Required reading: How to do self-therapy on Twitter.
If you have a Twitter account where you are doing self-therapy, there is an unfortunate element of trying to "perform" self-therapy and vulnerability.
I don't think this element can go away entirely. It didn't go away for me. So being motivated partly by that is fine.
But there are some things that I managed to get only by thinking "okay, fuck it, this is a therapy account, I will do whatever the fuck I want here, I'm not here to make friends".
I definitely wouldn't have started talking about sex, for instance, because the problem I had with sex as a topic was—I was sure it would turn people off. I solved it by talking about it anyway. But if I was thinking about keeping followers, that would prevent me from ever resolving stuff like that.
Another thing is—it's much harder to say X and then continue the thread with "actually, not X, hm", if you care about a coherent public brand and so on. A lot of problems can be solved by thinking them through, but you can't think something through if you are afraid to appear incoherent, and afraid to admit that "I actually have no idea what I'm talking about". If you always have to look like you know what you're talking about, you can't change your mind easily.
So—if you're trying to sort yourself out, and get practice doing self-therapy, a marketing / self-brand / public persona account is the worst place to do that. You start thinking about how you should only say things that you can justify, and boom, you can no longer figure anything out, and you can not backtrack.