I’m a therapist I had a couple of points where I thought Shrier was off the mark.
1. Telehealth is as effective as in person therapy and it greatly increases access to care. Especially in rural areas but for many people having to take an hour plus travel time off from work every week to get help isn’t feasible. A number of my clients move their lunch hour then talk to me from their car. I can give you numerous sources measuring telehealth’s effectiveness.
2. Intergenerational trauma is real but I learned of a different definition than what was described above. Traumatic event happens to generation A this greatly impacts their ability to parent generation B who then struggles with generation C. The effect does dissipate with time.
An example is WWII, my grandfather served on the USS Zeilin at Guadalcanal. His ship was attacked by Japanese bombers and nearly sunk. My grandfather was different after the war and ended up abandoning his family years later. My mom is a basket case and thats trickled down to my brother and I.
A fairly simple concept.
3. Shrier is complaining about woke therapists only. Which is fair since 90% of therapists are rabid progressives. Example: I’ve seen them push “healthy at all sizes,” which is a lie, to people recovering from anorexia. Yo-Yoing them from starving to death over to obese. Then telling them they could commit suicide if anyone questions their weight. No attempt at creating a healthy relationship with food. Only a woke therapist would do that.
Therapy is like a hammer, you can build a house with it or you can smash someone over the head. The problem isn’t the tool, its how its used.
Anyway I loved the book. Its mostly accurate. Although when this woke moment in history passes the critiques to Psychotherapy won’t apply anymore.
Telehealth (a sterile corporate term, makes it sound official and accepted), a.k.a video visits, *can* be as effective as in-person visits, once there is an established therapeutic relationship and it is a pretty standard session. No amount of "sources" will convince me that dealing with an actively suicidal, or with a desperately depressed person crying his/her eyes, or with someone having a panic attack, etc, i.e. in situations when your client really needs you, is as "effective" in person, in the safe and supportive comfort of your office, as with someone hanging out in their car in a parking lot. No way, never, and I suggest that you do not delude yourself.
Thanks David for your great comment. Could you please share a source measuring telehealth's effectiveness for mental health? I'd be interested in learning more about the topic and sounds like you may be a better source than google.
I also had a grandfather serve in WWII who was a POW after his plane was shot down. The experience destroyed my grandmother and led to serious family trauma - addiction, abuse, divorce, etc. My dad somehow rose above it which you can either view as an outlier/miracle or a testament to Shrier's point that the story of humanity is one of resilience. The latter resonates with me more personally. But either way your point is a helpful clarification.
Sure, here are some sources on telehealth being effective for treatment. Note by telehealth, I mean a video call, phone calls are not as effective as in-person.
There are four sources but I could keep going. Telehealth both for doctors appointments and therapy appointments has been studied heavily in the last ten years. There is little to no difference between telehealth and in-person appointments.
An exception would be working with small children. Play therapy needs to be done in person. But for adults and teenagers, telehealth is just fine.
Also, I don't have a fatalistic view of intergenerational trauma. People are resilient and can overcome problems. I'm not a victim. All it takes is one person to break intergenerational affect. My main point is that as a concept it does have merit.
Thank you for taking the time to reply with sources. There does seem to be a large body of research on this topic that supports your contention. One note that may relate to other comments in this thread, quoting from one of the meta-analyses:
"Lastly, the authors reported that studies with participants ages sixty-five and older and those with slower internet connections reported more variability in their findings. This suggests that a patient’s demographic characteristics and internet access could affect the use of a telehealth-administered neurocognitive test."
Telehealth may not work for everyone, which is true of pretty much every intervention. That doesn't mean it doesn't work for many others.
Haha yeah I did think about that when I was writing my reply. I really did ask the question honestly - I have a teenager who may need mental health services - and did read the references provided which support his claim. I'm skeptical that "success" can even be measured in mental heatlh so not totally sold but when someone shares sources with anonymous questioners I figure it's the courteous thing to do to say thank you and follow up. Beep Bop.
I must disagree about telehealths effectiveness. Between the disruptions in service, the delay time when speaking or the occasional echo, it makes a therapy session almost impossible to be effective. I did it for a time with my established therapist and hated it. I stopped going. It may be more convenient for the therapist but not for the patient.
This is factually incorrect. I work exclusively via telehealth, and those issues rarely come up. One of the studies I posted specifically measured patient/client satisfaction. Yes, for telehealth to work, a person has to have an internet connection and an electronic device that can support a video call. If you do not have this, telehealth isn't for you.
You're describing a technical issue specific to your own circumstances. This isn't a valid case against telehealth as a means of delivering service.
David, technical issues aside (which are quite common) this was my personal experience and you can't negative that as "factually incorrect" as they were the facts of what transpired. I believe you are trying to rationalize your telehealth business for your own self interest, which is quite disheartening.
I have to disagree, David, that Telehealth is as effective as in person therapy. When a person's life is so arranged that they can't take or make time to be in person with someone else raises more alarm bells than anything else, and should then certainly be the focus of therapy.
This would be true if there weren’t access to care issues such as available providers within insurance networks, extended travel time, and speciality services. Come on y’all - “black and white” zero sum answers can be fun for the sake of forensics but aren’t we tired at this point?
