Should everyone receive psychotherapy?
PSYCHIATRIC VIEWS ON THE DAILY NEWS
While my wife and I were away on vacation in Canada, as depicted in a series of Travel Log columns, I missed an important mental health column by David Brooks from August 10, 2023, in The New York Times, “Hey, America, Grow Up!”1 In it, he described the emergence of a “therapeutic culture” in the United States after World War II. More individuals, he contends, became “fragile narcissists,” where self-worth shifted away from obtaining life purpose from moral traditions or the workplace.
By 2010, surveys indicated that we were in a mental health crisis, which has only increased since the pandemic. Trauma of any sort or severity became the presumed cause with the avoidance of triggers to the trauma a societal institutional cause. Resilience and empathy were left behind. Helicopter parents tried to make ultra-sure that their children were safe and protected. Self-help strategies abounded in the media.
Not surprisingly, some follow-up letters to the editor about Brook’s article were published under the title “Does Therapy Culture Help or Hurt Us?” on August 28, 2023.2 There was feedback on how psychiatry tries to illuminate the real trauma, the financial windfall of the trauma business, and that those in poverty have many other real obstacles to self-actualization.
Likely connected to this issue is the surge of mental health spending during the pandemic and the lessening of psychiatric stigma. Mental health professionals have been added to crisis calls previously just handled by the police.
Coming out of Great Britain in the daily paper, Financial Times, is an August 28 article “‘Profession of the century’: why so many people are retraining as therapists.”3 Workers from farmers to investment bankers have been making the shift and England’s National Health Service has put a special focus on providing psychotherapeutic resources.
I know a Rabbi who recommends that everyone receive psychotherapy. The assumption is that we all have psychological weaknesses or conflicts that limit our potential and cause unnecessary suffering.
Should we in psychiatry be jumping for joy in this assessment of therapeutic need and the resources to help? Maybe not. I always thought our ultimate goal was to prevent mental disorders and undue stress as much as possible, putting some of us out of work with primary prevention. I even recall recommending that individuals should require a license, with renewal reviews, to have and raise children.
This state of psychological affairs, if accurate, seems to be the opposite. More psychological weakness and more psychotherapists. We have been a field that has traditionally emphasized the problems for obvious reasons; now we may need more of positive psychiatry. In financial market terms, perhaps this is a psychological bubble that needs some cooling off and an investment in developing mentally strong leaders who care not only for themselves but for others. Brooks does not say much about how to do this, leaving that up to us.
Gratitude for today: I am grateful for being married to a natural therapist who brings psychological sunshine to the world.
Dr Moffic is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. He is an advocate for mental health issues related to climate instability, burnout, Islamophobia, and anti-Semitism for a better world. He serves on the Editorial Board of Psychiatric Times.
1. Brooks D. Hey, America, grow up! New York Times. August 10, 2023. Accessed September 5, 2023. https://www.nytimes.com/2023/08/10/opinion/trauma-mental-health-culture-war.html
2. Bailey C. Does therapy culture help or hurt us? New York Times. August 28, 2023. Accessed September 5, 2023. https://www.nytimes.com/2023/08/28/opinion/letters/therapy-culture.html
3. Staton B. ‘Profession of the century’: why so many people are retraining as therapists. Financial Times. August 27, 2023. Accessed September 5, 2023. https://www.ft.com/content/c0a4958c-3e8b-4274-9ad9-228d7772ab1c