Think things are bad in 2025? It’s probably not as grim as living through the Black Death, the celebrity psychotherapist Philippa Perry cheerily tells Decca Aitkenhead.
I have never written to an agony aunt, but if I did, Philippa Perry would be high on my list. The opening line to a talk she gave in 2015 still makes me laugh: “If you want to be happy, there’s really one main rule. Choose your parents really, really carefully.” We first met when I interviewed her in 2021, after she’d written a bestseller that would probably have been a blockbuster on the strength of its title alone: The Book You Wish Your Parents Had Read (and Your Children Will Be Glad You Did).
By then she was already a celebrity - though she got a bit cross when I said so - having co-starred in Channel 4’s surprise 2020 lockdown hit, Grayson’s Art Club. Her husband had been a household name ever since he won the 2003 Turner prize wearing a pink satin frock, but his wife’s badger-streaked bob, flamboyant eyewear and gift for demystifying both fine art and the human condition made her the breakout star of the show.
Since then this child of “practically Edwardian” parents, who was educated at a Staffordshire boarding school and at a Swiss finishing school, has become only more famous thanks to another craftily titled global bestseller, The Book You Want Everyone* You Love to Read (*and Maybe a Few You Don’t), based on her correspondence with Observer readers, who write in every week with their problems. I doubt if many consider themselves the type to seek advice from an agony aunt, but then Perry writes self-help for people who don’t think they like self-help. The paperback edition was released this month and she is just back from a big book tour of Brazil (“I’m quite famous there,” she concedes) when she opens her front door on a quiet Georgian square in Islington. I’m here to ask, on behalf of all of us, for her advice.
The month of January is seldom joyful, but this one has arrived at a particularly bleak moment. President Trump’s return has set the world on edge, and the prospect of Putin’s victory in Ukraine is sending shivers across Europe. A lot of my friends in America have been unravelling into hysterical panic since Trump won, but the mental health crisis across the developed world long predates his re-election. Turmoil in the Middle East, sinister climate change that may have helped raze much of Los Angeles and a teetering economy at home are making it hard for many of us to find reasons to be cheerful. In 2012 Perry’s second book was called How to Stay Sane. In the political landscape of 2025, to lose our minds would feel quite easy - so what, I ask, should we do now to stay sane?
“Well, at the moment we’ve got peace and prosperity. We might not for ever, so I think gratitude is important - let’s appreciate and enjoy what we’ve got. Yes, Trump’s a despot and a clown. But we’ve had despots before and they usually go under. Every generation always thinks they’re facing the worst crisis the world has ever known - but what was the Black Death like? That must have felt like the bloody end of the world, mustn’t it? In 1939 we didn’t know the outcome of the war, but we can look back now and think, phew, the goodies won. So I like to think that 100 years from now we’ll look back on this time and go, ‘Phew, we had nothing to worry about.’ ”
The world is of course in crisis, she agrees, “But there’s another thing. We’re in a reality crisis, meaning that people think their feelings are so real now that they’re not worried about facts at all.” The irony of this coming from a psychotherapist doesn’t escape her. “Maybe I’ve been guilty of promoting that to some extent. But it’s not what I meant. Yes, what you feel is true, in that you do feel it. But how you’re talking to yourself, to make you feel what you’re feeling, might not be true. And people haven’t quite got that. As panic rises, people feed it by having more pessimistic thoughts. And there has to be a better way of ordering your mind.”
If we allow terrifying thoughts to fill our minds they are bound to harm our mental health, just as filling our bodies with junk food will harm us physically. “So we need to learn to distinguish between thoughts we want to hold on to and pay attention to, and thoughts we want to let go.” But when we go to our GP, “they don’t have time to teach that. They’ve only got ten minutes, so it’s much easier to say, ‘Would you like some Prozac?’ ”
Perry is worried that what she says next will be mistaken for a lack of compassion for the many millions going to see GPs about their mental health. “It will get me cancelled,” she frets. “I don’t want people to hate me.” She even phoned the following day in a panic to suggest I delete it altogether - but it sounds too manifestly sensible to me to be censored.
“It’s very normal,” she begins, “to have painful, uncomfortable feelings in response to our experience of the world. If you haven’t got enough money, why wouldn’t you have anxiety? Or shyness - we used to have shyness. It was normal to go into a party where you don’t know anyone, and feel it. But now” - and she adopts a grave physician’s tone - “ ‘You have social anxiety disorder.’ There’s no other illness that has to sell itself by putting ‘disorder’ on the end. You don’t have cancer disorder, or diabetes disorder.”
