Bad Therapy Book Summary
Why the Kids Aren't Growing Up
Book by Abigail Shrier
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Summary
In "Bad Therapy," journalist Abigail Shrier argues that today's pervasive "therapeutic" culture and overzealous mental health interventions are harming young people by promoting learned helplessness, pathologizing normal emotions, and inhibiting the development of resilience.
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1. Healers Can Harm
Parenting In An Era Of Widespread Therapy
The introduction discusses how the author's son was subjected to an intrusive mental health screening when taken to the doctor for a stomachache. This incident made the author realize how prevalent therapeutic interventions have become for today's children, even when not clinically indicated.
The author argues that in the past 75 years, mental health treatment has rapidly expanded to now routinely encompass children and adolescents. Despite more therapy than ever before, rates of anxiety, depression and mental illness in young people have paradoxically worsened over recent generations. The introduction sets up the book's core argument that therapeutic culture and overzealous mental health interventions may actually be harming kids.
Section: 1, Chapter: 0
The Loneliest And Most Anxious Generation
The rising generation, despite receiving unprecedented mental health accommodations and resources, has become the loneliest, most anxious, depressed, pessimistic, and helpless cohort on record. 42% have a diagnosed mental illness. Therapists insist this is because young people face more stressors than ever, like smartphones, the pandemic, and climate change. But the author argues youth mental health has been declining for decades before these factors. She believes the real problem may be the mental health system itself - convincing kids they are disordered, inculcating feelings of helplessness, and inhibiting normal development.
Section: 1, Chapter: 0
Therapy Can Help, But Crucially, It Can Also Harm
While therapy has the potential to provide relief for mental health issues, it's critical to recognize it also carries risks of harm (iatrogenesis). Potential negative effects include:
- Convincing a patient they are sick and organizing their identity around a diagnosis
- Encouraging family estrangement and loss of key support systems
- Reducing resilience and self-efficacy
- Retraumatizing a patient
- Fostering excessive dependence on the therapist
Especially for children, the power imbalance between therapist and patient makes them vulnerable to harm. Parents should carefully weigh risks and only pursue therapy for kids if clearly needed.
Section: 1, Chapter: 1
More Treatment Has Not Meant Less Mental Illness
Despite a 75-year surge in mental health treatment availability and sophistication, rates of anxiety and depression in young people have swelled. A "treatment-prevalence paradox" has emerged, where expanded access to therapy and medication has not reduced mental illness prevalence as expected.
Therapists argue this is because today's youth face unprecedented stressors compared to previous generations, such as smartphones, social media, the COVID-19 pandemic and lockdowns, and climate change fears. But the author contends that adolescent mental health has been slipping since the 1950s, long before these modern issues existed. She suggests that perhaps the mental health complex itself, in pathologizing normal stress, inhibiting coping skills, and creating dependence, is part of the problem rather than the solution.
Section: 1, Chapter: 12
Gen Z: The Most Fearful Generation
Psychologist Jean Twenge's research shows Gen Z is radically different from prior generations. They are:
- Far less likely to hit traditional milestones like dating, getting a driver's license, or holding a job
- More obedient to authority and politically radical, favoring far-left positions
- Deeply pessimistic about their personal potential and the world's trajectory; convinced of their own helplessness and an external locus of control
- Uncomfortable with in-person interaction and spend less time socializing
Twenge posits constant monitoring by hovering parents and schools, exposure to an unrelenting stream of negativity, and lack of independence may all be factors in this generation's unprecedented fragility and external locus of control.
Section: 1, Chapter: 2
Don't Look To Feelings As A Reliable Guide
Therapy often teaches kids to see their feelings as a valid and important signal. But feelings can be unreliable and manipulable, according to Dr. Yulia Chentsova Dutton. She argues emotions don't necessarily reflect reality and can lead us astray if followed uncritically.
Asking kids repeatedly how they're feeling has downsides. Dr. Michael Linden argues it inherently elicits negative responses, as most of the time we feel "just okay" while ignoring minor discomforts. Chentsova Dutton says focusing on momentary emotional states promotes an unhelpful "state orientation" vs the "action orientation" needed for achievement. For emotional regulation and success, kids need to be taught to be sometimes skeptical and dismissive of passing feelings.
Section: 1, Chapter: 3
The Proper Response To Trauma May Be Not Talking About It
Dr. Richard Byng runs a program helping ex-convicts, many of whom experienced severe childhood trauma, reintegrate into society. But he's found constantly probing their traumatic memories to be counterproductive. "Quite the opposite," he argues. For those with trauma, the healthiest approach is often to acknowledge it briefly, then pivot to focusing on the present.
Byng criticizes a culture of therapy that assumes everyone benefits from talking through their pain. The insistence on "processing" can make trauma loom larger. Some do best moving forward without dwelling on the past. Even for the traumatized, a level of healthy repression is often necessary to functioning.