For all those claiming that Abigail Shrier is attacking legitimate therapy, please identify “the people who are actually trying to heal” those suffering from crippling mental illness, whom Shrier supposedly maligns. Maybe I’m missing something, but I don’t see her ripping apart actual therapists. In fact, she quotes many in her work — many who are alarmed at the quackery and unethical practices of those who claim to be therapists, particularly in our schools. They’re throughout our schools, thanks to massive amounts of emergency funding from every level of government, and they’re roping in kids starting at the pre-school level. In Connecticut a pre-schooler by law (a law that predates Covid) can be accorded up to three mental health days per year if he or she needs it. My son, a licensed youth soccer coach at the development level (D1 and semi-pro) must deliver instruction as “a sandwich,” bookending the “you blew it” message with some inconsequential praise. Social Emotional Learning, a key manifestation of the bubble approach to child rearing, is a scourge that’s been in practice for more than two decades. Tragically ironic, for all this pseudo-therapy meant to undergird their resilience, kids are shooting up their schools, bullying and beating up their classmates, and killing themselves at accelerating rates. Something is deadly wrong. Credit Shrier for trying to identify it. I’d have hoped legitimate mental health professionals would stand with her. Looking at how the pediatric community rejected her attack on the transgender movement, I shouldn’t be surprised.
The Left is reductionist; if you're criticizing any aspect of something then you're criticizing all of it, because that's how they think.
I am a millennial who wholeheartedly agrees with all of the criticism of millennials because I am well-positioned to see that it is true a lot more often than it is false. I am able to make this agreement without professing to be personally guilty of the things that other millennials are guilty of; I understand bell curves.
But of course, I'm not left-wing, so I am capable of this nuance.
I think Shrier's position has merit. An obsession with how we "feel" can all too easily turn into unhealthy navel gazing, leading one to be more fragile and subject to their emotions. The field of psychology has promoted some of this molly-coddling. But, the field of psychology also promotes things like resilience and anti-fragility. The "compassionate" types in our culture have grasped onto the former, and see it as their raison d'etre to nurture those they deem to be fragile. I sympathize with the sentiment, but their execution is categorically wrong. Their methods (a laser focus on feelings, talking about feelings, seeing emotional outbursts as praiseworthy, "trauma-informed" language) ends up as Jung's Devouring Mother archetype. Their methods end up handicapping people. We need to end the trauma culture.
There's absolutely a need for therapists in our culture, but Shrier's point that the tools of therapy are being misused is correct.
One book that is a good complement to Shrier's would be The Best Minds, by Jonathan Rosen. In it, he describes the evolution of psychiatry and psychology, from treating the most mentally ill (which is hard!) to the "worried well" (which is profitable and easier).
This is why there is both a mental health crisis for the most deeply afflicted AND too much therapy to treat the normal human condition.
Agreed. It is a fantastic read. Gripping actually in its first half narrative and then seamlessly moves into the analysis of the professional field itself. Reminded me of how Viktor Frankle wrote Man’s Search for Meaning.
This kind of captures what goes wrong with almost all progressive policies, at least on the human/social services side of things. There are concepts and practices that are helpful in very specific, often clinical contexts, but then someone somewhere decides this needs to be "policy" and applied in a general context and it not only doesn't work, it can be harmful, especially in the larger social/cultural messaging outcomes.
My worry is that therapists and therapy are a modern invention that is replacing (poorly) what humans have been doing for thousands of years. Instead of reaching out to your friends, family, or community, you can call some random therapist over FaceTime in your car. That person doesn’t know you or care about you, they have dubious credentials, they may be more mentally unstable than you are. It’s just a cheap fast food substitute for leaning on the connections that are meant to make you feel better and stronger. Instead of going to your best friend, your rabbi, your neighbor, you are talking to some stranger, whose incentive is ultimately to keep you coming back. I have yet to hear of a therapist who said “your problems are minor and you don’t need me - you just need to suck it up and move on”. The incentive for the therapist is not to strengthen you. It’s to “validate” your feelings and let you regurgitate and feel briefly better - but that doesn’t leave you more resilient of better equipped to solve your own problems. It’s just the junk food that makes you feel better only while you’re chewing it. Unfortunately, like almost all things in life, the most correct thing to do is usually the most difficult. Eat well, exercise, abstain from drugs, work hard, work on your relationships and upkeep them, get fresh air, sleep well, do saunas and cold plunges, pursue a difficult and fulfilling career, have productive hobbies. That’s so much harder than going to therapy, but also, so much more effective.
Well, Dasha, I am a therapist and I do exactly that… I never try to keep someone in therapy to pad my pockets. I have a strengths perspective “you are stronger than you think, life has its challenges and let’s figure out how to meet them” approach. I am the child of a Holocaust survivor who spoke about her experiences, shared them with audiences all over the world, and wrote numerous bestselling books about her life. My life lesson has been one of perseverance and resilience, and this is exactly what I attempt to impart to my children and, yes, my patients.
We are not all of the “what went wrong this week “ variety. Some of us employ the “what went right and what did you do to help that happen so that you can do it again “ method.
Soon enough, I’m able to say to many, “you’re doing great, I think you’re ready to do it on your own. I’m always here if you need me “. We part ways, both of us feeling great about the work done together.
I’m sure you’re a great therapist and your patients feel you do a lot for them. My opinion is a dissenting and unpopular one - my feeling is that our current population is the most over-therapized, over-medicated of any in all of history or space. There’s every manner of therapy from online to in person to group to insurance covered to private to FaceTime. It’s every where you look. And yet people are diagnosed with more “anxiety” and “depression” than at any point in history. And I believe that therapy is part of the problem, not the solution. Training resilience in yourself is not easy or pleasant - if it were, it would be called therapy. The cure is not working.
