Dr. Suzanne Simpson:
Can you give me, like, in a sentence: what is that fine balance between us destigmatizing and not creating conditions for contagion?

Matt Hussey:
We must always come from a position of what is this person trying to communicate to me about what it feels like to be them. Perceive it as that, and be able to work with that.

Dr. Suzanne Simpson:
Good late afternoon to you, Matt Hussey.

Matt Hussey:
And to you. I am in London.

Dr. Suzanne Simpson:
What area of London are you in, by the way?

Matt Hussey:
I live in North London, just on the edge, in a place called Palmers Green.

Dr. Suzanne Simpson:
I was there a few years ago walking in really cold weather in January, and just loved it. Anyways, thank you for joining me. I want to talk to you today about this contagion that you and I connected about last month, I think it was, and I’m riveted. But before I ask you about contagion and mental health, I want to find out about you. I’ve read about you: you’re a journalist, you’re an editor, you’re a startup founder, photographer, content creator, and now a therapist. Tell me about yourself and how you got into therapy.

Matt Hussey:
Yeah, I’ve worn many hats in my career. I think the affectionate term for it now is a portfolio career, rather than someone who can’t sit still. So, started life out as a journalist, worked in the days when print journalism was alive and well, as opposed to now where it’s dead and buried. I spent years working for different magazines, travelling a lot, experiencing a lot. It was wonderful and amazing. And then the internet came along and laughed at my plans for stability and a career ladder. So I started this slow drift into other industries: technology writing, then financial reporting, crypto, all the terrible things that now afflict us. At the same time I was doing lots of personal things, trying to be a carpenter, a potter, a knife maker. I was looking for something.

Dr. Suzanne Simpson:
Sorry, how old were you then?

Matt Hussey:
Twenty-seven. And I reached this pinnacle of numbness where I could see there were situations I should feel something, but didn’t. So I Googled “therapy near me,” and turned up, met this lovely lady, saw her once, and thought, this is interesting. Then the second session she asked me why I chose her, because therapy is this weird thing where you get this big directory of faces and just have to go, how do I choose who’s right for me? And I said, because I thought you had a very nice, kind face. And she said, “we have to end there,” and ended the therapy.

Dr. Suzanne Simpson:
She ended it? You gave the completely wrong answer?

Matt Hussey:
Never really understood why until much, much later in my training. She said I should work with a man, that she had a colleague I could work with.

Dr. Suzanne Simpson:
Sorry, Matt, if you were a female saying that to her, it would have been fine. There’s something wrong with that. You didn’t say “you’re hot and sexy,” you said she has a kind face, which is what we want as humans.

Matt Hussey:
That’s it. She had an open face, she was smiling in her photo, it’s like, “you seem like a nice person, I think I need a nice person.” And she killed it. So I felt very rejected, passed on to a man, and I hated him. He was what I’d learn much later was purely psychodynamic, which meant he was this empty vessel for me to pour myself into, and he would just nod. Every week I’d come in, spill my guts about my family, be angry at my dad, and he’d just say “mm-hmm.” Then I’d have to gather up my guts again and go back into the world. I wasn’t telling anyone I was seeing a therapist, so it was all very secretive.

Dr. Suzanne Simpson:
Can I tell you my response to that story? I’ve been saying this more to the twenty, thirty-year-old former students I chat with: never underestimate the power of ruling out. Knowing that’s not the right way, I’m ruling that out. And for you in your practice, that’s been powerful, ruling out what you’re not going to do.

Matt Hussey:
Absolutely, and I think it’s a big lesson in lots of parts of my life: learning about what I want means doing an awful lot of what I don’t want, and embracing that.

Dr. Suzanne Simpson:
And then you went back to school?

Matt Hussey:
Yeah. I went back to school for three years, but the first year was really intense and I didn’t think I could handle it, so I took a break, came back and did the second year, took another break, kept working with clients, then finished. Graduated during the COVID era.

Dr. Suzanne Simpson:
So you were in your late thirties then?

Matt Hussey:
I was. I had a really great supervisor, and I was talking about how long it took me, ten years in total, and he said if he’d gone back and done it again he would have done it like I did it, taken his time, because there’s something about this work that requires time. Time for you, time for your clients.

Dr. Suzanne Simpson:
I wonder if enjoying that journey makes you better as a therapist, because there’s been so much depth and meaning in it.

Matt Hussey:
Yeah, and I think also the rare privilege of being able to work with one person for as long as I did with my wonderful therapist, Denise, who saw me through all kinds of stuff and was this unerring stability in my life. What that gave me is what I want to try to bring to my clients. There’s something about someone being very stable while you’re not, in a calm and caring way, that can help you do amazing things you didn’t think you could do.

