Customer Reviews

One Nation Under Therapy: How the Helping Culture Is Eroding Self-Reliance

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Reviewers have noted that the authors are affiliated with the American Enterprise Institute, a conservative think tank. I suggest that no one take this as having any bearing, pro or con, on the merits of the book. As a unabashed liberal in most matters, I am appalled by what has happened to this country since 1980 and am embarrassed to share a middle initial and surname with the current President. Yet as a clinical psychologist I can confirm much of what Sommers and Satel say about the blight of "therapism" that has overtaken us in the last 30 or so years. Painful as it may be to admit, every now and then there comes a conservative who gets something right. Sommers and Satel are two such. The case they make deserves to be taken quite seriously.

I believe that the review by Hara Marano, posted by another reader, misstates much of what the book has to say. Interestingly, the authors are not at all against psychotherapy per se. They are against a culture which medicalizes certain disorders so as to reduce the sense of individual responsibility for the choices that people make. At the same time, they are against a species of one-size-fits-all turnkey psychotherapy promulgated and administered by what I, for many years, have referred to as the "trauma mafia." This term may be unfair as many of these individuals are caring and well-meaning. Sommers and Satel maintain that many of these interventions are unnecessary and sometimes have unintentional negative effects in that they may interfere with help naturally present in community and psyche.

Some reviews have mainted that trauma counselors, whom the authors criticize, no longer use those methods that the authors are critical of. Were this only the case! I would personally advocate a worldwide moratorium on the training of both trauma and grief counselors.

As a psychotherapist, supervisor, and teacher with over thiry years of professional practice, I would say that a good part of my experience and that of my colleagues jibes with much of what the authors have to say. We fortunately did not see what we were told we would see after September 11. Many believe that PTSD is a relatively rare disorder which usually resolves without specific psychological intervention.

Marano states cognitive behavioral therapy has been extensively studied and has been found to be as least as effective as medication for many disorders. But a closer reading of psychotherapy outcome studies leads us to interpret claims of effectiveness with the utmost caution. The same can be said about much drug research. Although the problems with this research are beyond the scope of what I wish to write about here, the literature is there for those who would like to review it.

Any book that makes the leap from patterns of thought (e.g., the human potential movement) to gross issues tearing at the very fabric of society is bound to take some liberties and may not always apply so neatly. However, One Nation Under Therapy in my view is not glib, and is extensively documented. Whether what the authors call "therapism" weakens society is open to debate, but the authors make some important points which should not be ignored.

It's unfortunate that some here have dismissed a thoughtful and coherent thesis on the basis of presumptions about the authors' politics. I think that one can safely let the message speak for itself.

Contrary to the misreadings of some reviewers, Sommers and Satel are not attacking therapy. Indeed, the second author practices psychiatry in an inner city drug abuse clinic. Rather, the authors provide a refreshingly trenchant critique of the inappropriate extrapolation of the therapeutic ethos to settings where it does not belong and may, in fact, be harmful. More importantly, their conclusions are well-grounded in empirical research, as anyone perusing their abundant endnotes can see. "One Nation Under Therapy" will doubtlessly incite powerful emotional reactions, both pro and con. But if it also stimulates critical thought about "therapism" in our culture, it will count as a resounding success.

Sommers and Satel's thesis, which I find indisputable no matter what your politics, is that the therapy industry, driven by the human potential movement and making big bucks, has contributed largely to our nation's weakening psyche: We have become a bunch of over-sensitive cry-babies full of entitlement, divorced from common sense and self-reliance. What's really frightening is the manner in which the authors have put our therapy-numbed brains in the context of a post 9/11 world, a time in which we need to be tougher and more street-smart than ever. Woefully though, too many of us are still seduced by the fraud of the "fragile inner child," the cult of self-esteem, the obsession with removing morality and character in the name of "syndromes."

The most salient point is the hiring of grief counselors to help people cope with the aftermath of 9/11. The rest of the world must be laughing at us for seeing the war against us as a matter of grief counseling. How dangerously weak we've become. One Nation Under Therapy is a bracing wake-up call.

