Bad Therapy: Why the Kids Aren't Growing Up

“Parents often assume that therapy with a well-meaning professional can only help a child or adolescent’s emotional development. Big mistake. Like any intervention with the potential to help, therapy can harm.”

Shrier emphasizes the many potential negative side effects of therapy, such as an unhealthy focus on one’s feelings and a poor self-esteem. In presenting a Critique of Modern Psychotherapeutic Methods, she highlights their potential to cause young people to perceive themselves as defective. She argues that too many psychologically healthy people go to therapy and are harmed from it.

“Participating in group therapy to discuss a problem you didn’t already have? That may be sufficient to introduce it.”

Emphasizing a potentially negative effect from therapy sessions, Shrier maintains that group discussions can normalize unwanted behaviors and cause young people to experiment with those behaviors. She cites the example of the DARE program, which increased substance abuse.

“But she also casually bundles two sets of friends, as if they are one: those whose mental illness is so profound that it requires psychiatric commitment, and those who are seeking explanations for their unhappiness and discovering diagnoses.”

Shrier argues that members of Generation Z do not distinguish those with serious mental illnesses from those with mild forms of anxiety or depression. While Shrier wants to distinguish these groups and focus her Critique of Modern Psychotherapeutic Methods on the latter, she does not present an operational definition or categories to do so.

“And yet as treatments for anxiety and depression have become more sophisticated and more readily available, adolescent anxiety and depression have ballooned.”

Shrier attributes causality to this correlation, arguing that mental health treatments are a cause of increasing levels of anxiety and depression among adolescents. Focusing on the normalization of mental health awareness, Shrier accuses practices associated with such awareness of contributing to poor mental health.

“Therapy, when it works for adults, gets its power from the patient’s buy-in. But a child or adolescent who enters therapy invariably does so because she was strong-armed by an adult.”

Given the power differential between a therapist and a child, a child is unlikely to question ill-advised suggestions from a therapist. Therapy additionally has a demoralizing effect on children because they assume that their parents believe something is wrong with them. Furthermore, a child assumes they are in treatment because the parents cannot help them.

“But possibly the grimmest risk of antidepressants, antianxiety meds, and stimulants is the primary effect of the drugs themselves: placing a young person in a medicated state while he’s still getting used to the feel and fit of his own skin.”

Shrier dwells upon the negative effects of medication, such as side effects, but she also asserts that the intended effect of relieving anxiety or depression can be negative. She argues that anxiety and depression, when exhibited in healthy individuals, are natural responses that help people identify dangers and cope with failure. She does not acknowledge the potential benefits of these medications for anyone who doesn’t fit her definition of sufficiently mentally ill and thus deserving of treatment.

“In a remarkably unregulated profession, therapists still have a few ethical bright lines. And among the clearest is—or was—the prohibition on ‘dual relationships.’”

Criticizing school counselors and therapists for violating this ethical rule, Shrier explains that they by definition have dual relationships with their clients or students. In other words, they know the child’s friends, parents, and teammates, for example. One child might be speaking in therapy about another child, whom the counselor also sees. This may influence a therapist’s ability to be objective and offer unbiased advice.

“Rarely, if ever, do the lessons contemplate that a parent’s rule should simply be followed. The conceit is that parents and children exist on equal footing (though, of course, the school counselor presides over both).”

Highly critical of social-emotional learning, Shrier maintains that the method and the counselors who develop and administer it undermine parental authority. She accuses it of denigrating parents and undermining the child-parent relationship. Aiming to make The Role of Parents in Childrearing once again the most influential, Shrier sees social-emotional learning as something to resist.

“Delinquency is up. Chaos reigns. The system that elevated emotional harm to physical harm wound up excusing physical harm in the name of emotional well-being.”

Shrier blames the excusal of physical harm and bullying on the practice of restorative justice, which recommends counseling and positive intervention for bad behavior instead of punishments like suspensions and expulsions. She argues that the practice does not work and re-victimizes those who were physically bullied. It is another one of her critiques of modern psychotherapeutic methods.

“That is far from the majority of kids, and it is dangerous to conflate those who have suffered years of sexual abuse or been intentionally starved or burnt by the parents who are supposed to love them with those who have faced ‘adversity.’”

Shrier is critical of the extension of mental health screening to all children and to the use of therapists and medications for what she considers minor problems. For those with major problems, amateur therapists in the form of educators, per Shrier, are likely to do more harm than good. She recommends that schools get out of the business of psychology and focus on learning. This conflicts with her expressed desire to protect children’s and family’s privacy; to ascertain which children she finds deserving of therapeutic treatment would require investigating a child’s personal circumstances.

“Harvard University psychology professor Richard McNally has called repressed memory therapy ‘arguably the most serious catastrophe to strike the mental health field since the lobotomy era.’”

In her Critique of Modern Psychotherapeutic Methods, Shrier highlights the injustices from the 1990s when courts convicted innocent people of child abuse because of testimony from psychologists about the accuracy of repressed memories. She laments the return of this debunked technique in the popular imagination in the 2010s. In reminding readers of the abuses in the field of mental health, such as lobotomies and reliance on repressed memories, Shrier provides context for her scathing critique of therapeutic practices.

“That’s why the proper way to conduct a study on the long-term effects of childhood trauma is to create a prospective, or forward-facing, study.”

Highly critical of van der Kolk’s studies linking brain differences or damages to childhood trauma, Shrier explains that retrospective studies suffer from selection and information bias as well as confounding variables. Those adults who have a psychological problem, for instance, are more likely to recall childhood trauma and attribute the problem to that. She concludes that there is no proof that childhood trauma causes mental health problems in adults.

