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Originally published: 2005
307 pages
Chapter 44

ONE NATION UNDER THERAPY


Christine Sommers, Ph.D & Sally Satal, M.D.

In the early 1990s, an unpublished thesis discussed the emergence in modern society of a potentially maladaptive human behavior: the emotionalizing of life to the point of both personal and societal paralysis. The now ubiquitous emotional response and the transfer of "pathos to pathology"6 according to the authors of One Nation Under Therapy is seen to be prevalent in the U.S. mental health and legal systems and the media. In the thesis this response is compared to the ever-elongating saber-toothed tiger's incisors. Eventually the tiger became so overburdened with maladaptive dental apparatus that his extinction was foreordained.
     The same is suggested for Western society (in a political/social, if not biological sense), that we are becoming so emotionally over-involved in ourselves and our own supposed inabilities that we will lose the capacity to act rationally or respond factually on either the small or large stage. Because the real world will fade into the background, self-destructive decisions-those that go against logical action based on authentic circumstances-will proliferate to some point where we actually might do ourselves in, or more plausibly, we will become so politically and psychologically weak that others will find it easy to save us from our misery. One Nation Under Therapy takes this theory off the drawing board and brings it to the street.

6 pathos: a quality that arouses feelings of pity, sympathy, tenderness, or sorrow in another.
pathology: a biological or functional (mental) manifestation of disease.

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     In their book, Christina Hoff Sommers and Sally Satel dissect the therapeutic state-a social entity that is the care-all and resolver-in-chief for what ails almost anyone who doesn't live in Wyoming or Burundi, places where people haven't been overexposed to their own inadequacies and fragility and know they are supposed to take care of themselves in spite of life. The growing dependence on therapy as the answer to life as it is, is often bewailed by rationalist pundits and politicians, and a small cadre of mental health professionals. These observers, grounded in a real world, remember three centuries of American resilience, capability, confidence, and character. From them, the question is put plainly: has "therapism" gone awry and taken on a life of its own? The authors' short answer is "yes," and their longer response is a reasoned explanation and investigation-based on myriad studies, surveys, and research efforts that use science rather than emotion, intuition, or anecdote-to explain and support why they come to this conclusion.
     Although One Nation Under Therapy contains eighty-seven pages of footnotes, which exhibit detailed support of what is delineated in the main volume, that feat of professionalism did not cause the authors to use unintelligible jargon or rationalized gibberish in presenting their summary of the state of mental health care in America. This is a volume of clear, concise language and premises dealing with life as it is, and always has been; existence unmuddled by "psychobabble" or
presumptions of frailty or pretensions of pseudo-psychological acumen claimed by the practitioners of therapism.
     The authors present facts and a reasoned comprehension of human beings-and beg to have them tested against the claims of those who seem to have their conclusions written before the examinations begin. Most often Sommers and Satel detect the obvious flaws in the research and logic used by "professionals" who appear to have both an agenda and a stake in the outcome of their work and premises.
     In its essence this book is akin to the simplicity of Friedrich von Hayek's dissection of socialism in The Road to Serfdom (Chapter 13), where Hayek concludes that socialism won't work because it defies human nature. Sommers and Satel contend that modern therapism defies human reality. They bring the trauma, loss, and inconstancy of life into focus-as real facts-and explain that real people have been dealing with such events idiosyncratically for eons. Why are Americans, in particular, and modern society in general, all of a sudden so weak, delicate, and incompetent to deal with life? The authors inveigh that

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modern psychology (probably more than psychiatry) has "pathologized [that is, made an illness of] normal human response to tragedy."
     It is contended by the practitioners of therapism that trauma is not something an ordinary person can digest or respond to alone. In the words of the authors, by taking this tack the trauma "experts" have in all likelihood actually made matters worse than they might have been with a more nuanced, personal, and positive approach to human misfortune or even calamity. They conclude, based on the evidence,

               that most people are not clinically traumatized by extreme events. . . . The
               reframing of normal reactions to loss and tragedy as pathological-the notion
               that we are too often unfit to cope with adversity [has become] accepted
               wisdom. . . . [T]o presume fragility in the face of adversity [is to] forget
               how frequently survivors . . . persevere nobly.

They further suggest that

               [c]ommon sense alone should tell us that a one-size-fits-all psychological
               approach to anything as complicated and varied as human reaction to
               [trauma or tragedy] is deeply misguided.

