I recently listened to an episode of the Joe Rogan podcast that featured author Abigail Shrier who was promoting her book Bad Therapy: Why the Kids Aren’t Growing Up (2024). As a matter of full disclosure, I haven’t read the book or any other works written by Shrier.
Still, I remain familiar with a number of Shrier’s YouTube interviews following the release of her controversial book Irreversible Damage: The Transgender Craze Seducing Our Daughters (2020). Therefore, I was intrigued to see what the author had to say about my field of practice.
As a unique disclaimer, in the interest of critical thinking, I don’t agree with everything that anyone has to say about anything. Nonetheless, I agree with many points I’ve heard addressed by Shrier.
If you find yourself automatically agreeing or disagreeing with my critique of her propositions, then I invite you to question, analyze, and make logical and reasonable (collectively “rational”) judgements about my proposals. After all, neither Shrier nor I maintain perfect knowledge.
Before going any further, I think it may be useful to define a term. When discussing the field of mental, emotional, and behavioral health care (collectively “mental health care” or “mental health”), I’m broadly referring to what the American Psychological Association (APA) defines thusly:
[A] category of health care service and delivery provided by several fields involved in psychological assessment and intervention (psychology, psychiatry, neurology, social work, etc.). This type of care includes but is not limited to psychological screening and testing, psychotherapy and family therapy, and neuropsychological rehabilitation. Also called behavioral health care.
Although I informally began life coaching when in adolescence during 1991, I attained a master’s degree in counseling as an adult in 2011, and began practicing mental health treatment and management at that time. Being an overachiever, I didn’t stop attending school.
In 2014, I attained a master’s degree in social work. Moreover, I studied rational emotive behavior therapy (REBT) during both graduate study programs and received formal training from the Albert Ellis Institute in 2021, as the late psychologist Albert Ellis created this method.
As well, I’ve received formal training in other psychotherapeutic modalities and techniques since beginning my practice in the field of mental health care. In all, I’ve informally been working closely with people and their problems for over three decades and formally for over a decade.
As a matter of credentialing, I currently maintain licenses as a Licensed Professional Counselor and Licensed Clinical Social Worker. With a disclaimer, definition, educational and experiential background information, and credentialing qualifications out of the way, I now turn toward the podcast episode.
At approximately (approx.) minute (min.) 3:26, Shrier states, “If the gender activist position was a good one, they wouldn’t have to shut everyone up.” Here, “have to” functions as a form of demandingness – an irrational belief – relating to a should, must, or ought-type narrative.
Still, I agree with Shrier’s proposal. If gender activists maintained morally and ethically good arguments, then there must be no reason to silence dissenting viewpoints. When speaking about morals, I’m referencing that which is considered right or wrong regarding behavior.
When discussing ethics, I’m referencing the rules one pledges to live by which are based on morality (i.e., since murder is considered morally wrong, I have an ethical code not to commit criminal homicide). Bear in mind that morals and ethics are subjective in nature.
This means that not everyone agrees to or follows the same moral and ethical codes. Case in point, silence in the form of activistic complicity – especially regarding gender and sex issues – is common within my field. This is a stance that I morally and ethically reject.
Furthermore, I don’t require research from a broken peer review system or pseudoscientific qualifications from so-called experts to support this assertion. I maintain intact sense organs and functional cognitive abilities which remain capable of producing observational anecdotes.
Although anecdotal evidence may be considered the least certain type of scientific information which isn’t considered valid or reliable, I argue that allegedly scientific proposals which suggest that people can “feel” as though they are the right or wrong gender or sex are equally invalid and unreliable.
Therefore, many critiques of mental health care addressed herein may not correlate with what passes as “scientific” knowledge at the moment. It appears as though Shrier understands this point while nonetheless behaving as I do by citing select studies and repositories of data.
At approx. min. 6:51, Shrier states, “The problem with going after the gender regime through the courts – and I’m in favor of it, don’t get me wrong – but the problem is that gender therapists…that the therapists, the doctors were all following protocol when they transitioned a kid.”
Here, Shrier ostensibly raises a salient point in regard to perverse incentives. If there’s a lot of money to be made in pharmacological, surgical, or other clinical interventions for a medical condition – whether of a physiological or psychological nature – then presumably unintended or undesirable consequences may result.
Take for instance Emergency Use Authorization (EUA) in the United States (U.S.) during the response to the COVID-19 pandemic. Arguably, because other therapeutic interventions were preemptively deemed ineffective, there was but one medical solution available.
Many people received a so-called vaccine specific to the virus, which was incentivized through EUA funds, and these individuals were told that if they got vaccinated they wouldn’t contract COVID-19. Thus, there was ostensibly a perverse incentive to receive a shot that didn’t perform as intended.
The so-called vaccine manufacturers received money, people received a largely untested intervention strategy, and there have been some side effects which may not be fully understood for many years to come. Of course, EUA was a national protocol.
Those medical providers who promoted the jab weren’t necessarily nefarious actors – at least no more so than the medical providers who’ve advocated gender and sex transitioning. This is a glaring problem within the field of mental health care and I’m glad that Shrier voiced it.
At approx. min. 7:50, Shrier states, “In almost every case, there were medical professionals who should’ve known better, and very often therapists who should’ve known better, encouraging a younger girl who’s a little anxious – or had some anxiety, had some depression – encouraging her down this road as a solution.”
Here, Shrier uses what I presume is an empirical should belief by expressing that medical professionals and therapists “should’ve known better.” When using this form of should narrative, an individual is expressing that the conditions were in place for what happened to have or not to have happened.
This is a flexible variation to an inflexible absolutistic should belief. Using the former, I suspect Shrier is advocating adherence to the Hippocratic Oath (do no harm) rather than rigidly demanding the latter – declaring that under no conditions whatsoever should people transition.
Of course, given that Shrier discussed medically transitioning in regard to children, she may have been endorsing the latter and not the former. Suppose this is the case. How might her apparent proposition be represented through use of a syllogism? Consider the following:
Form (hypothetical) –
If p, then q; if q, then r; therefore, if p, then r.
Example –
If medical professionals and therapists are to do no harm, then the Hippocratic Oath absolutely shouldn’t be violated.
If the Hippocratic Oath absolutely shouldn’t be violated, then children who are incapable of issuing consent absolutely shouldn’t receive gender or sex transitioning services even if minors desire them.
Therefore, if medical professionals and therapists are to do no harm, then children who are incapable of issuing consent absolutely shouldn’t receive gender or sex transitioning services even if minors desire them.
Shrier’s imagined proposal follows logical form. Still, not all proposals which are logical remain in alignment with that which is reasonable. Herein is where subjective morals, ethics, principles, values, and other elements which are influenced by beliefs and which drive emotion and behavior come into play.
Presumably, the “gender regime,” as Shrier apparently refers to proponents of an affirmative care model, may believe that it’s a moral good to transition any individual – minor or adult – if or when a person self-deterministically and autonomously considers it appropriate to do so.
However, Shrier’s imagined proposition is that to do so is immoral concerning what’s in the best interests of a child. I’ve worked with people long enough at this point to know that if they’re stubbornly convictive of their irrational beliefs, they’re usually unwilling to change.
Whether in regard to the gender regime who advocates the removal of a child’s penis or Shrier who presumably doesn’t advocate this procedure, I’d likely be unable to convince a person who remained wedded to inflexible beliefs. Those who believe they must be right and who refuse to think critically tend not to change their minds.