I had the pleasure of reviewing this book earlier this year,along with an edited work of a similar theme by Cummings and Wright, for Cognitive & Behavioral Practice (13,98-101). While noting therein that "there is much with which to agree and more than a bit to dispute," I went on to argue that a principles read of both these texts can only improve our hope for a more reasoned and evidence based approach to assistance.

The success of any provocateur may best be assessed through the polarization of responses to his or her points. Given that metric, Sommers and Satel have certainly succeeded in sampling of reviews placed here. Those sympathetic to their arguments rave while those opposed rant. This is fine, but let not the heat prevent force us back too far to benefit from the light.

The real issue here is more about what psychology has become and will become in the future. Once a fledgling science of behavior crafted by august and critical thinkers, its scientific base has been diluted to homepathic proportions by ever increasing legions of well meaning but often undereducated quasi-professional providers for whom the notion of "intervention" is increasingly untethered to either specified mechanism or empirical outcome. This represents more than medocrity of application--it risks becoming a pernicious threat to our own understanding of ourselves and our essential human nature. That is the essential thesis Sommers and Satel ask us to consider carefully--no matter what one's personal disposition may be, it is a worthy and important matter to consider.

If I were Emperor of the Universe for a day, I would make this book required reading for every literate person in the United States. The authors not only demonstrate that an unhealthy therapism has come to dominate American culture, they also show that the popular versions of therapism that dominate are not supported by the best research and have been detrimental to many of those they have impacted.

Early chapters focus on the effect of therapism on education, where notions of childhood fragility have resulted in the elimination of healthy forms of competition and fun and have eroded emphases on achievement.

The chapter entitled "Sin to Syndrome" argues that some misguided therapies characterizing addictions as "brain diseases" have had the unfortunate effect of eliminating personal responsibility. Interestingly, the authors point out that their perspective is not inconsistent with traditional 12-step programs, which combine descriptions of addiction as an illness with helpful methods for accepting responsibility. In contrast, the "brain disease" model paints addicts as pure victims bearing no personal responsibility or wilfullness with regard to their situation.

The final chapters include extensive discussions of post traumatic stress disorder, beginning with its diagnosis with regard to veterans returning from Vietnam and continuing to public discussion of it in the aftermath of 9/11 and other recent tragedies. The discussion of the trend toward overly zealous and ever-present grief counselors descending on communities and schools victimized by tragedy would be humorous if untrue. The authors show convincingly that the methods employed by these counselors are frequently unhelpful, and that most people cope well naturally with the help of their own families and friends, as opposed to the help of strangers who insist they talk about their experiences.

This book is highly recommended.

I generally agree with the thesis that there is an identifiably ideology that can be termed therapism, and that it is problematic. I take issue with the polemical approach the authors take, however. I enjoyed the great anecdotes, but the authors never get beyond anecdotal lines of argument. This was particularly evident in the chapter regarding the Catholic priests and child molestation. The authors present therapism as being singularly responsible for the church's anemic response towards their priests' misdeeds, while ignoring other ideologies or concepts that played a role. The insistence in mapping on therapism to every social ill, to the exclusion of every other cultural phenomena, became tiresome after a while.

I took my degree in psychology in the heyday of Maslow and Rogers, and found the overemphasis on "finding yourself" narcissistic and off point. This book is worth it alone for the chapter on Esteem Thyself which traces how this crept into the field of psychology and opened the door to one nation under therapy.

The positive potential of the self-esteem and self-actualization movement got spun into the overwrought "therapism" that has come to pervade our lives and assume every situation has something that needs "help." This point is even demonstrated (unintentionally it appears) by another reviewer who presumes that people who like the book are just another group who needs help because they are looking for something to blame for their frustrations with modern life. That's just plain silly. Most don't need help and aren't necessarily frustrated with modern life (I am not). What's worse, it demeans the difficulties of those who truly do need help.

Well worth reading with much more, including the mythology of the fragile child as yet another object to be saved by the misguided helping culture.

