EF Volart

Therapy is making children ill

What would really help children’s mental health is talk about resilience


This article is taken from the April 2024 issue of The Critic. To get the full magazine why not subscribe? Right now we’re offering five issues for just £10.

If you don’t have words to express a thought, can you even think it? The idea that language shapes cognition is known as the Sapir-Whorf hypothesis, after American linguist Edward Sapir and his student Benjamin Whorf. Almost a century after it was proposed, it’s still controversial. Many thoughts aren’t really linguistic — they’re more like visual or other sensory impressions — and anyway, if thinking follows language, how, then, does language arise?

The 21st century has brought with it a new test for the hypothesis that language at least shapes cognition, even if it doesn’t entirely constrain it: the rise of therapy-speak and its impact on mental wellbeing.

More than a century ago Sigmund Freud gave the world the subconscious, phallic symbols, the Oedipus complex and much more — phrases that encode theories about what it means to be human and to be mentally distressed or well, and which are now commonplace in popular culture.

Batman is the superego and the Joker the id; Darth Vader symbolically castrates his son, Luke Skywalker, by cutting the lightsaber from his hand. Woody Allen’s films normalised the once-unthinkable idea that your miserable life or marriage might be improved by paying a professional to rummage through your memories and dreams.

All this happened despite few people actually undergoing therapy. What if that changed? For an answer, look to America. The national obsession with self-improvement and reinvention meant therapy was embraced early, and it is now on its way to being universal.

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In Bad Therapy, published in February, journalist Abigail Shrier — author of Irreversible Damage, which anatomised the huge increase in the number of teenage girls identifying as trans — turns her fearless gaze on America’s latest malign social trend: a bastardised form of therapy that’s making its youth more fragile and sadder.

Bad Therapy: Why the Kids Aren‘t Growing Up, Abigail Shrier (Sentinel, $30)

A remarkable share of young Americans — at least two-fifths of 15–21 year olds — have been treated by some sort of mental health professional. Ideas that originate in therapy are further propagated by a “bad feelings industry” of parenting gurus, teachers and school counsellors. The gurus preach “gentle parenting”, which seems to mean abandoning all authority and turning yourself into a punchbag for infant domestic tyrants. Meanwhile in schools, teachers and counsellors peddle “social emotional learning”, “empathy education” and “feelings check-ins” predicated on similar ideas.

The global influence of American culture via the entertainment industry and social media amplifies the trend: TikTok is teeming with photogenic young people suggest-selling mental conditions with checklists reminiscent of the cold reading technique employed by stage clairvoyants and other charlatans. Ever found it hard to listen when others talk, or had good ideas but not followed through? Congratulations! You are now the proud possessor of self-diagnosed “attention deficit hyperactivity disorder” (ADHD).

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Then there are the apps disintermediating and commodifying therapy. Some offer one-off sessions via Zoom or subscriptions entitling you to unlimited texting with a therapist. The latest, with perky names like Woebot, Earkick and Mindspa, use AI chatbots. Soon, therapy will be like Vitamin B in breakfast cereal or fluoride in water: a mass public health intervention dispensed to all.

Unlike Vitamin B or fluoride, Shrier argues, therapy as it is practised in America often causes the very harms it’s supposed to cure. One way that happens is by over-diagnosis. A startling sixth of American children aged two to eight have been formally diagnosed with a mental disorder; a tenth of under-18s have been diagnosed with ADHD alone.

No doubt some of those youngsters have severe emotional or behavioural problems. Whether the prescriptions that often follow diagnosis do any good is another matter. By attaching labels to an ever-wider range of personal quirks and challenging circumstances, this brand of therapy encourages people to think about them as permanent characteristics to be medicated rather than things they could learn to manage or might outgrow. It frames subpar behaviour as something you possess, not something you do.

Another problem is that simply talking about bad feelings can conjure them into existence. Think of those school wellbeing check-ins: a normal response to being randomly questioned about your emotional state when you’re going about your day is “fine — until you asked”.

Worst of all, Shrier documents the proliferation of surveys that ask pupils eye-popping questions about suicidal thoughts: how frequent, how intrusive, which methods? Thus suggesting to children that suicide is normal, even common, along with handy hints on how to do it. Indeed, the suicide rate amongst Americans aged 10-24 has risen by two-thirds in a decade. These are words that kill.

Life can break people, and whether they recover depends in large part on how their culture describes the injury, and the stories it tells about human nature. Which is the norm: resilience or fragility? Does suffering make you wiser or leave permanent scars? If you tell people about panic attacks, self-harm and eating disorders — even with the aim of encouraging sufferers to seek help — you teach people that this is how to express psychological distress. Some of them will oblige.

This phenomenon was christened the “symptom pool” by Edward Shorter, a historian of medicine. Each society recognises a set of psychological disorders, and patients’ mental distress is fitted into one of these by patients themselves in partnership with that society’s authorities, be they witch doctors, faith healers — or wellbeing gurus and TikTok influencers.

Tell them that bad experiences are likely to cause trauma, and often those experiences will

In his 1992 book From Paralysis to Fatigue: A History of Psychosomatic Illness, Shorter describes ailments no longer seen, such as hysterical blindness (sudden, unexplainable loss of vision) and vicarious menstruation (nosebleeds following a monthly cycle, supposedly because of a “reflex action” of the womb on the nervous system). If people think that’s how bodies and minds work, then that’s how they work. Similarly, tell them that bad experiences are likely to cause first trauma and then post-traumatic stress disorder, and very often those experiences will.

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Bad beliefs don’t just cause mental ill-health; they cause bad treatment. Hysterical blindness and vicarious menstruation were treated by removing women’s reproductive organs, thrusting them into premature menopause and leaving them infertile. Today’s equivalent, arguably, is the mass prescribing of psychoactive drugs to children and adolescents, with unknown consequences for their future brain function.

From abroad, Shrier’s book reads like dystopian science fiction — but bad therapy is coming our way. Already British schools are peppering the calendar with mental health days, giving pupils questionnaires that normalise dysfunction and signing them up to apps that ask endless, intrusive questions about their mood.

Many youngsters across the Anglosphere now talk like a cross between a wellbeing influencer and a daytime TV talk-show host. Friends who are teachers say that stress and anxiety are ubiquitous; negative experiences result in trauma and perhaps PTSD. That these disorders are often self-diagnosed is the less important part of the problem: more serious is that these explanations deny agency and responsibility, and make children feel worse, for longer.

By now you may be thinking that all this is a travesty of proper therapy. True enough: a good therapist can help you learn how to let go of unproductive anxiety, rumination, regret and rage, and will avoid foreclosing the possibility of change and growth. It is the opposite of the encouragement to self-absorption Shrier describes.

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What would really help children’s mental health is talk about resilience, strength and recovery, not trauma, fragility and relapse. In the meantime, tell yours to let their minds wander during assemblies on mental health and wellbeing, and if they have to fill in some damn-fool questionnaire on these topics, to avoid reading it and answer at random.

Opt them out of everything to do with mental health and complain to the school, too — we haven’t quite reached the situation in many American states, where schools have more rights over children than parents do.

The aim should be to reject these terrible descriptions of the human condition before they have time to take up residence in your head. Remember the wise words of Terry Pratchett in his Discworld novels, where what happens after you die is whatever you believe will happen — and it is therefore, as he deadpans, “important to shoot missionaries on sight”.

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