Shifting from the matter of gender and sex transitions, at approx. min. 7:50 Shrier was asked about her book Bad Therapy: Why the Kids Aren’t Growing Up and why she wrote it, as Shrier states, “They’re giving it [psychotherapy] to kids who aren’t sick, who aren’t actually struggling with mental illness or a disorder. They’re giving it to everybody.”
Rather than straw-manning Shrier’s position, I’ll attempt to provide a steel man representation of her argument. Before doing so, it may be useful to hear a bit more about what Shrier thinks. She continues at approx. min. 14:18:
So what they’re doing is making existing problems worse and they’re introducing new problems. Because therapy has side effects, just like any intervention that has the power to help, it also has the power to harm.
There’s a whole body of research on some of the side effects of therapy and they include things like alienation from spouse, alienation from parents, worsening of depression, worsening of anxiety, feeling of incapacity – feeling like you can’t do things without consulting your therapist.
All those are well-known iatrogenic effects. Once you have a mental diagnosis, the labeling – feeling limited by that label, “Oh, I have anxiety. I can’t.” So all those things are well-known, what they call, iatrogenic effects, meaning whenever a medical procedure actually introduces harm that’s an iatrogenic effect.
And we know that, of course, drugs and surgeries always come with – even the life-saving ones – can come with some harm. And what people might not know is that therapy comes with these risks, as well.
Before I comment, it may be worth noting that the term “mental illness” is a dated descriptor. The APA instead uses “mental disorder” and defines this category as:
[A]ny condition characterized by cognitive and emotional disturbances, abnormal behaviors, impaired functioning, or any combination of these. Such disorders cannot be accounted for solely by environmental circumstances and may involve physiological, genetic, chemical, social, and other factors.
With consideration of this clarification, here’s my steel man interpretation of Shrier’s argument:
People, and in particular children, without actual mental disorders are receiving psychotherapeutic services (“therapy”) which may exacerbate problems. Even if one were to attend therapy for relatively banal issues, there are side effects worth considering which aren’t commonly discussed.
These worsening agents are known as iatrogenic effects—ill effects of medical intervention (i.e., medication side effects, a staph infection obtained from a visit to a hospital, aggravated symptoms of depression when first beginning therapy, codependency on a therapist, etc.).
Moreover, people sometimes become their diagnosis, so to speak. For instance, if a child’s parents were both suddenly killed in a motor vehicle accident, the individual may improperly receive a diagnosis of posttraumatic stress disorder (PTSD) when in fact it’s merely bereavement the kid experiences at worst or the natural grieving process at best.
Therefore, as is the case with virtually all medical intervention strategies, therapy has known and unknown harms which may be worth considering before subjecting people – especially children who may not meet the criteria for diagnoses in the first place – to mental health care.
Presuming I’ve adequately steel-manned Shrier’s position, I can’t entirely disagree with this summation. Nevertheless, I think it’s a bit of an overreach to infer that no child recommendatorily should attend therapy – if this is indeed what Shrier is inferring.
To elucidate my point, forgive me two anecdotes. Child X was a client at a mental health care agency for which I used to work. Apparently, child X set fire to the bed in which the individual’s grandmother slept and wound up committing criminal homicide along with arson in the process.
When asked why the child committed the action, child X who was under 10-years-old stated with flat affect (blank, emotionless stare), “I just wanted to see what would happen.” There was no remorse expressed for the crime.
Child Y was the offspring of a friend, also under the age of 10. When having a one-on-one discussion with this individual about how school was going, child Y expressed that there had been trouble regarding this person’s behavior in relation to other children.
When asked for clarification, child Y stated something to the effect of, “I know it’s bad to be mean to people, but I just like it.” While expressing appreciation for maltreatment of other children, child Y maintained a smirk on her face. There was no expressed remorse.
Suspecting that I was being probed for an emotional reaction, I asked a series of questions to determine child Y’s sincerity. This individual was earnest in the notion that not only was mistreating others enjoyable, child Y was committed to continue behaving in such a manner.
In the cases of child X and Y, I argue that mental health care would be appropriate. Noteworthy, I retain specialized training in personality disorder treatment provision (2023) and I comprehend that children cannot be diagnosed with antisocial personality disorder (ASPD).
Moreover, I understand that traits regarding this diagnosis may be observed in childhood. Both child X and Y manifested such traits. As well, I understand that ASPD cannot be effectively eliminated through mental health treatment, though it can be managed.
If my understanding of Shrier’s argument is correct, child X and Y would endure worse outcomes if subjected to mental health care than without it. I emphatically disagree.
While I don’t argue that many children and adults may be misdiagnosed, or may even be treated or managed in the absence of a valid or reliable diagnosis to begin with, I don’t see evidence to suggest that this is the case for all or most individuals. Still, I’m willing to change my mind on this matter with the receipt of further evidence.
Still, I appreciate that REBT is a transdiagnostic modality that aims to target self-disturbing beliefs and it can help people to get better instead of to merely feel better. Thus, I wouldn’t need to diagnose child X or Y in order to provide psychoeducational lessons regarding rational living.
Presuming that either of these individuals was receptive to the information taught it’s unlikely that their apparent ASPD wouldn’t be fully resolved. Nevertheless, they may be able to refrain from acting upon impulse, which could be a benefit to these individuals and society alike.
In any case, at approx. min. 15:52, Shrier states that “a child or teenager is usually strong-armed into therapy,” as she lays out a case for why minors receiving mental health care is different to the experience of adults, “because they don’t have the life experience” to know otherwise.
Shrier’s point may be true for some minors. However, it isn’t valid in regard to all children or teenagers. What then is the remedy, to withhold mental health care from all minors so that those individuals without “life experience” may benefit from the lack of intervention?
Imagine making this argument about abortion. Because some religious women object to the procedure, all women should be prevented from having abortions. How about a separate medically-involved argument?
Because some people in the U.S. feared the effects of COVID-19, all U.S. citizens should’ve been forced to receive so-called vaccination. These arguments are genuine proposals with which I suspect you remain familiar.
Is it rational to prevent the majority of people from enjoying the liberty to voluntarily receive medical intervention strategies simply because a presumed minority of people is uncertain about such approaches? Here, I advocate voluntary access to mental health care versus the alternative.
At approx. min. 17:20, Shrier states, “That’s what can lead depression to get worse, sadness to get worse, is you sit and focus on your pain – if you’re not careful, especially with teens and kids – it can make the pain, the worry, the feeling of being harmed worse.”
Here, I can understand Shrier’s argument while also rejecting it. On one hand, I know of many psychotherapeutic modalities which essentially saturate an individual in suffering with the supposed objective of desensitizing a person to pain.
To me, this is something like taking a flamethrower to one’s home, simply because a fire breaks out in a closet. On the other hand, REBT is unlike this approach to wellness. Therefore, I wonder about whether or not Shrier has made the mistake of overgeneralization in her argument.
Overgeneralizing of this sort is apparent throughout the podcast episode. In any case, REBT primarily offers two main techniques to help people get better. Perhaps it’s worth briefly expanding upon these useful tools.
First, REBT uses the ABC model to illustrate how when Activating events (“Actions”) occur and people maintain irrational Beliefs about the events, these unhelpful assumptions – and not the actual occurrences – are what cause unpleasant cognitive, emotive, bodily sensation, and behavioral Consequences.
Addressing how people upset themselves with unhelpful attitudes, the ABC model incorporates Disputation of these unproductive assumptions in order to explore Effective new beliefs. Noteworthy, Actions and Consequences aren’t Disputed, as only unproductive Beliefs are challenged.