"The fateful question is: Will Americans actively defend the traditional creed of stoicism and the ideology of achievement, or will they continue to allow the nation to slide into therapeutic self-absorption and moral debility?" This book was a searing look into the ethos of "therapism" in modern America. The basic tenant of therapism is, simply put, that people are psychologically and emotionally fragile. School are increasingly becoming feeling-centered as apposed to knowledge-based and normal human responses to loss and crisis are readily being pathologized by health care professionals and the media. Resiliency, strength, and courage are not characteristics of those in "denial', but rather something we should teach our children and continue to uphold as American virtues.

Years ago I was enrolled in a psychology class in which I happened to be the only male present. On the first day, there were about thirty students arrayed at desks around a blackboard. The professor came in and introduced herself. Then she requested that each student say their name while "telling the class some details about yourself." When the procession reached me I said my name...and nothing else. The professor eyed me carefully. She then asked, "Won't you tell us something about yourself?"
"No," I answered. "I don't get into all that stuff."

Such expectations of personalization and sharing are now sadly the norm in primary, secondary, and higher education classrooms across the country. Requests to emote come from one's peers and associates and are more rule than exception. Reticence in meetings or events is viewed with suspicion. The value of being "A Quiet Man" man well have died with John Wayne.

Our nation is under the thrall of a movement that exerts its loathsome and self-righteous influence upon us whenever we tug at a dog's leash or tell somebody that they should "toughen up." The name of this movement and belief system is therapism and its take over of America has displaced traditional values like resilience, drive, pride, and honor.

For this reviewer, the most intriguing sections of the book concern our public schools which have become, in many ways, a loco therapistis for the country's children. To summarize the current situation, our primary and secondary institutions are presently expected to provide services which they are in no way qualified to offer. It is now believed by many professionals that bestowing students with a good education alone is not fulfilling our mission. They regard it as essential that we prepare pupils for every facet of life. The line between teacher and social worker is becoming increasingly blurred.

The school as one stop well-being center is now accepted by many an educator. Obsessing about feelings and processing them is the height of chic. The posture of care makes others regard you as devoted, empathic and vested. Should one appear otherwise they will look like a bat-wielding Neanderthal. Exploring moods and student vicissitudes is cutting edge. It's right up there with using words like "modality" and "rubric."
Should a teacher desire alienation, they would be advised to bring a copy of "Exploding the Self-Esteem Myth" into their building's faculty lounge and begin quoting from its pages extemporaneously.

By practicing reticence and reserve in regards to their feelings and thoughts it seems that many of our ancestors lived unfilled lives. Yet, One Nation Under Therapy illustrates that the endlessly processing of feelings makes for pessimistic and dispirited obsessions-and little else. Through constant discussion, irritation can morph into rage. The evidence suggests that inhibition and repression can be more adaptive responses to grief and stress than blabbing your feelings to every passerby.

How did such toxic views and practices arise? Sommers and Satel, in the chapter "Esteem Thyself", point in the direction of humanistic psychology and the works of Abraham Maslow and Carl Rogers. With the latter, his insistence that the quintessential question of life was, "Am I living in a way which is deeply satisfying to me, and which truly expresses me?" indicates just how shallow and narcissistic he desired his patients to be. On the left they might refer to such a solid link to therapism as "a root cause." On the right we might dismiss it with the commandment of "Get Over Thyself." Rogers saw schools as "personal growth centers" with nonjudgmentalism as their core requirement. As for Maslow, his theories were so vague and unfalsifiable that they left themselves open for misrepresentation and manipulation by thugs like Abbie Hoffman and Charles Dederich. Humanistic theory bares as close a resemblance to the truth as the fantasist political works of Noam Chomsky.

We live in days when the saying "Be Strong" is equated with insensitivity and that appeals to bravery are an embarrassment to those who make them. There is only one thing that must be done; all of us must be as judgmental as possible. We should never excuse the immoral behavior surrounding us. Rather than minimalize and rationalize pathological acts on the part of the narcissistic, violent, or drug-addicted, our nation must embrace personal responsibility without qualifications. We should follow the advice that Don Imus gives the sick children on his ranch, its time to "Cowboy Up."