The Therapy Beat

ASMR Videos

A New Tool for Therapists?

Magazine Issue
March/April 2019
Hands holding slime

They say you never really know somebody until you live under the same roof. But in the five years I’d known my 20-something former coworker, Craig, I thought I knew what to expect. When he asked to rent out the spare loft in my apartment two summers ago, I knew he wasn’t going to win any awards from Good Housekeeping. At work, his desk had been a graveyard of yellowed newspapers, cups of stale, half-drunk coffee, and crumpled energy-bar wrappers. Okay, he’s a little bohemian, I thought. But nothing I can’t handle. So, he moved in.

A few days later, I returned home from work to find the apartment completely dark, the window shades drawn tight. When I climbed the stairs and peered around the doorway, there was Craig, seated in the glow of his laptop. “Hey, didn’t hear you come in,” he said, yanking off an oversized pair of headphones and blinking to refocus his eyes. “Whatcha watching?” I asked tentatively. Thus began my official introduction to the mesmerizing world of ASMR.

I’d already heard a little about ASMR, or autonomous sensory meridian response, before this moment, but not much beyond the basics. A physical and emotional experience that 20 to 40 percent of people claim to have, ASMR is often described as a shiver or tingle that travels up the spine or lingers at the top of the head, triggered by particular sounds and images. The web is filled with hypnotic ASMR videos of whispering, finger tapping, scratching sounds, gentle hand movements, and demonstrations of close personal attention. These are the most common ASMR triggers, but enthusiasts report a wide range of other stimuli—say, brush strokes on canvas or hands kneading wet clay—also evoke the feeling.

It’s easy to laugh off ASMR as an urban legend, the stuff of Reddit forums and YouTubers looking to make a quick buck. But while the science on ASMR is slim, the videos that claim to elicit it are ubiquitous. In just nine years, an estimated 13 million online videos containing ASMR content have been created. The most popular ones have millions of views, like Maria’s Gentle Whispering ASMR channel on YouTube. A 16-minute video of her running her fingers over a wooden hairbrush, blowing out a candle, and simulating a scalp and shoulder rub on the viewer has over 21 million views alone. Browse the comments section of any ASMR video and you’ll likely find heaps of praise for their creators, or ASMRtists, as they’re called. For some viewers, finally putting a name to a sensation they’ve long felt but struggled to articulate can be a deeply compelling experience.

But why should therapists care? As it turns out, ASMR content appears to generate a deep, lingering feeling of calm and relaxation that some believe has powerful therapeutic potential for people suffering from conditions like anxiety, depression, insomnia, chronic pain, and PTSD. The online therapy platform BetterHelp, whose CEO has pledged to improve accessibility to mental health services, has even sponsored several top ASMRtists. A handful of university studies have explored the therapeutic benefits of ASMR content, some reporting that they may rival those of mindfulness-based stress reduction and yoga.

I decided to check out a few ASMR videos to see what all the buzz was about. I started with a Gentle Whispering ASMR video titled “Gentlemen’s Suit Fitting Session.” In a hushed voice, Maria smiles and explains that (unbeknownst to me) we had “a really nice conversation” earlier and now we’re going to choose from a few fabrics and styles. “If you don’t mind, I’ll come closer,” she says, never breaking her smile. “What kind of collar would you like to wear?” she asks softly. The volume increases in each earphone as she moves from left to right as if to examine my shoulders.

I feel an immediate jolt of adrenaline in my upper arms once the whispering begins, something that resembles the feeling of switching lanes on a busy highway and suddenly realizing another car is gunning for the same spot you’re heading toward. It’s certainly not a soothing feeling, but maybe I just hadn’t found the right video.

As my survey continues, I find many videos of ASMRtists twisting and squishing bright buckets of slime, wringing out soapy sponges, snapping and lighting matches, and tapping on empty Coke bottles. I find one video titled “Cardi B Explores ASMR,” where the outspoken Bronx-born rapper taps her long, candy-colored fingernails up and down a microphone, and another titled “ASMR Dog Enjoying Yellow Apple,” featuring a well-behaved but seemingly insatiable husky. Again, no tingles, but one thing’s for sure: there’s a veritable wild west of ASMR content to peruse.

