When an Entrprenuer Meets Resistance

What businesses in mental health keep missing

Over the last 18 months, I have had the fortune and misfortune of working with all kinds of startups in the mental health space.

Ever since COVID-19, there has been an increased interest in the mental well-being of individuals, especially in India. People seeking therapy, or talking about terms like mental health, psychologists, therapists, etc. have seen a meteoric rise.

Wherever there is money to be made, one should expect an entrepreneur to be close by. There are scores of companies and young startups trying to get into the space of mental healthcare to make money while helping those in need.

Being a big fan of helping people and making sustainable wages myself, I have been working closely with some startups to help them navigate this space ethically and efficiently.

In this time, I have had one particular type of conversation over and over again. It goes something like this,

“Arjun, we offer therapy at very cheap rates. Therapy used to be out of reach for most people in India. We have solved that problem. Why are we not getting enough clients? Why are we losing the ones who join us after 2-3 sessions?”

To a business mind, this is understandably a problem.

The users complained that they don’t use a service cause it’s too costly. The business reduced the costs, out of its own pocket. The user still does not use the service.

To a mind that has been trained in Psychology and psychoanalysis to a degree, this is not that much of an issue. The therapist’s mind should ideally see the lack of uptake in service as a form of resistance from the user rather than something being wrong with the business model.

I Can Fix You Problem

I have seen mental health startups mold and fix therapy into all kinds of things in order to make it more palatable to their target audience.

Therapy is too expensive?

We will give you sessions for Rs. 49-499 (0.5-6USD)

Therapy is too long?

We will give you options for 15, 30, 45, 60 minute slots.

Still too long?

You can pay the therapist by the minute. *First 5 minutes free*

Therapy is too slow?

We will get coaches in who will tell you what to do within the first session OR YOU GET YOUR MONEY BACK!

PLEASE FOR THE LOVE OF GOD JUST COME TO US!

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And yet, despite all this, mental health startups struggle to build or expand on their group of users.

You will see how therapy gets molded, turned into an unrecognizable thing, just to make it more profitable.

Therapy by the minute is not therapy. Therapy where the therapist takes control of the client’s decisions is not therapy.

The lack of expansion brings a lot of frustration for the mental health entrepreneur. He blames the society for not being ready for his great ideas.

WHY IS MENTAL HEALTH NOT SCALABLE? He laments.

Under pressure from investors, the entrepreneur pivots to a new business model. Frustrated. Angry. Flumoxxed at what just happened.

The Mighty Psychological Resistance

Something the entrepreneur simply doesn’t understand about the user is that their doubts or concerns with a service are not always conscious.

A layperson doesn’t always know why or why don’t they do something. Ask a person why they don’t go to the gym and you are likely to hear similar confabulations.

“The gym is too expensive”/ “I don’t have the time to go to the gym.”/ “Why go there when I can do it myself” and the list goes on.

Deep down, people feel a very strong resistance to the idea of being vulnerable and open in front of another individual. Resistance is a way of avoiding and in a way expressing the ideas and emotions the person deems unacceptable.

The resistance, which is fundamentally unconscious in nature, rarely comes to the surface simply by changes from the outer world.

You could change therapy into whatever a resistant person wants it to be, but you will still see that the person does not end up going to therapy. Even if they do, they are likely to drop out within the first few sessions.

The business person may think it is because the therapists are not good enough, or that their model is wrong.

The truth, most probably, is that the users don’t want to go to therapy because there is anxiety about what it would bring up.

In a way, for the layperson, it is a bit like this.

We know opening the cupboard will probably break a few bowls. So why do anything right? Why not just live life and never open this cupboard ever again?

What next for the entrepreneur?

So what should a business person do in such a situation? Do they give up or continue the bastardization of therapy as they currently do?

The best thing to do, as a businessperson, is to take it slow. It’s unlikely you will be able to scale both therapy (the actual type) and users at the same time.

It’s unlikely you will be at a unicorn evaluation in a few months as you would with a Tech company. While the user base of mental health startups is much bigger, it is also populated by the deep and complex jungles of the psychological world.

Mental health care demands introspection and changes in the being of a person.

It cannot be done within weeks.

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Question of the Week

Have you ever seen resistance as a therapist or as someone seeking therapy? How did you work with it?

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