Dr. Suzanne Simpson:
And you started “Together,” do I pronounce that right?

Matt Hussey:
Together, with no vowels.

Dr. Suzanne Simpson:
We were also talking about this earlier, before I clicked record: the importance of connection and building connections within therapy, which is a newer endeavour for you, right, to actually have this platform.

Matt Hussey:
It is, and it’s connection-based, born out of a real paradox that I see all the time. We have never been better at talking about mental health, we have never had more access to the tools and services of mental health, and yet when you look at the levels of emotional distress in any modern industrialized society, it keeps going up. The number of antidepressants prescribed keeps going up. Suicides, loneliness, the generation now in their twenties looks at their prospects with more pessimism than the generation above them, for the first time in recorded history. Something’s wrong: this explosion in mental health talk, but this counter-explosion of rising distress. For me, it was about the missing part of the therapy experience, the mental health experience: people, connection, relationship.

Dr. Suzanne Simpson:
You know what’s funny? I’ve got my notes here, and I actually wrote down: talking about mental health right now, we have more prescriptions than ever and more mental health disorders than ever. It’s not working. My question was going to lead into the contagion and stigma piece, but what else can you say about mental health in twenty-five, talking about Gen Z and mental health? I know this could be a whole other two-hour discussion. Can you give it to me in two more minutes?

Matt Hussey:
I could, yeah. What’s having Gen Z is they’re the first generation who learned this language as part of the language they learned about life. They learned about ADHD, anxiety, depression, bipolar, all these popular terms, in really crucial moments, ages eight to fourteen, when your brain explodes with self-awareness. Suddenly identifying ourselves using the language we’re taught becomes very valuable. So we have a whole generation who’ve learned this language to help them identify and explain how they feel about themselves. But the problem is those words don’t exist in a vacuum. They have connotations: when you talk to a doctor, a potential employer, people you want relationships with, because those words are contested and loaded and mean different things to different people.

Dr. Suzanne Simpson:
My perspective on that, being a teacher on a psych unit where I watched the diagnosing: number one, I saw a lot of great labels for just really bad behaviour. Now, I’m not the person to diagnose, but some of that may have been a way to justify bad behaviour, that may or may not be the case. But my other issue was our diagnostic and statistical manual, here in North America the DSM-5. Do you also use DSM-5 in the UK, or a different one?

Matt Hussey:
We do, it’s becoming the dominant way, that’s happening. And the thing I’ve been saying to anybody who’ll listen is we don’t require ruling out for diagnosing. The DSM does not require you to rule out anxiety, or childhood trauma, to diagnose ADHD or anxiety. You don’t have to rule out the trauma or the inattention. I’ve talked to former students now diagnosed with ADHD and asked, how did your psychologist rule out anxiety? The response is, they didn’t. They don’t have to. We’re going into frightening territory.

Dr. Suzanne Simpson:
Don’t get me going, I see it over and over, and we’re damaging… I’m not saying those diagnoses aren’t accurate when they happen, I’m not negating that. But they’re happening on a very broken foundation, of a book. It’s a book created by humans, and there’s no scans to confirm it, like we said earlier, it’s kind of a crapshoot.

Matt Hussey:
It is a crapshoot. There’s a great English journalist-therapist, someone I see as an aspiring person I’d like to become, who wrote an incredible book called Sedated, about how capitalism and mental health kind of colluded to create this pandemic of suffering. He interviewed the founder of the DSM, who was very remorseful about the work he ended up doing, because it started as something to guide and inform practitioners rather than to be hard and fast, and it became wildly different from that intention.

Dr. Suzanne Simpson:
We need to talk about that, but I just have to add one thing, it just struck me while you were talking. My dad’s just been through cancer, chemotherapy, he’s in remission. There was a formula: he took these medications, this chemotherapy, did this, and it was set, A-B-C-D-X-Y-Z, and you’re better. We like that. If I have diabetes, I take insulin, it’s a nice compact formula. But with mental health it is so much more than that, like your work on connection, and that’s not in a pill. But we like the pill, so when it’s not working like the pill, it’s because we’re veering toward that, it suits our humanity, and it works like that for physical health, but it can’t work like that for mental health.

Matt Hussey:
Absolutely, and I think it’s starting to change. Have you read The Myth of Normal, by Gabor Maté?

Dr. Suzanne Simpson:
It’s right here, I could show it. It’s required reading. He lives in my city, I’ve wanted to go to his front door.

