Bad Therapy: Why The Kids Aren’t Growing Up (Book Review)

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Title: Bad Therapy: Why The Kids Aren’t Growing Up
Author: Abigail Shrier
Publication Date: 2024 (book), 2024 (audio)
Publisher: Penguin Audio
Narrated By: Abigail Shrier
Recording time: 8 hours, 56 minutes

PUBLISHER’S SUMMARY

via Amazon:

NEW YORK TIMES BESTSELLER.

From the author of Irreversible Damage, an investigation into a mental health industry that is harming, not healing, American children

In virtually every way that can be measured, Gen Z’s mental health is worse than that of previous generations. Youth suicide rates are climbing, antidepressant prescriptions for children are common, and the proliferation of mental health diagnoses has not helped the staggering number of kids who are lonely, lost, sad and fearful of growing up. What’s gone wrong with America’s youth?

In Bad Therapy, bestselling investigative journalist Abigail Shrier argues that the problem isn’t the kids—it’s the mental health experts. Drawing on hundreds of interviews with child psychologists, parents, teachers, and young people, Shrier explores the ways the mental health industry has transformed the way we teach, treat, discipline, and even talk to our kids. She reveals that most of the therapeutic approaches have serious side effects and few proven benefits. Among her unsettling findings:

• Talk therapy can induce rumination, trapping children in cycles of anxiety and depression
• Social Emotional Learning handicaps our most vulnerable children, in both public schools and private
• “Gentle parenting” can encourage emotional turbulence—even violence—in children as they lash out, desperate for an adult in charge

Mental health care can be lifesaving when properly applied to children with severe needs, but for the typical child, the cure can be worse than the disease. Bad Therapy is a must-listen for anyone questioning why our efforts to bolster America’s kids have backfired—and what it will take for parents to lead a turnaround.

THE REVIEW

I was excited to read this, because I love trying to understand why things are the way that they are. This book did not disappoint. Bad Therapy is a thorough rebuke of not only a wide swath of modern parenting models, but of present-day American society as a whole. The book addresses the well-document problems now present in young Gen Z adults and how it happened. Shrier explains how the most recent generation of parents failed their kids by over-parenting, but also how and why society has collectively embraced and become guided by a therapy model that is not working. As I read this, I felt my own toes being stepped on multiple times, but I could not muster many internal arguments against a book that felt very much like a call to return to the traditional model, or at the very least, common sense.

The thing that struck me in reading the book is how very hard American parents have tried to do the right thing. If Gen X kids grew up feeling as though their parents left them to fend for themselves too often, a feeling that might be well-grounded in many cases, they responded by trying harder to be good parents than perhaps any generation ever has. The tragic irony is that so much of that effort has backfired in every imaginable way. Gen Z, the children primarily of Gen X, struggles with anxiety, depression, mental health disorders, and fearfulness of adulthood more broadly, more than any generation ever observed.

Shrier hits on a few points that just feel undeniably true.

• The extent to which many modern parents work around the clock to make perfect childhoods for their offspring, and to micromanage their child’s life to help them avoid difficulties, has led many parents into feeling as though their kid is a chore and a job. The kids pick up on this.
• By denying children the opportunity to experience risk, failure, danger, or discomfort, and work out solutions for those problems on their own, the kids are now reaching adulthood without ever having practiced risk, failure, danger, or discomfort. In short, they remain children. Developing resilience is an essential step toward becoming an adult. The modern culture of parenting and therapy is the culprit behind why this is happening.
• By insisting that all emotions should be dwelt upon, or talked about ad nauseum, we have taught “rumination” to an entire generation. Focusing on negative emotions can worsen mental health. If you focus on the negative, you begin to identify with the negative, and you lose the capacity for resilience, change, and growth. (This is why talk therapy does not work for many people and often makes their situations worse.)
• In many cases, there are bad incentives in play for therapists. An adult with a genuine disorder might be difficult or even dangerous to deal with. A teenager, with run of the mill teenage problems, and parents who always pay on time, can represent a preferable, long-term, income stream.
• The problem of bad therapy is that it has infected society as a whole, particularly public education.

“Therapists weren’t the only ones practicing bad therapy on kids. Bad therapy had gone airborne. For more than a decade, teachers, counselors, and school psychologists have all been playing shrink, introducing the iatrogenic risks of therapy to school kids, a vast and captive population.”

The culture of therapy has swept over almost the entirety of American society and is often wielded by authority figures who are inadequately trained – including public school teachers and public school counselors. Shrier gives several examples here. Something as seemingly innocuous as mandatory “emotional check-ins” to start the day, somethin that has become common in public education, has the power to lead to negative rumination by students, which would not have otherwise occurred. The reality is that happiness is fleeting, so if you ask someone to define themselves emotionally to start the day, then you might be unwittingly be setting that person up to define their whole day negatively. This is particularly true with children.

Shrier mentions that the first time anyone mentioned that her daughter might have an anxiety disorder was at a parent-teacher conference, when an assistant teacher suggested this after noticing Shrier’s daughter staring frequently at the clock. Shrier provides several other and better reasons for why her daughter may have done that and then notes that a generation earlier, it was unlikely her daughter would have been scrutinized in this way, over merely looking at the clock. Today, it is the culture of untrained adults (who barely know the kids in question) to casually suggest concern and to then advocate for therapy.