ASMR has already stirred up its share of controversy. In the popular media, clickbait phrases like “brain orgasms” and “whisper porn” abound. Some skeptics say ASMR’s benefits are nothing more than the placebo effect at work. Others warn that ASMR content could even be harmful, depending on what’s being shown and the viewer’s emotional state. A search for “ASMR therapy” on YouTube turns up several ASMRtists branding their videos as therapy, doing role-plays dressed up as clinicians, and even simulating therapeutic approaches like EMDR. Given that the bulk of ASMRtists aren’t licensed professionals, and clients looking for easily accessible, portable therapy tools might stumble upon this content, should therapists be concerned?

Not necessarily, says Dafna Lender, program director of the Theraplay Institute in Chicago. Referring to the vocal adjustments, steady eye contact, and simulated touch found in many ASMR videos, she says therapists do this all the time. “Our relationship with clients is built on caring eyes, caring voice, mirroring gestures, and facial expressions that say You’re not alone. Or I believe in you. Or I feel your pain,” she says. “It just happens that some YouTubers have capitalized on the emotional effect such messages have. But for clinicians, this is our everyday therapeutic currency.”

Lender, whose work emphasizes nonverbal interaction, believes that even though some people consider ASMR content strange, it actually taps into certain primal, universal human needs and responses. As an example, she describes how a mother soothes a crying baby by holding him close to her chest and making a shushing sound to make him feel less alone in his pain.

ASMR content functions similarly, Lender says, offering a fundamental experience of coregulation that’s more desired than ever in our touch-deprived society. “But the internet has demonstrated that we don’t necessarily need to be together to feel together,” she adds. “ASMR videos show that people can feel deeply comforted by seeing someone simulate touch without actual physical connection.”

As enthusiastic as she is about ASMR, Lender also counsels caution. She underscores that this doesn’t mean therapists looking to give their clients a little extra soothing should necessarily pull up an ASMR video in session. “If the client expresses an interest in ASMR and I think they’ll benefit from these videos, I want to be the one making them,” she says, adding that she might offer to record a video or audio file for them to take home. But when it comes to using ASMR in therapy, Lender says it’s best left to professionals who know the client’s history and any sights or sounds that might trigger them.

Too Much, Too Soon?

For therapists like Courtney Armstrong, the potential for adverse reactions to ASMR videos isn’t worth the risk. A trauma specialist, she says many of the clients she works with, including sexual assault survivors, would be triggered by ASMR content, especially since in some cases their perpetrators used whispering or soothing behavior to coerce them. “It’s a definite no from me,” says Armstrong, who finds many ASMR videos “creepy.” It’s not necessarily the visuals or sounds, she explains, “it’s that they seem to be creating a false sense of emotional connection. Some of the things people are doing in these videos are things you’d normally only do with someone you’re close to. The illusion of intimacy can be dangerous.”

Of course, we’re biologically wired to respond when someone speaks in a slow, soothing manner. But Armstrong says there are better ways to help people find calm and emotional balance than creating an imaginary relationship with a stranger in a video.

Despite her reservations about ASMR videos, Armstrong sometimes uses videos that feature music or abstract lights while doing guided imagery or meditation sessions to help clients process feelings they can’t put into words. If clients are working through something especially painful, she might start with songs that convey pain and gradually offer up ones that communicate how they’d like to be feeling. When they near the end of this process, she says, most clients feel empowered and see the later songs as tools they can draw upon to reinforce that newfound strength.

Experts in the field of ASMR research, like physiologist Craig Richard, a professor of biopharmaceutical sciences at Shenandoah University, are convinced that ASMR has plenty of clinical potential. In 2014, he and several colleagues started an ongoing ASMR research study that has over 27,000 participants to date, the largest of its kind. Through online surveys, he asks these participants how they feel psychologically, emotionally, and physically when they experience ASMR.