My friends are dumb and have problems of their own. They don’t substitute as a therapist if one is truly in need of counseling. That would be an example of taking someone hostage to my own drama. How about we focus on rebuilding self agency skills? Remembering where others end and I begin? For all this talk about a generation who only knows or focuses on themselves, they sure seem to have a tough time allowing others to be who they are. And who do we look to for that skills? Certainly not in the more senior humans on these discussion boards - best as I can tell.
Your point about hostagetaking and boundaries is very important. I am sure many people have been at the mercy of a narcissist, who expands their drama infinitely until we are ourselves never heard, but only a fan club for their latest injuries. However, I think there is a very important truth that should be looked at: why when we have a problem must we pay someone to listen to us? What DID happen to grandparents, aunties, doting uncles, confidantes? The statistics on American friendship or dismal. Vast numbers of people have no close friends to call on. The people I know who are the strongest and most resilient have close ties, confidantes, and people they call on whose perspective they trust both to comfort them and to set them on the right path when they make a self-destructive turn.
Here in Seattle therapy starts at about $150 per hour and goes up. This is for 45 minutes, 50 if you are lucky. I personally cannot afford this. When I have tried on occasion to go to my HMO’s co-pay, only people they are half my age, barely out of school and useless to where I am, and who I am. We need to bring back hanging out. We need to bring back long coffees and late night conversations around the kitchen table.
(Sorry for mangled sentences, couldn’t edit after posting.) I want to add that at a different phase of life when I was in my 20s I urgently needed professional therapy and tried to go to friends, but was so confused at what I was going through and so distraught I overburdened friendship and that pushed people away. There are issues like actual) physical and sexual abuse and alcoholism that can definitely benefit from the help of skilled professionals. Children from alcoholic homes or from homes with sexual abuse tend to gravitate towards others, who come from those same backgrounds and have similar wounds. Liz, I agree, confiding in people who are as confused, and who have similarly distorted perspectives, can create even more problems..
Yes, other than "the tales my mom told me of the barbed wire and death" caused me to have nightmares there really is nothing to it. Especially gene alteration.
Gene alteration is nonsense. I know of no evidence that epigenetics is involved here. It's all about how you are brought up and the stories you hear.
Example: my father volunteered in 1939 and had an exciting war until late 1944, when he met a butterfly bomb, eventually being discharged from hospital a couple of years later. He did not talk about it at all to my brother, but I was born seven years later and was very close to my father. He talked of little else to me, and in a way, it became my war too. I don't think it traumatised me to hear all that, but it did become part of my history even if vicariously received. After my father's death, my brother compiled and published his war diaries, but I already knew all the tales in them and did not feel compelled in the way my brother did.
Bad Therapy is such an important read. I've already passed on the recommendation widely. My big concern: how can this be reversed? I suspect with a lot of communication and introspection, parents can focus on building resiliency. But that will be hard if your social circle is a cadre of "gentle" parents. But entire education establishment still thinks this social emotional dysfunction actually works. Is it going to take whole groups of like-minded parents creating new cooperative schools? Do we need a movement that's like a counter-programming PTA?
And on a related topic, I wonder how much of what's going on with "gentle" parents is their own striving played out through their kids? Get into a group of professional class parents and the deeply held desire to get their child into the Ivy league drives all manner of bad behavior. Are kids really improved by being sent on choreographed "volunteer missions" or would camping with family be better? Have a kid playing a youth sport that's told by age 12 or 13 they must specialize, focus on one sport only, and play it year-round, and define success as being on the NHL draft track seems a prescription for disappointment, burnout, and neuroticism. But the parents just "want what's best" for their kids. Really?
Ahhhh...........there it is; resiliency. I watched as my son developed resiliency by his own ideas and actions. It was tough at first, but over time became something that was very satisfying for my wife and I. FYI, he strongly resisted talking to a counselor/therapist in lieu of figuring it out himself. We seem to have ceded this growth to the psychological services which seem to delay it, producing extended dependent children or at its worse inept adults.
I chuckle recalling my youngest, now 27. When he was little and took a spill, his first reaction was to look around to see who saw it. If he detected an adult, he burst into tears. If you saw it through a window and he didn't know you were watching, he'd dust himself off and keep going. Too much oversight and too much validation of trauma seems to backfire. (He's a ruggedly independent adult now!)
As a psychologist, I think her analysis is spot on. To illustrate how radically our orientations have changed, consider Abraham Lincoln’s observation about his childhood: “It is a great piece of folly to attempt to make anything out of my early life. It can all be condensed into a single sentence. … The short and simple annals of the poor.” The current endeavor to assume that most if not all of adult dysfunction stems from difficult or traumatized childhood leads many to cut off parents who were both dedicated and reasonable.
A great discussion. Shrier is cogent and seems to have great insight into our "let's find an expert to help" society. [Look at the damage "experts" caused during Covid.] We could do with a significant reduction in the amount of therapy in the US. As Shrier makes clear this is especially true for young people. The notion that schools have untrained employees - other than a PowerPoint session - assessing the emotional state of youngsters is appalling. Of course in a society where teachers and administrators feel free to encourage kids to adopt different gender identities and not inform parents is it any surprise this occurs?
Why isn't it just as plausible that the children of Holocaust survivors would be some of the most resilient people on earth - having learned first hand the power of perseverance and indefatigable will?
