Bad Therapy Book Review

How to save our kids from despair and enable them to be happy and successful

April 28, 2024

I recently finished reading Abigail Shrier’s book Bad Therapy: Why the Kids aren’t Growing Up. Is it the best book I’ve ever read? No. Do I think it was exceptionally well written? Not really, there were a few spots where I thought Shrier should have fired her editor because her points could have been better communicated. Do I think this is a book you should read? Yes, this is a book every adult should read, and if you have children or regularly spend time with children (including teenagers) I might suggest dropping whatever you are doing right now so that you can start reading this book. The research Shrier has done here highlights things that will help us raise kids to be strong and independent adults rather than the weak and helpless things many are growing up to be today. But I realize that most of you aren’t going to go out and read this book so I’m going to give you an overview of many of the points Shrier makes along with some of my commentary. But of course, reading this article is not a proper substitute for reading the book, I can’t squeeze the content of a 250 page book into a simple blog article.

The main idea of the book is that therapy, along with therapy inspired teaching and parenting practices, is bad for kids. But before I go on, it is important to point out that Shrier begins her book with a disclaimer which I will repeat in my own words. There are a number of obvious but rare exceptions to the claim that therapy is bad for kids. When Shrier says therapy is bad for kids she is not talking about the foster kid who was abused by her birth parents every day for five years, that poor girl needs therapy (from an actual therapist and nobody else). When Shrier says therapy is bad for kids she is talking about the millions of kids who have been convinced that they have severe social anxiety when the truth is they are just normal awkward teenagers, she is talking about the kids who are afraid to get a B on a math test, and she is talking about the kids who initially struggle to behave when they go into first grade because they aren’t used to having to sit quietly for that long. Therapists love treating these normal kids, they aren’t violent or crazy and their parents pay the bills; it is easy money for them and an absolute disaster for children and parents.

Iatrogenesis, Shrier explains, is the idea that medical treatment can result in harm. Before doing any sort of operation doctors are legally required to inform their patient of all the known risks of said treatments. This is not only important for the patient but it is an important practice for the doctor so they remember to be careful with what they are doing, no doctor wants to harm their patient. In the past few months I’ve had doctors inform me of these risks and the risks they mention vary from major ones to ones as simple as an infection at the site of an injection (which isn’t that big of a deal). Drug commercials list their side effects for this same reason. Therapists almost never do this with their clients, either they aren’t required to, or the mental health care industry hasn’t been interested in the potential iatrogenic effects of their treatment. I suspect most therapists don’t understand that their treatment has the potential to harm and have no idea how to recognize that harm when it happens.

Rumination is “one of the most significant iatrogenic risks of therapy,” it is, “a style of thinking characterized by brooding on past injuries and personal problems.” My simple definition for it is chronic venting. Shrier points us to Leif Kennair, an expert in treating things like anxiety, depression, and OCD, who says, “rumination is the major predictor for depression.” (emphasis in original text) Many therapy sessions led by bad therapists are ones where the therapist asks their client to talk about their personal problems and injuries, in other words they are encouraging their patients to ruminate. Therapists should not be encouraging behaviors known to promote depression.

But therapists aren’t the only ones doing it. In one part of the book Shrier expresses the frustrations of Sarah, a mother she met who had adopted some foster kids who came from parents who abused them over a long period of time (the type of kids who benefit from therapy). The kids’ therapist was making good progress in helping the kids move on from their painful past, but all that work was constantly being undone as the kids went to school and their teachers asked them to “talk about their trauma.”

On paper this sounds like a good idea. If a teacher understands the trauma of her students she could, theoretically, know how to better love and serve her students. And if students shared their trauma with the class the class could, supposedly, develop a greater sense of community and unity. But in reality teachers are not trained therapists, they are not equipped to deal with serious trauma like the stuff Sara’s adopted kids endured. And kids are cruel, one of Sarah’s kids was forced to eat kitty litter from the box before being liberated from her abusive parents, if that sort of information were to leak to a third grade class Sarah’s daughter could be given the nickname “Kitty litter girl” which would force the poor girl to relive that terrible moment of her life every single day. Sarah told Shrier, “by trying to do the right thing, [teachers] actually hurt my kid.” Even if the true extent of trauma Sarah’s adopted kids have endured never leaks to other kids in the class, how included or heard do you think they’ll feel when they learn that the worst thing that most of their classmates have gone through is no worse than a simple bike accident?