Helpfully, REBT uses the technique of unconditional acceptance (UA) to relieve suffering. This is accomplished through use of three philosophical elements: unconditional self-acceptance, unconditional other-acceptance, and unconditional life-acceptance. Regarding these UA elements, Ellis stated:
REBT does not say that these three major philosophic acceptances will make you incredibly happy. They won’t. You’ll still have your and your social group’s limitations. You’ll still have the ability—the talent!—to needlessly upset yourself by making your healthy desires into unhealthy demands.
You’ll still have physical problems to afflict you—such as floods, hurricanes, and disease. But your emotional-thinking-behaving problems will most probably be reduced—and so will your disturbed feelings about your thoughts, emotions, and actions.
What to do to cope with your own, other people’s, and the world’s problems? Make yourself fully aware of your own needless tendencies to upset yourself with absolutistic shoulds, oughts, and musts in addition to your desires and preferences. See your own (and others’) irrationalities as clearly as you can. Dispute them realistically, logically, and pragmatically. Dispute them thinkingly and emotionally and behaviorally.
Unlike other therapeutic modalities, REBT isn’t focused on sitting with problems for the sake of sitting with problems. Likewise, it isn’t a feel-your-feelings approach to well-being. Rather, REBT is an active-directive form of self-help that may assist children, teenagers, and adults to actually get better.
At approx. min. 17:46, Shrier states:
If you’re struggling with a condition of some sort – a phobia, anorexia, OCD [obsessive-compulsive disorder] – you know, any number of problems that you want to deal with, therapy can be great. Cognitive behavior therapy [CBT], especially, can be great. But if you go…if you’re a teen or a kid who shows up bummed out or, you know, just generally kind of anxious to a therapist, you have a good shot of having that problem made worse.
Here, “worse” is a subjective qualifier that could be applied to any number of topics. As an example, if I’m thirsty and subsequently drink too much water, my over-consumption of liquid could lead to abdominal cramping. Thus, my initial sensory problem would’ve been worsened.
When challenged on her assertion, Shrier provides justification for her proposition at approx. min. 17:46 by stating:
Because you’re gonna sit and talk about your worries regularly. They’re not gonna say, “You know that exercise is amazing for depression?” Study after study, in fact, there have been recent studies showing it’s better than antidepressants for a lot of, you know […] dancing is apparently amazing for low, you know, I’m not talking severe major depressive disorder.
Okay, when you have severe chronic depression you may need to treat it with medication or therapy. But for, you know, low mood, you know, sort of mild to moderate depression, exercise turns out to be better and it doesn’t have those side effects.
First, REBT is a form of CBT that Shrier praises. Without having access to children, adolescents, or adults, how would I determine whether or not an individual warrants CBT services in the first place? It’s as though Shirer’s advocacy for an anti-mental health care position misses this point.
Second, Shirer appears to paint with a broad brush in regard to therapists and self-care. This broad brush painting occurs throughout the podcast episode. To counter her claim, in a blogpost entitled Holistic Approach to Mental Health, I advocated the following:
· Making improvements in nutrition and physical activity levels
· Improving sleep to reduce impact of mental health symptoms
· Seeking self-care activities (i.e., acupuncture, yoga, massage, meditation, etc.)
· Making use of self-soothing techniques (i.e., listening to music, watching a movie, doing a facial mask, etc.)
· Participating in other non-clinical therapies (i.e., art, music, or equine therapy, etc.)
· Engaging in other well-rounded elements of care (i.e., psychiatric, medical, social, spiritual, lifestyle, behavioral, etc.)
If Shrier’s proposal about therapists not recommending holistic approaches to wellness were true, how is it that I – a psychotherapist – advocated use of these activities prior to her appearance on the podcast? Shrier is simply wrong in her assessment of mental health care.
Lastly, Shrier errs by stating that “exercise turns out to be better and it doesn’t have those side effects.” Although I agree that physical training may be a better option than psychopharmacological intervention for some people, it isn’t without side effects.
As an example, improper form, range of motion, or biomechanical movement when lifting weights or running on a treadmill may result in injury, which is a side effect of training. Similarly, proper execution of training could produce a side effect of muscular fatigue.
It simply isn’t intellectually honest for Shrier to make sweeping assertions. In any event, at approx. min. 17:46, Shrier states:
Do you see this generation feels that it can’t do, because they’ve gotten so much oversight and so much needless mental health intervention that they’re questioning themselves all the time? They’re in their heads all the time.
Suppose I were to assert that whatever generation (“gen.”) on which Shrier is focusing “questions themselves all the time,” because they’ve grown up using social media all of their lives and they’ve consumed too many processed sugars. On its face, this proposal seems plausible.
However, consider that according to one source, “In research that investigates a potential cause-and-effect relationship, a confounding variable is an unmeasured third variable that influences both the supposed cause and the supposed effect.”
Is it social media exposure, consumption or processed sugars, or perhaps a third variable such as impoverished sleep that may account for members of a particular gen. cohort subsequently questioning themselves all the time? The data is fuzzy, because it’s confounded.
Similarly, Shrier mistakenly confounds reported data related to members of a gen. cohort receiving “so much oversight,” “so much needless mental health intervention,” and perhaps a third variable such as in-group social contagion related to perceived inability to trust oneself.
An example of the latter could relate to social media messaging among gen. members whereby teenagers learn from each other that they’re incapable of trusting their own judgment regarding their level of functioning in social situations. This is a plausible confound.
Therefore, to lay at the proverbial feet of mental health care the perceived problems of an entire gen. is, in my opinion, reckless. Doing so professes too much.
At approx. min. 20:13, Shrier provides justification for her argument. The unspecified gen. referenced by the author is apparently “in the most distress” and “afraid to grow up,” because of mental health care.
Imagine if I were to boldly claim that, reportedly, “women’s happiness has declined both absolutely and relative to men,” because of feminism. One may expect ample data to support my claim.
However, Shrier confidently lays at the proverbial feet of mental health care her claim and cites a number of personal anecdotes and she references unspecified “studies” when damning my occupational field. To say this least, this seems inappropriate.
At approx. min. 22:32, Shrier states, “Childhood mental health has been…and adolescent mental health has been in precipitous decline in the country since the 1950s,” for which there is data available to support this claim. Regarding this matter, the APA states:
During the study period, social connectedness decreased because of higher divorce rates, more people living alone and a decline in trust in other people […] Most threats also increased during the study period, including violent crime, worries about nuclear war and fear of diseases such as AIDS. The study also cites increased media coverage as a source of a greater perception of environmental threat since the 1950’s.
How is a decrease in social connectedness, an increase in divorce rates, decreasing trust in other people, an influx in violent crime episodes, and fluctuating worry about other matters the fault of mental health care? It isn’t – not validly speaking anyway.
Not to outdo herself, at approx. min. 23:12, Shrier references a 2016 “report” wherein “one and six kids between the ages of two and eight” apparently had a “mental health or behavioral diagnosis.” Was this effect the fault of mental health care? You be the judge. Per one source:
Poverty, as well as health care, family, and community factors are associated with mental, behavioral, and developmental disorders (MBDDs) in children […] Parent-reported data from 2016 showed that a higher percentage of children in lower-income households had ever received a diagnosis of an MBDD and a lower percentage had seen a health care provider in the previous year, compared with children in higher-income households.
Shrier’s referenced study indicates that not only did the children aged 2–8 years not see a health care provider – which presumably includes therapists – they qualified for mental health diagnoses in relation to poverty, health care, family, and other community factors.