Section: 1, Chapter: 3
Good Therapy Doesn't Create Disorder Where None Exists
"Ortiz absolutely believes in the ameliorative power of specific kinds of therapies, especially cognitive-behavioral and dialectical behavior therapies (known as CBT and DBT) for remediating specific ailments like tic disorders, affective disorders, and obsessive-compulsive disorder... But he has enough respect for the power of therapy to reject the idea that everyone should be in therapy, a notion Ortiz likens to a surgeon who ventures: Well, he looks healthy, but let's open him up and see what we find."
Section: 1, Chapter: 3
2. Therapy Goes Airborne
Social-Emotional Learning: Therapy Disguised As Education
Social-emotional learning (SEL) has become a pervasive part of school curricula, aiming to teach kids "self-awareness," "social awareness," "relationship skills," "self-management," and "responsible decision-making." In practice, this often involves teachers eliciting highly personal information from students, documenting it, and providing feedback.
Despite claims it improves behavior and achievement, many teachers report SEL induces emotional dysregulation in students. Lacking therapists' training and ethical boundaries, educators are ill-equipped to manage the fallout. Rather than boosting learning as promised, SEL disrupts it with psychological meddling of dubious benefit.
Section: 2, Chapter: 4
SEL Undermines Parent-Child Relationships
Across SEL curricula, a troubling theme emerges: encouraging students to question their parents' judgment and cast them as obstacles to their well-being. Lesson plans often present conflicts with parents (on issues like screen time or clothing choices) and invite classmates to weigh in on whether the parent or child is being more reasonable. Students are asked to evaluate their parents on metrics like emotional supportiveness and time spent together.
Some programs go further, explicitly coaching students to monitor their home lives and report back concerns to teachers. The implication is that school staff are the real experts on a child's best interests, and parental authority is something to be challenged.
Section: 2, Chapter: 4
The Rise Of The Classroom "Shadow"
A growing number of students now have a dedicated adult aide or "shadow" that follows them throughout the school day. Shadows are now assigned for much broader behavioral issues like distractibility, social difficulties, or to provide emotional support and on-the-spot therapeutic interventions.
While intended to help kids succeed and prevent stigma, many students figure out which classmate a shadow is assigned to. It's unclear whether the constant adult presence and surveillance actually boosts learning and autonomy or hinders kids' self-regulation and problem-solving abilities in the long run.
Section: 2, Chapter: 5
Unintended Harms Of Excessive Academic Accommodations
Angela allowed her son Jayden to receive a 504 plan for untimed tests in high school due to his anxiety, on the advice of his counselor. But she believes it ultimately did more harm than good. "I really regret it because he used it as a crutch. Like, 'Oh, I can't turn the paper in on time because I have a 504 [plan],' " Angela said. "We thought we were helping, and I realized all these things are not helpful."
Teachers report a surge in students, often without a formal diagnosis, getting "accommodations" like extended deadlines, permission to miss class, or exemptions from assignments deemed too stressful. The line between legitimate disability accommodations and avoidant coping has blurred.
Section: 2, Chapter: 5
"Restorative Justice" Leaves Misbehavior Unchecked
Under the banner of "restorative justice," schools have shifted from punishing student misbehavior to accommodating it as a mental health issue. When fights, bullying, or disruption occur, interventions focus on eliciting the perpetrator's underlying pain, not imposing consequences.
Teachers report the approach emboldens students to act out without fear of repercussions. Serious infractions like physical assault often receive only a "talking to." The touchy-feely response leaves victims feeling revictimized and fails to curb the most violent offenders, who quickly realize they can get away with almost anything. Therapeutic victim-blaming has made schools less safe for the rule-following majority.
Section: 2, Chapter: 5
ACEs: An Unscientific Checklist For Lifelong Damage
The "adverse childhood experiences" or ACEs concept has become ubiquitous in education. It claims that kids exposed to various stressors (abuse, neglect, parental mental illness, etc.) are primed for a host of poor life outcomes from disease to delinquency.
But the original ACEs study was never intended as a screening tool for individuals. Misapplied, it massively overpredicts trauma prevalence and impact. Researchers conflate correlation and causation, retrospectively linking adult woes to childhood events. Genetics, temperament, and environment all influence whether difficulties derail or strengthen a child. Kids deserve high expectations and opportunities to prove their resilience, not preemptive pigeonholing as "damaged goods."
Section: 2, Chapter: 6
Empathy Alone Is A Poor Basis For Helping Traumatized Kids
Many trauma-informed educators argue the primary way to help struggling students is by empathizing with their pain. But this is often counterproductive:
- Encouraging kids to see themselves as victims risks a self-fulfilling prophecy. Resilience, not fragility, should be the message.
