The Impact of Therapy Culture

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Abigail Shrier: People are very bad judges of knowing if something’s working. Why? Because when they first hear that it’s not their fault, their divorce is not their fault, they’re, they’re getting fired isn’t their fault, they feel that’s it. It’s because of my bipolar disorder. It’s because of my trauma. And they will always feel like, wow, that, that was so great that now I know.

Zachary Karabell: What Could Go Right? I’m Zachary Karabell, the founder of The Progress Network, joined as always by Emma Varvaloucas, the executive director of The Progress Network. And What Could Go Right  is our weekly podcast in conjunction with The Progress Report, which is also part of our weekly podcast that looks at the news and some news that you can use, some news that you might not have noticed.

But What Could Go Right is our main aspect, as well as our newsletter, which is free, which you can sign up for at theprogressnetwork.org. We’re gonna look today at a bestselling book that has called attention to an emerging trend, particularly in the United States, of how kids are exposed to therapy and the drugs that are prescribed as a result of those therapeutic regimes.

And to the degree that we may be creating for our children a generation that is less resilient and less able to deal with the challenges of being alive, all in the name of trying to help them deal with the challenges of being alive. And that in the fear, Of all the challenges and problems, we have made decisions far more likely to make those fears true than to ameliorate them.

So that is going to be our discussion today. Emma, who are we going to talk to?

Emma Varvaloucas: We’re going to be talking with Abigail Shrier. She’s the author of two bestselling books, one that was met with a not insignificant amount of controversy, and that was Irreversible Damage, The Transgender Craze Seducing Our Daughters.

We’re going to talk to her today about her recent book, which is a bestseller. called Bad Therapy, Why the Kids Aren’t Growing Up. All right, let’s go find out why the kids aren’t growing up. Are you ready?

Zachary Karabell: I am. 

Abigail Shrier, thank you so much for joining us today for What Could Go Right. Your book, Bad Therapy, has been, to say that it has been in the news is an understatement.

It has, it has been the news in many ways. So for those who have not been tuned into the book and your thesis, and I know you’ve now at this point, it’s like when you show up at work or school or wherever you are with a cast the first time, it’s And everybody goes, Oh my God, what happened? And by like the 70th time, you’re so tired of the question and that you start making up stories.

So I know that you’ve, you’ve been asked the question about what your basic thesis is so many times at this point that you could either recite it in your sleep or it bores you to tears. That being said, just for the sake of our current conversation, please, please do so.

Abigail Shrier: Okay. Well, first of all, I love the way, let me just say, I love the way you said that because that is the crux of the problem is that we settle into these orthodoxies without ever looking at them and saying, have we gone too far?

Is this totally correct? Is it correct for everyone? And my book addresses one orthodoxy. And the orthodoxy is. That the mental health catastrophe of the rising generation, it does seem to be a bit of a catastrophe. The young people are unhappy in numbers we haven’t seen. They describe themselves as lonely, as anxious, as depressed, and they seem to be manifesting that.

We have, you know, everything from suicide, the ideation to suicide attempts are up. They seem to be in genuine distress. You know, this so-called Gen Z or the, you know, rising generation. The question is why? And the orthodoxy has always said, well, what they need is more therapy. They, they, they’ve gotten more mental health intervention than any generation.

They’ve had more therapy, nearly 40 percent have been in therapy. They’ve had more psychiatric medication. They’ve had more diagnosis than any other generation, but what they would need is more. They just haven’t gotten enough. So my book takes a look and says, wait a second, um, we know that, you know, that, you know, this is what researchers have called the treatment prevalent paradox around depression.

We know that with any good treatment that becomes more prevalent, more widely accessible and available, point prevalence rates for any malady should be going down, right? We saw this with breast cancer, uh, treatment and screening that, that, that deaths, you deaths from breast cancer went down. And it should be, we should see these young people as the picture of mental health.

After all, they’re getting more treatment. But instead, as I argue in the book, a lot of the treatment has actually been counterproductive. In fact, the kids are getting the kinds of therapy they’re getting and the kinds of interventions are often too much. They’re often inappropriate. They’re often over diagnosed, over medicated, and what we’re seeing are some of the known psychiatric effects and psychological effects, and you see this in the research.

of therapy, because therapy can come with side effects. And here’s the key, especially preventive mental health intervention. See, when you’re actually dealing with a serious problem, that tends to focus the mind and, and sort of laser, uh, uh, you know, uh, uh, outline the, um, solution. You know, it tends to pinpoint things.

But when you sit, sit a teen who’s just bummed out into therapy without any sense of where you’re going or what the problem is, There are a lot of the side effects of therapy can come in and I think we’re seeing that.

Emma Varvaloucas: How many teenagers and kids in the United States are actually in therapy?

All right, because it seemed to me sometimes like maybe it’s just like a very And, particular group of people, like usually like privileged people, right, that end up getting maybe lots of therapy that they don’t need?

