Prince Harry: There are big cultural differences about therapy in the UK & US

I haven’t looked at the British media coverage of this yet, but I’m excited to see how my predictions stack up. Prince Harry did a podcast interview with Reid Hoffman at Masters of Scale. The discussion was about mental health, therapy and veterans. My predictions: the headlines will be about “Woke Harry dropping Truth Bombs” and “Mentally Fragile Harry making dark confessions about his weak mind” and “Harry talks too much, no one cares, when will he ever shut up!” When really, Harry was engaged in a substantive discussion normalizing mental health discussions and people seeking mental health treatment. Some highlights:

Harry on how therapy is pretty common & normalized in California: “You’re absolutely right, Reid, about the cultural differences, they’re immense. You talk about it here in California, ‘I’ll get my therapist to call your therapist.’ Whereas in the U.K. it’s like, ‘Therapist? What therapist? Whose therapist? I don’t have a therapist. No, I definitely don’t, I’ve never spoken to a therapist.'”

Through therapy, Harry said he gained “one of the biggest lessons” in his life. “You’ve sometimes got to go back and to deal with really uncomfortable situations and to be able to process it in order to be able to heal. For me, therapy has equipped me to be able to take on anything. That’s why I’m here now. That’s why my wife is here now.”

His role with BetterUp: “The chief impact officer role for me at BetterUp is 100% about driving advocacy and awareness for mental fitness. 99.9% of people on planet Earth are suffering from some form of loss, trauma, or grief. It doesn’t matter what age you are, but the majority of us have experienced a lot of that in our younger years, therefore we’ve forgotten about it. Now, the body doesn’t forget, the body holds the score as we know. And therefore just as much as there’s a mental health aspect to it, there’s also the emotional aspect to it as well. And I think the more that we can talk about it, the more we understand it. The more we understand it, well, the more we understand each other.”

The link between physical fitness and mental wellbeing. He recounted meeting a soldier suffering from post-traumatic stress disorder (PTSD) who was “physically shaking” and “unable to look me in the eye.” However, when the soldier returned from a ski trip, Prince Harry was amazed by his change. “It was maybe four months later or six months later after he came back from a ski trip, had basically almost completely healed him. He came back, and he was a different person, it was like I was speaking to his twin brother. But it wasn’t, it was the same guy. That’s the power of sport. It literally has the ability to completely transform an individual.”

Shifting the mindset: “Why do we keep calling it PTSD? Why do we keep calling it a disorder? If you’re going to turn around to someone and label them with a disorder, that’s them screwed for the rest of their life. Why are we not calling it PTSI? It should be an injury. And if you’re telling someone that they’ve got an injury, then guess what they’re going to do? They’re going to try and get better.”

[From People]

That’s an interesting linguistic argument, that it should be post-traumatic stress injury and not post-traumatic stress disorder. I think there’s probably a clinical, medical, DSM (Diagnostic and Statistical Manual of Mental Disorders) reason for that. As for Harry and his commitment to being a mental health advocate, he’s great at it. This was never just a “soft” issue for him, something handed to him as an issue when he was a working royal. This has been his interest for years, not only healing himself and understanding his own journey, but trying to help other people, especially veterans.

Photos courtesy of Backgrid and Instar.

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43 Responses to “Prince Harry: There are big cultural differences about therapy in the UK & US”

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  1. Liz Gutierrez says:

    In Canada we call it OSI Operational Stress Injury

    • Louise says:

      I’m Canadian and I’ve never heard of that. And I have PTSD. Is that a Forces-only term?

      • Tanya says:

        Yes, OSI is military only, refers to the injury occurring during a military operation. For civilians I’ve heard reference to PTSD and PTSR (post traumatic Stress Recovery)

  2. ThatsNotOkay says:

    He speaks with authority, knowledge, and openness. Learn from it, grifters!

  3. Eggbert says:

    Keep doing you, Harry!

  4. HeatherC says:

    I can’t wait for the RR meltdown about this. It’ll be entertaining. But he is right, at least in my part of the US (NY) for the younger generations (GenX and down- I’m GenX), therapy is accepted and in many instances and situations expected. When my son was diagnosed with autism and mental illness, we started family therapy. When I was diagnosed with cancer, I started individual therapy.