- Focusing on validating kids' feelings of anger and hurt can inadvertently reinforce and prolong them. Pivoting to problem-solving builds more constructive habits.
- Lowering academic expectations robs disadvantaged kids of a path out of difficulty. Belief in their potential and insistence they develop their abilities maximizes possibilities.
Kids' hardships merit compassion, but pity is less productive than challenging them to transcend circumstances.
Section: 2, Chapter: 6
Mental Health Surveys Teach Kids To Pathologize Normal Experiences
The mental health surveys administered by schools don't just ask students to disclose serious issues like abuse or self-harm. They also encourage adolescents to reinterpret normal challenges and stressors as major risk factors.
But by training kids to view these difficulties through the lens of potential trauma and mental health crisis, rather than simply part of life, the assessments make problems loom larger.
Students absorb the message that ordinary pains are extreme and may believe they're not equipped to handle them. Rather than promoting honest self-reflection and healthy coping skills, the surveys teach kids to ruminate on distress, see themselves as fragile, and turn to authorities for healing.
Section: 2, Chapter: 7
Students Full Of Empathy, Devoid Of Decency
An elite NYC private school girl became a pariah after joking with friends over text about ill-advised Halloween costumes (like dictators or abstract concepts). Though her intent was benign teen humor, not genuine bigotry, classmates reported her to the administration for racism and anti-Semitism.
The incident epitomizes a broader trend. The same schools most aggressively teaching "social-emotional skills" like empathy are often cauldrons of vicious student-on-student cruelty. Researchers find over-emphasis on empathy counterintuitively fuels self-righteousness and merciless treatment of "offenders." In trying to create kinder campuses, progressive pedagogy has unleashed a new meanness instead.
Section: 2, Chapter: 8
Empathy Makes Us Tribal, Not Impartial
"Empathy is a spotlight focusing on certain people in the here and now. This makes us care more about them, but it leaves us insensitive to the long-term consequences of our acts and blind as well to the suffering of those we do not or cannot empathize with. Empathy is biased, pushing us in the direction of parochialism and racism."
"You cannot empathize with more than one or two people at a time. Try it." - Paul Bloom, The Case Against Empathy
Section: 3, Chapter: 8
A Generation Of Parents Afraid Of Their Kids
Many Gen X parents, seeking to raise their kids more gently than they were raised, have swung to an opposite extreme. Permissive parenting styles avoid punishment, constantly affirm the child's feelings, and abdicate authority. But in trying so hard to be their child's friend, these parents often earn their disrespect instead.
Parenting coaches report moms and dads tolerating egregious misbehavior and backtalk from even very young kids. The "gentle parenting" fad has created a generation of insecure kids and desperate parents.
Section: 2, Chapter: 9
"Don't Yell At And Punish Your Child"
Progressive parenting gurus have long argued that disciplining children damages them. The implication is that setting firm limits will spawn a sociopath, so parents should just pleasantly reason with kids instead.
But child psychologist Diana Baumrind found the opposite in her seminal studies on parenting styles. Children raised with clear rules and consequences, in the context of a warm relationship, had the best outcomes. Those whose parents avoided all punishment had more behavior issues.
Baumrind called the permissive approach a "misguided attempt to express love," with the "unintended effect of retarding the development of a child conscious and increasing the likelihood of his becoming a spoiled brat."
Section: 2, Chapter: 9
Why ADHD Shouldn't Be Considered A Disorder
Israeli psychologist Yaakov Ophir argues that ADHD fails to meet the medical criteria for a mental disorder:
- It's not "deviant." With up to 20% of children diagnosed, ADHD is too prevalent to be abnormal.
- It doesn't cause the child distress, only potential issues in certain environments.
- It doesn't prevent basic functioning and self-care.
- ADHD traits pose no inherent danger, and may even be advantageous in some contexts.
By definition, a mental disorder interferes with life activities across settings. Ophir contends that ADHD is better understood as a common set of traits that can be channeled positively with the right parenting and accommodations. Labeling it an illness requiring medication may do more harm than good.
Section: 2, Chapter: 10
Numbing Normal Feelings Robs Teens Of Crucial Skills
Many parents, in an effort to alleviate their teens' distress, are quick to seek medication for the normal mood swings of adolescence. But psychologist Scott Monroe cautions there are serious drawbacks to this:
"If you give [adolescents] medication for anxiety - and I would say, you could extend it to depression - if you palliate those symptoms, you are messing with the natural adaptive resources of the human being that has evolved over centuries. I'm not a biologist - I don't know how badly it can impair brain development. But it seems like those are prime years. I'd want to find alternatives before implementing that."
Experiencing difficult emotions like heartbreak, disappointment, anxiety and sadness - and learning to cope with them - is part of how teens build resilience.