Abigail Shrier: Right. It’s a brilliant question. It’s an important one. So am I just talking about a, you know, rich kids problem?

They’re, they’re the, you know, the Upper West Side, though they’re all throwing their kids into therapy, but the rest of America isn’t. Well, when I started the book, I thought that the problem, I had a different hypothesis that I sold the publisher, which was that it had something to do with the way kids were being raised today by their parent.

But then when I started going into the mental health interventions to see what we were doing to help kids, I started realizing that we were really dumping therapy into the drinking water by which I mean, look, nearly 40 percent of the rising generation says it’s been in therapy and I think the number is higher now.

It has been in some kind of therapy, and the reason I think it’s even higher is because we’re seeing extraordinarily high rates of kids responding that they’ve had a diagnosis. So somebody is diagnosing huge numbers of these kids, you know, the, when you look at the different diagnoses, these vary, but as early as 2016, one in six kids between American kids between the ages of two and eight already had a mental health or behavioral diagnosis.

So you’re seeing these extraordinarily high rates. of diagnosis, but you also, when you go into the schools, and this is public school. You see that not only have mental health staffs expanded in the last 15 years greatly, but they’re all doing this sort of social emotional learning, which looks a lot like group therapy.

It’s kids sitting around talking about, um, how they would handle various kinds of sadness, disappointment, struggle, and reflecting on their own. You saw that in the last generation, certainly all the bestselling parenting books are great. Many of them were written by therapists. And they sort of instruct parents in becoming like, you know, proxy therapists.

And so I started realizing, look, some of this was from actual therapists, but a lot of people were behaving like therapists with our kids and introducing similar concepts of affirming the kid’s feelings, never being judgmental, meeting a kid where they are, which means at eye level, never asserting their own authority, but just trying to understand every bit of, you know, bad behavior as a cry for emotional.

And I, when I, once I realized we all, everyone seemed to be behaving like a therapist with the kids. I realized that the problem was broader, much broader than, than parents. And it seemed to be that, that mental health so called experts were really calling the shots and, and all sorts of people from teachers to parents.

We’re really being, to pediatricians, we’re really being guided by the mental health industry.

Zachary Karabell: Yeah, I mean, I think that’s the very crucial, like even if you’re not, and you’re of a less privileged background, but you’re in a public school context, you have a whole sort of public school system now. Yes, and in conjunction with pediatrics, that it’s certainly for boys, you know, very quick to label ADHD, very quick to prescribe Ritalin or Adderall.

And those are, you know, you can actually look at those numbers as just the hockey stick of that. So that’s kind of observable, even whether or not someone’s in a talk therapy regime, right?

Abigail Shrier: Yeah, and we were losing something in the process too, right? Every adult who had, had so called undiagnosed ADHD was now saying, I probably had ADHD and it was never diagnosed.

And no one was mentioning the fact that those adults sometimes were wildly successful as undiagnosed ADHD adults, right? So in many cases, it hadn’t necessarily clearly hurt them to not be diagnosed. Nonetheless, we were letting kids, kindergarten teachers. Decide that their, you know, five year old boy really should be, you know, really should be screened for ADHD.

And you know, I was talking to parents who were saying, you know, one year a teacher said he had ADHD and then the next year nobody said a word. He was suddenly a great student and part of it was a different teacher. And going in and putting a kid, and I’m not saying nobody has ADHD, of course. But putting a kid on a dramatically personality, you know, altering drug, and here’s the kicker, a kid, meaning someone whose, whose entire being is necessarily in flux, was a way more serious intervention than I think we were treating it like.

Rather than having our default be, well, let’s see how he is. Let’s make some changes in the environment and see how he does. The default was a good, responsible parent immediately gets the diagnosis and proceeds with medication.

Emma Varvaloucas: You know, this question of does a diagnosis help or hinder is such an interesting one. My partner has ADHD and I think that he would very much so agree with you that like he always says I hate it when people use their ADHD as a crutch, right? Like that’s just like, It’s, uh, anathema to him, you know? On the other hand, how I grew up was there was a lot of undiagnosed mental illness around me.

And when the mental illness was finally diagnosed, it was a huge relief. That wasn’t me. Other people. There’s a way to, for people to be therapized or treated or healed, or like some people really do need medication. And I’m not necessarily talking about a five year old, but sometimes there really are things that need to be treated.

So I mean, how do we, I guess, make sure that when something needs to be treated, it is being treated, but we don’t end up treating people that are, it’s not necessary

Abigail Shrier: to be treated? Well, the most important thing is that the bar should be much higher for children. And the reason the bar should be higher for children, and I don’t think it is, the adults get in there, they sort of all agree that this is necessary and they go, go, go.

And here’s the problem. You don’t have anyone who can say, hold on a second. I remember how things were before the medication. I don’t think this is right. I don’t think this is working. I think I need an adjustment. You’ve taken the person out of the equation because it’s a child or adolescent. And with an adult, it’s so much safer to go ahead and give a medication a shot because they can tell you how they used to feel.