    There’s less…..shame (is that the right word?) now in seeking mental health care. There’s more recognition of not innately having the tools to deal with every situation and outcome so you go to learn the tools (and let’s be clear that EMDR therapy is effective and NOT new and NOT ‘new agey’ – Kiddo has been doing it for years to deal with over stimulation and processing)

    • tatannelise says:

      I am not trying to shame you at all–I am very sincerely glad you have been able to get the help you need for yourself and your family–but I wanted to point out that therapy is not nearly as widely available as it needs to be. I moved from the Northeast to FL, and there is a huge provider shortage here; I went from living down the street (literally) from my therapist’s office to dealing with months-long waiting lists while in the throes of postpartum depression/anxiety. And I am white and have good health insurance! If you are poor or marginalized in just about any way, the obstacles are incalculably greater. We have a lot of work to do as a country!

      • HeatherC says:

        Availability and access is a HUGE problem! But that’s different that societal acceptance that mental health care is vital. To be diagnosed in the first place, Kiddo was on a wait list which was horrible! Trying to navigate what is covered under insurance, which providers you can see, and when they even have an opening is so stressful (and IMO adds to everything else)!

      • tatannelise says:

        Absolutely concur! Always happy when people get the help they need–I just wish everyone could do so (and am aware of my relative privilege even though I struggle to access care). I also have a kid with autism (maybe/probably–kind of a borderline case) but his mental health seems to be okay at the moment, knock on wood.

      • bananapanda says:

        This is exactly why Better Up and others are offering online therapy – through phone or laptops – bc not everyone has physical access to trained professionals. Heck, some people can’t take the time (or willpower) to GO to an appointment.

    • VivaAviva says:

      I’m in NC and at least in my neck of the woods, therapy is not taboo among my peers (late 30s-mid 40s).

  5. MsIam says:

    Agree with the comment on changing the name of PTSD. It happens as the result of something you’ve been through and the emphasis should be on healing. Calling it a disorder puts the onus on the individual, as if they have some type of trauma processing flaw.

  6. KASalvy says:

    Every time he speaks he becomes more and more attractive.

    It’s almost a proud mama feeling watching him grow from the spunky little kid to this courageous, intelligent and gorgeous man. Cheers Harry, good on you.

  7. LBB says:

    I love WOKE Harry.

    • Ohcomeon says:

      Me too, but I also loved him naked playing pool in that Vegas hotel room. He’s just a wonderful, flawed human trying to do good in this world with the influence he has. Which is considerable. Good on him.
      And that’s exactly why he doesn’t fit in with the stiffs

  8. CatLady26 says:

    Harry is absolutely right. Mental health labels affect you so much. I suffer from a plethora of mental health labels… Depression, anxiety, panic disorder, ocd, PTSD … and I was labeled with a possible personality disorder. After getting the borderline personality disorder diagnosis several years ago, which is now in question, it affected me so profoundly. To me, when somebody tells me that I have a personality disorder, that means that there is something inherently wrong with who I am as a person. That I’m broken. I ended up internalizing all these labels and identifying as a disorder, something was profoundly wrong with me, and it ultimately ended up with me not leaving my house for almost 5 years. Not taking care of myself for almost 5 years. I’m finally starting to shake off those labels, but I’ve internalized them so much that it’s made me afraid to even speak to people. I know modern mental health is young and we are still learning so much, but these labels do you have a deep effect on your psyche and affect how you proceed with your life.

    • Ellie says:

      @CatLady26 – and we never ask about the people drawing up these harmful labels. Who are they? If they understood people they would know that words matter. Labels matter. I have ADHD – another disorder! These terms bring so much shame. Anyway big hugs to you and I hope you’re doing ok ❤️

      • VivaAviva says:

        The people who write the DSM are pre-imminent psychiatrists and mental health professionals working in the field. They are not out of touch with real people and the reason we’re on DSM 5 (maybe 5.5) is because as we learn more from research and clinical studies. The DSM has flaws and is an ever evolving document, but it isn’t put together by quacks.