I thought that, too, then continued down that thought path, wondering if its because they didn't live the experience themselves. It seems a prerequisite that in order to be resilient you need to experience the trauma firsthand rather than just knowing or observing it. In other words, the experience gives you the motivation (for lack of a better word) to be resilient.
Nice comment. I think you are onto the essential point - experience of horror versus hearing about an experience of horror. Two different experiences for an individual. Two different impacts. Resilience comes from living the horror personally. Impact on one's soul versus hearing about others' experience.
I like much of what Abigail Shrier shares, although I become mistrustful when she becomes dogmatic and seems to have an agenda. She creates a straw man with regards to gentle parenting. There was no need to do this and now I wouldn't recommend anyone listen to this podcast without a strong caveat. She chose only to focus on how gentle parenting can go wrong (as any parenting can) but had to have intentionally chosen not to pursue families in which this approach to parenting has gone very well.
Gentle parenting comes in many forms and much of it is authoritative. I know numerous young adults who are wise, compassionate, competent and successful people and were raised without punishments, time outs, yelling and threats. They were raised with respect, kindness and a relational parenting style. They're some of the most interesting and unique adults I know. Off the top of my head -- one is a farmer and soon to be a mother, another is a sign language interpreter, one is a professional musician, another doing very well at a UC college and another is the ED of a non-profit. All of them are strong, independent and full of zest for life.
As a Gen Xer who was spanked, grounded, threatened and yelled at, I knew I wouldn't duplicate a parenting style that made me sneak around, stop telling the truth to my parents, and left me on my own and at risk with many challenges. As much as I love my parents, I didn't have a relationship in which I felt I could go to them with my troubles and worries. My twelve year old has been raised without punishments including time outs, but with clear expectations. She shares her troubles and challenges with me. She comes to me when friends do things that go against the values we've instilled in her. She talks to me about boys. She isn't afraid to share her mistakes. She's been able to make her own breakfast since she was 2 years old, can't wait to get a driver's license, dreams about becoming a mother, competes in equestrian events, goes on trail rides by herself and just experienced a severe injury that required emergency surgery and lots of visits back to the surgeon. He commented on what a boss she is in how she has handled it all. She's hardly the disabled version of a human Shrier tells us gentle parenting will produce.
Life offers consequences. Go out when it's cold without a coat and you'll experience a consequence. Don't listen to mom when it's time to leave the playdate and next time she says we can't do a playdate today because yesterday it took too long to leave, but we'll try again another time. Eat too much dessert and you might have a tummy ache. Misread a recipe and put too much baking soda in your cookies and they will taste bad.
As tempting as it is to think that parenting is about raising children who "obey", obedience should not be our highest value in society. Look where that got us during the pandemic. Thinking through and appraising one's actions for one's self should be our goal in raising children. It's only through making mistakes and understanding the impact of our mistakes that we're able to alter our behavior from an internally motivated place.
Relational parenting that offers consistent love, guidance and appropriate boundaries is considerably more difficult than just punishing your child for disobedience. All healthy children defy their parents and if they don't they're not healthy. Those raised with punishments will typically defy by sneaking and lying. Those raised to be in relationship will do it openly and stay relational.
I want my child to work out things for herself and want her to take risks so I offer as much autonomy as I can. I also want her to know she can come to me with her mistakes and I'll support her when she needs it.
I have to say I am impressed with the self-awareness shown by Gwyneth. She is, perhaps, the exception that proves the rule that the way we bring up children now does them much more harm than the rather laissez-faire method employed, often by necessity, when I was a kid.
There seems to be quit a few apologists here. Thee fact is there is more of a problem now that therapy is deeply involved than in the results are worse
Anyone who espouses a theory that replaces individual accountability with any other factor and removes your control over life's ills and your own poor decisions will find a willing audience.
Anyone who espouses a theory that places individual accountability at the center of your life and insists on your own control over poor decisions will be derided for it.
"The slippage between metaphor and rigorous claim that characterizes much of our talk of “trauma” makes it very difficult to evaluate many of the claims... nothing good is accomplished by telling children they have inherited trauma from their ancestors."
The disconnect between "my personal experience" vs. what we as a society should implement ("impose," in a lot of case) for everyone as policy (formal or informal) is vast.
Where "woke" went wrong, where so much good intentioned progressive policy recommendations go wrong is they don't contemplate the broader (inevitable?) consequences, what the existence of a particular policy (or outcome of that policy) "says" to the rest of society, especially children and youth.
E.g., harm reduction in its most targeted form is literally about reducing the worst harm of death (via overdose) or physical disease (via dirty needles), but harm reduction as policy is *very harmful* for neighborhoods and communities b/c it doesn't even consider reducing the harm for those entities, doesn't allow for the observation that allowing for addicts to just use with impunity (yes, including not dying from ODing) on the streets is harmful for those entities, especially for the children in those neighborhoods (as the mom in the great article about Kensington in Philly noted).
I’m a therapist I had a couple of points where I thought Shrier was off the mark.
1. Telehealth is as effective as in person therapy and it greatly increases access to care. Especially in rural areas but for many people having to take an hour plus travel time off from work every week to get help isn’t feasible. A number of my clients move their lunch hour then talk to me from their car. I can give you numerous sources measuring telehealth’s effectiveness.
2. Intergenerational trauma is real but I learned of a different definition than what was described above. Traumatic event happens to generation A this greatly impacts their ability to parent generation B who then struggles with generation C. The effect does dissipate with time.