And they can tell you, you know what, I don’t have a sex drive now, and I don’t like that. They can tell you, I’m really overeating. I’m concerned about that. I’ve put on a lot of weight, but it’s much harder for a teenager to evaluate those things because, of course, You know, a teenager, you know, a young person is changing so rapidly.

They’re just developing a sex drive and getting a handle on it. So, so the number one most important thing is that it should be a higher bar for kids and I don’t think that it is, right? It’s just too easy for adults to sit around and all agree that the child needs medication um, without the, the young person having a meaningful part in the discussion because they can’t.

They really can’t. An adult can, you know, can say, you know, look, a decade ago, I was doing much better and I wasn’t on this medication and I think I can get back there, but it, but there’s something else too. A person who gets a diagnosis will always feel relief, almost always feel relief. That is not proof that the diagnosis is accurate or that the, that the, or that the medication is helping.

And very often what it’s doing is it’s taking responsibility off the person. We might want to do that for an adult for various reasons, and we might be willing to let that, you know, you know, err on the side of over diagnosis with adult, but you don’t want to take away, you know, efficacy or responsibility or agency from a child who is just developing a sense of, wait a second, I was being lazy.

If I’m being honest, I could have worked harder. If I’m being honest, I could have taken my math test. I kind of exaggerated. You don’t want to relieve a kid of that responsibility unless you have to. Unless the problem is pronounced enough, you can say, look, I’ve been their parent. I can tell you those struggles with math are really serious or whatever it is.

We need to, we need to do something.

Zachary Karabell: Yeah, I mean, this sort of gets this contemporary, particularly in the Western affluent world, fear based parenting on the one hand, and I will protect my child from all harm slash pain slash difficulty on the other. And you know, Jonathan Haidt certainly talks about that too, separate from the social media factor, right?

The free range child versus the, unless you’re wearing a Kevlar suit and are, you know, put in an armored vehicle. You shouldn’t be allowed to go to school or be in a playground. And I think there’s an element of that too, in that, you know, there’s been a, certainly a widespread sense of any harm is to be avoided, but unfortunately at significant cost.

And that’s been somewhat lost. So, I mean, there’s the, there’s the parenting part of that that’s very deep of like, and then there’s the social reinforcement of that. Like, if you don’t do that, you’re a bad parent. You’re not being considerate. Like, how do you, how do you interact with those realities?

Abigail Shrier: I think that’s right.

We ended up with this fear based parenting. And so I asked why. I wanted to know why did parents, and what were they worried about? And it struck me that what they were worried about was, was not physical harm, principally, any longer. It was emotional harm. One of the things that was driving parents was this terror of emotional harm, this terror of a kid ever feeling unsupported, that that was now playing a bigger role.

And that’s why we needed to track kids. We needed to be around, an adult had to be hovering around them at all times. Why? Because someone could call them a bad name. Someone out of earshot could call them ugly, fat, stupid, whatever, and they would be marked for life. And that was the worry. It’s not true.

Right? We’ve all been called bad names, and kids need to learn to survive those things. Why? Because they’ll be called bad names again, as I’m sure you’ve had the experience of being, you know, criticized for, you know, things you’ve done. Being able to weather a certain amount of criticism is absolutely just a part of adulthood because you will get it, right, in any job.

And um, and shielding kids, I mean, we were worried that if anyone ever touched them in any way that was unwanted or whatever, that that would be permanent. They would now permanently live with that trauma. And first of all, it wasn’t true. Um, but second of all, I think that the mental health, I mean, I, I know that the mental health industry played a big role in scaring the hell out of parents.

And I think, I think it was a huge, huge overstep and it wasn’t true. People actually are incredibly resilient, which doesn’t mean you want your kids called bad names and it doesn’t mean you want your kids bullied and it certainly doesn’t mean you want them touched. You know, in ways that they don’t want or too aggressively or knocked around or any of the other stuff.

But it wasn’t true that it would mark them for life or that they would walk around with this now, you know, uh, emotional disability in effect. That wasn’t true. And we know this because there’s been really great research on all kinds of things happening to kids and them, and, and, and as adults putting it behind them, or even, you know, in childhood being resilient to all kinds of pain from the loss of a parent, the loss of a sibling, um, even to certain kinds of abuse.

People can get past them. And so not, not that any of that, we don’t, of course, we want to protect our kids from the, you know, extreme instances of those things, you know, things that go beyond just teasing. The question is, is it going to mark them for life? Are they permanently damaged? And the answer to that for most things is no.

So I’m

Emma Varvaloucas: really curious if you’re able to detail a pathway from the concept of trauma, like you might call big T trauma. to like little t trauma, which is what you’re just talking about, right? I’ve been to trauma therapy. I know people have gone to therapy for like very serious stuff, sexual abuse, physical abuse, you know, like I’m not talking about like your parents were mean to you one time.

