• DSTLLD
  • Posts
  • đŸ”„ Take: Please Don't Send Your Kids To Therapy (Extended Distillation)

đŸ”„ Take: Please Don't Send Your Kids To Therapy (Extended Distillation)

A Review of Bad Therapy by Abigail Shrier

April 08, 2024

Before we begin, I highly encourage every single person with school age kids or who might soon have school age kids to read the book. Bad Therapy: Why the Kids Aren't Growing Up

I ask my podcast guests at the end of each episode, “What is the last thing you changed your mind about?”

Here’s mine:

Kids should almost never go to therapy.

Two things to note.

  1. The book obviously goes much more in depth and contains citations for everything I’ll mention.

  2. Remember that I said almost never. Cognitive Behavioural Therapy (CBT) interventions have been shown to work in cases of eating disorders, phobias, OCD and PTSD among others. These may present in some kids/teens.

I, like many of you, naively assumed up until a month ago when this book was released that there were never any negative effects of therapy. That therapy was only ever a good thing and that it was something everyone should do.

Boy was I surprised to learn about the vast literature of iatrogenic effects — illness caused by medical examination or treatment — of therapy in up to 20% of patients.

Here’s the quick list of bad outcomes for everyone (not just kids):

  1. Dependance on a therapist

  2. Family estrangement

  3. Increased depressive symptoms (including, in some cases, suicidality)

  4. Decreased self-efficacy

  5. Extended mourning periods

  6. Medicalization of normal emotions

  7. Negative alteration of memories

Shrier tells a story in the book that mirrors my own, about introduction to the therapeutic pipeline. So here’s my personal anecdote:

My parents inadvertently changed my life through omission when I was 8 years old. I’m assuming anyone who was or knew an 8 year old boy knows how energetic they are.

The current education system isn’t doing them any favours by making them sit at a desk for 6-8 hours a day. Again, another topic for a different day.

I don’t know if my 3rd grade teacher didn’t like me, couldn’t handle my energy or a combination of both. The story I was told was that she wanted me medicated.

Thankfully my parents pushed back and I was able to continue as my normal 8 year old boy self
 minus my desk chair as punishment for repeatedly rocking back and forth.

What happens if my parents had a little less confidence in themselves? Would I have become dependant on methamphetamines to focus for my entire life?

“No industry refuses the prospect of exponential growth, and mental health experts are no exception. By feeding normal kids with normal problems into an unending pipeline, the mental health industry is minting patients faster than it can cure them.”

I shouldn’t have to put this caveat here but I will, kids can undergo traumas but being put in timeout, taking away a toy or reasonably being told no doesn’t count as trauma. Despite what some parenting experts might have you believe.

Here’s the cultural headline:

Parents have abdicated their decisions to people who cannot possibly know or love their children better than themselves under the guise of expertise. Despite the threshold for what qualifies as expertise falling through the floor.

I can’t stress enough how important this previous statement is. It doesn’t take a lot to reverse this trend. It just involves parents having a little more faith in their intuition.

Here’s why therapy is so dangerous for children in particular.

They are very easily manipulated by people in positions of authority.

I could pipe up with: “I think I gave you the wrong impression.” Or, “Maybe we’re placing a little too much blame on my mom?” Or even, “I’ve decided to terminate therapy.” Children and adolescents are not typically equipped to say these things. The power imbalance between child and therapist is too great. Children’s and adolescents’ sense of self is still developing. They cannot correct the interpretations or recommendations of a therapist. They cannot push back on a therapist’s view of their families or of themselves because they have no Archimedean point; too little of life has gathered under their feet.

Children are easily convinced of things. Think recovered-memory therapy, a dark episode in the history of psychiatry in which therapists inadvertently implanted false memories in child patients.

Beyond that, there is little evidence that any therapeutic intervention is beneficial for kids.

For most problems, Ortiz says, individual therapy has almost no proven benefit for kids. “The evidence is pretty clear that parent-based approaches are more effective.” Meaning, a therapist should treat a kid’s anxiety by treating the kid’s parents. Parents often unwittingly transmit their own anxiety to their kids. And parents are in the best position to help a child deal with her worries on an ongoing basis.

Anyone with a small child knows this. What happens when a child falls down and hits their head?