An example is WWII, my grandfather served on the USS Zeilin at Guadalcanal. His ship was attacked by Japanese bombers and nearly sunk. My grandfather was different after the war and ended up abandoning his family years later. My mom is a basket case and thats trickled down to my brother and I.
A fairly simple concept.
3. Shrier is complaining about woke therapists only. Which is fair since 90% of therapists are rabid progressives. Example: I’ve seen them push “healthy at all sizes,” which is a lie, to people recovering from anorexia. Yo-Yoing them from starving to death over to obese. Then telling them they could commit suicide if anyone questions their weight. No attempt at creating a healthy relationship with food. Only a woke therapist would do that.
Therapy is like a hammer, you can build a house with it or you can smash someone over the head. The problem isn’t the tool, its how its used.
Anyway I loved the book. Its mostly accurate. Although when this woke moment in history passes the critiques to Psychotherapy won’t apply anymore.
Telehealth (a sterile corporate term, makes it sound official and accepted), a.k.a video visits, *can* be as effective as in-person visits, once there is an established therapeutic relationship and it is a pretty standard session. No amount of "sources" will convince me that dealing with an actively suicidal, or with a desperately depressed person crying his/her eyes, or with someone having a panic attack, etc, i.e. in situations when your client really needs you, is as "effective" in person, in the safe and supportive comfort of your office, as with someone hanging out in their car in a parking lot. No way, never, and I suggest that you do not delude yourself.
Thanks David for your great comment. Could you please share a source measuring telehealth's effectiveness for mental health? I'd be interested in learning more about the topic and sounds like you may be a better source than google.
I also had a grandfather serve in WWII who was a POW after his plane was shot down. The experience destroyed my grandmother and led to serious family trauma - addiction, abuse, divorce, etc. My dad somehow rose above it which you can either view as an outlier/miracle or a testament to Shrier's point that the story of humanity is one of resilience. The latter resonates with me more personally. But either way your point is a helpful clarification.
Sure, here are some sources on telehealth being effective for treatment. Note by telehealth, I mean a video call, phone calls are not as effective as in-person.
https://academic.oup.com/milmed/article/187/5-6/e577/6345927
https://www.healthaffairs.org/doi/10.1377/hlthaff.2018.05132
https://www.liebertpub.com/doi/10.1089/tmj.2013.0075
https://bmjopen.bmj.com/content/7/8/e016242
There are four sources but I could keep going. Telehealth both for doctors appointments and therapy appointments has been studied heavily in the last ten years. There is little to no difference between telehealth and in-person appointments.
An exception would be working with small children. Play therapy needs to be done in person. But for adults and teenagers, telehealth is just fine.
Also, I don't have a fatalistic view of intergenerational trauma. People are resilient and can overcome problems. I'm not a victim. All it takes is one person to break intergenerational affect. My main point is that as a concept it does have merit.
Thank you for taking the time to reply with sources. There does seem to be a large body of research on this topic that supports your contention. One note that may relate to other comments in this thread, quoting from one of the meta-analyses:
"Lastly, the authors reported that studies with participants ages sixty-five and older and those with slower internet connections reported more variability in their findings. This suggests that a patient’s demographic characteristics and internet access could affect the use of a telehealth-administered neurocognitive test."
Telehealth may not work for everyone, which is true of pretty much every intervention. That doesn't mean it doesn't work for many others.
This feels like a scam poster. “I had such a hard time figuring out the market blah blah.”
Next poster: “You should check out Ms X. She really helped me figure everything out.”
“Thanks so much for that info. I’m going to look into her.”
Haha yeah I did think about that when I was writing my reply. I really did ask the question honestly - I have a teenager who may need mental health services - and did read the references provided which support his claim. I'm skeptical that "success" can even be measured in mental heatlh so not totally sold but when someone shares sources with anonymous questioners I figure it's the courteous thing to do to say thank you and follow up. Beep Bop.
I must disagree about telehealths effectiveness. Between the disruptions in service, the delay time when speaking or the occasional echo, it makes a therapy session almost impossible to be effective. I did it for a time with my established therapist and hated it. I stopped going. It may be more convenient for the therapist but not for the patient.
Anyone who tries to tell you video conferencing is equivalent to in-person should be viewed with suspicion.
Agreed.
This is factually incorrect. I work exclusively via telehealth, and those issues rarely come up. One of the studies I posted specifically measured patient/client satisfaction. Yes, for telehealth to work, a person has to have an internet connection and an electronic device that can support a video call. If you do not have this, telehealth isn't for you.
You're describing a technical issue specific to your own circumstances. This isn't a valid case against telehealth as a means of delivering service.
David, technical issues aside (which are quite common) this was my personal experience and you can't negative that as "factually incorrect" as they were the facts of what transpired. I believe you are trying to rationalize your telehealth business for your own self interest, which is quite disheartening.
You sound like a bot.
I have to disagree, David, that Telehealth is as effective as in person therapy. When a person's life is so arranged that they can't take or make time to be in person with someone else raises more alarm bells than anything else, and should then certainly be the focus of therapy.
This would be true if there weren’t access to care issues such as available providers within insurance networks, extended travel time, and speciality services. Come on y’all - “black and white” zero sum answers can be fun for the sake of forensics but aren’t we tired at this point?