It was very helpful. Uh, you know, none of the therapists were encouraging them to sit around and wallow in stupid stuff. They’re trying to get you to get past it, right? They want you to to thrive and be resilient like you’re describing. But on the other hand, there certainly are those pieces, like I’ve talked to people where Again, they come from incredibly privileged backgrounds, they go to trauma therapy, all of a sudden they’re talking about how like a vacation with grandma was a traumatic moment and you’re like, how did we get here?

So that’s my question to you, like, how did we get there? Because in my experience, there are a lot of very good trauma therapists out there. And if you read some of the trauma books, like what they’re really talking about is like PTSD, rape victims in war, severe beatings as a kid. And I just don’t know how we kind of jumped the shark a little bit here.

Abigail Shrier: Oh, how we jumped the shark? Well, I think we dropped the shark with the expansion of mental health experts, with the, you know, with the expansion, expansion of trauma gurus, right? You know, I talked to neuropsychologists, neurobiologists on this.

You can’t really generalize from combat experiences and severe, you know, instances of, you know, rape and violence to feeling left out. And yet trauma therapists do this all the time, right? If you read the books, they’re always saying, and now we can look at a kid who was neglected because they were in a very unsupportive home, or mom was working two jobs and never around.

And by the way, popular, you know, therapeutic popularizers do this all the time. You just look at them on Instagram and they’re always generalizing. And also they’re reasoning backwards. If you have this psychopathology as an adult, you must have been experienced, you experienced this as a child. And then, and then comes a revelation.

Oh, yes, I was right. It’s never falsifiable. It’s not particularly rigorous. And here’s the kicker. People are very bad judges of seeing, of knowing if something’s working. Why? Because when they first hear that it’s not their fault, their divorce is not their fault, they’re, they’re getting fired isn’t their fault.

They feel that’s it. It’s because of my bipolar. disorder, it’s because of my trauma. And they will always feel like, wow, that, that was so great that now I know, right? Now, that doesn’t mean that’s never true. Of course, there are instances when it is true, right? Where people have gone through, you know, these, these sudden shocks to the system that can produce PTSD.

By the way, not every combat vet gets PTSD. It’s still a small minority because actually we are built for resilience, which doesn’t make those experiences Pleasant or, or, you know, or, or, you know, easy, but actually most combat vets left alone will not get PTSD, which is remarkable. It’s remarkable. And we’re not telling people that.

We’re not telling them that the number of women my age who have experienced unwanted sexual advance, is it a hundred percent? It’s very high, right? And it’s just the idea of telling people that that is traumatic and you have PTSD from that is often untrue. It’s, we know it’s in, of course, of course it’s going to be in the treatment provider’s interest.

To keep you coming back, which doesn’t mean it’s conscious, but is it an accurate diagnosis? In most cases, it isn’t.

Zachary Karabell: It’s funny. I mean, you could also turn that on its head without getting too into therapy land, that whether or not this, the, the, the spectrum of big T trauma and small T trauma. is highly subjective, that most people experience some form of trauma in their lives, but that the end outcome of all of it is, okay, how am I going to live and what am I going to do about that?

And how am I going to live in a way that is both resilient and whole and not eternally captive to that experience? Meaning you could, you could actually accept that there may be a much wider trauma envelope. Then we have hitherto in in our human experience allowed for maybe because we have the time and freedom to do so.

Meaning the elemental needs of food, clothing, shelter, security have largely been removed from our daily equation more or less. And that gives us a lot more time. To, uh, navel gaze, if you want to say it pejoratively, or know ourselves, if you want to say it more, uh, embracively, either way, it doesn’t necessarily matter if, if the goal is to not live with kind of a trauma jacket that you carry with you forever.

So it doesn’t necessarily matter whether your trauma is, I had a crappy vacation with grandma or. I was, you know, chained up in a a, a room. The, the, the, the healing and the moving on is still the goal in any case. Right? 

Abigail Shrier: Right. So this is the question. What if it’s all, what if a lot of it’s just metaphor.

It’s just harmless metaphor. I call it trauma. I don’t mean that I actually have PTSD, I’m just sort of jocularly referring, here’s the problem. The rising generation is using it as an excuse to opt out of life. They seem to be utterly literal about their PTSD. That’s the problem. If it was all adults, sitting around with wine, talking about their bad experiences and the trauma and whatever.

I, you know, and they were moving on and leading productive lives, I wouldn’t have written the book. Because who cares? Really, who cares? Right? That’s how I feel. But when you have young people who say, Oh no, you know, my parents made me move. And that’s why, you know, insert deterministic answer here. My parents made me lose.

I move, I lost my friends in middle school. And that was my trauma. And because of that, I can no longer form lasting relationships, whatever, and you’re seeing that and it’s tragic because it’s not true and it’s giving them the excuse. And, and in some cases, you know, the, almost the mandate to get out of hard things that will make them stronger and happier.