The parent can have 2 reactions:

  1. “Oh my gosh hunny are you okay!” Wahhhhhhhhhhhhhhhhh

  2. “Oops just a little fall, you’re okay.” The kid is totally unphased.

Kids look to their parents for how they should react. How do you think an anxious parent typically reacts?

Shrier’s 10 Steps To Bad Therapy

See if you can figure out how many of them we’re doing. Hint: all of them.

  1. Teach Kids to Pay Close Attention to their Feelings

  2. Induce Rumination

  3. Make “Happiness” a Goal but Reward Emotional Suffering

  4. Affirm and Accommodate Kids’ Worries

  5. Monitor, Monitor, Monitor

  6. Dispense Diagnoses Liberally

  7. Drug ’Em

  8. Encourage Kids to Share Their “Trauma”

  9. Encourage Young Adults to Break Contact with “Toxic” Family

  10. Create Treatment Dependency

Here’s where things get even worse.

You’re saying, that’s great Blake but my kids don’t go to therapy. Are you sure about that? How about public school?

In my case it was medication but there are equally as many cases of kids being misdirected into therapy sessions under the guise of trauma-informed education or social-emotional learning (SEL).

“It trained teachers to understand “trauma” as the root of student misbehavior and academic underperformance. These efforts didn’t aim to produce the highest-achieving young people. But millions of us bought in, believing they would cultivate the happiest, most well-adjusted kids. Instead, with unprecedented help from mental health experts, we have raised the loneliest, most anxious, depressed, pessimistic, helpless, and fearful generation on record.”

I read this on Twitter LAST WEEK:

For those ticking off bad therapy steps, schools are racking up quite a few: inducing state orientation with emotions check-ins. Encouraging kids to focus on their feelings, which can cause bad feelings to perseverate. Treating kids with in-school therapy, which can introduce all kinds of iatrogenesis, especially where it does not abide an ethical “dual relationship” boundary.

Folded in with social-emotional learning is the increased prevalence of teaching aides and restorative justice.

Teaching aides or “shadows” provide accomodation for kids with additional classroom needs. Thanks to SEL almost any child could petition to have additional needs.

In private schools, they are called “shadows,” but in public schools you’ll hear them called “ed techs,” “paraprofessionals,” or “parapros.” Part body man, part special ed teacher, shadows are hired privately by parents or supplied by public schools to stick closely to one particular kid, ostensibly to smooth the kid’s acclimation to class.[1] More than a decade ago, shadows made it mercifully possible for kids with autism or severe learning disabilities to remain in a classroom with neurotypical kids and avoid the stigma of being sent out to “Special Ed.”[2]

[
]

Today, public schools assign shadows to follow kids with problems ranging from mild learning disabilities to violent tendencies, and private schools advise affluent parents to hire shadows to trail neurotypical kids for almost any reason. To help a kid make friends on the playground, to soothe a kid wriggling in his seat, to help a kid succeed and have fun at school. Do you think now might be a good time to raise your hand? Why don’t you share your snack with Paige? How about complimenting Ella’s doll? That’s enough hugging—Sebastian might not like to be touched. More monitoring, more dependence on an adult, less practice handling themselves, less inducement to believe that they can.

We’ll come back to this last point later, it makes up the crux of Shrier’s argument for the solution to raising healthier kids.

Restorative justice is a term you’re probably familiar with but in the most extreme educational cases it can have dire consequences:

Several teachers told me that thanks to restorative justice, public schools no longer hold back or expel kids in any but the most extreme circumstances. Until they commit egregious acts of criminality, violent kids are kept in school and assigned shadows, under the therapeutic ethos: treat, don’t punish. Nikolas Cruz, a student at Marjory Stoneman Douglas High School, had committed violent and menacing acts for years. He was assigned a shadow—his mom.[9] “The Parkland shooter” later took seventeen lives.

[
]

A RAND meta-analysis showed that schools that implemented restorative justice fell apart. At the middle school level, academic outcomes worsened in schools with restorative practices. There was no reduction in incidents of violence or weapons violations, no fewer suspensions for male students, nor even reduction in arrests at these schools.

At this point you’re probably thinking 2 things:

  1. Blake, I thought this book was just about therapy?

  2. It can’t get worse can it?

It’s not and it can.