Matt Hussey:
For anyone who hasn’t read it, it makes the case that we’ve historically separated body and mind as two distinct entities, but they are not, we cannot separate them. What I loved about his work, coming from a position of being a doctor, is he realized you can treat an illness and get incredible results. But if you treat the person, and they enter into a relationship with you and the process, recovery rates are higher. He looks at things like autoimmune problems, and what he found astounding is when people go to doctors and say, I have this autoimmune issue, my skin is attacking itself, or I have irritable bowel syndrome leading to Crohn’s disease, no doctor asks what their quality of life is like, what their stress levels are, what job they do, how’s their home life. And when they do, people’s emotional worlds have often changed quite radically leading up to those diagnoses. I hope that’s the trajectory we’re moving toward, where we’re finally taking down these walls, where you as a person is not a sealed box, you’re a kind of centre of gravity for experience, relationships, history, geography, ethnicity, race, that gathers around you, and that is you. Treating you like a sealed box requires risk and vulnerability that we don’t like to face, but we have to be vulnerable to actually be human to humans, and connect.

Dr. Suzanne Simpson:
Okay, we’ve got to move on, because I know you have a client, so I’m watching the clock. I want to talk now about looking at destigmatization, and then look at the contagion challenge, because you wrote a great article that I’m going to get to, but let’s first talk about the power of destigmatization. I don’t even need to give you much data on this, we know from suicide prevention that talking about it does not create more suicide. There’s more and more dialogue about destigmatizing, and I’m working with former students of mine willing to say “I was depressed throughout high school,” and this is what it looked like, which wouldn’t have happened twenty years ago. So what is the power of destigmatizing?

Matt Hussey:
A good way to think about destigmatization is to see it as understanding. An innate need of every person on this planet is to be understood in some meaningful way, and the way we seek understanding takes many forms. Somewhere in that mix is a desire to be understood by the world in a certain way. When people are able to share how they feel, share what they feel they are, and the world says back, “I understand what that feels like,” it changes the way the person looks at themselves. Because the self is essentially three ideas: your relationship with you, your relationship with the world, and your awareness of what the world thinks about you. When we talk about stigmatization, to feel stigmatized means how you feel about you does not align with how the world looks at you, and you feel othered, different, isolated. And isolation tends to kill people quite quickly, chronic disease, depression, the death of despair, can all be gathered under the idea of being misunderstood. So when we destigmatize someone, what we’re really saying is, what you feel about who you are and what your experience was, is okay. No one else is an expert in you, you are the expert in you. So when people come to me, or come to you, Suzanne, and say “this was what my experience was like,” for you to say “I get that,” or “tell me more,” or “I had something similar,” that little spark of someone else going “I get what it feels like to be you” unlocks lots of other doors.

Dr. Suzanne Simpson:
I want to speak for education, because this is my field, teaching. I’m coming into almost three decades of teaching, and I can say, plus the five and a half years with hundreds of them on a psychiatric unit inpatient, the number of kids who’ve been damaged by misunderstanding from teachers, your list goes on and on. It’s so important, one of the things I want to bring to education, we have to understand, because if we understand, even if we don’t experience but have an idea of what it is to have debilitating anxiety, that it’s so much just for me to get through the hallway with hundreds of people to get to you, all of a sudden we’re responding better. When we know better, we respond better. Teachers need that knowledge.

Matt Hussey:
Of course, and I think with teaching there’s always this automatic hierarchy, where as a teacher, a therapist, anybody in a position of authority, there’s this baggage that comes with it: if someone comes to me with a problem, the almost knee-jerk response is I have to try and solve it. If a child or a client comes to me with crippling anxiety, the first instinct is, let’s work on it, I’ll give you six steps, do this exercise, you’ll be great.

Dr. Suzanne Simpson:
My daughter was told to go for a walk in the forest. I’m not kidding, I was there.

Matt Hussey:
Sometimes a walk in the forest is a good thing, keep going. On paper, theoretically, that’s trying to help. But what we miss so often, the irony of authority, is we fall into the fallacy of being the expert in the person sat in front of us, and we’re not, and we never will be. I was talking to my supervisor today about the bliss of ignorance that is this work: the more you do this work, the less you know about people, and there’s a real bliss in that, because if you accept you don’t know anything, then to learn you have to be curious. If a child comes to you and says “I feel terrible,” the difference between saying “go for a walk in the forest” and “tell me more about that” sounds very simple, but it’s profound, because it says to the person, what you’re saying has validity, tell me more.

Dr. Suzanne Simpson:
Yeah, good, that’s good, wow, I need to sit on your couch for therapy, I feel.

Matt Hussey:
Well, we can make it a series.