What other things do teachers and others ask kids (and adults) that isn’t helpful? The simple question, “How are you feeling?” (which is how most people interpret, “How are you?”, “How are you doing?” and, “How’s it going?”) is one of the worst things you could ask a person. German psychiatry professor Michael Linden taught Shrier:

Happiness is actually a very rare emotion, statistically speaking. Only a tiny percentage [or our day is] spent in a state we would call “happy.” Most of the time we are simply “okay” or “fine,” trying to ignore some minor discomfort: feeling a little tired, run down, upset, stressed out, irritated, allergic, or in pain.

At least 95% of the time when we ask someone how they’re doing, we are asking them either to lie about how they are actually doing or to admit that they aren’t happy in that moment. Neither of those things are good for a person, so we need to get out of the habit of asking those questions. This can be hard for a lot of us. I told a friend that these questions were bad to ask people and she told me she already knew and had been making an effort to avoid asking them to people; I resisted the urge to tell her that no more than five minutes before our conversation I watched her ask multiple people, “How are you doing mentally?” an even worse version of “How are you feeling?” This is a hard habit for people to break.

Shrier tells us that thousands of schoolteachers (from how she characterized it mostly elementary schoolteachers) start out class by asking students some variation of, “How are you feeling?” They all have their own unique ways of asking the question, they’ll often assign different colors or something to different points on the happy/sad scale for the kids to communicate if they are having a good day, a bad day, or a mediocre day. Using Linden’s logic we see that none of the honest kids will report they are having a good day and all of the kids who do report they are having a good day will be lying. Over time kids will be incentivized to lie and report they are having a good day, because they will get tired of being asked why they aren’t. My usual answer to the question, “How are you?” (and variations of it) is, “Alright.” People who don’t know me very well will then ask the follow-up question, “Why just alright?” which annoys me to no end. “Alright” is not a negative word, it literally means, “all is right,” but when “good” is the only acceptable answer to the question “How are you doing?” then people learn to lie to avoid further questions, especially when they are a kid being asked those questions by their teacher in front of the entire class.

Now we’ve spent enough time criticizing teachers playing “amateur therapist,” lets move on to school administrators who, Shrier tells us, often hand out mental health surveys that include questions which they probably shouldn’t be legally allowed to ask, or at least survey writers should be smart enough not to ask. For example, millions of young teenage girls insecure about their appearance have been given a survey, by their school administrators, that has a questions that sound like this, “Have you ever purposely gone a long period of time without eating in an attempt to loose weight?” or, “Have you ever purposely overdosed on laxatives in an attempt to loose weight?” Remember, a good survey is written to present questions from a neutral point of view, meaning these bad ideas aren’t presented as bad ideas, they are simply ideas being planted into our daughters’ heads, nowhere are they told not to do these things.

And sadly it gets much much worse. In the 80s and 90s the US government put out their “Just Say No” campaign as a part of its war on drugs. This campaign has earned a lot of modern criticism because it taught kids back then all the common street names for drugs, what drugs look like, where to find drugs, what drugs do, and essentially told them everything they needed to know to get their hands on drugs but told them to “just say no.” It had good intentions but incredibly poor execution. Nowadays schools aren’t doing that, instead, according to Shrier, they give students surveys which ask questions that force kids to consider whether or not their parents would care if they did drugs, and other questions that cause students to consider whether or not their parents actually care about them. If the “Just Say No” campaign of the 80s and 90s gave kids a roadmap to drugs, the surveys of today are giving them an invitation to try them.

And it gets even worse than drugs. Shrier has a whole chapter that shows us dozens of terrible questions given to students, it is the most poorly written chapter in the book, but, luckily for Shrier, good writing is not necessary for us to see how bad these questions are as they speak for themselves. Here is a question Shrier found that was given to middle school children in Delaware:

Sometimes people feel so depressed about the future that they may consider attempting suicide or killing themselves. Have you ever seriously thought about killing yourself?

This is not an appropriate question to ask anyone, let alone a fourteen year old child from the most mentally ill generation in history. The question presents suicide a logical and acceptable solution for depression. This is clearly unacceptable.

To quickly recap the things from the book I’ve touched on so far, we have therapists who convince kids they are depressed, teachers who amplify that depression, school administrators (often required by clueless state legislatures) giving kids surveys that present suicide as a cure for depression, and we wonder why kids are killing themselves.