Like, you know, going for that job they now don’t feel up for. Even showing up to work. We have generation that is not reliable. You know, employers will say, they’re not reliable. They don’t show up. These are employers who want to hire their, these people’s parents rather than them. We used to love hiring the next generation.

They were hardworking. They would do anything to succeed. They had endless energy. Their brains were sharper. Now employers want to hire their parents. And that’s a tragedy, you know, that really is something that needs to be fixed at least. Because they have all the potential, they have all the, you know, they have everything in front of them.

We don’t want them opting out. But they have become awfully literal about these diagnoses that many people seem to be using as metaphor.

Emma Varvaloucas: Can I ask you both, since you both have kids, right, is this something you’ve seen in your kids and your kids cohort? Because I don’t have kids. So sometimes when I hear this stuff, I’m thinking to myself, like, they used to say that about Millennials too, right?

When Millennials entered the workforce, I remember it very well. People were like, Ugh, Millennials. They don’t want to get, they don’t want to do this. They don’t want to do that. Like, I don’t know. We turned out okay. Yeah, I’m just curious about your, both your personal experience. 

Abigail Shrier: I think millennials turn out amazing in a lot of ways.

I mean, you know, whatever you think about your subjective feeling about millennial, you know, I’m, I’m the tail end of Gen X. I’m not a millennial. But whatever your subjective feelings about them, I wouldn’t have written this book about millennials. And the reason is, first of all, the biggest difference is they have an internal locus of control.

They report feeling like they have the power to make a positive change in their lives. And one of the most disturbing things about the rising generation is in numbers we’ve never before seen, they respond to surveys that they don’t believe they have a capacity to make a positive difference in their own lives.

That’s a problem.

Zachary Karabell: It’s interesting, historically, that there were these moments of which the Salem Witch Trial was certainly one of the most dramatic, but there are also, there have been at times like weird suicide clusters, like where particularly young people and teenagers. seem to simultaneously go, well, what we would have used to have said, go crazy simultaneously.

I know that that’s completely on PC to use that. I apologize to people listening. If you, if you find that insensitive, it’s, it’s a simply a shorthand for there are periods of time that we know historically where it’s almost like a storm or a disease just like descends simultaneously on a cohort of people and then goes away.

Right. That’s also the weird thing about it. And at times I wondered whether we’re in one of these moments, but it’s, it’s now so amplified by channels of social media. And then as you say, an industry, which also never existed before, that there’s no passing, like, like these things used to descend and then like dissipate.

And there seems to be no dissipation, but I do think there’s something very human about these kind of odd moments.

Abigail Shrier: Yeah, I think that social contagion is real and that we are so, you know, we are creatures who tend to take on each other’s pain in various degrees. And I think that if people, young people’s deciding that they had PTSD were accompanied with and now I’m going to do the following, you know, I’m going to exercise every day.

I’m going to go whatever, then I’m going to make sure I’m surrounded by community. Then you would say, okay, it’s harmless. But actually, you know, we’re hearing more and more of these people saying, you know, I, I mean, think about this, you know, they’ll have people who say they were in therapy for 10 years.

Well, was that 10 years of progress? Maybe, but there seems to be a lot of going around in circles, right? And who, for an adult, my general attitude is who cares? Who cares if they’re, if you’re not making progress in therapy, that’s your business. You know, maybe you just like it. But with kids, it’s a big problem.

It really is. It’s a big problem if kids feel that, now I have a diagnosis, now I can’t take any risks without checking in with this adult or this expert. I need my medication adjusted. I can’t do it on my own. And this is the, I can’t do it generation. And that’s just a massive problem for, for any country.

It’s a massive problem for ours, but it’s also just. It’s really troubling because the truth is they can do it. They really can. There’s so much they can do. They can take that test. Many of them don’t need that accommodation. It’s not helping. And there are all these, you know, one of the things I looked at the book is there are all these people who seem to be, or are posing as the helpers who are not helping.

They’re being counterproductive. In one example, as I talk about the school counselor, well, what is the school counselor’s only leverage? Like, what can they do? They can get a child out of their responsibilities in school. That’s the main, you know, tool that they have in school, but we don’t want kids avoiding every test.

Unless they have, again, unless there’s a severe problem, of course, you don’t, you know, force a kid who’s dyslexic necessarily to complete things in the same time as someone else, you know, whatever. But aside from that, a kid who just have, has testing anxiety, we know that facing the, the thing that’s causing anxiety is the best thing for the kid.

But, but starting with, I mean, how many professions require regular testing? Is it true that they’re going to get untimed for the rest of their lives? So pushing them, pushing them a little is, is often better than getting them out of that responsibility. Nonetheless, we’ve got this whole apparatus where the only tool they’ve got is to excuse these kids from tests or, um, you know, whatever the assignment is.

Zachary Karabell: Which also, by the way, does engender a degree of cynicism and frustration amongst a whole other set of people who don’t get the accommodations, who views some of that with real skepticism. They’re like, oh, come on, you know. Joni didn’t need two hours and he got it, but he didn’t need it. But maybe I should find a way to get it too.