Nowhere in the report is mental health care faulted as a causal effect for such diagnoses. Furthermore, according to a separate source that addressed similar 2016 data:
A recent analysis of 2016 National Survey of Children’s Health data published online in JAMA Pediatrics indicated that as many as one in six U.S. children between the ages of 6 and 17 has a treatable mental health disorder such as depression, anxiety problems or attention deficit/hyperactivity disorder (ADHD).
The analysis also found that nearly half of children with these disorders did not receive counseling or treatment from a mental health professional such as a psychiatrist, psychologist or clinical social worker.
It simply isn’t the case that mental health care is to blame for Shrier’s referenced 2016 data. In fact, the aforementioned study outright states that children “did not receive counseling or treatment from a mental health professional.”
All the same, Shrier continues to bolster her argument during the podcast episode by stating, “I don’t think that phones explain everything, or social media, is because they…in societies where they use just as much social media – it’s not great for their kid’s mental health, no doubt – but they have much better rates of anxiety and depression than we do” (approx. min 24:41).
In a blogpost entitled Smartphone and Social Media Addiction, I stated, “Although many of my mental health peers may disagree with my perspective, I don’t consider the existence of smartphones and social media to be corrupting elements within society.” Thus, I concur with Shrier on this point.
Blaming smartphones and social media for one’s own self-disturbed outcomes is a form of victimhood whereby an individual’s personal agency and personal ownership regarding unpleasant consequences isn’t taken into account. I’m not fond of disempowerment of this sort.
Still, Shrier then shifts back toward her argument of mental health care villainization by claiming that children raised in conservative households, wherein authoritative parenting styles are used, tend to be “happier” and “more successful,” because such parents are “less likely to turn their kids over to a mental health expert” (approx. min. 26:50).
I would like to review the data from which Shrier makes this causative versus correlative claim. Without such data, one would presume that children are also better off when not seeking the services of dentists, primary care physicians, and other medical providers, as well.
At any rate, Shrier continues painting with a broad brush by describing Gen. X – a cohort of which we’re both members – as a cluster of individuals that “thought, ‘Therapy’s good for everyone,’ and they sort of naïvely turned their kids over to a mental health expert” (approx. min. 30:03).
While there are arguments to be made about various data sets and debates regarding dissenting views on mental health care from qualitative and quantitative perspectives, here, Shrier merely pulls a proverbial rabbit out of her hat – one that has paint slathered on its body from the brushstrokes she’s applied.
How on Earth could it be that Shrier magically knows the inner-workings of the mind regarding all members of Gen. X? Her argument is so absurd that it’s not even wrong. At approx. min. 30:11, Shrier states:
I talk to moms who signed their kids up for therapy, because a cat died, because their grandma died, because basically anything that would happen in their life, even routine events – and yeah, look, having your grandparents die is very sad, but that’s not, you know, an unexpected trauma. That’s part of life, right? And signing up your kid with a therapist might help if they’re having a real problem, but it could also introduce other problems.
First, I agree that not every event that’s classified as “trauma” in modernity meets the criteria for trauma associated with PTSD. Regarding this matter, I stated in a blogpost entitled Big T, little t:
Conflating actual traumatic experiences—those in which imminent danger or loss of life is at hand—with that relating to offense or dissatisfaction may be incredibly invalidating to those who struggle with pathological symptoms of a verified category of traits which result in a clinical diagnosis.
Second, I disagree with the presumed inference that because therapy could “introduce other problems” it’s wise simply not to seek psychotherapeutic services. How might I test whether or not rejection of Shrier’s proposition is rational?
Suppose that I stated, “Reading Bad Therapy: Why the Kids Aren’t Growing Up might help if you’re having concerns about sending your child to therapy, but it could also introduce other problems.” Would this statement serve as sound justification not to read Shrier’s book?
Personally, it’s nonsensical rhetoric expressed by a person with a foregone conclusion: thing X is bad; therefore, don’t engage with thing X. Given this irrational framework, virtually anything could qualify as thing X, to include wiping one’s ass after defecating.
It could help, but it could also introduce other problems such as anal chaffing, poopie paper balls (toilet paper stuck to one’s anus), running out of toilet tissue, or needing to wash one’s hands after wiping. In your opinion, is this a rational argument for not wiping after taking a shit?
At approx. min. 32:42, Shrier states:
We spend so much time worrying about trying to make our kids happy and we don’t spend enough time trying to make them strong. And you know what? We’ve made them neither, because making happiness your goal is a recipe for being unhappy. And if you don’t make a kid strong, he can’t be happy.
Here, I agree with Shrier while also rejecting the broad brush with which she continues to paint. For instance, consider what I stated in a blogpost entitled Happy Place:
Tolerance and acceptance of undesirable events, people, moods, and other matters can lead to a suitable “good enough” standard of living which is in alignment with contentment. Furthermore, I argue that contentment is a longer lasting experience than happiness.
I part from Ellis’ apparent advocacy for happiness – as he supported the notion of happiness in many of his writings, by instead inviting people to consider contentment as a default setting to which we may strive in life. Unfortunately, I’ve observed a seemingly countless number of people who’ve disagreed and who irrationally pursue happiness as a life goal.
Such behavior seems particularly prevalent in regard to how many U.S. parents raise their children. Providing an opportunity for pleasure and happiness at virtually every opportunity and at all costs doesn’t set realistic standards for the children who will one day become adults.
Rather than unrealistic expectations of life somehow serving as a euphoric playground, I concur with Shrier’s advocacy for fostering strength – though with contentment. Regarding this matter, I stated in a blogpost entitled Resilience, when describing an unpleasant aspect of my past Marine Corps training:
Although it was true that I didn’t like or love the experience, I could bear it. Furthermore, I could use the moment to prove to myself that I was capable of resilience—an ability to recover from or adjust easily to misfortune or change.
Resilience-building is a concept I use when practicing REBT. The more an individual is able to face discomforting, unpleasant, or altogether perceivably distressing events, the better prepared one is to courageously face similar circumstances in the future. I further discussed this in a post entitled Stoicism when stating:
Concerning courage, one source states, “Seneca would say that he actually pitied people who have never experienced misfortune. ‘You have passed through life without an opponent,’ he said, ‘No one can ever know what you are capable of, not even you.”
I advocate both resilience and courage more so than encouraging the foolish pursuit of pleasure and happiness. Perhaps when painting with such broad brushstrokes Shrier has fundamentally misunderstood that not all mental health care approaches represent her hastily-illustrated picture.
When Rogan challenged Shrier’s perspective, advocating “middle ground” between resilience-building and mental health care, at approx. min. 34:40, Shrier states:
The problem is the mental health profession doesn’t look at, doesn’t track – there’s no requirement that they track negative side effects. They’re not measuring in general. Now I have some exceptions that I mentioned in the book, but in general they’re not measuring, “Is your anxiety going…getting better?” like cognitive behavior therapists will often measure.
And they’ll often say to a parent, “I’m going to see them for this many sessions and we’re gonna measure and make sure the phobia is improving.” But very often, they’ll just talk about pain. And talking about pain regularly, endlessly, you know, is often not as good for a kid as joining the basketball team.
Shrier offers little justification for her proposal, though her book may contain such information. Going off of her anecdotal evidence discussed in the podcast, allow me to use a similar argumentation style.
As a resident of a children’s home at the time, I played football in the eighth and ninth grade. One of my house parents suggested that participation in team sports may increase my level of confidence while also allowing me to take out pent-up aggression on players who wore protective equipment.