But let’s take a step back now. Kids are distressed these days and adults recognize that fact but where is this distress coming from? According to Shrier, therapists would say, “Young people simply face more formidable challenges than did their predecessors. Therapists typically point to three: smartphones, COVID-19 lockdowns, and climate change.” Let’s work through these backwards.

Climate change anxiety is not a thing. Shrier interviewed a phych nurse named Beth who has spent over a decade working with college students in a mental health clinic. She asked Beth how many of her patients cited things like climate change or systemic racism as the source of their anxiety. Beth’s answer: None. Shrier tells us kids don’t stress about big social and political issues, if they say do it is because an adult encouraged it and they are just going along to make the adult happy. According to Beth, the things that actually stress students out are just normal school things and normal social mishaps, definitely nothing more formidable than their predecessors faced.

The COVID lockdowns and their aftermath, however, are a more unique challenge of our day. I don’t think I need to waste your time explaining why they were bad, Shrier didn’t waste that time either. But she did point out that mental health experts made no effort to stop the lockdowns or even denounce them despite the millions of parents and others who clearly saw that they were a problem from the beginning.

Then of course smartphones are a big cause of mental health problems in young people. One could probably write an entire book investigating that fact. So the simple solution would be to take the phones away right? Well parents are too scared to do it, and schools aren’t allowed to do it anymore. What do the therapists say? Shrier tells us, “Therapists typically discourage parents ever from taking away a teen’s smartphone, on the grounds that doing so will only sabotage the parent-child relationship.” So phones are a big problem but we’re not allowed to get rid of the problem, that sure makes a lot of sense.

So what solutions do the therapists provide? Shrier gives us a bunch and I’ll talk about a couple.

Drugs of course are a big one. Israeli clinical psychologist Yaakov Ophir advised countless parents that they should put their children on Ritalin to deal with their ADHD, until his four-year-old son was the patient. Once it was proposed that his son start taking Ritalin Ophir decided that he needed to do some research on the topic before proceeding. After his research Ophir proclaimed “ADHD is not an illness and Ritalin is not a cure” publishing an article in an Israeli newspaper and later a book with that title. Those are two things I plan to read at some point in the future.

Ophir explained to Shrier, “A real disorder interferes with the ability to lead a normal life.” ADHD doesn’t do that, but severe depression can, so can severe anxiety; are those feelings that we should medicate away? Probably not to the extent that we are. Depression and anxiety are emotions that serve a purpose in our lives. Shrier talked to University of Virginia psychiatrist Andy Thomson who told her a story of a patient who wanted to lower the dosage of the antidepressant she was taking. Thomson asked the patient if the drugs were working and she responded saying, “Yes, they’re working great. I feel so much better. But I’m still married to the same alcoholic son of a bitch. It’s just now he’s tolerable.” We shouldn’t completely mask feelings that are trying to warn us of things.

The drugs obviously do something, but they’re often not the best solution. My favorite few pages of the book are the ones where Shrier explains the smile she saw on Yaakov Ophir’s face as he would describe the funny things his ADHD son would do, the kind of behaviors that Ritalin would have erased. Shrier didn’t see that type of joy when she would talk to other parents about their drugged ADHD suffering kids.

Of course Ophir couldn’t raise his kid as easily as he would a normal kid. One thing that he does to help his son figure out how to deal with his ADHD is make sure his life has structure, rules, and responsibilities. This is the opposite of what many therapists would suggest for a kid suffering from some sort of mental health problem, they constantly tell parents and teachers to lower their expectations to help their kids succeed.

Nowadays kids are being sent to school carrying doctors notes that aren’t for just excusing an absence but now they exist to excuse a student from due dates and time limits on tests. I feel bad for the teachers who are being forced to play along with this nonsense, if an assignment can be turned in at any time then a teacher has to be ready to grade anything at any time which makes grading more complicated and time consuming.

But of course it is the kids we are focused on here. It sounds compassionate to push back a due date or take chores away from a kid who is stressed about them, but when we do that it tells the kid that they aren’t good enough. When they fail it isn’t telling them to try again and they’ll do better next time, the message is, “I guess you can’t do that,” which is the opposite of empowerment.

Kids, especially boys, thrive when they are given high expectations. Shrier points us to psychologist Rob Henderson who writes:

People think that if a young guy comes from a disorderly or deprived environment, he should be held to low standards. This is misguided. He should be held to high standards. Otherwise, he will sink to the level of his environment.

Henderson also writes, “young men will only do what’s expected of them,” so by taking away expectations like chores and homework we are depriving them of opportunities to succeed, grow, and gain the confidence they lack which is what lands them in a therapist’s office in the first place.