The single block in the precarious Jenga tower of childhood therapeutic intervention is a study exploring “Adverse Childhood Experiences” or ACEs. The presupposition is that all children endure some level of these experiences AND that they emerge wholly traumatized as a result.

This means therapists, counselors and educators must do everything in their power to acknowledge and heal the trauma. Hold on a second


There is no good reason to believe that most kids are traumatized. The best research indicates the opposite: even among victims of heartbreaking circumstances, resilience is the norm.[18]

The original ACE study was intended to find population level patterns in people who had these experiences. Not diagnose individuals.

Also, for something propping up a large industry, surely that study is not riddled with questionable methodology


Harvard Medical School psychiatry professor Dr. Harrison Pope, in a telephone interview, called the ACE study of childhood trauma “a classic example of a methodologically flawed study.” If you want to find out whether trauma causes some pathology, there is a rigorous way to proceed: prospectively. You find children who have suffered trauma and document the trauma on the spot. Then you send in researchers blinded to which group suffered actual, documented traumatic experiences to check in with the subjects ten or twenty years later and note if the subjects demonstrate a larger incidence of illness and psychopathology than similarly situated people who have not suffered trauma. But if you proceed retrospectively, as the ACE study does, if you only select adults and ask about their history of trauma, the group you survey is very likely to be selected in a biased fashion.

[
]

One of the authors of the original study, Robert Anda, recently worried aloud that his study was being misused. The ACE categories are “crude” measures, never intended to apply to assessments of individual risk, Anda said in a lecture. Researchers citing the study often fail to consider the variability of human response to stressors experienced in childhood. Some kids will weather difficult circumstances just fine.

As a side note I recently learned about “p-hacking” or “data dredging” turns out probably around 30% of scientific studies have some dubious results. So if the headline says “studies show” you should probably at least click through and read the abstract.

I’m gonna skip a good chunk of the book here.

If you need to know what is explained at this point, it’s basically that Bessel van der Kolk (the guy who wrote The Body Keeps The Score) is responsible for some very questionable science. Including part of the previously mentioned stain on psychiatry of repressed and recovered memory.

Several of the academic psychologists I spoke to think this view is wholly misguided. They wanted me to know that this theory runs contrary to the best research. In fact, their work showed that the opposite was true: resilience—not permanent traumatic response—is the norm. Even for kids subjected to desperate hardship—poverty, alcoholism in the family, family instability, and parental mental illness—studies showed that in all but the most persistently dire circumstances, they typically demonstrate resilience.[32]

[
]

There’s no evidence that even survivors of the worst traumas hold memories implicitly or that those memories can be stored outside of the central nervous system.[34]

[
]

Academic psychologist Martin Seligman, winner of the APA Award for Lifetime Contributions to Psychology, has reviewed and summarized the studies on childhood trauma this way: “The major traumas of childhood may have some influence on adult personality, but the influence is barely detectable. . . . There is no justification, according to these studies, for blaming your adult depression, anxiety, bad marriage, drug use, sexual problems, unemployment, beating up your children, alcoholism or anger on what happened to you as a child.”[35]

Okay, back to schools not doing your kids any favours by attempting to treat their mental health.

Keep in mind any of the following surveys were only available through hundreds of Freedom of Information Act (FOIA) requests from non-profit Parents Defending Education.

Schools wouldn’t want you knowing too much about the questions they ask your kids.

Another important note:

Congress passed a law in 1978, and then expanded it, called the Protection of Pupil Rights Amendment (PPRA). It prohibits schools from asking about the following:

  1. Political affiliations

  2. Mental and psychological problems potentially embarrassing to the student or his or her family

  3. Sex behavior and attitudes

  4. Illegal, anti-social, self-incriminating and demeaning behavior

  5. Critical appraisals of other individuals with whom the student has close family relationships

  6. Privileged and analogous relationships (e.g., lawyers, physicians, and ministers)

  7. Religious practices, affiliations, or beliefs

  8. Family Income

How do the federal government, local schools, and state health organizations brazenly ask about topics verboten under federal law? Provided the surveys are voluntary and anonymous, courts have ruled[5]: They’re kosher!

The surveys are technically voluntary because parents have the ability to opt out, but by default kids are opted in.

More surprising than the surveys’ extensive array of questions about middle schoolers’ sexual orientations and gender identities is their blithe disregard for criminal law.