If some diagnoses are possibly specious, why would so many people describe them as life-changingly positive to receive? “Because it’s a narrative that makes sense of how they feel. Human beings are made of stories - it’s what makes us different from cats. We used to have religion to give us a story, and now the current trend for making sense of your feelings is a diagnosis. The diagnosis is a story that makes sense of your life, so no wonder you’d cling on to that. And it’s nice to begin with because you feel, ‘Oh, it’s not my fault that I leave my keys in the fridge.’ But it takes away from your self-agency, and I think it’s got out of hand.”
She is not, she quickly clarifies, suggesting psychiatric disorders don’t exist. “Not at all. I’m just saying the net has got wider and wider. Increasingly people seek to pathologise their feelings or behaviours, placing the emphasis on external diagnoses and pharmaceutical solutions rather than internal reflection or behavioural change.”
Perry’s worry about saying this in public is understandable. Anyone who does can expect to be savaged online, and many medical professionals she knows do not dare to. One of the very first people I ever interviewed, in 1995, was a psychiatrist at a high-security mental hospital, concerned about resources being exhausted by people who were not mentally ill. “The vociferous ‘worried well’ keep turning up at the doctor’s with personal problems they used to take to their priest,” he told me. “They’re much better equipped to voice their ‘choice’ than a seriously disturbed schizophrenic, hiding in his bedroom gibbering.”
He said GPs felt pressured to provide “what the punter wants” even back then, and three decades later Perry makes the same point. “This is clogging up the NHS, and means that people who have a narrower definition of mental illness are being held back from seeing a doctor.”
A more fashionable explanation for the rocketing mental health caseload is destigmatisation. Mental distress used to be silenced by shame - so the surging numbers just show how much better we’ve become at talking about it. Isn’t that a good thing?
“No, it’s not a good thing. Because it’s spreading social contagion. Yes, it’s very important to tell your nearest and dearest what’s going on for you, and how you’re feeling. But mental health is being commodified by people selling their brand of mental health on TikTok. And the madder you claim to be, the bigger hit you are online.”
One popular buzzword on the internet is neurodivergence. Is narcissism another? She hoots with laughter. “Of course. But that one is never self-diagnosed. ‘My mother’s a narcissist, my sister’s a narcissist, my ex-husband’s a narcissist.’ They’ve fallen out with someone, so that must make them a narcissist.” Social media is awash with quizzes purporting to diagnose mental health disorders, so as an experiment Perry took one herself. “And guess what? I’m completely neurodivergent! I think it’s now more typical to be neuroatypical than it is to be neurotypical, if you were to do the test. People love the relief - ‘So that’s why I’m always losing my keys!’ - and I’m happy for them. But it doesn’t last, and you still leave your keys in the fridge.”
More importantly, she fears these labels risk actually making our mental health worse. When the pandemic ended and lockdown lifted, Perry couldn’t wait to go to a friend’s party. She had always loved parties. Beside herself with excitement beforehand, within 45 minutes she had to leave. “I’d forgotten how to talk to people, they didn’t know what to say to me, I hated it so I ran away. And then I started to get scared of parties.” She had to force herself to keep going to them, and it took a year before she was “100 per cent looking forward to a party rather than thinking, ‘Oh shit, people.’ ” Had she been diagnosed with social anxiety disorder, she might have given up and stayed at home.
“People isolate too much, and then they don’t have the checks and balances of normal human interaction. You know what I think and feel about you because you can see it mirrored in my face, and you’re doing the same for me. And if we don’t get that, I think we go a bit crazy. I get a bit emotional about this, but other people are so important.”
Her book is all about how we make human connections and how these keep us sane. “People are now having to send Gen Z employees on courses to understand how to disagree with other people, because they experience conflict as abuse or bullying. But when you form connections with people, you learn how to argue and how to cope with change.” Faced with the crises in the world, she says, the last thing we should do is fret about them alone.
“We can wring our hands in despair and say all is lost. Or we can get together with groups of people and see what we can do to stop the things we don’t want to see happen. And we can’t do that alone. We can meet with like-minded people, and that’s all anyone’s ever done to bring about change.”
