After Being Sued by Talkspace, I Never Thought I’d be Agreeing With Them. Or am I?
The following first appeared on Medium. Reprinted by permission. — Ed.
We at PsiAN have long had concerns about Talkspace as a company, and the category of apps and asynchronous texting positioned as psychotherapy, so I was interested in Kara Swisher’s interview of Oren Frank, CEO of Talkspace, on the July 22, 2021, episode of her podcast Sway. As Kara stated in her opening remarks, there are “all kinds of questions about quality control, accountability, and of course, privacy.” We had made these and other concerns known in a letter we wrote to the American Psychological Association, and in return, Talkspace sued PsiAN and its three co-chairs for defamation, libel, and $40 million.
We were ably defended by the firm Arnold & Porter, and the case was quickly dismissed by the presiding judge. Our experience with Talkspace and others’ concerns are outlined in this expose by Kashmir Hill of the New York Times. It seems like Talkspace hardly needed our money; as many community mental health agencies are folding, and insurance companies ratchet down their reimbursements to therapists, Talkspace just went public with a valuation of $1.4 billion. With all of this in mind, I was curious to hear the latest from Oren.
In the category of stranger things, I found myself agreeing with Oren at several points in his interview. First, in trying to define Talkspace, Kara said, “you’ve described Talkspace in, like, six different ways. Do you think of it as a platform or a medical clinic? You described yourself as a health-care company, a software company. You’re obviously a little bit of a marketing company. What do you think it is?” Oren seemed to struggle to respond and clearly define Talkspace. And I couldn’t agree more. The marketing muscle — huge budgets and flashy celebrity spokespeople like Michael Phelps and Demi Lovato — pushes the Talkspace brand to billboards, subways, and screens across the country, with a polished and persuasive message of “therapy for all.” It’s now trying to reposition itself as a health-care company. Or is it a software company? Or, as Oren says, “I think it’s a technology health-care company…as opposed to…the older generation of health-care companies…So I don’t want to pick any specific description. But I think the platform notion is correct… and for that, you have to be a technology and data company with a platform.” Despite Kara’s pushing, it seems like there’s still a lot of confusion about what exactly Talkspace is, and I can appreciate why Oren seems flustered by her questions.
As far as the role of technology and artificial intelligence in the therapy space, I was surprised to find another area of agreement with Oren. He is referencing Woebot, an app which advertises itself as “your coach for life’s ups and downs.” He says, “it is not in my foreseeable future, the way I see technology in the future, that this will, in any way, shape or form, replace a human.” I couldn’t agree more.
Given all we know about implicit and embodied communication, the changes that occur and the losses incurred when communication and relationship are mediated by technology, the impossibility of true empathy and connection with a piece of software, we cannot expect such machines to come close to replacing human beings. We can expect only the illusion of a relationship. Machines might be able to provide information or make self-help advice readily accessible in the palm of one’s hand — but they cannot attune, empathize, or understand deeply another person, their culture and context, their unconscious desires and fears, their relational dynamics. Only another human being is capable of all of this, in the context of a caring and trusting relationship, and all of this is needed to help people uncover obstacles, make meaning, transcend suffering.
These are the tasks and goals of real therapy, and here again, Oren and I find alignment. He says that Talkspace “is not here to replace face-to-face therapy. I actually love this,” referring to face-to-face therapy. I’m thrilled that Oren professes his love for face-to-face therapy, and that he apparently has also engaged in it himself. In both of those things, we find common cause. And, clearly, we both also agree that Talkspace will not, cannot, replace real therapy. A Talkspace customer can send text messages to their assigned “therapist,” and then wait to receive responses — 5 responses/week — when the therapist checks their inbox. Talkspace pays its therapists by word count; I’m unaware of any research validating the importance or impact of word count as a source of therapeutic action. The impact and foundation of real therapy rest in other things: the therapeutic relationship and alliance; exquisite attention to the patient’s individual values, preferences, culture; the wisdom and experience of the therapist. It makes sense when Oren says that Talkspace cannot replace real therapy.
Finally, I resonate with Kara’s description of the reputation of Talkspace for being litigious with a tendency to send “threatening emails.” She also notes that Oren “got into a fight with a guy named Ross on Twitter,” (Oren had mocked him for paying for therapy, as described in the New York Times article), and asks how he feels about being “so pugnacious.” Oren acknowledges Kara’s observations, referring to “two things… my particular personality and my issues. And I can lose it from time to time. But that’s me. I’ve learned to accept myself after many years of therapy. And it’s not necessarily always the right thing to do.”
I do not know Oren, but his descriptions remind me of the interactions and communications that PsiAN had with Talkspace and its lawyers. It is PsiAN’s mission to advocate for therapies of depth, insight and relationship, and to stand up for the evidence base underlying these therapies and the legions of people who have benefitted from these treatments. We have no interest in fighting, only in speaking truth. Oren states that he accepts criticisms of his company “with love.” It sure didn’t feel like love to us, but maybe that’s his marketing flair coming through once again.
In all, stranger things have surely happened, but finding myself in any agreement with Oren Frank is certainly unexpected. Still, he is an expert marketer, Talkspace is a well-funded brand, and I question what lies beneath the polished veneer. I’m not so sure our agreement is anything more than skin deep.
Linda Michaels is a psychologist. She serves as co-chair of the Psychotherapy Action Network (PsiAN), is an Associate Editor of Psychoanalytic Inquiry, and is a fellow of the Lauder Institute Global MBA program. She lives in Chicago, Illinois.
Photo by Laura Vinck on Unsplash.