What he’s found is startling: ASMR is experienced in over 110 countries, by people of all genders and ages. It’s proof, he says, that ASMR is a biological phenomenon, not a cultural one. What’s more, among respondents with anxiety diagnoses, about 50 percent report that ASMR content helps them feel more relaxed and regulated, and 50 percent with insomnia report it helps them sleep. For those with depression, almost 30 percent say they experience improvements in mood. These figures are all the more impressive considering that psychiatric medication can take months to kick in, with questionable efficacy rates, and talk therapy is often not readily accessible or affordable.

But even proponents like Richard warn that ASMR isn’t some sort of therapeutic silver bullet. In clinical settings, he emphasizes that treatments will still need to be individualized. “You can’t just slap headphones on somebody and think ASMR is going to help them,” he explains. It’s a matter of finding the right triggers. “You wouldn’t take any random food and stick it in someone’s mouth and think they’re going to like the taste,” he continues. “Using ASMR triggers is like choosing from a buffet: you have to find the right stimulus for the right person.”

So what’s standing in the way of ASMR stimulation gaining more acceptance in clinical circles? Richard says that it’s often dismissed simply because, compared to therapeutic tools that have had decades to establish credibility and get research funding, it’s the new kid on the block. Today, there are a mere 10 research articles on the subject. That said, Richard is excited to see future ASMR studies being pioneered not by top universities and acclaimed researchers, but by young scholars who discovered ASMR while beginning their careers.

Giulia Poerio, a psychological scientist at the University of Sheffield in England, remembers feeling a wave of calm wash over her as a child in the 80s when she’d watch The Joy of Painting with Bob Ross, today considered an ASMR grandmaster of sorts. But it wasn’t until the term went mainstream several years ago that Poerio realized how common this kind of experience is. “Once I started digging,” she says, “I found a whole community of people like myself who’d experienced it since they were very young.”

Seeing a dearth of research on ASMR, Poerio and a handful of colleagues at Sheffield decided in 2014 to compare the stress-reduction effects of ASMR with those of mindfulness meditation and listening to relaxing music. They found that ASMR reduced participants’ resting heart rate by an average of three beats per minute, on par with the meditation and music trials. From these data and questionnaires, Poerio and her colleagues also debunked a common myth about ASMR—that it’s primarily a sexual response. However, she acknowledges “the videos can be very intimate, so I can see why people might perceive it this way.”

Poerio says more research needs to be done to answer several lingering questions: What makes for effective ASMR content? Since not everyone experiences ASMR, is it even worthwhile to develop treatments? And since some of those who do eventually report a buildup of tolerance to ASMR, what happens to treatment if a client suddenly stops responding to it? We’ll cross that bridge when we come to it, says Poerio. For now, she just hopes therapists will keep an open mind.


Many slime videos into my research, I had to admit that the whole ASMR phenomenon remained mostly a mystery to me. I couldn’t really experience it: where some people got tingles, I got jolts. Where others tuned out, I became hyperfocused. At times, it almost felt as if I’d been denied entry to some sort of exclusive club. So I picked up the phone and called the one person I knew who would give it to me straight: Craig.

Over the next hour, I learned how someone who responds to ASMR experiences it day to day. Craig often listens to ASMR content on a long drive if he’s not in the mood for a podcast or a comedy special. He uses it to wind down after a long day at work. And he says sometimes it’s fun just to browse online for new ASMR triggers.

“Some people look at ASMR and say it’s weird,” he told me. “But I like to think of it this way. You know when the barber hands you a hot towel after a shave? That’s how ASMR feels for me.” Whatever researchers may eventually conclude, for people like Craig, the evidence of their personal experience is all that matters.

 

PHOTO © ISTOCK/PHOTOAQUILA

Chris Lyford

Chris Lyford is the Senior Editor at Psychotherapy Networker. Previously, he was Assistant Director and Editor of the The Atlantic Post, where he wrote and edited news pieces on the Middle East and Africa. He also formerly worked at The Washington Post, where he wrote local feature pieces for the Metro, Sports, and Style sections. Contact: clyford@psychnetworker.org.