I was so clueless and unskilled in the sport that the head coach didn’t take interest in learning my name. Rather, he dismissively referred to me as “No Name.” This moniker caught on and soon I was bullied both on and off the field by members of the football team.
Although I’d informally begun life coaching for other children at the time, I didn’t have anyone in whom I could confide. Joining a sports team didn’t improve my life. Rather, the event simply gave more opportunity for beliefs to manifest with which I self-disturbed.
Looking back, it would’ve been preferable to have had an REBT practitioner who could’ve showed me how not to upset myself. While I agree with Shrier’s assessment in regard to the inefficacy of talking about pain for the sake of catharsis, REBT could’ve benefitted me.
When Rogan further challenged Shrier’s perspective, inquiring about whether or not she could conceive of “good therapy,” at approx. min. 35:26, Shrier states:
Good therapy is therapy for a kid who needs it, not preventative […] I think it would be something where you can’t…the parent has tried to stabilize the kid. It’s, they have a problem, it’s interfering with functioning, and they can’t stabilize the kid. They’ve tried other methods and if they still can’t stabilize the kid, I think therapy could be absolutely really helpful. And I think you should research the therapist like you would any surgeon.
Three things come to mind. First, REBT is a method of preventing future self-disturbance. Once an individual learns how to effectively use the ABC model and UA, this psychotherapeutic modality can then become a routine form of preventative care.
Second, I concur with Shrier’s recommendatory should belief. Recommendatorily, parents interested in mental health care for their children “should research the therapist like you would any surgeon,” because there are some therapists who I wouldn’t let clean my car windshield, let allow access the recesses of my mind.
Last, there are some parents – for a multitude of reasons – who remain ill-equipped to take on the burden of proper parenting. If parent X realizes that he’s unable to adequately teach his son methods of reducing self-disturbance, why would mental health care serve as an inappropriate option to address this matter for both the parent and child?
At approx. min. 37:29, Shrier states:
There is no oversight, which is a huge problem, right? There’s no one…the profession doesn’t require it. They’re not measuring harms, they’re not tracking harms. The medical professions, of course, do require it. They’re federally required. If you have an adverse reaction to a drug, it gets reported. But with therapy, there is no tracking […]
Why are the people who are getting the most treatment and the most access to mental health treatment, they’re having the worst anxiety and depression? Why? It’s skyrocketing! It should be going down. If treatment were effective, it would be going down.
You know, I’ve noticed that the big umbrella industry has very little oversight, right? Of course, the rain parka industry is heavily regulated. However, no one is measuring or tracking harms associated with umbrellas.
Why is it that with more umbrella use there tends to be more rainy conditions? And why is no one looking into the matter of how umbrellas do so little to protect feet from wetness? Wet feet associated with umbrella use is skyrocketing! If umbrellas were effective, feet wouldn’t get wet.
My asinine argument is no less ridiculous than the proposal made by Shrier. Nevertheless, provision of a snarky response is an unfitting form of argumentation. Therefore, I’ll provide one example about how Shrier’s proposition isn’t necessarily valid.
According to the U.S. Centers for Disease Control and Prevention (CDC) website:
It is usually not possible to use VAERS [Vaccine Adverse Event Reporting System] data to calculate how often an adverse event occurs in a population.
The number of people receiving a vaccine is usually not available (a notable exception was during the COVID-19 public health emergency when the number of doses of COVID-19 vaccine administered was reliably reported to CDC).
If measurement of medical harms were “federally required”, per Shrier, then the CDC missed the memo. Shrier appears to be quite competent at broadly painting her arguments, seeking validation for a listener to concur with her (i.e., “right?”), and mis/disinforming her audience.
When Rogan advocated a balanced perspective in regard to the confounding variables which may’ve impacted her proposition, Shrier responds, “Where were the mental health experts with social media, right? They could’ve called for a ban. They didn’t” (approx. min. 39:26).
Presumably, Shrier advocates a totalitarian nanny state that infringes upon the 1st Amendment – an amendment under which many protections rest in regard to social media. If my presumption is correct, I reject what Shrier has to offer in the way of mental health remedies.
At approx. min. 45:10, Shrier states, “There are therapists who went on Zoom and never went back, right? You get none of the benefits of in-person.” Here, Shrier appears to advocate mental health care, though not in teletherapy form—the sole method I use in my practice.
According to one 2024 source, “Teletherapy has proven to be as effective as in-person therapy, particularly in the treatment of anxiety, depression, PTSD, panic disorder, and eating disorders.” That broad brush with which Shrier paints has long since lost its overburdened bristles.
At approx. min 45:54, Rogan disputes Shrier’s obvious contradiction by stating, “You’re sort of arguing against therapy, but yet saying therapy in person is better than therapy on Zoom.” In that moment, Shrier’s facial expression displays what I’ve seen many times when conducting therapy.
She appears to be surprised that her proposition isn’t as sound as perhaps she believed it to be. At approx. min. 46:04, Shrier then responds:
I’m not arguing against…first of all, adults can see therapists for any reason. And that’s totally not only up to them, I think they have the stand to get…they are in a much better position to possibly benefit from it. I’m concerned about therapy for kids – especially kids who don’t really need it – who are a little bummed out. But in any case, we know that Zoom therapy or text therapy for the most anxious generation, for the most socially phobic generation, supposedly, well, that’s not helpful.
Shrier stumbled through a defense of her proposition, seemingly relenting her position to a degree. Apparently, mental health care for adults is acceptable. Perhaps mental health treatment and management can be beneficial for minors, as well.
However, Shrier clarifies that those “kids” who she uniquely perceives as not needing or benefitting from therapy ostensibly shouldn’t receive mental health care – especially not via teletherapeutic means. Very well. Since Shrier appears to value studies, let’s examine a couple.
According to one source, “Multimedia message delivery for PTSD treatment showed symptom-reduction rates similar to traditional forms of treatment delivery.” If texting can address PTSD symptoms, could it also address teenage angst? According to another source:
This study examined outcome trajectories following 12 weeks of psychotherapy delivered through asynchronous two-way messaging. The study involved a very large sample of treatment seeking individuals with clinician-reported diagnoses of depression or anxiety, endorsing symptoms in the moderate to severe range.
Results showed that depression and anxiety symptoms decreased in the majority of the identified subpopulations (67.6% of the sample), with nearly a third reporting very few symptoms indicating a good outcome relative to the established thresholds of the measures (Recovery and Acute Recovery, 30.7% below the mild threshold). Clinically significant symptoms improvements were observed in 47.78% of the sample for GAD-7 and in 53.03% for PHQ-9.
Not only is texting said to be effective for the treatment and management of PTSD, it’s also clinically indicated for depression and anxiety. Therefore, using Shrier’s logically fallacious tactic of appealing to authority, I’ve countered her proposal with authoritative sources.
Unsurprisingly, Shrier continues her coherent, though wacky, rambling in the podcast episode. At approx. min. 47:05, she states, “Thinking about yourself is the same as unhappiness in a certain sense, right? It is indistinguishable from anxiety and depression.”
When hearing Shier’s outrageous claim, one is reminded of the scene in which Dr. Evil described his father in Austin Powers: International Man of Mystery. Perhaps it was Shrier who actually invented the question mark. (If you know, you know.)
Yet, I digress. While there’s some validity to the notion that obsessing on oneself and problems associated with life represents a form of neurotic self-disturbance, I reject the notion that merely thinking about oneself is “the same as unhappiness” and represents “anxiety and depression.”