The 2021 and 2023 Youth Risk Behavior surveys, authored by the CDC, asks middle school children: “How old were you when you had sexual intercourse for the first time?”[6]

A. I have never had sexual intercourse

B. 8 years old or younger

C. 9 years old

D. 10 years old

E. 11 years old

F. 12 years old

G. 13 years old or older

There’s a word for “sexual intercourse” had by children at any of the ages listed above. It’s “rape.”

These surveys are collected anonymously so the guise of asking these questions to protect kids from predators is off the table.

An intake form at a psychiatric hospital asks prospective patients the following:

Just kidding. These are a standard series of questions administered to public high school kids in several states, all for the sake of tracking their wellness.[25]

Again, anonymized, they can’t even claim to be using them to save lives.

There are at least 5-10 other examples of surveys in the book. I had to share a couple because they genuinely broke my brain.

I’m sure if my wife wasn’t out with friends at dinner while I finished this section of the book she would have heard an audible “What the fuck?” emerge from the bedroom where I was reading.

You might be wondering: What sadist put this in front of middle school children? “Have you ever seriously thought about killing yourself?” is typically the sort of taunt one teen texts to another, or a troll writes on social media. Mental health experts who would slide this list of questions onto the desks of eleven-year-olds—to satisfy the state’s or school’s curiosity—really ought to be kept away from children.

Time for a quick sidebar on one of my favourite topics lately: Incentives!

Guess how federal, state and local mental health resources get their funding for treatment (and to maintain their jobs).

If your answer was anxiety, depression and crisis inducing surveys you would be a winner!

Absolutely no conflict of interest on that one.

Because suicide and self-harm are so contagious among teens, [Jordan] Peterson said, adults must be extremely careful not to ask kids leading questions. “Like, ‘When was the last time you thought about cutting your wrists?’ Do you know how much information there is in that statement?”

He ticked off the embedded implications. “First of all, the information is—‘Well, people do this.’ The next piece of information is: ‘You could be doing this.’ The next piece of information is: ‘It’s so likely that you’re doing this that I can just ask it as a casual question.’ And the next implication is: ‘Well, what the hell’s wrong with you if you’re not doing this?’ ”

[
]

As we’ve seen, the famous D.A.R.E. campaign led to increased teen drug use, perhaps for this very reason: it may have created curiosity about the very activity it hoped to disparage.[34]

I’m gonna skip another section here. It lays part of the problem of raising anxious kids rightfully at the feet of parents.

But more specifically, gentle parents. Forward this to some gentle parents.

The conclusion is that:

Gentle parenting is, at very least, trading one set of problems for another.

In an attempt to not be like their “toxic parents” — that they learned about in therapy — they tried something different and raised “the loneliest, most anxious, depressed, pessimistic, helpless, and fearful generation on record.”

All while getting black-eyes from disobedient and emotionally stunted kids.

We assumed with perfect faith (and wholly without evidence) that gentler parenting could only produce thriving children. Shouldn’t flowers bloom in powdered sugar? Turns out, they grow best in dirt.

At this point we’ve exhausted the bad news.

Unfortunately, there is a lot of it.

Fortunately, it’s all fixable.

By you.

The parent.

Without outside resources.

Yes really.

Remember that point earlier that I said we’d come back to?

Here’s the prescription:

Loving, rule-bound parenting with a healthy dose of risky and independent play for your children.

Throw in a large dollop of skepticism for anyone who wants to insert themselves between you and your kids and you’ve got the whole cocktail.

Here’s a takeaway I’m thinking about as I wrap up my thoughts:

Why is it that every intuition my parents had about how to lovingly raise a kid was right. And, that every “parenting expert” for the past 50 years — save for a select few — has been wrong?

There is obviously some selection bias in that anecdote, there are other children who have awful parents.

Reading a book on gentle parenting and implementing it is better than beating your kids when they make a mistake.

But, something tells me that parents who are beating their kids aren’t searching out the best new parenting advice.

These parenting experts are being flocked to by parents who just don’t have enough faith in themselves.

Sounds a little self-referential if all of this is leading us to raise kids who don’t have faith in themselves. My tinfoil hat isn’t that tight but it’s an interesting observation.

If you’re reading this, the selection effect means you’re probably not beating your kids.

So trust yourself a little bit more, okay!

Reply

or to participate.