Article
Comment
Mental Health
Podcasts
4 min read

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 is Associate Minister at Holy Trinity Clapham, 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
Comment
Gaza
Middle East
5 min read

The human cost of the Israel-Gaza war

A veteran volunteer surgeon laments a well lived life.

Tim Goodacre is a reconstructive plastic surgeon, and volunteer at a hospital in Gaza.

A young doctor wearing scrubs smiles.
AbdulRahman at work.
Tim Goodacre.

The Israel-Gaza war rages on. Every few days a new tragedy hits our dulled senses. The West Bank and now Lebanon are getting dragged into the conflict. Palestinians and hostages continue to die, and hunger and disease threaten Gaza's displaced people as autumn and winter approach. 

Yet what is often lost is the human face of this conflict. This is the story of one such life. 

AbdulRahman was an intelligent, gentle and diligent young third year medical student in his early twenties, with judgement well beyond his peers. Towards the end of 2023, as the war spread more viciously towards southern Gaza, he was one a group of around 10 students who volunteered to join the team of health care workers at the European Gaza Hospital (EGH). I was volunteering there as a reconstructive plastic surgeon and and met him in the hospital.

Both medical schools in Gaza before the war began were in the north alongside their parent universities. They had been destroyed during the onslaught in the early months of fighting. In the southern town of Khan Younis, the EGH was the sole surviving operational facility to which the wounded could be transferred. It was overwhelmed by the vast numbers of families also taking refuge in what was deemed a safer space than most of the surrounding war zone.  

Many of the senior medical staff and surgeons had retreated to scattered parts of the strip, displaced frequently by the ever-moving conflict and driven by the need to support their families and stay together. ‘Live together-die together’ is an understandable feature in the horror show of war. Students, frequently left with no money or resources, started to volunteer to serve in hospitals in exchange for a little food and a sense of worth in the work they could offer. Any functioning hospital, if briefly ‘deconflicted’ so they could provide relatively safe care, found itself staffed by a disparate crew of local staff, displaced students, and an indeterminate number of more senior surgeons from both Gaza and humanitarian agencies. 

His desire to learn all that could be learnt, and to try to become the best surgeon possible, was palpable.

It was into this chaotic mix that young AbdulRahman walked having fled his family home in the east of Khan Younis in November 2023. A bright young man, with great aspirations to qualify as a surgeon and serve his community, he had spent the first six weeks of the war at home, unable to attend his medical school in Gaza City to the north, but working hard at his studies regardless, using every online and library resource available to him.  

At some point in late November, the battle zone moved south, and his family home was shelled along with many dwellings in the vicinity. Caught in crossfire, he sheltered in his neighbouring relative’s house after his parents and other close family had escaped to Rafah. 

Abdulrahman told me the dramatic story of his escape into the house in which he survived for a week alongside his relative’s family when I spoke to him in late January 2024. This young man not only survived an ordeal of indescribable fear and potential slaughter, but he was then arrested and interrogated in brutal fashion by IDF forces.  

On his release after a harrowing week, he made his way barefoot to the nearest hospital, which happened to be the EGH. In that place of safety, he was given food and water and after recuperation, volunteered to work alongside a reconstructive plastic and burns surgeon who had recently returned to Gaza after training in the UK. 

Although his family were still all alive in Rafah in displaced makeshift shelters, he opted to stay and throw his weight into whatever he could do to support the hospital whilst continuing to learn his profession as a doctor. Travelling occasionally at great personal risk to see and support his family, he devoted all his waking hours to surgical work in EGH operating theatres and wards. His excellent command of English made him immensely valuable to any visiting surgeons who managed to access Gaza during the war months. He was always cheerful, always willing to respond to requests for his time, however stressful the surrounding clamour from desperate patients and relatives might become.  

When his working day was done, in the middle of the night he would arrange for his fellow students to have informal teaching seminars from whoever he could cajole to deliver them, and would absorb knowledge and ideas about best practice like a sponge. His desire to learn all that could be learnt, and to try to become the best surgeon possible, was palpable.  

I had every intention of supporting this fine young man in achieving his professional aspirations by whatever means I could once a ceasefire arose and he could be brought safely to Europe to continue his training. 

In the last week of August, AbdulRahman was sheltering in a relative’s house in Khan Younis. In the small hours of the morning an Israeli attack was launched on the neighbourhood and the house took a direct hit. AbdulRahman was killed instantly. 

He knew, as does every Gazan in these troubled times, that nowhere was safe, and all lives in that tragic zone are at risk. His is a story of a life tragically cut short, of the randomness and destructiveness of war. His death strikes right at the heart of my hopes for the remnant of the fine young population of such a desperately sad nation state. He, and those like him, could have been at the heart of the re-building of Gaza, able to live in what now feels a far-off peace. I cannot translate this into anger, as AbdulRahman himself had a passionate concern for peace and reconciliation, and never once spoke to me in many conversations of support for Hamas, or of hatred for those who had destroyed his country.  

What can be done however, is to honour his life and commitment with similar tenacity in supporting the pursuit of peace, justice for his people, learning and education for the remnant of the nation, and reconstruction of a Palestine that can proudly and honourably reflect the finest values it possesses. AbdulRahman was a great Palestinian, and his all too short life was one which I want to celebrate as one of the finest I have seen in many students of the next generation of doctors. May he rest in peace, and may a lasting peace come quickly to Gaza, to all of Palestine and the whole of the Middle East.