At approx. min. 47:41, Shrier states, “If you want to get anything done in this world, you need to, yes, repress your feelings for a time and focus on the task.” Here, “need to” represents a should, must, or ought-type advisement.
Being charitable to Shrier’s claim, I suppose she’s using a recommendatory should belief. Thus, if one wants to accomplish a task, one recommendatorily should temporarily disregard emotions and bodily sensations—which represents what “feelings” actually are.
I accept this framing while rejecting Shrier’s misuse of the term “repress.” The APA defines repression as operating “on an unconscious level as a protection against anxiety produced by objectionable sexual wishes, feelings of hostility, and ego-threatening experiences and memories of all kinds.”
Repression isn’t a conscious act, as suggested by Shrier. On the other hand, the APA defines suppression as “a conscious effort to put disturbing thoughts and experiences out of mind, or to control and inhibit the expression of unacceptable impulses and feelings.”
I imagine that to the uninitiated, the references interlaced with Shrier’s arguments seem intellectually stimulating. However, to those who professionally practice mental health care – the very people against whom Shrier ostensibly rallies – the author’s misunderstanding of mental health is disappointing (at least to me, that is).
At approx. min. 49:14, Shrier provides a personal anecdote regarding a “research scientist” friend who reportedly claimed that members of the Gen. Z “constantly” discuss their “mental health.” Anecdotally, I’ve observed a similar trend and stated in a blogpost entitled It Isn’t Always Mental Health:
Though it’s fashionable to claim, “I need a mental health day,” when stressed out at work or, “You’re messing with my mental health,” when angered during an argument, it isn’t always mental health that is to blame for your reflexive emotions, sensations, or behavior.
Although I won’t point the finger at the entire cohort of Gen. Z as Shrier appears to comfortably do, I’ve noticed a significant number of people younger than the Gen. X cohort who neurotically focus on mental health. It isn’t always mental health that deserves focus, because it’s quite often one’s own nonsensical beliefs which need disputing.
At approx. min. 50:33, Rogan states, “There’s a fine line. Where is the point of diminishing returns? Like, where is it valuable to address feelings and anxiety and thoughts? And is it irresponsible to do so without giving them tools to mitigate those things?”
I view Rogan’s questions as rational in nature. Regarding this matter, I’ve dedicated an entire section in my blog to free Tools which people may use to improve their lives. Rogan prefaced his queries by stating, “You don’t wanna tell them, ‘Hey, you’re gonna have to suck it up” (approx. min 50:16).
At approx. min. 51:04, Shrier responds, “So the problem, as I see it, is not that you’re not saying suck it up, it’s that no one ever says suck it up – no matter how minor the scratch – to these kids.” One is uncertain as to whether or not Shrier is using a referential index shift when stating that “no one ever says suck it up.”
Suppose that Shrier is being literal and that she truly believes no one – not a single therapist alive – is using a “suck it up” approach, or other disambiguated form of Stoic practice with the younger gen. of the U.S. If this is the case, I suspect that the author is unfamiliar with my blogpost Cowboy Up, in which I stated:
I’m not advocating an approach to life whereby I say to myself, “Suck it up, buttercup!” Rather, I consider what circles of control, influence, and concern exist […]
Still, I keep my mental health in perspective of the suffering inherent in life. I don’t have to like or love problem X, yet I can “cowboy up” in the presence of adversity. Some of my colleagues in the mental health field will undoubtedly disagree with my approach.
Is it true that literally “no one ever says suck it up” in mental health care, as Shrier suggests? Clearly not. Therefore, I again reject the broad brush with which she paints my field. Arguably, not many clinicians practice a Stoic approach to rational living, though some of us do.
At approx. min. 51:32, Shrier states:
They recently did these studies on these, you know, coping techniques. They taught coping techniques to teenagers – over a thousand teenagers in Australia – it’s called the WISE Teens program […] and it turned out it made kids sadder and more anxious. They measured this. And the reason was regularly ruminating on your bad feelings can make you feel worse.
I’m grateful to have made the decision to sift through the line-by-line strokes which Shrier painted during the Rogan podcast. Initially, I wasn’t aware of why much of the painting she illustrated was tinted brown. Now, I understand it’s likely due to the bullshit she claims. According to one source:
Contrary to expectations, students who completed the WISE Teens program reported increased overall difficulties and worsened relationships with parents. Their depression and anxiety symptoms also rose slightly after the intervention. Compared to the control group, participants in WISE Teens exhibited heightened emotion dysregulation, reduced emotional awareness, and decreased quality of life. No change was observed in academic resilience. Notably, 13% of WISE Teens participants experienced a significant worsening in depression symptoms post-intervention, compared to 7% in the control group […]
While the study contributes significantly to the evaluation of mental health protection treatments, the authors acknowledge that the exact causes of the observed outcomes are unclear, particularly as session attendance was not recorded. Furthermore, all outcome measures were based on self-reports.
The authors of the WISE Teens program do not provide a causal reason, as suggested by Shrier. Nevertheless, she confidently asserts that mental health care in general is to blame for the results of the study. Upon what evidence does Shrier base her bold claim? I smell bullshit!
Understandably, Rogan asked Shrier if she consulted with therapists when drafting her book. At approx. min. 52:17, Shrier states, “What was interesting is a lot of the clinical therapists were…either minimized the risks of therapy or denied that there were any.”
I’m a clinical psychotherapist who wasn’t contacted by Shrier for assessment. In any event, I acknowledge that there are risks to therapy. Likewise, there are risks to gullibly believing in the bullshit peddled by Shrier without first thinking critically about her message.
All the same, I’m not waging a campaign to stop Shrier from spreading her message. In fact, I encourage people to listen to the full podcast interview and read her books, as I’ve provided links to her content herein.
When engaging her content, I simply invite you to consider that there are risks to ingesting Shrier’s material, just as there are risks associated with mental health care. At approx. min. 53:56, Shrier states, “Very often, therapists don’t turn them [clients] away. That’s the problem.”
Upon what does Shrier base this claim? How “often” is often, and what metric is used to justify Shrier’s claim? Which “therapists” don’t turn away clients, and how does Shrier measure this outcome? From where does she gather such data?
To definitively assert, “That’s the problem,” one would suspect that Shrier would do her due diligence of qualifying and quantifying her claim. However, much as is the case with Shrier’s villainizing of an entire field of practice, she recklessly paints with a broad brush while smiling and imploring the audience to validate her claims when overly using the term “right?”
If you consume her content and find yourself nodding along, perhaps as a means of providing intangible capital in the form of your attention and validation of Shrier’s nonsensical claims, perhaps mental health care may be a step that you could consider. What do you think?
At approx. min. 54:53, Shrier states, “The incentive is for the therapists to treat the least sick for the longest period of time.” It’s this claim that morally and ethically condemns all mental health care providers. I wholeheartedly reject this unkind and untrue characterization.
At approx. min. 55:43, Shrier states, “The number one symptom of depression is what they call rumination—this pathological obsessing over your pain.” To refute this claim, one source states:
According to the National Institute of Mental Health, the most common symptom of depression is the overriding sense of hopelessness. It’s more than simply feeling sad for a couple of days–it’s a persistent, unrelenting feeling of worthlessness.
The APA defines rumination as “obsessional thinking involving excessive, repetitive thoughts or themes that interfere with other forms of mental activity. It is a common feature of obsessive-compulsive disorder and generalized anxiety disorder.” Contrary to Shrier’s misguided report, a separate source states:
Rumination is one of the co-occurring symptoms found both in anxiety disorders and depression. It is often a primary symptom in Obsessive-compulsive Disorder (OCD) and Generalized Anxiety Disorder. When people are depressed, the themes of rumination are typically about being inadequate or worthless. When rumination has a more anxiety-based theme, people tend to get stuck because the thoughts encourage the pursuit of answers to unanswerable questions and truths to unknowable truths.