If, if, if it’s going to help me. And if I’m going to be disadvantaged by not getting it, then maybe I should find a way to, you know, get that accommodation too. And if you think that doesn’t go on, I mean, that’s, that goes on a lot. Like the, that’s a sort of an ancillary issue to what you’re talking about, but it affects everything else.

Abigail Shrier: Absolutely. I mean, I, I remember what the numbers were, but I heard, and my, my boys are just starting, going to be starting high school in the fall. And I heard the numbers of kids who have some sort of testing accommodation and the percentages was so high. It, it doesn’t really make any sense now, um, that, you know, of course it doesn’t mean that no, it’s never appropriate, but let me just say, if that were in the best interest of kids, if kids were being helped by it and I didn’t think they would be harmed by it, I would say, okay, well, I guess, you know, some kids are just going to need to study harder or whatever you, you say, it’s not particularly fair, but it’s not the end of the world.

The problem is that once you tell a young person, no, you have a brain problem, you They often take that awfully seriously. We’re seeing them put it in their social media bios. They see it as a limiting factor for the rest of their lives. And an adult can say, I probably had ADHD that’s undiagnosed, and he’s got this whole career to look back on, and you can tell it doesn’t really affect him.

But a young person who’s just starting out might always think, I can’t because of my ADHD. I need my Adderall for that. And that’s a really, that’s a much worse position to be in as a young person, especially when it’s not necessary.

Emma Varvaloucas: So I asked the same question to Jonathan Haidt, I’m going to repeat it to you. Do you think the poll is going to swing back in the other direction? Meaning that I think some of the parents as therapists trend came from people not wanting to repeat the parenting that they had, right? Like they were, I’m not saying they were traumatized necessarily, but they didn’t feel like it really, really did them a whole lot of favors, I guess.

So they tried something else with their kids. Gen Z now, having grown up in that way. I mean, do they feel satisfied with this and they’re going to repeat it on their kids? Or do we think that they’re like, yeah, no, we see that this is not the way, let’s try something new?

Abigail Shrier: I love that question. And it’s important.

And I think the answer is, you know, possibly yes. We know that things, a lot of this gentle parenting went too far. Look, with trends and fads, they tend to swing back where you don’t have an entrenched group fighting. Sometimes they do just switch back. And I think people are waking up to the idea of. Of the, the dramatic over application of words like trauma and diagnosis and whatever.

But, but here’s, here’s the problem. The problem is we do have this entrenched group, which really does have the incentive, you know, therapy, unlike medicine, where you really are always evaluating or ideally in most instances, you’re really evaluating, did the rash go away? Do I, you know, am I still sneezing?

Am I still coughing? You know, we have these external measures. It’s much harder to measure if therapy is working and there have been these studies showing that people tend to feel purged after therapy regardless of whether it’s actually helping the underlying problem. So they tend to, you know, our own feelings of that felt great.

Therapy is helping. Oh gosh, 10 years just slipped by and I have the same problems. They tend not to notice that. And the, and the problem is biggest with kids. And we do have this, you know, ever expanding, I mean, they’re demanding we, you know, we I think as an industry, they’re demanding more and more resources.

They want more and more expanded interventions in schools. By the way, the, the, you know, when you look at the empirics on these interventions in schools, they’re not impressive to put it mildly, but nonetheless, they’re demanding more and more. So there’s a lot more feelings focused on this generation, a lot more talk on their pain.

And I do think it’s very, very counterproductive. It is a way of sort of disabling kids. resources for overcoming, you know, their own distress or discomfort. And, um, I, I do think, I, I hope we can see some backlog, you know, you know, response to it or pushback. And, uh, you know, I’m optimistic that there can be, but, but, but we need sort of a concerted effort.

Zachary Karabell: Yeah. I mean, the other thing that I think is very human, but also quite unhelpful is this narrative of a crisis that has never before been X, right? Whether it’s, you know, teen depression, uh, teen suicidal ideation, teen, you know, feelings of loneliness, disconnect, all of it, without the awareness of until, until we, A, created a category of teenagers, which in the greater scheme of things is recent in and of itself, even the category of childhood, right?

I mean, there’ve been great historians who will kind of look at childhood is not a category that you think it is, right? No one ever asked these questions, right? There’s no, we don’t know what the mental health was of a cohort of young people and teenagers. in 1880, because it didn’t even occur to human beings that this was a, a thing that you should investigate, right?

I mean, it, it, it’s a really recent idea that we have this inner life that is nascent and developing that requires kind of attending and in the same way that you do like diet and exercise, all of which are also newer things, right? Nobody was hitting the gym in 1914. It wasn’t a thing. No one, like, like, So, I’m just also struck by that, like, we, we think we know what the resting state of human beings is, and maybe we’re learning what the resting state of human beings is, which is chaotic and non generalizable and messy and confusing and beautiful and ugly and horrific and terrible and magnificent and wonderful and all of the above, all at the same time, much within the same person.