“But even if no adolescent attempts suicide after extensive questioning like this, there can be no doubt that it normalizes suicide for them. If you were a kid in high school, you might even think nearly everyone was contemplating self-destruction.”

Shrier argues that mental health screening in the form of questionnaires have negative side effects, giving students ideas about suicide and other problematic behaviors. They normalize dangerous behaviors that very few contemplate. As a result, she is highly critical of the normalization of mental health awareness. While her point may come from a place of concern, the conclusion here is ultimately speculative.

“Under the banner of ‘whole child’ education and ‘trauma-informed care,’ educators greet every child with the emotional analogue of a gurney, all but begging kids to hop in.”

According to Shrier, mental health awareness causes children to assume that it is normal to be psychologically unstable. Rewarded for sharing feelings about trauma, Shrier contends that children make stories up or exaggerate details to win the attention of adults. Such a focus on feelings, she argues, increases anxiety and depression while undermining academic performance.

“Like the disempowered masses of a totalitarian regime, kids reach for the remaining implement in an otherwise empty toolbox: tattling.”

Because Shrier describes children and adolescents as dependent and highly monitored by adults, she compares them to citizens in totalitarian regimes. In such regimes, individuals are isolated, watchful of all, and prove their loyalty by turning in other citizens. She notes the increase in tattling, based on conversations with parents, and notes that young people retain embarrassing screenshots of their conversations with friends in case they become a target and need leverage.

“We assumed with perfect faith (and wholly without evidence) that gentler parenting could only produce thriving children. Shouldn’t flowers bloom in powdered sugar? Turns out, they grow best in dirt.”

Shrier argues that a permissive model of parenting, which she claims has been widely adopted by Generation X, does not work. It produces unhappy children who crave structure and authority. Instead, she recommends an authoritative model with The Role of Parents in Childrearing being one of leadership. The parent is loving and negotiates rules but retains control and final decision-making power.

“The approach to bad behavior is always therapeutic—meaning it is nonjudgmental. It’s the parent’s job to understand a child’s frustration—never the child’s job to control his impulses.”

Attributing this approach to gentle parenting, Shrier explains that it is backwards. It creates ill-behaved children and unhappy parents. Additionally, it instills no regard for others, as parents do not instruct children on the effects of behavior on siblings, friends, or the general public. This assumes that those who gentle parent don’t instruct children to consider the impact of their actions, and it implies that the authoritative method she prescribes requires ignoring the reasons behind their children’s behavior.

“For thousands of years, until the therapeutic turn in parenting, societies took it for granted that parents’ primary job was to transmit their values to their children. […] Once parents decided the goal of child-rearing was emotional wellness, they effectively conceded that the actual authorities were therapists.”

Per Shrier, the preoccupation with feelings and emotional wellness not only fails to produce well-adjusted adults, but it also demotes The Role of Parents in Childrearing. They were the experts about their own values. With this new goal, they defer to mental health professionals. This doesn’t acknowledge that emotional intelligence and understanding can be a value in and of itself.

“Depression’s well-known symptom—stopping you from engaging in social activity—may be evolution’s way of curtailing distraction so that you can reflect unimpeded on your problem.”

In psychologically healthy persons, depression and anxiety perform positive functions. In this case, depression causes people to take stock and perhaps make constructive changes to a poor situational environment. Shrier argues that medications should not be used to prevent depression and anxiety in all but the extreme cases, such as people with a long-term inability to function in society.

“We are not the subordinates of the school psychologist or the pediatrician or our kids’ teachers. We are more important than all of them combined.”

Referring to parents, Shrier encourages them to take control from teachers, physicians, and mental health professionals. Parents are primarily responsible for their children, including their upbringing. While mental health experts preach the need for expertise in parenting, the reality is that parenting is a relationship. Shrier asserts that parents need not consult mental health professionals for advice because their instincts should be sufficient.

“And yet my generation’s style of parenting has been characterized by the opposite: accommodation. Parents working overtime to create a noiseless, sanitized, pain-free terrarium for kids who then cannot bear the world outside it.”

Shrier contends that moderate deprivation, challenges, independence, and risk are good for children and adolescents. Those who have such experiences are more likely to lead happy and successful lives because a child overcoming issues on their own will learn how to cope with problems in the future, while children who are only taught about problems in the abstract will be ill-equipped to handle things on their own. She thus chastises her generation for doing the opposite, overprotecting children and not subjecting them to any deprivation.

“One of the worst consequences of our hyperfocus on present feelings, our willful divorce from historical perspective, and the professionalization of our child-rearing is that we’ve devalued everything grandparents had to offer.”

Shrier maintains that Generation X limited or barred the access of grandparents to their children. When access is allowed, parents are quick to police interactions between grandparents and children. She considers this development a loss for children, though she does not provide data to support her claims about the prevalence or impact of this phenomenon.

“We’ve allowed our kids to drink from mugs full of such spoons: the iPad when they were little, then the iPhone, which was worse. Each began the process of vitiating their attention, leaching away their joy in the world around them, which could only pale in comparison.”

Citing the negative effects of technology and social media on children and adolescents, Shrier recommends that parents greatly reduce their children’s access to it. She additionally calls out the APA for not calling for reduced access to social media and the prohibition of phones in classrooms. This is an element of her overall argument that isn’t widely contested, as many agree on the negative impacts of screentime and phones on everyone, particularly children.