For all those claiming that Abigail Shrier is attacking legitimate therapy, please identify “the people who are actually trying to heal” those suffering from crippling mental illness, whom Shrier supposedly maligns. Maybe I’m missing something, but I don’t see her ripping apart actual therapists. In fact, she quotes many in her work — many who are alarmed at the quackery and unethical practices of those who claim to be therapists, particularly in our schools. They’re throughout our schools, thanks to massive amounts of emergency funding from every level of government, and they’re roping in kids starting at the pre-school level. In Connecticut a pre-schooler by law (a law that predates Covid) can be accorded up to three mental health days per year if he or she needs it. My son, a licensed youth soccer coach at the development level (D1 and semi-pro) must deliver instruction as “a sandwich,” bookending the “you blew it” message with some inconsequential praise. Social Emotional Learning, a key manifestation of the bubble approach to child rearing, is a scourge that’s been in practice for more than two decades. Tragically ironic, for all this pseudo-therapy meant to undergird their resilience, kids are shooting up their schools, bullying and beating up their classmates, and killing themselves at accelerating rates. Something is deadly wrong. Credit Shrier for trying to identify it. I’d have hoped legitimate mental health professionals would stand with her. Looking at how the pediatric community rejected her attack on the transgender movement, I shouldn’t be surprised.
The Left is reductionist; if you're criticizing any aspect of something then you're criticizing all of it, because that's how they think.
I am a millennial who wholeheartedly agrees with all of the criticism of millennials because I am well-positioned to see that it is true a lot more often than it is false. I am able to make this agreement without professing to be personally guilty of the things that other millennials are guilty of; I understand bell curves.
But of course, I'm not left-wing, so I am capable of this nuance.
Yes. Psych is a liberal field. Lot’s of DEI. However, very good Therapist’s and leftists.
I think Shrier's position has merit. An obsession with how we "feel" can all too easily turn into unhealthy navel gazing, leading one to be more fragile and subject to their emotions. The field of psychology has promoted some of this molly-coddling. But, the field of psychology also promotes things like resilience and anti-fragility. The "compassionate" types in our culture have grasped onto the former, and see it as their raison d'etre to nurture those they deem to be fragile. I sympathize with the sentiment, but their execution is categorically wrong. Their methods (a laser focus on feelings, talking about feelings, seeing emotional outbursts as praiseworthy, "trauma-informed" language) ends up as Jung's Devouring Mother archetype. Their methods end up handicapping people. We need to end the trauma culture.
There's absolutely a need for therapists in our culture, but Shrier's point that the tools of therapy are being misused is correct.
One book that is a good complement to Shrier's would be The Best Minds, by Jonathan Rosen. In it, he describes the evolution of psychiatry and psychology, from treating the most mentally ill (which is hard!) to the "worried well" (which is profitable and easier).
This is why there is both a mental health crisis for the most deeply afflicted AND too much therapy to treat the normal human condition.
Agreed. It is a fantastic read. Gripping actually in its first half narrative and then seamlessly moves into the analysis of the professional field itself. Reminded me of how Viktor Frankle wrote Man’s Search for Meaning.
Great insight!
This kind of captures what goes wrong with almost all progressive policies, at least on the human/social services side of things. There are concepts and practices that are helpful in very specific, often clinical contexts, but then someone somewhere decides this needs to be "policy" and applied in a general context and it not only doesn't work, it can be harmful, especially in the larger social/cultural messaging outcomes.
My worry is that therapists and therapy are a modern invention that is replacing (poorly) what humans have been doing for thousands of years. Instead of reaching out to your friends, family, or community, you can call some random therapist over FaceTime in your car. That person doesn’t know you or care about you, they have dubious credentials, they may be more mentally unstable than you are. It’s just a cheap fast food substitute for leaning on the connections that are meant to make you feel better and stronger. Instead of going to your best friend, your rabbi, your neighbor, you are talking to some stranger, whose incentive is ultimately to keep you coming back. I have yet to hear of a therapist who said “your problems are minor and you don’t need me - you just need to suck it up and move on”. The incentive for the therapist is not to strengthen you. It’s to “validate” your feelings and let you regurgitate and feel briefly better - but that doesn’t leave you more resilient of better equipped to solve your own problems. It’s just the junk food that makes you feel better only while you’re chewing it. Unfortunately, like almost all things in life, the most correct thing to do is usually the most difficult. Eat well, exercise, abstain from drugs, work hard, work on your relationships and upkeep them, get fresh air, sleep well, do saunas and cold plunges, pursue a difficult and fulfilling career, have productive hobbies. That’s so much harder than going to therapy, but also, so much more effective.
Well, Dasha, I am a therapist and I do exactly that… I never try to keep someone in therapy to pad my pockets. I have a strengths perspective “you are stronger than you think, life has its challenges and let’s figure out how to meet them” approach. I am the child of a Holocaust survivor who spoke about her experiences, shared them with audiences all over the world, and wrote numerous bestselling books about her life. My life lesson has been one of perseverance and resilience, and this is exactly what I attempt to impart to my children and, yes, my patients.
We are not all of the “what went wrong this week “ variety. Some of us employ the “what went right and what did you do to help that happen so that you can do it again “ method.
Soon enough, I’m able to say to many, “you’re doing great, I think you’re ready to do it on your own. I’m always here if you need me “. We part ways, both of us feeling great about the work done together.
I’m sure you’re a great therapist and your patients feel you do a lot for them. My opinion is a dissenting and unpopular one - my feeling is that our current population is the most over-therapized, over-medicated of any in all of history or space. There’s every manner of therapy from online to in person to group to insurance covered to private to FaceTime. It’s every where you look. And yet people are diagnosed with more “anxiety” and “depression” than at any point in history. And I believe that therapy is part of the problem, not the solution. Training resilience in yourself is not easy or pleasant - if it were, it would be called therapy. The cure is not working.