     As well, the authors find the careless and often intrusive use of therapism, involving the negative power of suggestion, a large part of their diagnosis of amateurism. The imposition of outsiders into the lives of strangers to insist upon therapy as the answer to virtually everything that ails us is as offensive as it is inappropriate. Those in the "profession" cannot seem to see how disabling their own intrusions are. Even U.S. Supreme Court Justice Antonin Scalia, viewing the spread of psychological assessment practiced by everyone from school administrators to members of the Court, could not help commenting in Lee v. Weisman,

               [I]nterior decorating is a rock-hard science compared to psychology
               practiced by amateurs. A few citations of "research in psychology" . . .
               cannot disguise the fact that the Court has gone beyond the realm where
               judges know what they are doing.

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     There is in the authors' findings a theme of professional failure in the therapy community. This is a deficiency those in charge refuse to recognize. The authors discern, essentially, more individual agendas and egoistic empire building in the ideas that permeate the assertion of massive psychological inadequacy in modern America than they detect actual therapeutic skill or understanding. What their research brings to the fore is the need for intellectual and social integrity in this arena-not just more training. In other words, it isn't just the professional ideas that are wanting; it is the people who practice them.
     There is a necessity for a force of practitioners who are substantively dispassionate and independent, and capable of seeing and understanding what is before them in factual and psychological terms, rather than the amateurs, even charlatans, who adhere to quack-degree, simplistic, and universally applied formulations of dealing with human emotion. For many in the field of therapism, it may be as much about their own goals and their own wallets (an especially important aspect that the authors essentially leave alone), coupled with an almost unimaginable ignorance and lack of intellect that drives the practitioners of therapism ever more intrusively into our society. The America of this battalion of "trained experts" is one that could not possibly have created the America of the twentieth century, or the nineteenth, or eighteenth, or seventeenth; the America that is the focus of so much admiration and imitation. These "experts" see a nation of weaklings who cannot cope without their help, without the assistance of those who truly "understand their pain, and feel it."
     Mass therapy being applied across major segments of society or in response to catastrophic events, such as the terrorist attacks of 9/11, or Hurricane Katrina along the Gulf Coast of the U.S. in 2005, the authors find to be inappropriate at best, almost universally counterproductive in general, and damaging at worst. In catastrophic circumstances the loss experienced by each victim can be substantial, long lasting, and most importantly, personal. But, as the authors comment, loss is also one of life's essential ingredients. If human beings hadn't developed an ability to deal with such things, then human beings would have evolved into something else-a branch of the wildebeest family, for example. And, yes, there are those who truly need therapy and psychiatric care, no one would deny this, least of all the authors, but their point is that those cases are the exceptions. To suggest otherwise, as many women's magazines and daytime television talk shows do, to suggest

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that almost no one can get through life without therapy whenever something goes wrong, is wrong itself.
     Although Sommers and Satel address the often inappropriate, even incongruous, response of therapists to major tragedies, the same response on an individual basis in individual therapeutic practice can be just as dangerous and just as inappropriate-for the same reasons: lack of professionalism, lack of control, lack of ability, and worst of all, the greed factor. Although the authors don't directly bring their thesis and investigation down to the level of individual therapy, the questions they raise regarding the therapy brigade in major venues seemingly apply equally to the individual. Of course, it is likely that the mass response so decried in the book blossomed from the objects and conclusions of individual therapy in the first instance. The professional extension might have been thus: if our practice works for individuals, why, we'll just market this on a wholesale basis-because the same ingredients are present in both individual and society-wide situations. In other words, it may have been a "eureka" moment. Therapy became more business than profession.
     The status of mental health practice today would be a bad joke if the subject matter, the victims, and practitioners weren't so ever present in modern media. The media effect is strong and relentless. The public is subjected daily to disasters large and small, and the more tears, the greater the wrenching anguish of the victims, the more close-ups the camera offers. TIME Magazine's Pictures of the Year for 2005 contained almost nothing but such images, as though nothing good, uplifting, successful or even comical happened for a whole year. The media offers that the world is a terrible place and then asks, how can anyone cope? But cope we do, and quite well, thank you. We wouldn't know that we could if we didn't actually do it; there are too many "professionals" telling us otherwise.
     The omnipresent insistence of the therapy community that life is so bad we likely cannot endure it without "professional" help (and the spread of this story by their partners in inadequacy-the media) is sometimes taken literally, according to Sommers and Satel. This approach is certainly something politicians use no matter what they may believe themselves. We see the government response (mostly in the form of Congress and the White House each trying to outdo the other in empathy) in the face of adversity, that they will take care of everyone-whether everyone needs or wants their help, or, God-forbid, deserves it (a very politically incorrect question). This not only encourages all to seek succor

