And How Does That Make You Feel?: Unpacking the Phenomenon of TikTok
Creators: name: Stein, Krysten Nicole
Publisher: name: University of Illinois at Chicago
Year: 2024

description: This dissertation examines TikTok Therapy (TherapyTok) through interviews with 42 licensed mental health practitioners who create content on TikTok and a textual analysis of 150 TherapyTok videos. It explores the practitioners' motivations for content creation, the impact of TikTok's political economy and platform politics on practitioners' experiences and content, and the strategies practitioners use to establish credibility and authenticity. Neoliberalism and Foucault's concepts of governmentality, biopower, regimes of truth, and madness are used to analyze the power dynamics at play.

Specifically, the findings reveal that practitioners turn to TikTok to escape the traditional constraints of the mental health field, yet they then experience dual exploitation regarding compensation and labor, both in their full-time jobs as therapists and online as creators. Moreover, mental health creators craft and balance their professional and personal personas through performance strategies like sharing their qualifications and disclosing their own mental health struggles. To elaborate, they do this to establish their credibility and authenticity. However, TikTok's platform politics, driven by an attention economy, often pressure creators to produce sensationalized or simplified content. Consequently, while TikTok increases the visibility of mental health information, this visibility often comes at the expense of depth, educational rigor, credibility, and ethical standards. This can be problematic because it undermines the quality and reliability of mental health information available to the public, potentially leading to misinformation and harmful practices.

Furthermore, the study traces the evolution of the representation of therapy from traditional media like talk shows and reality television to digital platforms, with a focus on TikTok's role in mental health entertainment. I place TikTok on this continuum to show how these forms of media build on one another and why this progression is significant in understanding the current landscape of mental health content. To explain this phenomenon, I coined the term "theratainment" to describe the blend of therapeutic information with commercial entertainment. Moreover, these forms of media reflect neoliberal logics of individual responsibility and market-driven solutions, which can obscure the need for systemic change and collective action.

In addition, Foucault's concepts provide a critical framework: Governmentality reveals how platform algorithms and audience expectations shape creators' content and behavior. Biopower highlights the regulation of bodies and minds, as creators can influence viewers' practices and perceptions of mental health. Regimes of truth show how legitimate knowledge is constructed, validating certain mental health narratives while marginalizing others. The concept of madness underscores the marginalization of non-normative mental health discourses and the “madness” or stress and burnout creators experience due to content creation pressures.

Ultimately, this research sheds light on digital therapeutic practices and the complexities of performing mental health expertise on TikTok. It calls for a reassessment of platform policies to prioritize the credibility and educational value of mental health content. The findings can guide mental health professionals, developers, and policymakers in creating a more informed and supportive digital environment for mental health discourse.