Dr. Suzanne Simpson:
Okay, one more question before I talk about the contagion piece. I’m assuming you agree that it’s been necessary to destigmatize, based on what you’ve said. Why has this been needed, what’s gone on in our history that we’ve needed this growing movement to destigmatize mental health, as we have diabetes and cancer?

Matt Hussey:
It’s needed because if you look at the history of anything that was stigmatized before, what happens to the people who were stigmatized is never great. I’m a big student of the history of illness and madness, as it was once called. A great example is the HIV virus: it became very quickly a cultural illness, about people being homosexual, engaging in amoral sexual practices, being dirty, all very different from what was a horrible illness that killed tens of thousands of people worldwide. Approaching it with a stigmatized lens meant the people who had HIV and AIDS died really fast. My wife’s uncle had HIV and died in the 1990s. When he died, no funeral home would take his body. When he was dying, no hospital wanted him. When he got diagnosed, his family ostracized him. When we stigmatize, when we tell someone the thing that’s happened to them is wrong, we take a moralizing lens and apply it to their experience, and people tend to decline quite quickly.

Dr. Suzanne Simpson:
So the drive to destigmatize is purely based on necessity.

Matt Hussey:
I think it comes in two forms. The reason it’s necessary is because if you want people to survive, in both life-and-death and psychological, relational ways, telling them they are morally bad, or wrong, or broken, doesn’t make them better, it tends to make them worse. And the second reason is, we can learn an awful lot from people who feel like they’re on the fringes of society. If you think about people we hold up as great visionaries, artists, actors, and you read their diaries or interviews, everyone from Caravaggio to Marilyn Monroe to Van Gogh, they all felt like outsiders, deeply othered by society, but they often told the most accurate depictions of what it felt like to be a person, through their work, and that shaped culture in wonderful ways. So the need to destigmatize is driven by a need to understand people, to help us understand everybody else, because if you’ve had a different experience, we might seem different from each other, but ten years later I might have the same experience you did.

Dr. Suzanne Simpson:
You wrote a great article, and honestly, I’m not just saying this, I was actually really taken by the research you did. You write a weekly newsletter, right?

Matt Hussey:
Yeah.

Dr. Suzanne Simpson:
You wrote “Is Mental Illness Contagion.” I was so taken by it because I’ve watched firsthand contagion happening on my psych unit. For example, somebody starts hitting the wall with their fist, and within two days, no kidding, they’re all doing it. Can you talk to me about what contagion is, and how it happens, in three minutes or less?

Matt Hussey:
Sure. Contagion, from a psychological perspective, is the idea that a symptom appears in a group or society. At first there’s always a baseline of that symptom, but without observation or recognition it remains a kind of fringe thing. What causes it to suddenly spread is a publicization of it. A few examples: in Hong Kong, in the 1950s and 1970s, there was no such thing as anorexia in the way we understand it in the West, people refused food, but it wasn’t diagnosed that way. Then one day a schoolgirl was walking home from school in her uniform, watched by a shopkeeper on the street, and a bus went past, and she just dropped down dead. It caused a huge scandal: how could a girl drop dead in the street? Doctors saw she’d been malnourished, and the pathologist, an English pathologist trained in England, resident in what was then still a colony, said, I know what this is, this is what we call anorexia nervosa, which at that point was only a Western idea documented in America and parts of Western Europe. The press started talking about it, looking for experts, and the recorded rate of anorexia went from maybe ten cases a year for twenty years, to thousands upon thousands.

Dr. Suzanne Simpson:
Shocking, I was shocked, that’s just absolutely unbelievable.

Matt Hussey:
And you see it everywhere. Another example is bulimia: rates in England in the 1980s were marginal, a fringe discussion, adjacent to anorexia. Then Princess Diana came along, and the media worked itself into a frenzy about her having an eating disorder. She denied it, denied it, denied it, then finally in a TV interview admitted she had bulimia, and cases of bulimia skyrocketed in British society. But when Diana died, rates of bulimia started to go down.

Dr. Suzanne Simpson:
I know, this is your article, it was shocking. So here’s the big problem, the big question I have for our entire time together: we know it’s good to destigmatize mental health disorders for the reasons you discussed. But how, by talking about it, do we avoid the contagion, in terms of more people doing it, more of my students punching their hands against walls, higher levels of cutting, that’s a huge one. I’m at a loss for how you mitigate the contagion while talking about it.

