Bad Therapy: Why the Kids Aren’t Growing Up (Abigail Shrier)

CATEGORY: BOOK REVIEWS

Written by Michael S. Scheeringa
Read time: 2.7 minutes

Book Summary
Abigail Shrier’s 2024 book, Bad Therapy: Why the Kids Aren’t Growing Up, analyzes the so-called youth mental health crisis. Shrier is clear that there isn’t a mental health crisis. Those who believe there is a crisis have conflated two groups of children. One group has “profound mental illness” and are truly impaired in their ability to function; that group has not increased.  
Her aim is to explain the other group—the non-disordered group—those who don’t belong on medications or in therapy, “the worriers; the fearful; the lonely, lost, and sad.” This group has increased and they are miserable. It is not, however, mental illness; "It’s an emotional hypochondriasis and iatrogenesis crisis.” Her book aims to explain how these worriers have been created by the failures of adults. According to Shrier, there is a lot of blame to go around:

• Parents were too soft with therapeutic parenting designed to make children happy, and avoid all risks.
• Schools usurped parental authority with a “therapeutic pedagogy,” taught social-emotional learning, trauma-informed care, and restorative justice.
• Smartphones caused anxiety, depression, and self-harm.
• Academia pushed fake narratives that humans are fragile, i.e., Adverse Childhood Experiences and trauma damage brains and souls. Specifically, Bessel van der Kolk—the “High Priest of the Church of Trauma”—and Gabor Maté were skewered. Van der Kolk, per usual, hid from criticism. Shrier wrote, “I reached out to Dr. van der Kolk for an interview. He responded quickly and affirmatively to the request and then abruptly ceased communication.”
• Government mandated school surveys about suicide, depression, and anxiety, which planted suggestive concepts in children’s minds that maybe they should be worried.
• Therapists framed patients as sick, caused family estrangement, blamed parents, and decreased self-efficacy.

 
Lastly, Shrier offered common-sense solutions that prescribed essentially the opposite of the problems she uncovered, which I will not detail for brevity.

​Who Wrote This?
Shrier originally worked as an attorney and then became a successful writer. She wrote opinion pieces for the Wall Street Journal from 2018-2020. Her first book in 2020, Irreversible Damage: The Transgender Craze Seducing Our Daughters, analyzed the surge in popularity of identifying as transgender. 

Analysis
Overall, the book is excellent because Shrier analyzed a lot of things accurately and she's a good writer. My main criticism is that you can’t fully explain a problem if you just describe behaviors; you need to describe the etiology. Shrier correctly identified part of the etiology (e.g., harmful practices of many groups of adults), but omitted that they are a subset with distinctive motivations. She seemed to miss that the worried, non-disordered children are a subset, too. Most children are not suggestible to lunatic teachers and social media rubbish.
For example, Shrier noted in one sentence that liberal females are overrepresented in this unhappy subset of children, but  never explained why and never followed up. It’s not clear if Shrier doesn’t believe there is an underlying ideology, or doesn't understand the ideology of these children and of these zealous parents, teachers, and scholars, or if she opted to ignore it because she (or her publisher) believed, probably wisely, more people would read the book if it wasn’t political.
 
Another criticism is that the book could easily be perceived as anti-medication. She talked to two armchair psychologists who would not recommend medications for ADHD, depression, or anxiety, but never asked a psychiatrist’s opinion, who actually has clinical experience with these medications. The practice of trying medications in humans with heterogenous syndrome profiles is more complicated and less nefarious than Shrier presented it.

Lastly, her description of parents putting their children in therapy when they don’t need it is not my experience during thirty years of practice in child psychiatry. It’s a high bar for parents to bring their kids to therapy or put their children on medication, and it’s usually done only after years of suffering and trying everything else. I don’t recognize the community Shrier lives in. Maybe it’s because I live in a red state and Shrier lives in California. Again, this reinforces my point that when Shrier describes the problems, she absolutely nails them, but they are applicable only to an ideologically-skewed subset of vulnerable humans.

 
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