But what is causing parents to listen to the therapists? It is their fear of causing childhood trauma, but that scam requires a history lesson.

In the 1990s the psychiatrist Bessel van der Kolk popularized a theory which claimed that traumatic experiences cause our body all sorts of trouble down the line that can’t be cured. Shrier paraphrased his 1994 paper saying, “The ‘memory’ of ‘trauma’ … is ‘encoded in the viscera, in heartbreaking and gut-wrenching emotions, in autoimmune disorders and skeletal/muscular problems.’ Traumatic memory can be stored anywhere.” That traumatic memory would then haunt a person for the rest of their life and seemingly any problem that a person has could be blamed on their past trauma. Van der Kolk called these debilitating traumatic experiences “repressed memories.”

The problem with the repressed memory theory was that it had no scientific evidence, it was completely bogus. Shrier quotes Harvard professor Richard McNally who said the theory was, “arguably the most serious catastrophe to strike the mental health field since the lobotomy era,” because it led to terrible treatments and outcomes. By the 2000s the scientific community thought they had undone the damage the repressed memory theory caused,they got the public to stop believing it and therapists to stop treating it. But in the last ten years the repressed memory theory is back with a new name, childhood trauma.

Shrier clearly teaches us that childhood trauma is the same dis-proven theory pushed out by the same controversial van der Kolk. Except the rebrand now preys on the gentle loving nature of inexperienced young mothers giving them more stress than they should have. I’ve heard people claim that something as simple as letting a baby cry themself to sleep is enough to cause debilitating childhood trauma, there is no scientific evidence for this. There were probably plenty of times when you were left to cry yourself to sleep because your mom had to do things like take care of other kids, or shower, or maybe your cries just failed to wake her up from her much needed sleep.

The fear of childhood trauma is one of the primary motivations behind the “gentle parenting” trend, which Shrier argues is bad for kids and bad for parents. She dedicates the longest chapter in the book to this argument. Gentle parents try hard to remove all sorts of discomfort and unpleasantness from their kids’ lives. Shrier writes, “The environment they curate is so frictionless, it offers the child no preparation for the normal chaos of the world.”

On top of that gentle parents end up letting their kids become the head of the house in many ways. If their three-year-old wants mac-and-cheese the parent makes mac-and-cheese and if the kid decided they want chicken nuggets the moment the mac-and-cheese was presented to them the gentle parent would take the mac-and-cheese away and throw some chicken nuggets in the oven and hope their kid doesn’t loose interest by the time they are done. These parents miss out on an opportunity to teach their kid an important lesson and instead teach them that the world revolves around them.

Over time, these kids become incapable of receiving discipline because their parents are afraid to give it. When the parent finally becomes fed up with their kid and attempts minor discipline they get hit with a manipulative line like the one (unqualified) parenting book author Keith Gessen got from his pre-school son, “You’re a bad dada and I’m never going to listen to you again!”

Gentle parenting is bad for society too. When these kids reach school they terrorize their teachers because they have never been forced to behave. Then when they go out in public they have no consideration for others around them. Shrier shared an experience she had sitting in front of a young family on a plane. At one point during the flight their little girl let out a loud scream. Her gentle father calmly explained to her that everything was okay trying to comfort her, her gentle father did not do what he should have done which was telling the girl that screaming on a plane is wrong because there are 100 other people on the plane who don’t want to hear her scream. Shrier tells parents they need to be authoritative, “loving and rule based,” it is okay for parents to have a bit of “give-and-take” with their kids but parents need to be willing to draw a hard line that is not to be crossed.

Shrier of course talks about a lot more things that will help parents. The book isn’t a parenting book but it is targeted at parents. She closes her book with a message to parents and I feel that it is appropriate to close my review with that message as well:

Remove …: the technology, the hovering, the monitoring, the constant doubt. The diagnosing of ordinary behaviors as pathological. The psychiatric medications you aren’t convinced your child needs. The expert evaluations. Banish from their lives everyone with the tendency to treat your children as disordered.

You don’t need them. You never needed them. And your kids are almost certainly better off without them.

Having kids is the best, most worthy thing you could possibly do. Raise them well. You’re the only one who can.

Obviously there was more in this book than I could have possibly covered here, I wish I could have gone over it all but that would be a waste of my time and yours. I highly encourage everyone to buy and read this book, it will help you guide the rising generations out of the rut they are in and enable them to succeed in our wonderful world.