At this point in my critique of mental health care for children, according to Shrier, I’m comfortable with outright stating that she has little clue about the subject matter discussed on the podcast episode. As such, Shrier is clearly confused about the field in which I practice.
At approx. min. 56:03, Shrier states:
Sitting around, talking and thinking about your problems, that’s a bad habit. And the best cognitive behavioral therapists and others, you know, the dialectical behavior therapists – the ones who do really well with depression, the first thing they do is try to break that bad pattern.
One wonders about whether or not Shrier is aware of her self-contradictory position. On one hand, she criticizes the WISE Teens program study that used a dialectical behavior therapy (DBT) intervention strategy.
On the other hand, Shrier praises DBT clinicians for their CBT style. I’ve been formally trained in DBT and I was taught that “talking and thinking” about problems is precisely how the psychotherapeutic modality approaches mental health care – that to which Shrier refers as a “bad habit.”
At approx. min. 57:16, Shrier states, “What we should be telling kids is that the amazing story of human history is of resilience.” Here, I agree with Shirer’s recommendatory should statement. This accurately describes my approach to mental health care.
During a discussion about bullying, Rogan challenged Shrier regarding episodic bullying that “can lead to lifelong depression,” to which Shrier replies, “I don’t know that it can” (approx. min. 59:04). Here, I partially agree with both Rogan and Shrier.
From an REBT perspective, it isn’t the bullying (Action) that causes depression (Consequence). Therefore, Shrier is correct in her response. Still, Rogan’s proposition is partially accurate, though with noted modification.
When one is bullied (Action) and unproductively Believes, “I’m worthless,” “This is awful,” “I can’t stand being bullied,” or, “This shouldn’t happen to me, or else I’ll die,” then these sorts of unhelpful assumptions could cause depressive symptoms (Consequence).
At approx. min. 100:28, Shrier states, “We’re going in with medication and we’re deleting things like anxiety and depression. Anxiety helps you make beautiful memories. You remember Christmas morning, because of all the nerves about it ahead of time.”
Here, I agree with Shrier’s critique of psychopharmacological intervention. Professionally, I’ve worked with relatively few clients who’ve actually needed medication for psychiatric or neurologic disorders. Many clients may believe they need medication, though I have doubts.
Personally, I’ve found that medication strategies for my own psychiatric and neurologic disorders haven’t been as beneficial as other holistic measures which I currently employ. Of course the anecdotes I’ve addressed herein aren’t without exception.
For instance, I once worked in a criminal justice diversion program that served clients who were impacted by the justice system and who were diagnosed with schizophrenia, bipolar disorder, or major depressive disorder. Most of those individuals required medication.
However, for the symptoms I frequently hear reported in regard to anxiousness, sorrow, inattention, and other common indications of distress, I maintain that these ordinary symptoms have been pathologized to an alarming degree. Thus, I suspect Shrier is correct on this point.
At approx. min. 103:30, Shrier addresses an elephant in the waiting room of the Department of Veterans Affairs (VA) when discussing U.S. military veteran rates of PTSD in comparison to veterans of the Israel Defense Forces (IDF). This is a contentious topic, to say the least.
According to Shrier, IDF members are taught that traumatic experiences are treated as “normal.” At approx. min. 1:04:10, Shrier states:
With America, when someone had seen something horrific, we pull them out of battle. They would meet with a therapist who would tell them, “You have the symptoms of PTSD. Here is PTSD. Your government did this to you and you may be…it’s possible you may be suffering with this chronically.” And they didn’t recover at the same rates.
As a matter of full disclosure, I’m compensated for PTSD through the VA. My symptoms of this mental disorder were incurred in childhood and were aggravated through military service. Likewise, I previously worked for the VA.
It was an open secret among VA clinicians that there appeared to be perverse incentives for U.S. military veterans to attain mental health diagnoses and not to get better. Feeling better seemed to be well-accepted, though actually getting better could’ve resulted in a loss of benefits.
Thus, researchers, clinical staff, and administrative personnel with whom I spoke while working for the VA expressed disbelief in the elevated number of veterans with PTSD diagnoses in comparison to the general public. Here, I can’t fully argue against Shrier’s critique in this regard.
At approx. min. 1:11:20, Shrier states:
Some of the most effective ways to treat childhood anxiety is by treating the parents. Parents are a huge source of anxiety for kids. Worry over everything, teaching kids they have to be afraid of everything – that they can never do anything without the parent supervision. They could never go anywhere, because their parents won’t see them.
Because they could be abducted or hurt or abused. Calling the teacher and saying, “My daughter was bullied, because someone said something mean to her.” The child gets the message, “I can’t handle mean things said to me. I will fall apart. That’s what my mom’s saying. She’s so scared I’m going to fall apart, she’s calling my teacher.”
Here, it would be intellectually dishonest for me to argue with Shrier’s proposition. According to the National Institutes of Health (NIH) website, “The best way to help children with an anxiety disorder may be to help their parents first, a new NIH-funded study has found.”
When at an internship site while in graduate school for counseling, I was able to work with children and their parents or caregivers. There, I learned that the overwhelming majority of mental health issues which children faced were directly correlated (if not outright caused) by adults.
Many of the parents and caregivers were simply too stubborn to receive mental health care for themselves. Therefore, I learned that rather than attempting to metaphorically ice skate uphill, I’d forego working with children and adolescents. As such, I concur with Shrier’s proposal.
When asked if she’s received any “pushback” associated with her book Bad Therapy: Why the Kids Aren’t Growing Up, at approx. min. 1:13:52, Shrier states, “The dad’s, especially, love the book. The dads will be like, “Can you give this to my wife?”
This is unsurprising to me, as one source reports that in the U.S. “65.1% of all mental health workers are women, while 34.9% are men.” Likewise, a separate source reports that about “three-quarters (77%) of teachers are women and 23% are men.”
With children in the U.S. exposed to more women than men, it’s predictable how the “dads” spoken of by Shrier would praise a book that essentially advocates a more masculine than feminine approach to mental health care intervention. The field in which I work is highly feminized.
At approx. min. 1:17:49, Shrier states:
People who turn their pain into an organized principle of life – of their whole life – they have a hard time overcoming it. It becomes their identity, and that’s what kids are doing today about their emotional pain. “Oh, I have social anxiety. I had trauma from my breakup.”
You don’t have trauma from your breakup, okay? You had a breakup and it’s painful. But using these psychiatric terms, it’s not helping. It’s not! It’s exaggerating the pain and it’s making that pain feel worse.
Here, I wholeheartedly agree with Shrier’s proposition. For clarity, consider what I stated in a blogpost entitled Diagnoses Feel Empowering, “I’ve encountered a number of people who shirk personal ownership for their behavior by blaming their symptoms of diagnosis.”
With many contemporary cases, I’m finding that people are essentially self-diagnosing through use of information on the Internet, social media, and other sources. Apparently, at some point within the past couple decades, psychotherapeutic terminology gained mainstream appeal.
This phenomenon is known as therapy speak—incorrect use of jargon from psychology, especially jargon related to psychotherapy and mental health. “I have trauma from a breakup, because my ex was a narcissist,” an individual may unprofessionally declare.
