Kindly asking my body to stop keeping the score” – a tweet which garnered 22.7k likes. “Very good,” says van der Kolk. He says that he is too embedded in the trauma world to ask about how perceptions have changed, but likes the memes I read to him. “Trauma is usually about shame and secrecy,” he says. “Somebody does something to you, and you blame yourself. The people who did these things to you say you’re making it up or you’re crazy, or you’re making a mountain out of a molehill. And so the way to actually deal with trauma is very much to find people who are there with you and who support you.” Those people may well be online, as Erin Taylor says she has found. “Obviously, I have a therapist but some aspects of healing trauma require moving past the shame you’re convinced of, so it was really liberating to tell a ton of strangers, to not give a fuck if my life felt shameful, sad, or made others feel bad. I was just like, this is my life and this is who I am, and here it is on a little image graphic that allows you to feel a little too seen.” “I think the only downside that can occur is when people reach out asking for help on how to change their situations, but I’m not a professional counselor,” she says. “Sometimes I’m able to offer some advice, but it’s ultimately hard not being able to do more.” Van der Kolk is believes that anything that can help people make sense out of what they are going thorough is helpful. “The state of trauma is one of utter confusion, of having a lot of sensations or feelings, but you can’t make sense out of it. Any sentence or image that helps you to visualise what’s going on would, in principle, give you a sense of perspective. That’s a good thing to do. You go on a journey of healing.” I ask him if he’s worried that some of the information might be inaccurate, or that reliance on internet communities might dissuade some from seeking professional help, and he is sanguine. “I wouldn’t overestimate the capacity of professionals to know what’s right. We’re all embedded in the culture we live in. The culture of psychiatry – that’s my official profession – is very much focused on giving people the right drug, which in terms of trauma is largely not a very useful thing to do,” he says. He’s open to the idea that youth culture might actually be ahead of the curve with this, just as it is, he says, with climate change. Humor can also be therapeutic, I say. He nods. “If people have a sense of irony, that’s very important,” he explains. “If there’s only one perspective – of ‘everything sucks and everything’s miserable’ – you cannot get out of it. So you really need to have these two perspectives living side by side.” The internet substitutes for therapy for those without access Lucia Osborne-Crowley, whose memoir I Choose Elena examines the legacy that a violent rape left on her physical and mental health, says she is happy the conversation is happening. “As someone who is very interested in the study of trauma and making people more aware of it, I think it’s really great,” she says. But she is concerned that the dialogue lacks critical thinking. “It’s very strange to see it come into the lexicon in such a swift particular way, without analysis behind it.” As with “triggered”, it’s often the case that as certain terms and ideas hit the mainstream, the original definitions are lost. Osborne-Crowley had to wait 12 years to get a PTSD diagnosis, and so she recognizes that the mental health meme landscape, where references to PTSD abound, could have helped her when she was younger. “Maybe if I’d seen [a meme] on Twitter when I was 15, I might have thought differently about myself and my experiences.” She might even have sought help sooner. On the other hand, she observes, there’s a reductive “flattening” effect that doesn’t acknowledge how trauma can manifest in myriad ways depending on the sufferer – such as a focus on nightmares and flashbacks when, in her case, the effects of trauma were physical. She notes that she was lucky to receive treatment, and says a lack of access to therapy may lead people to turn online for support and information from those who are in treatment. It isn’t fair, she argues, that you should be able to glean understanding of your condition only if you are able to pay. Jessi Gold, an assistant professor in the department of psychiatry at Washington University School of Medicine, loves mental health cartoons. She sends me some of her favourites, which include images about depressed dinosaurs. “People worry about using humor as being degrading or bad, but I think there’s a mature and OK way of using humor,” she says. “Humor can be bad – you can definitely make fun of mental health. I have seen that,” she says, adding: “There’s a reason humor is a mature defense mechanism.” She is pleased to see mental health as just another topic of discussion. “I think people are more comfortable with vocally expressing things that have happened to them,” she says. “With the use of a hashtag as a movement, people realise you get a sense of community and a sense of validation.” I ask Gold if she is worried about people self-diagnosing through memes. If someone comes to see her having self-diagnosed via the internet, she says, she’s not about to tell them that’s they’re wrong: “I’m going to say OK, let’s talk about it.” Gold still thinks there’s some way to go, however, in our embracing the language around mental health. It needs to go deeper. “In the US, we’ve had like 600,000 people die [from Covid] … that’s a lot of grief and pain and trauma that, if you look online, nobody’s really talking about,” she says. “We’re more open to the idea that this has been traumatic. But I don’t think that we’ve really talked about specifics.” In other words, we have named the thing, but we are not really going beyond that to ask, how is it manifesting? And how can we heal? Will corporations co-opt this free-form, ironic trend? I have certainly found humor to be helpful in my own recovery, though memes less so. Like Lucie Chateau, however, I have reservations. Chateau, a PhD researcher at Tilburg University, studies digital aesthetics and the political potential of memes and is the author of the journal article Irony, Memes and Risk in Internet Depression Culture. She has been monitoring mental health images and memes for years, and has noted a shift from the romanticising of mental illness to the kinds of memes we are now talking about. These memes often start ironically, but, Chateau says, they are given the illusion of authenticity due to their use on platforms such as Facebook. What you end up with, she says, is “people trying to promote a mental health discourse more based on resilience, and one that fits with a neoliberal idea of mental health, with recovery and accountability [framed] as the steps towards recovering from mental illness.” In other words, it’s all about individual improvement, with no idea of the collective or of structural problems such as, for example, access to therapy. “Ultimately, these public interactions are being held on private platforms,” says Chateau, and they are bound to be coopted. “These narratives are always going to be recuperated by the platforms where they occur, and by kind of larger discourses that are not really our own.” She highlights the use of mental health terminology by corporate brands, such as a tweet from McDonald’s suggesting that if you’re feeling “anxiety” you should order for delivery, or another from juice drink Sunny D, that adopts the tone and style of social media users tweeting about their anxiety and depression (“I can’t do this any more”). “When you get brands and private companies coopting the language that we use to diagnose ourselves and inform ourselves, that’s what’s the most dangerous. It’s depression as a marketing tool.” This is especially prevalent on woo-woo wellness Instagram accounts, some of which are monetised – all empty buzzwords for the purposes of commerce. You wonder how much “healing” is really being offered. Mental health is political – the conditions of capitalism shape our psychology, just as they shape who has access to therapeutic help. The so-called BuzzFeed-ification of mental health describes how online users are increasingly splitting into “micro-identities” – so you have people with ADHD, depression, OCD, etc defending their separate patches. It has potentially damaging implications, especially when you consider the role that peer support has played in the treatment of trauma, where working collectively is key. Van der Kolk’s work owed a lot to the feminist movement, he says – specifically women talking about their experiences. Some of that may have moved online, but can it really serve the same function when it comes to healing? “In some ways it can offer support, but it leaves out the body,” he says. “How do you comfort little babies? You rock them, you hold them. And even as adults, when something bad happens to us – that is our primary source of comfort. You don’t have to talk, you don’t have to explain. You can just feel ventral to ventral contact, body context, that is such a profound comforting for us as primates.” In other words, a meme may help, but it doesn’t come close to a hug.