Section: 2, Chapter: 10
When Suffering Becomes Identity
Melanie has accommodated her son Dylan's every sensitivity, avoiding activities and situations that make him uncomfortable. Finally one prescribed Lexapro, an antidepressant, despite no clear diagnosis. Now Melanie wonders if the medication is even helping as Dylan's anxiety continues to rule the family's life.
For kids like Dylan, a diagnosis often becomes the organizing principle of their identity. Minor setbacks feel catastrophic as they lose faith in their own natural resilience. Well-meaning parents, overly focused on "fixing" their kids with therapy and meds, end up pathologizing them instead.
Section: 2, Chapter: 10
3. Maybe There's Nothing Wrong with Our Kids
Parents, Not Experts, Belong In The Driver's Seat
In an era of ubiquitous "expert" parenting advice, it's easy to forget a basic truth: parents, not psychologists or teachers, bear ultimate responsibility for their children. Moms and dads shouldn't be afraid to push back against well-meaning but misguided intrusions from professionals, especially when it comes to mental health overreach.
The author recalls how her own grandmother shut down an art teacher who suggested her dreamy son might have a psychiatric issue: "I pay you to teach him art, not to psychoanalyze my son." Kids are often better served by parents who trust their own judgment and authority over that of a revolving door of experts. Guardians may not have PhDs, but they have the deepest possible stake in their child's welfare. Outsourcing this sacred duty to therapists and educators can erode the parent-child bond.
Section: 3, Chapter: 11
Credentialed Experts Lack Skin In The Game
"Today, the story would likely proceed differently. The mother would panic and invite the art teacher to tell her more. The rest of the snowball's descent is predictable. At the parents' invitation, a now-familiar phalanx of professionals would blunder in, lodging themselves between parent and child: therapists, teachers, educational and parenting experts, psychiatrists, and even activists - anyone with an opinion about a child they may have just met and for whom they have neither love nor responsibility. None of whom bears the slightest consequence of their bad advice."
Section: 3, Chapter: 11
What A Lonely, Therapy-Saturated Childhood Looks Like
Today's teens have less in-person interaction and laughter with friends than ever. Their time is heavily scheduled and surveilled by hovering adults. School has become a vortex of "trauma-informed" emotional labor, not academics.
Immersed in the therapeutic worldview, many are quick to pathologize setbacks as mental health crises. Inundated with morbid messages, death by suicide feels like a looming specter. Learned helplessness is endemic as teens marinate in their diagnosis of brokenness.
Anxious parents outsource the heavy lifting of mentorship and guidance to paid professionals. But while well-meaning, therapy is often a flimsy backstop against the ennui of a medicated, artificially prolonged adolescence. Atrophied by overaccommodation, young adults feel stranded between childhood and independence.
The path forward is the same as it's always been: embracing the bog-standard discomforts of the human condition and growing the hell up already.
Section: 3, Chapter: 12
Stop Monitoring Kids' Every Feeling And Let Them Learn By Doing
Imagine the parent of a toddler learning to walk, hovering inches away and catching her before every stumble, constantly asking "Are you hurt? Frustrated? Tired? Scared?" The child would become so preoccupied with analyzing her own reactions, she'd never build strength and confidence.
We've become those parents, micromanaging teens' every emotional wobble. But confidence and resilience aren't gifts parents can bestow through validation - they're the byproducts of weathering life's challenges with a secure base of love and faith in your back pocket.
Section: 3, Chapter: 12
Parents Need to Stop Running Interference
"You obviously don't need to hurt your kid's feelings in order to strengthen her. You just need to stop running interference. Stop micromanaging her relationships in the hopes that no one and nothing in the vicinity will ever make her feel the slightest bit bad. The project is doomed to backfiring. Pathogens always worm their way in, even to the most sterilized environments. Better to develop an immune system."
Section: 3, Chapter: 12
A Roadmap For Restoring Healthy Childhood
- Remove the "spoons" - all the interventions making your kid miserable without even realizing it. Limit social media, over-scheduling, handwringing over grades and milestones.
- Detach from the feelings-centered feedback loop. Don't fret over their every mood. Respond to actual problems, not hypotheticals. Let them come to you.
- Recognize kids' natural antifragility. Tolerable stress and disappointment fuel growth, not damage. Stop treating them like hothouse flowers.
- Don't immediately pathologize your kid's quirks and struggles. Every deviation from the norm isn't a symptom. Give them space to be an individual.
- Question the "experts." Mental health professionals aren't infallible and may give awful advice. You know your child best - don't surrender authority to clinicians.
- (Re)introduce healthy risk and autonomy. Let them test their capabilities. Failure won't kill them - it's instructive. Rescuing them from every scrape erodes their plasticity.
- Foster deep family and community bonds. The "therapeutic alliance" is a weak substitute for lifelong connections. Resist narratives that relatioships are disposable.
Section: 3, Chapter: 12
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