I don’t know what my question is in that, but these things palpably come to me when I read your book, and I listen to these, because it There seems to be a lack of humility of we’re just figuring out what we are internally. Like, this has not been a huge element of societal pursuits until very recently.

Abigail Shrier: That’s exactly right. And here’s the thing that I think we’ve lost, the sense that we can ever ignore any of it. We can ignore it. There are things you can ignore, right? We don’t have to be in a state with kids where we’re constantly attending to every emotional, you know, just every bit of distress. And here’s, here’s why it’s so important.

Look, an adult who grew up in an earlier era and maybe more repressive one and wants to, you know, unearth some things or, or revisit them, things that that’s one thing. But in a child and an adolescent, these are very emotionally volatile young people, right? And if we never give them, if we never tell them, you know, you can just put that behind you and get on with school, they might never know that they can.

And we’re seeing these kids who are so dysregulated showing up to school, so frantic about every one of their emotions, right? That they don’t even know they could ignore a certain amount of that. And now as young adults, they’re unable to, right? They’ve always been told repression is always bad.

Repression is how you get through a job. Right? It’s how you show up for work. Because you know what? There are plenty of days when none of us feel like working. And yet we do, you know, and, and you can’t raise kids with no sense because they’ve been told they’ve been treated like, you know, by therapists or therapeutic proxies at every turn who’ve dealt with every possible, you know, uh, you know, um, uh, manifestation of distress.

You raise a kid where every feeling they think is front and center, and lo and behold, they can’t put their feelings ever to one side. And that’s a problem too. I know that we’re talking about kids

Emma Varvaloucas: and that’s the premise of the book, but I couldn’t help wondering as you know, I was reading the book and as we’re having this conversation, do you think therapy is beneficial for adults?

Abigail Shrier: Absolutely. And the question is when and what kind. Now, first of all, I think that there are iatrogenic effects of therapy. They’re known, you know, that’s, that’s just, there’s a great body of research on that. And I think as a profession, they’re not as upfront about them as they should be. I mean, some of the best therapists and psychologists, typically academic psychologists, they’re well aware of them and they’ll talk about them, but a lot of the practitioners won’t.

And they get very offended if you bring that up. Well, of course there are side effects to any helpful, efficacious intervention. And we should be able to talk about the side effects, the known side effects of therapy. Like my depression got worse. Like my anxiety got worse. People don’t, got worse. People don’t even know that that can happen.

Now the best, you know, in my view, the best clinical therapists are people who, you know, are aware of those and even are willing to talk about them with their patients and have some sense of whether they’re getting worse, right? Therapy is at its best when it’s dealing with an actual problem, right?

Something getting in the way of your functioning of normal life, right? So if you have any number of Of, you know, anything from anorexia to, uh, you know, obsessive compulsive disorder, any, any problem that’s really getting in the way of your functioning, I think therapy can be very helpful. And there’s good study, you know, there’s good evidence of that.

But I think sitting around with a therapist, especially for a teenager, where it’s undefined in scope, where the problem is sort of amorphous. That comes with a lot of risks and it can be beneficial, but it can also introduce risks like alienation from mom and dad, like, you know, increased depression, like over reliance on the therapist.

And the problem is that I think as a profession, they’re not as upfront that those are risks. Before you start therapy, you should know, here are some of the known side effects. We don’t do that with therapy, but we should.

Zachary Karabell: So two questions, one very broad and one very specific, and we’ll start with the specific one first.

I want to ask you about drugs because it struck me in reading the book, and this is also something I’ve been focused on for years, that we prescribe these very powerful drugs to kids to treat something, an issue, a problem, internally. And then we categorize another set of drugs as like the most dangerous, harmful, potential substances in the world.

So we basically said, here’s one set of very powerful drugs that we’re going to tell you to take, and here’s another powerful set of drugs that we’re going to tell you to avoid at all costs. Do you think that part of the problem of, of whatever our, our issues around illegal substances is that we’re so busy prescribing so many legal substances that whose, whose effects are just as powerful?

Abigail Shrier: That’s a great point. I think absolutely, absolutely. We are so, uh, honestly, I, I, I think we are so quick to introduce things like Adderall and Ritalin. And then, and these are profound, you know, habit forming drugs potentially. I mean, these are not nothing. And then we say, oh no, those other drugs, those are the bad ones.

And I think that’s very confusing to a teenager who’s learned to feel like, to rely on a drug It feels like, oh my God, this is amazing. This is so much harder than, you know, leaving my phone off and sitting down and doing my homework, which is really frustrating, right? And wow, look, I was, I, without, without, you know, and, and becoming reliant on them.

It’s very confusing for kids and, and look, let’s be honest, I think they have a lot of the same pitfalls, right? And the pitfall is if you’re using a drug to get out of something you should face, right? And you can face that’s going to be, that and it feels great to take. That really is a high likelihood of being habit forming.

