Toward an Ethics of Therapeutic Speech in Public

Monday, August 31, 2026. This is for “Concerned and Curious”

TLDR: Therapists should take greater responsibility for how professional authority is used online.

But ethical evolution itself cannot be outsourced to regulators, critics, or licensing boards.

It must also arise from within the profession—and within the therapist. That includes AI.

A reader who signed their letter “Concerned & Curious” recently wrote to me about the ethics of therapists using social media.

Their letter was complimentary, serious, and sufficiently uncomfortable to be useful.

They had read my essay, “When the Therapist Has Already Decided Who the Villain Is,”

in which I examined what happens when a therapist enters the clinical space with a prefabricated moral story.

One partner becomes the wounded truth-teller.

The other becomes the narcissist, gaslighter, avoidant, abuser, or designated explanation for everything that has gone wrong.

My correspondent suggested that an even larger problem sits upstream.

Before bias enters the therapy room, they argued, it is often rehearsed in public.

Licensed therapists now appear online as educators, influencers, political commentators, memoirists, entertainers, authors, podcasters, relationship experts, and promoters of their own services.

These roles can become thorny to separate.

A personal conviction may be delivered with the authority of a clinical judgment.

Unresolved personal material may be presented as universal psychological truth.

A simplified villain-and-victim story may attract an audience, sell a book, and quietly teach thousands of people how to interpret their families.

Therapists are not ordinary content creators.

A professional credential changes the weight of the speech.

“Concerned & Curious” asked whether clearer standards—and stronger enforcement—might be needed.

They’ve identified a real problem.

However, I am less certain that its deepest remedy will come from outside the profession.

A License Changes the Meaning of Speech

A therapist does not stop being a citizen after receiving a license.

We retain political convictions, moral commitments, religious beliefs, personal histories, aesthetic preferences, and the occasional opinion that may not survive cross-examination.

A license is not a muzzle.

It is also not a halo.

It confers perceived authority.

Readers do not always distinguish between a therapist speaking from clinical evidence, professional experience, political conviction, personal injury, or ordinary human irritation.

The credential travels with the speaker even when the therapist insists, usually in small print, that the post is merely personal.

This does not mean therapists may never speak about politics, culture, family life, injustice, sexuality, religion, or public figures.

It means we should know which kind of claim we are making.

“This policy is morally wrong” is a political or ethical judgment.

“People who support this policy are narcissists” is a clinical-sounding claim used to settle a political argument.

“I found this relationship harmful” is a personal account.

“Anyone who behaves this way is an abuser” converts an experience into a universal diagnosis.

The therapist’s responsibility is not to become opinionless.

But it is to consciously restrain their professional authority from doing work the evidence cannot support.

The Regulatory Gap Is Real

Most professional codes were designed for recognizable clinical relationships.

A client enters treatment. Confidentiality, informed consent, boundaries, competence, documentation, exploitation, and conflicts of interest become reasonably visible.

Social media is decidedly more slippery.

A therapist may address an audience containing current clients, former clients, prospective clients, colleagues, distressed strangers, aggrieved relatives, and someone searching “signs my wife is a narcissist” at two in the morning.

No informed consent has occurred.

The context is obviously unstable.

A nuanced distinction can be detached from the paragraph that made it nuanced.

A tentative interpretation can become a screenshot. A useful concept can leave the therapist’s hands and return as a verdict delivered across a kitchen table.

Licensing frameworks have not fully caught up with this reality.

But regulation faces an obvious difficulty.

The state may punish false advertising, confidentiality violations, exploitation, or conduct that clearly breaches professional standards.

It cannot—and should not—attempt to police every careless opinion, clumsy metaphor, political statement, or oversimplified video made by a license holder.

Free expression matters.

So does professional responsibility.

The space between them cannot be governed entirely by law. The community of mental health practitioners must engage with reasoned critiques. We have a tradition of reliably doing more than the bare minimum.

Ethics Begins Where Regulation Ends

Professional codes establish a dirt floor.

They tell therapists what conduct is sufficiently harmful, deceptive, exploitative, or incompetent to justify formal discipline.

Necessary rules.

But a person can remain technically compliant while behaving badly.

A therapist can add a disclaimer and still encourage an audience to diagnose strangers.

A therapist can say “this is not therapy” while cultivating followers who experience every pronouncement as personalized clinical guidance.

I once heard a major thought leader describe doing couples therapy with a 6 foot red headed woman who worked on Wall Street. I cringed at the needless specificity.

A therapist must be sufficiently nimble to protect a client from public identification, while telling a story so distinctive that the client can safely recognizes themself.

This is not necessarily about our professional culture. Nothing in the rule book needs to be violated for something ethically shabby to occur.