        As for the terminology of disorder vs injury, I think it depends on the condition. Some conditions are acute and can be completely healed. I would call that an injury. Something like ADHD is life long and chronic. I don’t have a problem calling it a disorder (and I have it and a bunch of other stuff).

    • Gubbinal says:

      I remember when the DSM described “homosexualty” as a mental illness. In 1973 they removed it as an illness from the DSM.

      The use of “disorder” is a terrible word choice. I think that the DSM in psychiatry is a bit like a horoscope in its generic way: people are too complicated and distinctive to be labelled ACCURATELY by one of the “disorders.”
      I encourage people to seek help. Therapy can save you sometimes. Talking is helpful. Imagine if we were not ashamed to be ourselves?

    • Lady D says:

      CatLady26, your comment is such a good reminder to be kind to everyone we meet. You just do not know what struggles people are fighting through to survive.

  9. Saucy&Sassy says:

    Let the BM have their little tantrum. It’s what they do best. The other area that there is a cultural difference is how service members/veterans are viewed in the US as opposed to the UK. The BM won’t be winning prizes by taking potshots at our service members/veterans in order to score points off of Harry.

    Harry has said some significant things over the last two years, but I think changing the word “disorder” for “injury” has a huge impact. Post traumatic stress has been treated for some time and successfully. It appears that the US should have taken it’s cue from our neighbors from the North. Canada has already figured it out.

    Kaiser, I think you probably ought to add California to your headlines. The BM have no inclination to educate themselves and think only things like this happen in California. It would probably help if they understood the size of the US (and Canada).

    • ciotogista says:

      We also know now that PTSD is a brain illness, not just a “mental” illness. It involves damage to the actual organ.

  10. SarahCS says:

    I’m a business psychologist so my knowledge here is tenuous but isn’t a lot of how DSM is constructed/updated to do with health insurance in the US and categorisation that links to treatment (costs)? Do correct me if you know better!

    I do agree with his ‘injury’ point, there’s a long way to go in redressing the balance between physical health and mental health in how we think about them.

    • JanetDR says:

      You are correct about it being a billing issue, but the DSM could change the label.

      • SarahCS says:

        Oh absolutely, I know it’s had various versions over the years and will presumably continue to evolve.

    • Blithe says:

      Another issue is that insurance—in my limited experience— will pay for an initial assessment, but beyond that, will need a diagnosis for billing. This can mean that interventions such as therapy sessions for someone in a crisis or for bereavement or divorce or developmental issues won’t be reimbursed, unless and until symptoms meet the criteria for a DSM diagnosis.

  11. Harla says:

    Just a reminder that not one of the royal social media sites have congratulated TeamUK on games well played at the Invictus Games. It must be tough for those who served, fought and were injured for queen and country, to realize that the queen and co are too petty to acknowledge what they’ve been through and what they’ve accomplished.

    • Jaded says:

      Gee… now wouldn’t this be perfect for Khate to take on as an adjunct to her Heads Together work…. oh right. She doesn’t work.

  12. Merricat says:

    Harry fights the good fight. His open-heartedness is part of what makes him beloved.

  13. MangoAngelesque says:

    People don’t hesitate to support someone for seeing a doctor about a physical injury. But when the injury/issue is mental or chemical, the side-eyeing and tutting about self-indulgence kicks in with many people. And that’s just ridiculous. Healing should be the goal, whether it’s a badly broken leg, or something less tangible or invisible.

    And there really shouldn’t be a distinction made. Healing is healing.

  14. Amy Bee says:

    I can’t wait to read about Harry’s mental health journey in his book. I know he’s talked about some of it already but I feel we will get a deeper understanding of what he went through and how he’s managed his mental health over the years. I suspect the Royal Family put a limit on what he could say about it when he was a working royal.

