Bad Therapy by Abigail Shrier

I was at Chandler's house when I saw this book on her shelf. I love Abigail Shrier and so I asked if I could borrow it. Turns out I bought it for her in the first place! I cannot say enough for Bad Therapy by Abigail Shrier. Anyone who knows a child, has a child, or was a child needs to read this book. Although I really liked her conclusions, the sheer scope and scale of the problem depresses me. It's a behemoth. 

She starts with therapy itself. Shrier quite persuasively makes the case that therapy, the way it is done today, is actually iatrogenic, that is it harms more than helps. In this section she outlines exactly what "Bad Therapy" is:

"What does bad therapy look like, I wondered. If a sadist wanted to induce anxiety, depression, a feeling of incapacity, or family estrangement, what sort of methods would she employ? How would a malevolent mastermind induct a generation into a tyranny of feelings? Like this.

1. Teach Kids to Pay Close Attention to their Feelings...

2. Induce Rumination...

3. Make 'Happiness a Goal but Reward Emotional Suffering...'

4. Affirm and Accommodate Kids' Worries...

5. Monitor, Monitor, Monitor...

6. Dispense Diagnoses Liberally...

7. Drug 'Em...

8. Encourage Kids to Share Their 'Trauma'...

9. Encourage Young Adults to Break Contact with 'Toxic' Family...

10. Create Treatment Dependency..." (p. 42-63). 

We have created hypochondriacs who experience the same pain as everyone else, except they fixate on every sign or symptom. They make themselves sicker by worrying about getting sick.

In the next section, "Therapy Goes Airborne," she discusses the ways in which Bad Therapy has migrated into the schools. This is the most depressing part because there are literally millions of teachers, almost none of whom are trained therapists. If they were, they would have to follow the ethical guidelines and best practices of therapy. Even though therapy has a lot of problems, they can fix them as a licensed group and hold their members accountable. But they hold no sway over teachers. And teachers are an ornery bunch, much like herding cats. Many simply are not that smart and whatever sounds good is taken as gospel truth. Even the smart ones are not reading the latest studies and diving deep into the latest conversations on the best way to help children struggling with mental health. It's like giving teachers access to the latest in chemotherapy treatments and so, "just in case," they administer a small dose to each student every day. Here's where the iatrogenesis leaps into the general population. 

In the classroom, it starts with "Social-Emotional Learning." This is the latest fad and every teacher from kindergarten on up is asked to evaluate their students social and emotional "temperature." This can be emotional check-ins where students are asked daily how they are doing. Often, one student's sadness can infect the entire class and an emotive, therapeutic trauma session ensues. Much crying and flagellation are signs of a good check-in despite the complete lack of academic purpose or even therapeutic progress. These amateur group therapy sessions teach students that they are emotionally fragile and probably broken. Students are then coddled and those from the most disadvantaged backgrounds lose out the most. Rather than being held to high standards and given the tools needed to better their situation, the students are excused, accommodated, and unmotivated to succeed. Schools are on the hunt for trauma and it's surprisingly easy to find. Figuring different traumas stack up and believing "the body keeps the score" (a debunked, but highly popular theory), the children are poked and prodded until the slightest trauma can be unearthed and "dealt with" whether or not parents agree to any of this. In fact, since most of the trauma is apparently a result of parental action, it's best to keep parents out altogether. Therefore the students are endlessly surveyed and inculcated with the idea that something is wrong with them. Their teacher and school counselor just need to figure out what. 

Not only is all this poking and prodding hurting the students and introducing trauma where none existed, it has led to a type of toxic empathy. Anyone, anywhere can claim to feel "unsafe" and she is automatically the victim. Regardless of the motives or even the actions of the "perpetrator," all empathy channels toward the aggrieved. This has led, apparently with no recognition of the irony, to the most bullying of environments. Shrier calls this "The Tattletale Generation." Victims are virtuous and the perpetrators beyond the pale and without redemption. This simultaneously reinforces the victim narrative and introduces new "trauma" to the "perpetrator."

In exasperation, Shrier asks, "Who raised these children?" She answers her own question with "Gentle Parents." This is the other side of the coin where the teachers playing therapist are one side and the parents playing therapist are the other. Rather than a simple (and time-tested) "Knock it off," children are indulged and analyzed and their feelings held up for endless examination. This has produced a generation of tiny tyrants who scare their parents. In our desire to avoid becoming authoritarian parents, we have neglected to be authoritative parents. But something has to keep these tiny tyrants under control. So we turn to drugs. Shrier has a lot to say on the drugging of our children that has replaced old-fashioned discipline. TL;DR: She's against it.

Finally, in the last section, Shrier proclaims, "Maybe There's Nothing Wrong with Our Kids." She advocates that parents disregard the "experts" and allow their children to be children. When they mess up, discipline them. Provide them with love and independence. Don't coddle them but encourage resilience. Invite extended family to speak into their lives. Don't treat your child as the center of the universe, to the detriment of all others. 