What the general public appreciates is that ethics begins where regulation ends.

It asks what we should decline, to do even when no authority can forbid it.

What kind of attention am I inviting?

Whose vulnerability is carrying this story?

Am I helping readers think—or helping them feel certain?

Am I teaching from clinical experience, or converting clinical intimacy into professional visibility?

What happens to this claim when the context disappears?

These questions cannot be answered by a legislature.

They require judgment. And often a novelistic flair for safe and confidential psycho-educational storytelling.

Ethical Evolution Is Not Outer-Directed

This is where I respectfully differ from the regulatory emphasis in my correspondent’s letter.

Clearer standards may help. Licensing boards and professional associations should examine public-facing conduct, update guidance, and respond when therapists use their credentials deceptively or exploitatively.

But ethical evolution is not fundamentally outer-directed.

It does not begin when legislators draft a restriction or licensing boards identify a punishable offense.

It begins when practitioners recognize that their authority creates responsibilities no regulation can fully describe.

Law can restrain misconduct.

It cannot manufacture humility.

A board can discipline a confidentiality violation.

It cannot create reverence for another person’s privacy.

A code can prohibit exploitation.

It cannot make a therapist notice when professional ambition has begun feeding on a client’s pain.

Regulation can establish compliance.

It cannot produce or restore conscience.

We should listen carefully to our critics.

But we should not outsource our consciences to them.

A therapist who speaks publicly should be careful because people matter—not merely because someone may be watching.

The goal is not compliant speech.

It is responsible freedom.

Fear Is Not an Ethical Framework

There is another danger here.

When the standards are unclear and the possibility of complaint is ever-present, therapists may conclude that the safest public position is silence.

That would also be a loss. Therapists can often be timid. I saw that during COVID.

Many therapists possess knowledge the public needs. And some are fools. Such is the price of freedom.

We know something about betrayal, attachment, grief, shame, sexual desire, neurodivergence, resentment, repair, and the ways two decent people can repeatedly injure each other before lunch.

Keeping that knowledge entirely inside the consulting room is not ethically neutral.

Silence also has consequences.

If responsible therapists withdraw from public life, psychological language will not stop circulating.

It will be explained by influencers, provocateurs, marketers, wounded partisans, and people whose principal qualification is that they have become very comfortable speaking into a ring light.

Therapists should not claim exclusive authority over public psychological speech.

But neither should we surrender our place in the conversation.

We should participate carefully and fearlessly.

Care without courage becomes professional timidity.

Courage without care becomes content.

Public Psycho-education Is Not Public Psychotherapy

I write directly to clients and readers about psychoeducational subjects that all of us need to understand better.

That is not the same as practicing psychotherapy wholesale in public.

Public psychotherapy would presume knowledge of a particular person’s history, symptoms, motives, relationships, and psychological organization. It would imply an assessment that has not occurred and a clinical relationship that does not exist.

Psychoeducation does something more limited.

It describes patterns.

It presents research.

It makes distinctions.

It helps our gentle and patient readers develop better questions.

A responsible public essay should not tell readers what diagnosis belongs to a person the therapist has never met. It should explain what evidence would matter, what alternative explanations might exist, and what cannot be determined from a spouse’s account or a collection of clips.

The difference is between certainty and orientation.

Certainty is more marketable.

Orientation is more ethical.

Therapeutic Language Requires Stewardship

As I have frequently pointed out, ad nauseam, psychological language has escaped the consulting room.

That is partly a triumph.

We can now recognize coercive control, emotional abuse, trauma responses, attachment patterns, postpartum depression, neurodivergence, and family dynamics that previous generations endured without language.

Names can reveal patterns and reduce shame.

But once therapeutic language enters public life, it changes.

A boundary can become punishment.

Gaslighting can mean disagreement.

Unsafe can mean uncomfortable.

A trauma bond can mean a difficult attachment.

Narcissist can mean a selfish person who failed to apologize correctly and continued possessing needs while someone else was upset.

The problem is not that these concepts are empty.

The problem is that they are powerful.

Powerful language requires stewardship.

Therapists understand distinctions that public discourse routinely collapses:

Discomfort is not always danger.

Selfishness is not always narcissism.

A disputed memory is not necessarily gaslighting.

Validation does not establish every interpretation as fact.

A boundary can protect a relationship—or terminate one without acknowledging that termination is the goal.

Estrangement can be necessary self-preservation. It can also be an attempt to escape a painful relationship before learning whether repair remains possible.

These are difficult distinctions.

That is precisely why therapists must remain involved in a wider conversation about values.

Observation Is Not Diagnosis

Therapists are trained to notice patterns.

That does not give us supernatural access to strangers.

