Is therapy good for you? Many people have benefited from it, and the word itself, from the Greek, therapeia, means "healing."
But what happens when the effort to heal extends beyond necessity? Or when a focus on trauma stunts the development of resiliency? Or when families raise children to believe that the normal slings and arrows of childhood are the beginning of lifelong mental health issues? Or when most of the socially formative institutions in the lives of the young regularly force-feed them a message of victimization and weakness?
These are some of the urgent questions Abigail Shrier asks in Bad Therapy: Why the Kids Aren't Growing Up. "The rising generation has received more therapy than any prior generation. Nearly 40 percent of the rising generation has received treatment from a mental health professional—compared with 26 percent of Gen Xers," she writes.
How did we get here?
Much of this began as an effort to help children, as Shrier notes (her introduction is titled "We Just Wanted Happy Kids"). But the iatrogenic effects of such efforts are now impossible to ignore: The kids are not alright; they are suffering. Young people have experienced an alarming rise in depression, anxiety, and self-harm, and many now believe they cannot handle the challenges of life without constant therapeutic interventions. "How did kids raised so gently come to believe that they had experienced debilitating childhood trauma?" Shrier asks. "How did kids who receive far more psychotherapy than any previous generation plunge into a bottomless well of despair?"
Shrier identifies several recent developments that likely contributed to the steep rise in mental health treatment among the young, including the impact of COVID-era school closures; the near-constant use of smartphones and social media; and the general message of anxiety around climate change. Like many critics before her, she also indicts a culture of parenting that has allowed a therapeutic approach to childrearing to flourish. "We parents have become so frantic, hypervigilant, and borderline obsessive about our kids' mental health that we routinely allow all manner of mental health expert to evict us from the room," she argues.
And those mental health "experts" are not always as well-versed in the art of healing as one might hope. The "bad therapy" Shrier describes encourages children to ruminate on problems; to pay close attention to their feelings; to "make 'happiness' a goal but reward emotional suffering"; and to constantly identify and share their "trauma."
Such interventions yield behavioral changes. One high school student Shrier interviews tells her matter-of-factly, "You're expected to have these mental issues. And these things are being normalized." Another student in Brooklyn says, "Identifying with your strengths now isn't seen as too cool because some people may manipulate you into thinking that you're privileged because of it." In other words, the adults in children's lives reward them for emphasizing (or even manufacturing) mental health challenges rather than encouraging them to become resilient.
Not surprisingly, teenagers and young adults have discovered they can use a mental health diagnosis to evade responsibilities. "They ask a college counselor—or even a parent—to schedule an appointment on their behalf. They claim their 'social anxiety' forbids this task," Shrier writes. In reality, "They've just never been made to do anything on their own."
Not every therapist is keen on expanding his or her practice to every teenager in the nation, and Shrier performs a service by ensuring the voices of critics of the current therapy culture are heard. She speaks to a clinical psychologist who believes cognitive behavioral therapy can be helpful for specific kinds of challenges, but who "has enough respect for the power of therapy to reject the idea that everyone should be in therapy." The therapist likens such an approach "to a surgeon who ventures: Well, he looks healthy, but let's open him up and see what we find." Or, as Shrier puts it, "That's how the snipe hunt for childhood trauma begins."
Another researcher, Yulia Chentsova Dutton of Georgetown University, who studies emotions, tells Shrier, "We are basically telling them that this deeply imperfect signal" (feelings) "is always valid, is always important to track, pay attention, and then use to guide your behavior, use it to guide how you act in a situation." But as Shrier argues, "Attending to our feelings causes them to intensify. Leading kids to focus on their emotions can encourage them to be more emotional. … Emotions are not only unstable, they're also highly manipulable."
In what should be the most worrisome part of the book for parents, Shrier describes the effort to embed bad therapy in K-12 education under the broad tent of "Social Emotional Learning" (SEL). She reminds readers, "Most American kids today are not in therapy. But the vast majority are in school, where therapists and non-therapists diagnose kids liberally." The problem is likely more widespread than many parents recognize: "For more than a decade, teachers, counselors, and school psychologists have all been playing shrink, introducing iatrogenic risks of therapy to school kids, a vast and captive population." Many advocates of SEL begin with the assumption that most children "have suffered serious traumatic experiences that leave them unable to learn" and thus insist that "social-emotional learning happens all day long."
What form does this learning take? The examples Shrier offers are concerning. "Student outbursts that might once have earned a kid detention, suspension, or a trip to the principal now prompt a scheduled visit with a counselor or school psychologist," she notes. Other counselors and teachers seek to meddle in complicated matters related to children's sexuality and sexual preference. "One parent I interviewed told me that her son's high school counselor had given him the address of a local LGBTQ youth shelter where he might seek asylum and attempt to legally liberate himself from loving parents," Shrier writes.