And we’re seeing all these kids addicted to Adderall. Why? Because they learned they were to do it young. It was, it produced an immediate great response, right? It made them feel great. Now they never want to get off it. And that’s the problem. That’s a lot of the same stuff we’re worried about with any drug.

Zachary Karabell: So the big picture question as we end is, have you found that in the response to this book, and you did an earlier book that was also, you know, controversial in its way about transgender issues, have you felt more heartened at what Emma just talked about, that there may be a inflection point or, you know, peak therapy, peak bad therapy, or has the tumult that the book has created.

made you feel like we’re still really deeply mired in this, meaning your own, your own experience of the effect of your own argument on a direction that you hope society takes.

Abigail Shrier: I’m very optimistic about this issue. You know, the earlier book, I got so much backlash. This one, I thought there was a possibility I would get backlash, but that’s not what I’m getting.

The, the overwhelming response has been relief and not just by parents, although it’s clear from parents, but also by practitioners, the number of people in the psychiatric and psychological field who have reached out and said, thank you for writing this book. I really, this has gone so far overboard in my own field.

And that’s been very heartening. And so I, I think this absolutely that we can sort of reset the default settings. And that’s the only thing I ever wanted to do was when I looked at this, my, you know, my overall, you know, sort of where I ended up is we need to change the default. And the default is don’t introduce these things unless you absolutely need them.

That, that really should have been our default with kids and adolescents. And I’m very hopeful about that. And one of the, one of the funny things that turned out is I was very early with the first book in terms of the social contagion of the transgender identity among teenage girls. And I think a lot of the resistance was that I was, I sort of saw a lot of the problems that, that hadn’t yet made it through the culture.

And, and so there was a lot of resistance with this book. I think there really has been this dawning that, uh, awareness that really is too much. It really is too much feelings focused. It’s too much diagnosis. It’s too much psych med. And, um, and so, and so I’m very heartened that I, I seem to have hit on something that, that people are, are themselves coming to on their own.

Zachary Karabell: I know that not everyone’s going to agree, but it is absolutely wonderful that you’ve created the space to have these conversations, which orthodoxies tend to try to shut down. I mean, I think the most important thing is to examine, are we doing the right thing? Is this the way we should be raising our children?

Is this the way we should be functioning in our society? Like, what’s, what’s the right thing? You’ve done a great service to us all by opening up the space of that conversation and making people question and ask, you know, is this working?

Abigail Shrier: Thank you. That’s, that’s exactly what I hope to do. And if I, if I even got the conversation going, then I, I feel really great about that.

So thank you for having me on your show to, to have that conversation. It was wonderful. Thanks so much, Abigail.

Zachary Karabell: So I personally wouldn’t be so troubled by some of this were it not accompanied by the drug regimens. and particularly binary that’s created between these drugs are powerful. We’re going to prescribe them early and often, and we’re even going to tell parents they have to give their kids these drugs or their kid will be taken out and put into a different program.

I mean, there’s a coercive element of you have to prescribe these drugs. And then we go about and make, I mean, this is the conversation we had at the end with Abigail. We make all these other drugs, quote unquote, illegal that are equally powerful. And we completely mix the signals of. What are these substances?

What are they for? Are they helpful? Are they harmful? Um, but the, but the medicating of kids, which has clearly increased immeasurably over the past 10 to 20 years. I mean, that’s, I don’t think that’s debatable, right? Because we can see that. That’s, I find a very troubling aspect to all this. Far more than if you just told a bunch of kids they had to go to therapy.

Emma Varvaloucas: Yeah, no, I agree with you wholeheartedly about that point. I always said too, if I ever have kids, like, I’m not going to put them on a drug. Like, that would be the very, very last step. Those things aren’t even proven to work in adults sometimes. 

Zachary Karabell: By the way, I mean, I’m not saying this with any critique of parents who do this.

I mean, often there is a socially, there’s a lot of social pressure to this. They’re being told. This will be helpful and are doing so based on the inputs they have, which are limited, but from experts that they feel have their kids best interest at heart.

Emma Varvaloucas: Yeah, we’ll see, um, what happens next, right? The retraction of things.

What ends up happening out there in the real world and schools and therapy and so on.

Zachary Karabell: Absolutely. Anyway, thank you all for listening. send us your comments, particularly on this issue. If you’ve got stories that illuminate this one way or the other, we would be fascinated to hear them and Emma, I’m sure, can then highlight them if,that is worth doing in a newsletter or a subsequent conversation, so we will be back with you next week.

Emma Varvaloucas: Thanks everybody.

Zachary Karabell: What Could Go Right is produced by the Podglomerate, executive produced by Jeff Umbro, marketing by the Podglomerate. To find out more about What Could Go Right, The Progress Network, or to subscribe to the What Could Go Right newsletter, visit theprogressnetwork.org. Thanks for listening.