Matt Hussey:
It’s a really important, really difficult question, because underneath all of this is a desire to be understood. If I said “hi Matt, how are you” and I just talked gibberish, complete incoherent babble, you’d have no idea what that means, you wouldn’t feel understood. But if I say “I’m anxious,” or “a bit depressed today,” you immediately know how I feel, or have an understanding of it. So inside all this contagion is a desire to be understood. With anorexia, with bulimia in England, there were lots of people suffering emotional distress who didn’t have the language to describe it, and that language brought an easy way for other people to understand what was happening. So at the heart of it is a drive to be understood, but the flip side is, in our need to be understood, people can add their own interpretations of what we think we’re telling them. If I said I’m depressed and taking antidepressants, you might have a judgment on that, might think I’m a bit odd, or you wouldn’t trust me around your kids, you might bring your own judgment in. So these words become contested and start to become very fluid.

Dr. Suzanne Simpson:
Yeah, we chuck out words all the time. If you look on the internet, you’re either a narcissist or, what’s the word, basically just derivatives of the idea of someone being an arsehole essentially.

Matt Hussey:
When we use medical words and throw them at other people, what we’re really doing is using the authority of medicine or mental health to denigrate and lessen the experiences of somebody else. That’s why I come back to this idea, these words are contested, because whoever uses them, applies them to themselves or to denigrate somebody else, changes their meaning. If I say I’m depressed, it might be because I want to be understood. If you tell me you think I’m depressed, you might be trying to other me, or change the dynamic of power here.

Dr. Suzanne Simpson:
Could we lessen it? What I’m hearing you say is if we hold onto language and maybe not normalize it, there’s a difference between destigmatizing and normalizing, and as soon as we normalize something, there’s your contagion too.

Matt Hussey:
Exactly. So when I have clients come to me with all kinds of very articulate mental health diagnoses, they say “I am an anxious, avoidant attachment style and want to move to a secure form of attachment style.” What I do is say, okay, I want you to tell me what it feels like to be you, and not use those words. Use just the language you use every day, tell me what it’s like, but don’t rely on that language. And what you find is a completely different story. These words that were designed to be helpful, this shorthand for understanding, I think it would help to push past them. So if a child comes to you and says “I’m really anxious” or “I’m depressed” or “I think I’m a psychopath,” asking them to tell you what it feels like to be them without using those words often reveals far more.

Dr. Suzanne Simpson:
Matt, I know you have a client waiting for you, and I could talk to you all day, but I want to do three quick wrap-up questions, thirty seconds or less each, to wrap us up. Number one: can you give me, in a sentence, what is that fine balance between us destigmatizing and not creating conditions for contagion?

Matt Hussey:
I think the balance is that we must always come from a position of what is this person trying to communicate to me about what it feels like to be them, and then receive it as that, and be able to work with that.

Dr. Suzanne Simpson:
Okay. Number two: if there’s one thing you could do to change how we’re talking about mental health disorders, what would it be, to remove the contagion effect?

Matt Hussey:
It would be to remove the idea that you are broken if you suffer.

Dr. Suzanne Simpson:
Good, totally, look at you, one sentence or less. Okay, here’s my last one. You and I talked a lot before about connection. What would connection between human beings, if we could grow that more, versus rely on pills, what would that do to potentially slow down contagion, if we were connected?

Matt Hussey:
I think it would not only slow contagion down, I think it would do a lot to repair a lot of the social contract we live in at the moment. We live in a really volatile time, and I think the reason life has become so volatile is because we’ve let something come in between people, and that’s technology. If you think about what we really see now in the world: I am very angry, and the internet, the algorithm, goes, here’s someone else who was really angry too, and it pushes you together and you’re going to shout at each other, because that’s popular in the algorithm’s eyes, that’s the yardstick it measures your engagement by. If I shout and you shout at each other on the internet, the algorithm goes, I’ve done my job, I’ve created engagement. Take that algorithm out of the picture, and go, tell me what it’s like to be you, and I’ll tell you what it’s like to be me. What you find, when you clear out all the middlemen trying to monetize your feelings, is connection, and I think the world would be a far better place.

Dr. Suzanne Simpson:
That is good, I like that. Matt Hussey, where can people find you?

Matt Hussey:
I’ll put it in the show notes. You can find me on LinkedIn under my name, on Instagram under my name as well, and when I get the time I try to do long-form YouTube videos, though I haven’t done many recently, but I’m on there.

Dr. Suzanne Simpson:
Matt, thank you so much for your time. It’s really nice to connect with you across the pond, eight hours ahead as you are. Thank you, I really could talk to you literally all day long.

Matt Hussey:
Okay. Thank you so much, thanks for watching.

Dr. Suzanne Simpson:
If you want more videos like this, and to learn more about how we find connection, you can subscribe to this channel. And by the way, you can click like on that little link below.