  15. DeluxeDuckling says:

    I think the DSM is always playing catch-up. Mental health stuff always takes forever to evolve. For ages it was thought women were hysterical/crazy if they weren’t obedient, and vibrators were invented as a medical aid 😆 women used to pass around contact info for ‘good doctors’ 👌😉✨

    I hope “PTSD” will get an update, Harry is just articulating what a lot of people without his platform have been saying for ages. I’m glad he’s shining a light on it

  16. Chelsea says:

    The therapy comparison was specifically in regards to California compred to the UK and was said in response to a lighthearded comment from the host about how everyone’s in therapy in CA. Its a pretty common one as even the show Lucifer starts off with a gag about how everyone is LA is in therapy to the point that even the devil got a therapist( though as the show goes on you see some characters who aren’t in therapy start going after traumatic events and using it to work towards better health).

    I think even in the US there is a huge disconnect from people in more liberal areas talking more freely about being in therapy than more conservative parts. Growing up down south no one ever talked about therapy and i felt like i had to hide it when i was in therapy in high school. But in my friend group i have now that lives in a very big blue city they talk about it all the time and it made me feel a lot more comfortable about asking to get help again and then eventually mentioning it to a family member when asked about what my doctor appointment was for. I still don’t like to bring it up to my family but i feel very comfortable talking about it with friends and even some coworkers now.

  17. Over it says:

    This man is who Harry is. Someone who is thoughtful and willing to learn and help. He knows when he needs help and when he can assist others who need it and be there for them. I see a man in Harry , a man who is constantly working on himself to be the best of himself for him and his wife and children.
    The angry petulant unstable child Tina brown insists on painting to make William the bashed look better is a complete and total lie.
    I really really don’t have any good feelings for Tina.

  18. Sassypants says:

    An injury is the trauma itself, it becomes a disorder when you effects your mood, mind, or daily routine. PTSD is aptly named

    • Saucy&Sassy says:

      Sassypants, the word disorder tends to make me think that this is something that hangs with you forever. In some cases, perhaps it does. That doesn’t negate the fact that most are treated successfully just as a broken leg is. As someone who is rehabing from a broken shoulder which has affected my mood, mind and daily routine, I can assure you there is no disorder involved. Frustration? Yes. Disorder? No. That’s the point, I believe, that Harry is making. Too many movies were made in the past that vets with PTSD were creating mayham everywhere they went. There’s a public perception that needs to be counteracted and this is a really great way to start that process.

      • Sassypants says:

        That is just not true. PTSD cannot be “cured” and it doesn’t go away. You learn to live with it and you learn how to alleviate the worst of it. Comparing that to a broken shoulder is idiotic and insulting to those who suffer from PTSD.

      • Saucy&Sassy says:

        Sassypants, I know people who have suffered post traumatic stress and I assure you I would never insult them. They are the ones who tell me that the treatment for this is something that works and they do live their lives free from the effects. I’m not saying that everyone will be able to do that, but I do think we need to stop looking at it as a disorder. They would tell you the same.

  19. L4Frimaire says:

    I listened to this yesterday. It was a good conversation. It mostly focused on Alexis and gave some great shop talk in how he built BetterUp and got there. The one thing that really resonated with me from Harry’s conversation was his reasons for joining. He mentioned that while he believes in mental health, that’s not always what people need. We all have our issues and frustrations, but that doesn’t always mean we need therapy or have clinically diagnosed issues that require therapy. Although he mostly refers to a work context, this applies to life in general. There are times we get stuck, would rather be proactive and anticipate issues, or see patterns. Mental fitness sounds a bit jargon-y but makes sense, esp. with the company he’s with. In his way he’s trying to normalize and de stigmatize checking in with one’s self. It never clicked for me but I’m currently doing a few check ins with a wellness coach, provided through my health plan. It’s good to work with someone you can sort of talk through certain roadblocks with. Anyway, enjoyed the podcast, liked how it focused on work, which I suppose is very American, but it was good.

  20. SuzieQ says:

    This is what the royals mean when they say they no longer recognize Harry: He’s a fully actualized human being, who’s done the difficult work and reading necessary to attain better mental health. He’s clearly not interested in repressing his true feelings and viewpoints anymore, for the sake of keeping a stiff upper lip, and good for him. (Viewing a stiff upper lip as an ideal behavior has harmed generations of Brits.)
    He also clearly has done his research, talking so comfortably about trauma and how our bodies “keep the score.”

  21. bettyrose says:

    “I’ll get my therapist to call your therapist” <- I've lived all over this state and no lies detected.