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in the arms of "the state," but also encourages many not to take care of themselves in the future, for they now believe that's the government's job. This political reaction is present even in circumstances far from real trauma, such as rising gasoline or food prices, that have less to do with true hardship than economics.
     It is to be noted that while decrying the excesses and inappropriateness of much of therapism's agenda, the authors do not simply dismiss human response to tragedy with a cavalier "Get over it." What they do recognize is that human beings are built to get over it, but the thrust of therapism has been to undermine that reality and to assert that we are weak and incapable. The facts, of course, demonstrate otherwise. It appears that therapism, an essentially unregulated segment of business often heavily disguised as caring, has overstepped the bounds of common sense. Returning to a realistic and workable middle ground is all the authors seek.
     Moving toward that end, Sommers and Satel ask, "Why . . . have so many mental health experts underestimated our inherent resilience and resourcefulness? Why do they presume fragility in the face of powerful events?" The answers are found in the "professional," personal, and economic benefits to be derived from engagement in the proliferation of a presumed mass need for therapy. In the words of one social commentator, "If you go to the optometrist, you come out with a pair of glasses." If you come across a therapist, or more to the point, if a therapist comes across you, you'll likely find yourself with a syndrome-and an appointment.
     The authors comment that as therapists tamper with or even misdirect the mind's natural defenses, they are likely to do more harm than good. Instead, they suggest that the therapy community begin operating on the premise that people will pull together. People will realize that most likely others are far worse off than they are. They will recognize that rather than focusing on the negative aftereffects of something that cannot be changed, they should concentrate on our remarkable capacity for post-traumatic growth. With this far more common outcome, the practitioners will be able to capitalize on the impulses that bring healing and progress in the
aftermath of trauma. And, although Sigmund Freud has been largely superseded by modern psychiatric research and practice, the authors fall back on his fundamental wisdom to bring more optimism than pessimism for the long haul:

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               The voice of intellect is a soft one but it does not rest till it has gained
               a hearing.

     Ultimately, Sommers and Satel propound that "therapism falters under rational scrutiny." The only remaining question is, when? Will it be sooner-as we call to account the excesses of an almost out-of-control and self-aggrandizing group of "professionals"-or later, when far more harm than good has eventuated? The authors' thoughts coalesce around the idea that "therapeutic 'kindness' is inadvertently [or is it directly?] unkind and disrespectful . . . " and forgets that there is such a thing as right and wrong. Therapism is seen to be at odds with our values. It comes to its brigade post as an adjunct to legitimate psychology, yet it engages in "medicalizing the human condition." This is self-destructive, for the human condition is real; it is not bad; it needs definition and direction, but it cannot itself be eliminated without also eliminating the uniqueness of the human experience.
     The practitioners of therapism see virtually all of life as disease. They are able to claim this because there are no perfect people, or perfect circumstances. The rest of us see life as a risk, and the better we are able to deal with that reality without the need to fall back on therapy or government, the better off each of us will be.
Perhaps the most cogent observation on the modern practice of psychology, especially mass psychology, was voiced by G.K. Chesterton (1874-1936), English novelist, poet, journalist, and playwright:

               It seems a pity that psychology should have destroyed all our knowledge
               of human nature.

And perhaps we should we add "common sense."

About the Authors
Christine Hoff Sommers studies feminism and American culture, American adolescents, and morality in American society from her post at the American Enterprise Institute. A former university philosophy professor, she is the author of Who Stole Feminism? and The War Against Boys. Her professional career has included membership on the Board of Advisors, Center for the American Experiment, and as chairman of the Board of Academic Advisors, Independent Women's Forum. From

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1980 until 1999 she was a professor at Clark University. Dr. Sommers earned her BA at New York University in 1973 and received her Ph.D. in philosophy from Brandeis University in 1977.

Sally Satel is a resident scholar at the American Enterprise Institute in the W.H. Brady Program in Culture and Freedom. She is also the staff psychiatrist at the Oasis Clinic in Washington, D.C. Dr. Satel serves on the advisory committee of the Center for Mental Health Services of the Substance Abuse and Mental Health Services Administration. In 2003 she served on the Fowler Commission that investigated sexual misconduct at the U.S. Air Force Academy. Dr. Satel earned a BS from Cornell University, an MS from the University of Chicago and an MD from Brown University. After
completing her residency in psychiatry at the Yale University School of Medicine, she was an assistant professor of psychiatry from 1988-1993. During 1993-94 she was a Robert Wood Johnson Health Policy Fellow with the Senate Labor and Human Resources Committee. Dr. Satel has written widely in academic journals on topics in psychiatry and addiction medicine. She has published articles on the cultural aspects and political trends in medicine and science in the New York Times, New Republic, Commentary, Atlantic Monthly, New York Times Magazine, and the Wall Street Journal. Dr. Satel is author of PC, M.D.: How Political Correctness is Corrupting Medicine and Drug Treatment: The Case for Coercion.

Available through:
St. Martin's Press
175 Fifth Ave.
New York, NY 10010
www.stmartins.com

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