|Originally published: 2005|
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In the early 1990s, an unpublished thesis discussed the emergence in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
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.
a quality that arouses feelings of pity, sympathy, tenderness, or sorrow
pathology: a biological or functional (mental) manifestation of disease.
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
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.
[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.
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
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
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
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
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:
The voice of intellect is a soft one but it does not rest till it has gained
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
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.
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