Why Therapy is Bad For Kids (Unless They Really Need It)
Why we need to stop making youth development so therapeutic and why it can be damaging to reach for therapy and diagnoses when they aren't necessary.
Hello Bar-Setters,
Abigail Shrier’s Bad Therapy starts with a disclaimer:
Talk of a “youth mental health crisis” often conflates two distinct groups of young people. One suffers from profound mental illness…. These precious kids require medication and the care of psychiatrists. They are not the subject of this book.
This book is about a second, far larger cohort: the worriers, the fearful, the lonely, lost, and sad."
For the first group, psychological expertise is a must. For the second group, psychological “expertise” is a major part of what has caused the “youth mental health crisis” in the first place.
Mental Health Natives
From the time they enter schools, today’s kids are saturated in emotional check-ins and talk about their feelings. Often, their parents promote the same in their adherence to gentle parenting techniques. But rather than turning kids into thoughtful, enlightened little bodhisattvas, these tactics actually prime them to be more distressed.
Acute feelings aren’t a very good barometer of happiness, it turns out. The happiest people are often distressed and uncomfortable. To some degree, in fact, what makes them happy is that they willingly enter uncomfortable states such as exercise, self-denial, and working on their relationships.
When we teach our kids to always monitor how they feel, we subtly suggest to them that if they don’t feel great something might be wrong. We teach them to obsess on themselves and their immediate comfort levels, rather than on the process of working toward meaningful goals.
According to emotions researcher Yulia Chentsova Dutton, training our kids to check on their emotions only makes the normal struggles of life that much worse:
Emotions are highly reactive to our attention to them. Certain kinds of attention to emotions, focus on emotions, can increase emotional distress. And I’m worried that when we try to help our young adults… what we do is throw oil into the fire.
Making a Mountain Out of a Molehill
Therapy culture teaches people to see negative emotional states as potential indicators of a mental health disorder.
Kids often begin to see normal emotional reactions as “symptoms” and to view their experiences as evidence of a larger disorder. They start to see the world in mental health terms.
As, Oxford psychologist, Lucy Foulkes writes:
Teenagers, who are still developing their identities, are especially prone to take psychological labels to heart. Instead of “I am nervous about X,” a teenager might say, “I can’t do X because I have anxiety” — a reframing that research shows undermines resilience by encouraging people to view everyday challenges as insurmountable.
Teaching Kids That They Can’t Handle Life Without Professional Help
Young people often start to believe that each challenge is more harmful than it actually is.
They become convinced that the inevitable sad parts of a life (such as a dog or a grandparent dying) are potentially debilitating traumas, which will require therapy to work past.
Kids are often convinced that they are not capable of dealing with normal life struggles without professional help.
Social critic Christopher Lasch saw this trend developing way back in 1991:
As therapeutic points of view and practice gain general acceptance, more and more people find themselves disqualified, in effect, from the performance of adult responsibilities and become dependent on some form of medical authority.
This also discourages depth in our relationships by keeping us from relying on the people who really know and care about us.
Where people would once chat about their struggles with the people closest to them, now every decision must be run through a professional. Consequently, many young people don’t develop a complex web of mentors and confidants who they can go to to help them process their challenges.
P.S. Therapy Doesn’t Work Well For Young People
Even when there is an actual disorder, the chances that a therapist can help an immature young person is quite low, according to child and adolescent psychologist Camilo Ortiz, who Shrier cites throughout her book. As Ortiz says:
Let’s say I’m the best therapist in the world and I teach her some amazing techniques for dealing with anxiety, on a Monday at four p.m. So we’re supposed to believe that on a Friday, when she’s dysregulated, and anxious, at age five, she’s going to remember what we talked about, and then be able to institute difficult techniques in a a moment of dysregulation? I can’t get adults to that. It just doesn’t work with children.
Ortiz claims that the parent-based therapy approaches are usually a far better way to treat young people who have a disorder.
Supportive Parenting for Anxious Childhood Emotions (SPACE) is one such treatment. SPACE has been very effective at treating childhood anxiety by teaching parents to stop creating an environment that enables their child’s avoidant, anxiety-stoking behaviors to persist.
The best treatment for anxiety is exposure therapy, whereby a patient gradually exposes themselves to the thing that is causing them anxiety. For example, someone with a fear of elevators can only get over that fear by riding the elevator. They might start by watching people get on an elevator. Then they might push the button and walk on and off. Then they might ride the elevator up one flight of stairs. Then they’d get on an elevator and ride up and down for five or ten minutes. This could all be accomplished within a couple of hours or less. As I’ve shared before, I know this process well.
But exposure never happens in homes where parents cater to their child’s anxiety and try to reduce their painful emotions. By accommodating their children’s desire to avoid discomfort, they make the problem worse.
The best way to help a young person is, often, to get their parent to stop “helping” their child avoid their fears and start creating an environment where the student has to gradually expose themselves to what provokes their anxiety the most.
Thank you for reading and sharing!
I can’t recommend Shrier’s book enough. Her chapter on modern schools is a must for all parents, educators, and modern citizens.
Also, if you are interested in learning more about my anxiety disorder and how I worked past it, see this post.
Carry the fire!
Shane