In traditional therapy, the therapist was ethically forbidden from having dual relationships. This guardrail existed to protect the patient from exploitation. In the public school setting, the teachers and counselors have dual relationships all over the place. When this obvious ethical problem became obvious, the longstanding ethical rule was revised in 2006 to allow therapists to have dual relationships, provided the therapist was not having a current sexual relationship with a current client. (This is like lowering crime statistic by making crime legal.) Perhaps unsurprisingly, with this change in mind, American news cycles are now replete with stories about parents fighting with public school counselors and administrators over what they deem to be abuse and exploitation of their children. American children are now somewhat commonly diagnosed and treated for gender dysphoria, and encouraged to transition, all while the parents are kept in the dark that this is happening. Many U.S. states make it legal for schools to keep any student-counselor discussions secret from the student’s parents. Does a school counselor know a child’s family medical history? Does a school counselor know a child as well as his or her parents? Should we assume the counselor has the interest of the student more in his or her heart than the child’s parents? Do parents have the right to seek out second opinions, and to reject the school counselors’ opinion if the psychiatrist they hire provides a different diagnosis or treatment? Shrier says that one of the parents she interviewed for the book discussed a school counselor who even advised a student in question to secretly seek out a youth asylum and legal emancipation.

“There are good school counselors, I interviewed several, but the problem is that the power structure is all wrong. Grant a leader the powers of a monarch and he may give his subjects freedom. But what’s to tether him to his promises? That’s placing a whole lot of trust in an individual counselor’s conscience.”

In one other harrowing example, Shrier describes a Social and Emotional Learning group session (which occur in public schools everywhere), wherein a genuinely emotionally traumatized elementary school student is coerced into sharing a painful personal trauma for the benefit of the group. Now imagine being a minor and feeling coerced into sharing pain over your parents’ divorce, or your own sexual abuse history, in a circle of your peers in the name of “Social and Emotional Learning.” Common sense suggests that asking students to do this is ludicrous but it happens regularly. Remember that therapists used to be barred from dual relationships to avoid exploitation. What bars fellow students from exploiting the pain of a classmate? Nothing. In this way, SEL group therapy re-abuses some of its participants.

Shrier gives an academic history as to how we got here. Much of the modern therapy culture, she says, can be traced back to the notion of childhood trauma, which works for many people as an unfalsifiable explanation for all present-day woes. It explains all our troubles while also letting us off the hook for them. It also means that nearly everyone can be argued to need talk therapy. Dutch psychiatrist Bessel van der Kolk and his book, The Body Keeps the Score, are origin points for this concept. The problem, as Shrier points out, is that despite his fame, many other leading experts consider his theories to be “a bill of goods.” Van der Kolk’s ideas previously wore the descriptor of “repressed memory therapy” but after the psychiatric community distanced itself from that concept (a professional cited by Shrier described “repressed memory therapy” as the worst thing to happen to psychiatry since lobotomies), his ideas returned rebranded as “(childhood) trauma therapy.” Despite van der Kolk’s ideas virtually vanishing in peer reviewed literature, much of the modern therapy landscape is still built around them. It’s not hard to understand why. This notion benefits the patient who wants absolution from his or her own problems. This notion benefits the therapist who wants a steady paycheck and a world in need of his or her services. The loser though has been an entire generation of people who have been encouraged not to develop the coping skills or resilience traditionally associated with adulthood.

Shrier ends the book with an exhortation to parents to stop handing over the care of their children to “experts,” noting that many of the experts don’t deserve that title and that this practice has been an unequivocal failure. Instead, she encourages parents to let kids be exposed danger and risk at an early age – the way human beings always previously reared their kids. She also encourages parents to give kids exposure to their extended family, for better or worse, so that they can learn to face and deal with things outside the norm of their nuclear family, but while still safely ensconced in an environment of love. She notes also that this will help children not only to develop into adulthood, but also to feel as though they are part of a genetic heritage with a history of success in navigating the world. That, she argues, should reduce a child’s fear in navigating the day-to-day of adulthood.

One area wherein I wish the book had delved more deeply was the psychology of why a generation of parents abandoned the existing system and turned to experts in the first place. I suspect that Gen X in particular was its own unique break from norms. While there has always been a certain amount of freedom given to children, perhaps they were collectively given too much freedom. The parenting of Gen Z – largely the children of Gen X – might have been an overreaction in the opposite direction.

I found Shrier’s book to be compelling. Anecdotally, Gen Z seems to be much more timid and unconfident than earlier generations. When I have sat in on job interviews from that age group, counter-intuitively the most confident and competent applicants were former home-schoolers. I have heard other people my age relay the same stories. “They wouldn’t look me in the eyes.” “They brought their mom to the interview.” “They seemed terrified to talk on the phone.” “They didn’t seem to want to learn how to drive.” Bad Therapy provides a very plausible explanation as to why this has happened and also a strong argument for how to fix the situation. This is of course not going to be easy. Nobody is comfortable letting their children do what feels like dangerous tasks. It is more difficult to be less fearful as a parent, today, inculcated in a 24 hour news cycle of non-stop fearmongering. In addition, once an ecosystem of jobs takes root, it is tough to remove it. A return to traditional norms will mean removing a lot of therapy jobs from public schools and other places and returning the focus of those places to their original purpose. I doubt the therapists will go quietly. That said, are our kids worth the effort? Absolutely.

I highly recommend Bad Therapy and if you’ve had a chance to read it, I’d love to know what you think. Did it speak to you? Did it change your views?