Social media exhortations such as “Good vibes only!” are not helping. “Telling people to be superhappy all the time is untenable and it’s raising false expectations about what good mental health is. Good mental health is being able to cope with feeling shit, knowing it will pass and holding yourself until it does. But we’re so scared of uncomfortable feelings now. Instead of containing our friends and family going through uncomfortable things, we tell them to get diagnosed.”
Like most psychotherapists, Perry has had her own experience of poor mental health. She was born in Cheshire in 1957 to wealthy parents who were “good people but saw children more as projects to shape than people to relate to”. When her father, a civil engineering contractor, overheard Perry remark, aged 11, that she wasn’t having an especially happy childhood, he was furious and insisted she was. In her twenties she married an Oxford graduate who by her account sounded cold; she worked as a clerk, a private detective and at McDonald’s, studied fine art, split from her first husband and volunteered for the Samaritans, until at 30 she signed up to an evening class in creative writing, where she met Grayson. For their first date he took her to a transvestite club.
On paper, the angry young penniless artist living in a squat was not obvious marriage material. Perry herself was not in great shape, waking up every morning in tears. She went into therapy, they wed five years later, she trained as a therapist, talked her husband into seeing one, and six years into therapy Grayson won the Turner prize. Ten years later he was awarded an OBE, followed by a knighthood in 2023. Nobody would describe the couple as grand - in the hours before I meet Perry, both had been on a picket line outside The Guardian, protesting against its sale of The Observer - but their mantelpiece is crammed with elegant invitations to London’s most exclusive Christmas parties.
The house is a riot of colour. Bright yellow walls are plastered in artwork, and the spare room on the first floor is a froufrou temple to Grayson’s alter ego, Claire, done out in floral wallpaper and huge framed photos and paintings of him in drag, with a dressing table groaning under the weight of his make-up kit. Some of the art on the landing is by their daughter, Flo, 32, an artist who now works with adults with learning disabilities. A lot more of the artwork in the house was made by Perry - abstract paintings, glazed ceramic tiles, an extraordinary gothic fireplace - and she has her own art studio nearby, but says she doesn’t mind at all that people assume Grayson to be the only artist in the family.
To have become famous relatively late in life probably helped insulate her from the usual insecurities and other psychological perils of celebrity. After the publication of How to Stay Sane in 2012 she took a sabbatical from the private therapeutic practice she’d begun in the early 1990s and never went back. “I wanted to devote more time to psychotherapy outreach work - public speaking, making documentaries, writing books and articles about psychology.”
She has been an agony aunt for more than a decade, first for Red magazine and since 2021 for The Observer, so I wonder if she gets tired of being asked for advice by everyone who runs into her. “No. I’m always quite pleased when they do because it’s very interesting. I don’t find it pesky at all.”
Advice is often easier to seek than to follow. How many readers would she guess actually put hers into practice? “Well, I think good advice for you is somebody telling you something you’ve always known but have never articulated. I think you kind of know what to do, and when somebody tells you what you already know, but you haven’t put into words, that feels amazing.”
I’m curious about how she chooses which problems to reply to. Does she pick those she thinks most readers could relate to - or the ones most interesting to her?
“I like to reply to the letter I’m a little bit initially stumped by. Because then I think, well, the readers will be stumped by it. So I want to be giving the readers new information if I can. You know, if I get a heartfelt letter saying, ‘My husband hits me, should I leave him? He says he’s a reformed character now, but he does get cross.’ Well, we all know what the right answer is for that, so I’m not going to answer that one. I might answer it privately - like, ‘Get the f*** out of there before you get murdered.’ But everybody knows that. That is such obvious f***ing advice, so I wouldn’t give it in public. I like unusual problems, ones where I can sort of flex my philosophical muscle, ones that make me think.”
I ask if unsolicited advice is ever a good idea. “No - never dispense unsolicited advice. If you feel the urge to give it, ask permission. And think very hard for whose benefit this is. If somebody says, ‘Do you want some advice about that?’, I have the option of saying no.”
It would be slightly rude to say no, wouldn’t it? “I don’t care. I think it’s slightly rude to offer advice that isn’t wanted.”
The Book You Want Everyone* You Love to Read *(and Maybe a Few You Don’t) by Philippa Perry (Penguin) is on sale now.
Written by: Decca Aitkenhead
© The Times of London