There are some therapists who will tell you to stop coming and there is not need but those are few and far between.
My friends are dumb and have problems of their own. They don’t substitute as a therapist if one is truly in need of counseling. That would be an example of taking someone hostage to my own drama. How about we focus on rebuilding self agency skills? Remembering where others end and I begin? For all this talk about a generation who only knows or focuses on themselves, they sure seem to have a tough time allowing others to be who they are. And who do we look to for that skills? Certainly not in the more senior humans on these discussion boards - best as I can tell.
Your point about hostagetaking and boundaries is very important. I am sure many people have been at the mercy of a narcissist, who expands their drama infinitely until we are ourselves never heard, but only a fan club for their latest injuries. However, I think there is a very important truth that should be looked at: why when we have a problem must we pay someone to listen to us? What DID happen to grandparents, aunties, doting uncles, confidantes? The statistics on American friendship or dismal. Vast numbers of people have no close friends to call on. The people I know who are the strongest and most resilient have close ties, confidantes, and people they call on whose perspective they trust both to comfort them and to set them on the right path when they make a self-destructive turn.
Here in Seattle therapy starts at about $150 per hour and goes up. This is for 45 minutes, 50 if you are lucky. I personally cannot afford this. When I have tried on occasion to go to my HMO’s co-pay, only people they are half my age, barely out of school and useless to where I am, and who I am. We need to bring back hanging out. We need to bring back long coffees and late night conversations around the kitchen table.
(Sorry for mangled sentences, couldn’t edit after posting.) I want to add that at a different phase of life when I was in my 20s I urgently needed professional therapy and tried to go to friends, but was so confused at what I was going through and so distraught I overburdened friendship and that pushed people away. There are issues like actual) physical and sexual abuse and alcoholism that can definitely benefit from the help of skilled professionals. Children from alcoholic homes or from homes with sexual abuse tend to gravitate towards others, who come from those same backgrounds and have similar wounds. Liz, I agree, confiding in people who are as confused, and who have similarly distorted perspectives, can create even more problems..
Intergenerational trauma just seems like munchausen by proxie
Yes, other than "the tales my mom told me of the barbed wire and death" caused me to have nightmares there really is nothing to it. Especially gene alteration.
Gene alteration is nonsense. I know of no evidence that epigenetics is involved here. It's all about how you are brought up and the stories you hear.
Example: my father volunteered in 1939 and had an exciting war until late 1944, when he met a butterfly bomb, eventually being discharged from hospital a couple of years later. He did not talk about it at all to my brother, but I was born seven years later and was very close to my father. He talked of little else to me, and in a way, it became my war too. I don't think it traumatised me to hear all that, but it did become part of my history even if vicariously received. After my father's death, my brother compiled and published his war diaries, but I already knew all the tales in them and did not feel compelled in the way my brother did.
Bad Therapy is such an important read. I've already passed on the recommendation widely. My big concern: how can this be reversed? I suspect with a lot of communication and introspection, parents can focus on building resiliency. But that will be hard if your social circle is a cadre of "gentle" parents. But entire education establishment still thinks this social emotional dysfunction actually works. Is it going to take whole groups of like-minded parents creating new cooperative schools? Do we need a movement that's like a counter-programming PTA?
And on a related topic, I wonder how much of what's going on with "gentle" parents is their own striving played out through their kids? Get into a group of professional class parents and the deeply held desire to get their child into the Ivy league drives all manner of bad behavior. Are kids really improved by being sent on choreographed "volunteer missions" or would camping with family be better? Have a kid playing a youth sport that's told by age 12 or 13 they must specialize, focus on one sport only, and play it year-round, and define success as being on the NHL draft track seems a prescription for disappointment, burnout, and neuroticism. But the parents just "want what's best" for their kids. Really?
Ahhhh...........there it is; resiliency. I watched as my son developed resiliency by his own ideas and actions. It was tough at first, but over time became something that was very satisfying for my wife and I. FYI, he strongly resisted talking to a counselor/therapist in lieu of figuring it out himself. We seem to have ceded this growth to the psychological services which seem to delay it, producing extended dependent children or at its worse inept adults.
I chuckle recalling my youngest, now 27. When he was little and took a spill, his first reaction was to look around to see who saw it. If he detected an adult, he burst into tears. If you saw it through a window and he didn't know you were watching, he'd dust himself off and keep going. Too much oversight and too much validation of trauma seems to backfire. (He's a ruggedly independent adult now!)
As a psychologist, I think her analysis is spot on. To illustrate how radically our orientations have changed, consider Abraham Lincoln’s observation about his childhood: “It is a great piece of folly to attempt to make anything out of my early life. It can all be condensed into a single sentence. … The short and simple annals of the poor.” The current endeavor to assume that most if not all of adult dysfunction stems from difficult or traumatized childhood leads many to cut off parents who were both dedicated and reasonable.
A great discussion. Shrier is cogent and seems to have great insight into our "let's find an expert to help" society. [Look at the damage "experts" caused during Covid.] We could do with a significant reduction in the amount of therapy in the US. As Shrier makes clear this is especially true for young people. The notion that schools have untrained employees - other than a PowerPoint session - assessing the emotional state of youngsters is appalling. Of course in a society where teachers and administrators feel free to encourage kids to adopt different gender identities and not inform parents is it any surprise this occurs?