She ends with, "Remove the [harmful interventions]: the technology, the hovering, the monitoring, the constant doubt. The diagnosing of ordinary behaviors as pathological. The psychiatric medications you aren't convinced your child needs. The expert evaluations. Banish from their lives everyone with the tendency to treat our children as disordered. You don't need them." (p. 250)

I think she's right.

Being Mortal by Atul Gawande

Somehow the book Being Mortal by Atul Gawande was recommended. After getting it from the library, I got jammed up with other, more pressing books. I considered skipping it. I do judge books by their covers and this one seemed boring. 

This is one a handful of books that I believe will stick with me... probably forever. 

I'm glad that I read it, and also exhausted!

Here is the money quote at the end:

Being mortal is about the struggle to cope with the constraints of our biology, with the limits set by genes and cells and flesh and bone. Medical science has given us remarkable power to push against these limits, and the potential value of this power was a central reason I became a doctor. But again and again, I have seen the damage we in medicine do when we fail to acknowledge that such power is finite and always will be.

We've been wrong about what our job is in medicine. We think our job is to ensure health and survival. But really it is larger than that. It is to enable well-being. And well-being is about the reasons one wishes to be alive. Those reasons matter not just at the end of life, or when debility comes, but all along the way. Whenever serious sickness or injury strikes and your body or mind breaks down, the vital questions are the same: 

• What is your understanding of the situation and its potential outcomes?
• What are your fears and what are your hopes? 
• What are the trade-offs you are willing to make and not willing to make? 
• And what is the course of action that best serves this understanding?

Liberty or Lockdown by Jeffrey Tucker

I was reading an article recently that recommended this book, Liberty or Lockdown by Jeffrey Tucker, as the best thing on our current Covid response. So I ordered it right away. It's a collection of essay published throughout 2020 at the American Institute of Economic Research. Some have not aged well, as most were written before September. The principles, however, hold. 

Lockdowns do not deter a virus. Trading liberty for the promise of safety nets us neither. 

Although I wouldn't say the book is a top ten or anything like that, it's worth the read. It's short and eminently readable. The first few essays alone are worth the price of the book.

The American Institute of Economic Research is free-market think tank, and as such subscribes to the theory of diffused knowledge being the best way to gather all the relevant information. Therefore, when the Covid virus hit our shores, the best thing would have to been to diffuse knowledge and let the aggregate determine the best course forward. Of course we know that is the opposite of what happened. The original sin in the Covid response was limiting knowledge and therefore seeking to avoid a panic. To this end, testing was only to be done at the CDC/FDA direction. Private companies were not allowed to develop and administer their own tests. Knowledge became a premium commodity available only to a select few if at all. Lack of knowledge coupled with the call to, "Do something" led to the hysterical and irrational initial responses. 

Ironically the knowledge we needed actually existed. Humans have been dealing with pandemics for all of history. "Somehow in the 21st century, we find ourselves in the awkward position of having to relearn the basics of immunology that everyone from 1920 to 2000 or so seemed to understand." (p. 20) There are only two ways to defeat a virus: to develop immunity through contracting the disease or through a vaccine. Somehow, the decision-makers in our society decided that they alone could pioneer a new way forward, which involved lockdowns and quarantining healthy people. We forgot what we knew. In thinking we were so much smarter than those of the past, we made ourselves stupid. "It was pure speculation that lockdowns would suppress this virus, and that speculation was based on a hubristic presumption of the awesome power and intelligence of government managers." (p. 24)

As one country after another copied whatever the previous leader did, the arrogance metastasized. Now all efforts went toward propping up a policy based on nothing and accomplishing nothing. To intentionally hurt people by destroying their businesses, throwing them out of work, decimating their mental health, stealing educational opportunities, and shredding the fragile social fabric that holds societies together takes a special kind of callousness. "The more pain you inflict on people, the worse of a person you become. Power is dangerous even when not used, but deploying it brutally and pointlessly rots the soul." (p. 33) Therefore the big lie becomes necessary. The leaders must double-down to justify their policies. 

Other than the obvious damage the Covid response has had on the world, Tucker makes an even more compelling point, "Once you lock down a population by executive fiat, based on obvious ignorance and fear, you send a signal that nothing much matters anymore. Nothing is true, permanent, right, wrong. Might as well tear it all down. You literally unleash Hell." (p. 34) Therefore the riots and rage seen all over the country is the predictable, and actually rational, response. "If we stay on the present course of hiding and futilely trying to suppress the virus, wee will end up making all of society poorer both materially and spiritually and also delivery a dangerous blow to our biological health." (p. 127)

The response to the Covid pandemic has not only failed to mitigate the effects of the disease, it has made it far worse. We now suffer not only the effects of the virus, but the effects of the cure. "From early in the lockdown days, it became clear that this crisis would not make us 'come together' and be 'better people.' It would not be like 9-11. Instead, it would shatter our lives and make us worse people. We would turn on each other, engage in dramatic deeds that would hurt and harm people we like and love, and push our political agendas ahead of basic humane values." (p. 176)

It's a good, yet depressing, read.