In all, I find this observed trend to be mostly unhelpful. Although the stigma relating to mental health is largely weakened from what it once was society appears to have overcorrected by empowering people to exaggerate their disappointing, though not devastating, experiences.
At approx. min. 1:19:19, Shrier states, “So this endless rehashing of your pain, this myth that you can only be helped by talking about your pain, it’s just not true. There’s no evidence behind it.” Here, I partially agree and disagree with Shrier.
First, I maintain that virtually “endless rehashing” of pain can lapse into a neurotic experience that keeps people tethered to self-disturbance. This feel-your-feelings approach to mental health care isn’t something I advocate. Therefore, I agree with Shrier on this point.
Second, I disagree with Shrier’s ostensible assertion that there’s “no evidence” behind the exploration of problems with an interest to improve one’s level of functioning and quality of life. REBT is, in fact, an evidence-based psychotherapeutic modality of the sort.
At approx. min. 1:19:48, Shrier promotes one of the many “studies” spoken of during the podcast episode – without specifically citing the research itself – in which she states:
They’ve done these studies where burn victims – one portion of them went to group therapy, the other portion didn’t – and the ones who didn’t go to therapy ended up better, with less symptoms after, you know, nine months I think it was.
There very well may be a study that supports Shrier’s claim. However, one study that I reviewed reports that the independent variable group (those who received treatment [CBT]) maintained better outcomes than the control group (those who didn’t receive treatment).
At approx. min. 1:19:48, Shrier states that “42%” of Gen. Z members maintain a “mental health diagnosis.” I was surprised by this claim, so I looked into it.
According to one source, “The younger generation has powered through a lot of upheaval in their short lives but it’s taken a toll on their mental health. A new survey finds that an astounding 42 percent of those born between 1990 and 2010 – Gen Z – have been diagnosed with a mental health condition.”
Reviewing the foundation of that aforementioned study, one source reports that aside from the 42% figure, apparently 57% are currently medicated for a mental health condition, anxiety is the most common condition reported, and 39% attend weekly therapy, as 87% of those people report helpful therapeutic outcomes.
At approx. min. 1:21:23, Shrier states that of Gen. Z cohort members, “86% of them think they have menu anxiety.” As I was unfamiliar with this figure and associated anxiety type, I looked into it. According to one source:
Up to 86% of Gen Z is impacted by what is called “menu anxiety,” compared to 67% of all respondents […] The main source of anxiety when eating out is due to the cost of the meal, as well as other factors such as not being able to find something they like on the menu and regretting what they ordered.
What in the name of mental health fuckery is this!? Rather than outing my professional colleagues, I’ll merely mention that I Googled “mental health providers who specialize in menu anxiety” and there are apparently clinicians who validate this nonsensical so-called condition.
I maintain that validation of this sort is largely unhelpful. Anxiousness stemming from one’s neurotic and self-disturbing beliefs isn’t about the menu. Treating this matter as though a menu can cause anxiety lends credence to the notion of an action-consequence connection, which I reject.
At approx. min. 1:26:38, Shrier clarifies her overall thesis by stating:
The problem is not parents seeking out help. The problem is when it’s the first resort. The problem is not that parents ever allow their kids to get a diagnosis. The problem is that some parents are going diagnosis shopping […]
And they’re doing it, because they haven’t…they don’t have, you know, sometimes they don’t…they’re unwilling to be in authority in their home. Maybe because they feel that’s traumatizing. They’re unwilling to impose any kind of discipline. The kid is disordered. The kid has a lot of tech. And then lo and behold, he can’t concentrate in school and they’re sure…the teacher has a problem with him.
Here, Shrier has inadvertently outlined a case for why mental health care for children whose parents are simply unwilling or unable to properly parent their children is in the best interest of these children. It’s difficult to understand how she perhaps can’t understand the contradiction of her original proposition.
That final quote from Shrier is one worth stopping on, as the remainder of the podcast episode was devoted more toward parenting than mental health care. Having assessed her line-by-line verbal statements, I will once again attempt to make a charitable steel man representation of Shrier’s argument:
It isn’t as though mental health care for children, adolescents, or adults is an inherently bad or unhealthy consideration. Rather, in the U.S., people tend to hyper-fixate on clinical remedies when evolutionary evidence from our relatively not-so-distant past is incongruous with this approach to wellness.
In particular, Gen. Z has arguably been led to believe that common problems experienced by virtually all humans – such as anxiousness in social situations, sorrow following breakups, frightfulness in relation to dangerous events, and otherwise – are somehow devastating rather than merely distressing, disappointing, or dis-pleasurable.
Because of the overly reactive response to fairly ordinary issues, Gen Z. experiences learned helplessness—a condition in which a person has a sense of powerlessness that arises from a challenging event or persistent failure to succeed.
Rather than exercising resilience in the face of suffering, this generational cohort instinctively turns toward mental health care services which may not be clinically indicated for commonplace occurrences and responses to these unpleasant events.
Therefore, in its current state of functioning, the field of mental health care does more harm by fostering learned helplessness than help which would come from a holistic approach to living that utilizes psychological and psychiatric intervention strategies as a last resort.
Presuming that Shrier would accept my steel man framing of her argument, I cannot fully reject this proposition. Herein, at times, I’ve taken an intentionally antagonistic approach to Shrier’s argument – especially when genuinely disagreeing with some of the nonsense she stated in the episode.
Nevertheless, the final steel man representation of Shrier’s position seems rational to me. Of course, I would add one caveat. Rather than pointing the proverbial finger at Gen. Z, I suspect that learned helplessness could apply to other generational cohorts, as well.
In any case, this is my perspective of Shrier’s appearance on Rogan’s podcast. Perhaps you view matters differently. What do you think of Shrier’s proposition, my perspective of her stance, and mental health care in general?
Far be it for me to speak on behalf of all mental health practitioners. I couldn’t even speak for most life coaches, counselors, or social workers in the field. In fact, regarding a blogpost entitled Matching Bracelets, I highlighted how different from other clinicians I tend to be.
Moreover, I wouldn’t dare speak on behalf of many REBT practitioners. The only individual I can definitively vouch for in regard to a mental health care perspective is the person drafting this blogpost. That’s it.
Therefore, it very well may be that the majority, most, or even many clinicians within the mental health care field are causing harm in the manner spoken of by Shrier. I doubt it, though it’s possible. Likewise, I could be the very person causing harm when practicing my craft. Who knows?
All I can do is try to help people increase their level of functioning and quality of life. This, I do imperfectly and as a fallible human being. In any case, if Shrier’s perspective on resilience and learning a humanistic approach to dealing with your problems sounds appealing, I look forward to hearing from you.
If you’re looking for a provider who tries to work to help understand how thinking impacts physical, mental, emotional, and behavioral elements of your life—helping you to sharpen your critical thinking skills, I invite you to reach out today by using the contact widget on my website.
As a psychotherapist, I’m pleased to try to help people with an assortment of issues ranging from anger (hostility, rage, and aggression) to relational issues, adjustment matters, trauma experience, justice involvement, attention-deficit hyperactivity disorder, anxiety and depression, and other mood or personality-related matters.
At Hollings Therapy, LLC, serving all of Texas, I aim to treat clients with dignity and respect while offering a multi-lensed approach to the practice of psychotherapy and life coaching. My mission includes: Prioritizing the cognitive and emotive needs of clients, an overall reduction in client suffering, and supporting sustainable growth for the clients I serve. Rather than simply trying to help you to feel better, I want to try to help you get better!
Deric Hollings, LPC, LCSW
*References in adjacent post – Addressing Critiques of Mental Health Care for Children References
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