Really good interview. Bari.
Why isn't it just as plausible that the children of Holocaust survivors would be some of the most resilient people on earth - having learned first hand the power of perseverance and indefatigable will?
I thought that, too, then continued down that thought path, wondering if its because they didn't live the experience themselves. It seems a prerequisite that in order to be resilient you need to experience the trauma firsthand rather than just knowing or observing it. In other words, the experience gives you the motivation (for lack of a better word) to be resilient.
Nice comment. I think you are onto the essential point - experience of horror versus hearing about an experience of horror. Two different experiences for an individual. Two different impacts. Resilience comes from living the horror personally. Impact on one's soul versus hearing about others' experience.
I like much of what Abigail Shrier shares, although I become mistrustful when she becomes dogmatic and seems to have an agenda. She creates a straw man with regards to gentle parenting. There was no need to do this and now I wouldn't recommend anyone listen to this podcast without a strong caveat. She chose only to focus on how gentle parenting can go wrong (as any parenting can) but had to have intentionally chosen not to pursue families in which this approach to parenting has gone very well.
Gentle parenting comes in many forms and much of it is authoritative. I know numerous young adults who are wise, compassionate, competent and successful people and were raised without punishments, time outs, yelling and threats. They were raised with respect, kindness and a relational parenting style. They're some of the most interesting and unique adults I know. Off the top of my head -- one is a farmer and soon to be a mother, another is a sign language interpreter, one is a professional musician, another doing very well at a UC college and another is the ED of a non-profit. All of them are strong, independent and full of zest for life.
As a Gen Xer who was spanked, grounded, threatened and yelled at, I knew I wouldn't duplicate a parenting style that made me sneak around, stop telling the truth to my parents, and left me on my own and at risk with many challenges. As much as I love my parents, I didn't have a relationship in which I felt I could go to them with my troubles and worries. My twelve year old has been raised without punishments including time outs, but with clear expectations. She shares her troubles and challenges with me. She comes to me when friends do things that go against the values we've instilled in her. She talks to me about boys. She isn't afraid to share her mistakes. She's been able to make her own breakfast since she was 2 years old, can't wait to get a driver's license, dreams about becoming a mother, competes in equestrian events, goes on trail rides by herself and just experienced a severe injury that required emergency surgery and lots of visits back to the surgeon. He commented on what a boss she is in how she has handled it all. She's hardly the disabled version of a human Shrier tells us gentle parenting will produce.
You know people who never gave a child a single consequence? And, yet they were "authoritative"? How? Did their child never disobey?
Life offers consequences. Go out when it's cold without a coat and you'll experience a consequence. Don't listen to mom when it's time to leave the playdate and next time she says we can't do a playdate today because yesterday it took too long to leave, but we'll try again another time. Eat too much dessert and you might have a tummy ache. Misread a recipe and put too much baking soda in your cookies and they will taste bad.
As tempting as it is to think that parenting is about raising children who "obey", obedience should not be our highest value in society. Look where that got us during the pandemic. Thinking through and appraising one's actions for one's self should be our goal in raising children. It's only through making mistakes and understanding the impact of our mistakes that we're able to alter our behavior from an internally motivated place.
Relational parenting that offers consistent love, guidance and appropriate boundaries is considerably more difficult than just punishing your child for disobedience. All healthy children defy their parents and if they don't they're not healthy. Those raised with punishments will typically defy by sneaking and lying. Those raised to be in relationship will do it openly and stay relational.
I want my child to work out things for herself and want her to take risks so I offer as much autonomy as I can. I also want her to know she can come to me with her mistakes and I'll support her when she needs it.
I have to say I am impressed with the self-awareness shown by Gwyneth. She is, perhaps, the exception that proves the rule that the way we bring up children now does them much more harm than the rather laissez-faire method employed, often by necessity, when I was a kid.
There seems to be quit a few apologists here. Thee fact is there is more of a problem now that therapy is deeply involved than in the results are worse
Anyone who espouses a theory that replaces individual accountability with any other factor and removes your control over life's ills and your own poor decisions will find a willing audience.
Anyone who espouses a theory that places individual accountability at the center of your life and insists on your own control over poor decisions will be derided for it.
Bingo
She seemed to offend the therapist,truth sometimes hurts
"The slippage between metaphor and rigorous claim that characterizes much of our talk of “trauma” makes it very difficult to evaluate many of the claims... nothing good is accomplished by telling children they have inherited trauma from their ancestors."
The disconnect between "my personal experience" vs. what we as a society should implement ("impose," in a lot of case) for everyone as policy (formal or informal) is vast.
Where "woke" went wrong, where so much good intentioned progressive policy recommendations go wrong is they don't contemplate the broader (inevitable?) consequences, what the existence of a particular policy (or outcome of that policy) "says" to the rest of society, especially children and youth.
E.g., harm reduction in its most targeted form is literally about reducing the worst harm of death (via overdose) or physical disease (via dirty needles), but harm reduction as policy is *very harmful* for neighborhoods and communities b/c it doesn't even consider reducing the harm for those entities, doesn't allow for the observation that allowing for addicts to just use with impunity (yes, including not dying from ODing) on the streets is harmful for those entities, especially for the children in those neighborhoods (as the mom in the great article about Kensington in Philly noted).
https://www.thefp.com/p/harm-reduction-kensington-causes-harm