Beware Psychotherapy That WorksMuch has been written about the problems caused by therapy when it fails. Less discussed are the problems it can cause when it succeeds.
Steve Salerno
8 Aug 2023
Historically, the knock on psychotherapy has been that it’s a pseudoscience perpetrated by overeducated life coaches. Their insights are so arbitrary and insubstantial that they can render diametric judgments under oath about the risks posed to society by the same accused serial killer.
Jaundiced perceptions aside, therapy’s role in modern life is no joke. America is a nation increasingly surrendering itself to the therapist’s couch. Forty-one million American adults sought therapy in 2020–21 alone, which was peak-COVID. Nevertheless, that figure reflects a therapy juggernaut not out of line with trends before or since. Nearly a quarter of America has been in therapy in the past 12 months, according to Gallup polling. It is nigh impossible to consume any form of media without being bombarded with PSAs that herd people into overcrowded therapy waiting rooms the way Japan’s oshiya herd people into jam-packed subway cars.
Obviously, then, psychology’s efficacy is a matter of some importance. Yet this is where we encounter an irony—it may be that psychotherapy is most dangerous when it works.
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And yet, as bad as therapy may be when it fails, there is no discounting its possible dangers when it succeeds.
In the 1990s, when assertiveness training was all the rage, a joke circulated about how you could tell if total strangers were alumni of such programs. They were the ones in restaurants who demanded a different table from the one the hostess selected and then sent back their food at least once. The training “worked” for them in tight focus—but how the people in their orbit felt about it was another matter. Graduates of such training were bracketed as rude, difficult, demanding, opinionated, and aggressive.
By definition, psychotherapy lacks a social conscience. It does not concern itself with building a better society. Rather, psychology’s province is to equip you with the emotional skills to get what you want out of life. It promotes a “healthy selfishness” rooted in identifying and meeting your needs. (In prelude, psychotherapy must first help you overcome the fear that it’s self-indulgent to assign primacy to your “internal world.”)
Facilitating such goals is a canny new vocabulary as well as a conception of “boundaries” that fuels self-interested behavior. At first blush, this delineation of boundaries may seem reasonable and innocuous. But the solipsistic timbre of the broader discussion of such points suggests that it’s natural and even healthy for your engagement with others to be about your expectations, your wants, your sense of agency, and the validation that you reap from such interactions.
There’s also the validation you receive during therapy itself. Two of the realm’s canonical watchwords are affirmation and empathy, neither of which evokes a climate of candid appraisal. From the popular site Open Counseling: “To be good at what they do, therapists must avoid sitting in judgment of any of their clients.” Psychology Today observes that “unconditional positive regard is considered to be a common factor in mental health treatment.” The only exception is the therapist’s duty to report a patient perceived as an imminent danger to a specific third party.
More cynically put, a patient’s value and right to fulfillment are taken as givens, regardless of whether the patient has such value and/or if his wishes are deserving of fulfillment. The fly in this ointment should be evident. Even within the industry, critics recognize the risk of affirming self-serving (if not delusional) narratives that patients spin in projecting responsibility for their problems. From the above-linked piece in PT:
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Source:
https://quillette.com/2023/08/08/beware-psychotherapy-that-works/