She describes in detail surveys administered to school children across the nation, often without parents' approval or knowledge, that "pry into the most private details of teenage experimentation and family life: alcohol consumption, drug use, and sexual orientation, along with the de rigueur inquiry into race and gender identity." Surveys even "ask kids whether they feel loved by their parents" and proffer "very specific questions on what types of self-harm they have tried." Schools are not eager to disclose these activities. Indeed, the only reason such invasive surveys came to light is through the determined efforts of the nonprofit organization Parents Defending Education, which submitted multiple FOIA requests demanding to see them. Shrier correctly concludes, "Surveys betray an ontology—a view of the world and what objects furnish it. And in the world of these surveys, trauma is rampant—if not universal."
Once SEL is institutionalized, it facilitates endless excuse-making: Schools adopt policies that ensure students can't fail and are allowed to redo their tests and homework or are never marked late to class. Savvy children exploit these circumstances. "One of my seniors, she'll come in, like, 'I just can't play today. I'm having a really tough, tough Mental Health Day,'" a music teacher tells Shrier.
By their nature, SEL policies also undermine parents' authority. Shrier notes the "casual denigration" of parents in much of the SEL literature: "Mom and Dad are only 'caregivers,' service providers, and incompetent ones at that, who might even be harmful to their kids' mental health." Parents have been far too passive in accepting the ascension of the experts: "We parents are by now so accustomed to being called our schools' 'partners' in raising our children, we hardly notice the demotion," Shrier argues. "Pediatricians tell us what our kids need from us emotionally (and not only medically); school psychologists inform us how to talk to our kids about hard things, or send home prompts for important 'social emotional learning discussions.' No one solicits parents' advice because our advice is nonexpert and, therefore, presumably without worth."
Yet Shrier holds parents to account, too. Her book's subtitle asks why the kids aren't growing up. Her answer? We aren't letting them. She is a staunch critic of the "gentle parenting" movement that eliminated the setting of limits and consequences for children, as compared with more authoritative parenting styles. One sympathizes with her exasperation with these earnest acolytes of gentle parenting: "These parents are 'intentional' about everything," she writes. And they are eager to see their children as special—or especially vulnerable. "Whenever parents become 'educated' in the therapeutic method," Shrier observes, "they invariably conclude that they have a 'sensitive child.' Nearly every recent parenting book I've read prompts readers toward that notion."
Shrier suggests parents take back the central role in their children's lives from the so-called experts: "I don't know how to raise your kid. I don't know your values. And I distrust, instinctively, most who would claim to know these things. I certainly don't believe that any mental health expert does." Such experts have "presided over a disaster" by convincing parents "that we didn't know what we were doing." But as she argues, "Parenting is not a skill. It's a relationship—or, it was."
Shrier makes many good suggestions for fixing these problems: Encourage more free play for children, more time outdoors, and less time with technology; don't pathologize or medicalize normal childhood behavior. Her book would have benefited from acknowledging that neither the problem nor these solutions are novel. Critics have raised concerns about an increasingly therapeutic culture for decades; Philip Rieff's 1966 book, The Triumph of the Therapeutic, is one example among many. For decades, alternative voices in the parenting-advice industry also have raised concerns similar to the ones Shrier outlines, in books such as The Blessings of a Skinned Knee and Free-Range Kids. Readers would have benefited from hearing from Shrier whether and how our current moment is different from what came before.
She also says little about the decline in religious observance as a possible reason for the increasingly therapeutic approach to childhood. Children raised in religious families report being happier and demonstrating better mental health than children raised in nonreligious households; might some of the turn to therapeutic solutions be an effort to replace more traditional approaches to childhood challenges?
And although she includes a caveat at the outset of the book about children suffering from profound mental illness, contrasting those cases with what she is describing, there are times when her dismissal of children's anxiety or depression and her calls to treat them as within the normal range of childhood experience seem cavalier. Some children do suffer significantly from such conditions and benefit from both medical and therapeutic intervention; as well, the range of children, particularly in the public school system, who might come from less-than-ideal home situations makes her blanket dismissal of all counseling opportunities too extreme. The therapeutic excesses she describes are prevalent in upper-class and upper-middle-class homes; among broken families further down the income scale, however, chaos and disorder are common, and basic interventions more critical. For many of these children, school is the only place they might receive help.
These are quibbles, however. Shrier's insistence that these therapeutic approaches be assessed for their suitability and effectiveness is much-needed, as is her warning about starting children on therapy too readily or at too young an age. Most important is her warning about the ways in which SEL has woven its way into too many schools, and the harm caused when people unqualified to diagnose and treat mental health issues impose bad therapies on children.
The effects are likely to be felt for generations, but one can already see signs in the real world, most notably among young employees who fervently believe that it is their employers' responsibility to attend to their every emotional need and who are quick to claim trauma and victimization when those needs aren't met. As one mother warns Shrier, the therapeutic culture "creates unbelievable narcissists." Shrier's book is a welcome—and important—step in shifting the culture away from such harmful self-indulgence and toward greater resilience.
Bad Therapy: Why the Kids Aren't Growing Up
by Abigail Shrier
Sentinel, 320 pp., $30
Christine Rosen is a senior fellow at the American Enterprise Institute. Her book, The Extinction of Experience: Being Human in a Disembodied World, will be published by W.W. Norton in September.