Dr Julie Smith, 37, is a clinical psychologist in private practice in Hampshire who has spent 10 years working for the NHS. In November 2019, she started doing tik tok contains clear and engaging advice on various mental health issues. He has more than 3 million followers and in January he published his first book, Why hasn’t anyone told me this before?which has been at the top of the best-seller lists for four weeks.
There are many self-help books published; Why do you think yours has struck a chord??
I think people like the fact that it’s evidence based. I’m a clinical psychologist, so the things I put in there were tested with the latest research and are things that are taught to people in therapy, depending on what they’re going to therapy for. They are also life skills that we can all use.
Everyone has had days when their mood is lower than they’d like it to be or days when they’re dealing with more stress, pain or anxiety – all those normal human feelings that can hold us back or be hard to deal with if no you don’t have the right skills. Also, we just went through a pandemic and I think a lot of people are thinking, “How can I get through this?”
How did you get on social media and TikTok?
When I was offering psychological therapies, I discovered that many people did not realize that a part of therapy is educational. He talks a lot and solves his problems, but he also learns a little about how his mind works, how it can influence his moods and emotions, and how it can affect his everyday mental health.
People found that educational aspect so empowering that there was a change in their ability to manage their mental health from day to day. So I’d come home and harangued my husband about how these things should be more available, that people shouldn’t have to come to me to find out the basics, and he’s like, “Well, go ahead and make them available.” . . Put it on YouTube or something.
Giving people tools: that’s cognitive behavioral therapy, isn’t it?
There is a mix there. I have tried to keep it in everyday tools. I’ve been very careful with that distinction: “This is the educational element of therapy, it’s not therapy.” These are tools that you can put to use today and tomorrow, but the book is not a therapist.
Social media is often blamed for the mental health problems of young people, especially self-esteem and anxiety…
Some of my videos try to remind people that what they see on social media isn’t always real. Be aware when they spend time with certain content of how it makes them feel and use social media to enhance their life rather than take away from it.
Behavior on social networks such as ghosting, trolling or the blockage can be distressing. What advice do you give to people who find being online pretty brutal?
It’s about recognizing that you have the power to choose. You have a choice of how much time you spend online, you have a choice of who you follow and who you don’t and what content you engage in. When you’re aimlessly scrolling, it can feel like you have no choice.
So my videos have really been about reminding people and helping them create that awareness: if this is affecting you in a negative way, you’re one decision away to do something different.
There is a line that runs often generation Z and millennials are more prone to mental health issues, which are basically snowflakes. What would you say about that?
It’s not something I would get involved with at all. For me, mental health is no different than physical health. Nobody is immune. If you take someone and start messing with their basic defenses like sleep, routine, social connection, nutrition, and exercise, then that person becomes vulnerable to physical and mental health issues.
I think more people are starting to realize that now and that’s helping to address the stigma around mental health. It’s a much healthier way of looking at things.
So are people better at naming things nowadays, instead of being more brittle?
You are not more physically fragile by talking about your physical injuries. No more broken legs just because we bandage them now. You’re moving in the right direction, but you’re always going to get some backlash, that’s how change happens.
“Metacognition” is a key concept in his book; Because it is important?
It is a kind of thoughts about your thoughts. It is one of the main tools we use in therapy: to be able to step away from thought processes and observe them. By doing that, you can see them for what they are.
People often think that therapy is about changing their thoughts. You can’t really decide what thoughts are going to pop into your head, they just happen. What you can choose is how much air time you give each thought.
You seem to be quite depressed by positive thinking. Is positive thinking bad?
Positive thoughts are great, they are not bad. But there is this kind of movement online around just positive vibes; don’t let negative thoughts be there. If you have that standard for yourself, as soon as negative thoughts start popping up that you can’t control, you start to feel like you’re failing or not positive enough. That you are not enough in general. It sets you up to feel worse.
Therefore, therapy is often about accepting thoughts as they come and then making decisions about what to do with them. If I spend time with these thoughts, will that help me move where I want to go? Or if I spend time with these, what impact does that have that is different? It’s allowing your brain to think of whatever comes to mind and then choose what to do next.
There’s a chapter in your book called “How do you force yourself to do something when you don’t feel like it?” We have all been there. Which is the answer?
There are always things we don’t feel like doing. There is something that is taught in a therapy called dialectical behavior therapy, DBT for short, which is opposite action. Mindfulness is a really helpful element of this, where you become aware of impulses to act. So each feeling will give you the urge to do or not do something. And often you’ll feel the sensation and you’ll go and do the thing and you haven’t really separated the impulse and the action, you just do it all at once.
But what you can do is begin to become aware of an impulse and begin to recognize that you don’t have to act on it: you can act against it. This becomes a tool that you can use in those little moments that seem insignificant, but actually add up.
How do you think your content might change as we (hopefully) put the pandemic behind us?
I don’t imagine for a minute that because the lockdowns are over, the psychological fallout will. People are dealing with huge amounts of losses. Not just where people have lost family and friends, but also where they’ve lost livelihoods, jobs, financial security, homes, a sense of security coming out. There are tremendous amounts of change that will continue for people.
The cost of the therapy puts it out of reach for most people and there is limited availability on the NHS. How do you square this? with the increase in the number of people who show up?
That’s partly why the book felt so timely. I can’t give everyone individual therapy, but I can do something. I can share some basic education as widely as I can.
I had no interest in being a public person or being on social media; it was actually about sharing that information. And it was hard to do. I have three kids and a job and what kept me going was the feedback. It has been overwhelming. Every day, people send messages saying, “Thank you very much. This is making a difference.” It’s not an ideal world and I don’t have all the answers, but I can do my bit.
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Why hasn’t anyone told me this before? by Dr Julie Smith is published by Michael Joseph (£14.99). to support the guardian Y Observer order your copy at guardianbookshop.com. Shipping charges may apply