A public figure may behave grandiosely, cruelly, deceptively, or impulsively. We can discuss the behavior. We can examine its effects. We can ask what a marriage or family organized around such behavior might feel like.

But diagnosis requires more.

It requires history, context, direct assessment, functional impairment, and consideration of alternative explanations. Even then, competent clinicians sometimes disagree.

The distinction matters because diagnosis carries a moral weight in public life that it was not designed to bear.

A diagnosis is supposed to organize treatment.

Online, it often organizes blame.

Public therapeutic speech must therefore separate observation from diagnosis, interpretation from fact, and moral judgment from clinical assessment.

A person may behave badly without requiring a psychiatric explanation.

Sometimes the clinical vocabulary may have the evening off.

Clients Must Never Become Raw Material

Therapists learn from clients.

Decades of clinical work deepen our understanding of how people love, betray, protect, withdraw, pursue, forgive, and occasionally make elaborate disasters out of relatively ordinary misunderstandings.

That accumulated knowledge should be shared.

The client’s recognizable life should not be.

Changing a name is not always enough. Changing a profession, city, or family detail may not be enough. Combining cases can still preserve an emotional architecture recognizable to the people who inhabited it.

The ethical question is not merely whether strangers can identify the client.

It is whether the client can identify herself.

There is a difference between teaching from what clinical work has taught us, and using a client’s private life to make the therapist sound more interesting.

Clinical intimacy is not a content mine. However, psycho-education requires a premise of emotional toughness.

Therapy is the thickening of a narrative. It is the closing of a new story over an old. Clinical intimacy is the impulse to keep turning the pages.

Why I Choose Writing

I have made a deliberate decision about how I participate in public life.

I prefer long-form blog writing, and the occasional interview-based video.

I do not want to build my work around reels, rapid reactions, decontextualized clips, or platforms where confidence is easily mistaken for truth and complexity is treated as poor audience retention.

This is partly about my temperament.

But it’s also about my ethics.

Writing permits qualification, revision, context, uncertainty, and competing truths. A reader can stop, reconsider a sentence, follow a source, disagree privately, and return later.

The written form does not guarantee wisdom. Libraries contain sufficient evidence to the contrary.

But good science writing creates a healthy, ethical friction.

A sentence can be reconsidered before publication. An interpretation can be softened when the evidence does not justify certainty. A distinction can remain attached to the claim it qualifies.

The reader also controls the pace.

I am not appearing in someone’s feed with manufactured urgency, staring through a camera as though I have personally discovered why their marriage is failing.

I am offering an argument. Perhaps with a side of applied research.

The reader may enter it, examine it, challenge it, or leave.

That is the public relationship I prefer.

I proffer my blog as a therapeutic handshake.

I write to dialogue with my clients and prospective clients.

I do not write to reveal them.

Toward an Inner-Directed Professional Ethic

A mature ethic of public therapeutic speech would begin with self-governance.

Teach patterns without necessarily diagnosing strangers.

Protect clients not only from identification but from recognition.

Distinguish clinical evidence from political conviction and personal experience.

Say what the evidence supports—and stop there.

Remember that the absent spouse, parent, or child has not been assessed.

Do not use a license to convert one-sided information into professional certainty.

Choose forms capable of carrying the complexity of the subject.

And notice when the desire to help has become difficult to separate from the desire to be watched helping.

These principles will not answer every question.

Ethical maturity is not a system in which every decision has been made in advance.

It is the capacity to remain responsible when no rule provides an easy answer.

A Reply to “Concerned & Curious”

My correspondent “Concerned and Curious” has identified a genuine problem.

Therapists are not ordinary content creators.

Our credentials give public speech weight.

Personal branding, political certainty, unresolved injuries, clinical authority, and commercial ambition can combine in ways that damage public understanding of mental health and family life.

Professional organizations should take this seriously.

But the deepest remedy cannot be imposed entirely from the outside.

The profession must become more willing to examine itself—not because critics might report us, but because authority should make us more reflective rather than less.

Therapists should help shape the ethical evolution of public psychological speech.

We know how language can clarify suffering. We also know how quickly it can become a weapon.

Our codes establish the floor.

They do not relieve us of the responsibility to construct the ceiling.

The answer is neither unrestricted performance nor frightened silence.

It is disciplined participation.

Understand the power of storytelling and narrative truths.

Speak publicly.

Teach what matters.

Defend complexity.

Accept scrutiny.

Impose limits on yourself before someone else has to impose them for you.

And remain willing to revise those limits as the culture, the technology, and our understanding of harm continue to change.

Ethics does not require therapists to disappear from public life.

It requires us to appear there responsibly—not governed by fear, not intoxicated by authority, and not waiting for an external power to tell us what conscience should already have begun to ask.

Be Well, Stay Kind, and Godspeed.