Cruel Compassion
By Karlyn H. Bowman, Sally Satel, Christina Hoff Sommers

TAE contributing editor Karlyn Bowman recently sat down with Dr. Christina Hoff Sommers and Sally Satel, M.D., resident scholars at the American Enterprise Institute, to discuss their new book One Nation Under Therapy: How the Helping Culture is Eroding Self-Reliance.

 

TAE: You criticize what you call "therapism." What is that?

 

CHRISTINA HOFF SOMMERS: Therapism celebrates emotional self-absorption and the sharing of feelings. Its proponents believe that vulnerability, not strength, characterizes the American psyche. They see us as an anguished, emotionally apprehensive population that requires a vast array of counseling to cope with the trials of everyday life.

 

TAE: Let's start with the myth of the fragile child.

 

SOMMERS: There is a great deal of anxiety about the mental health of the nation's children because some very widely read psychologists claim to have found a crisis. In her bestselling book Reviving Ophelia, Mary Pipher describes girls as "crashing and burning." She says adults fail to appreciate how universal and extreme their suffering is. William Pollack, a psychologist at Harvard Medical School, wrote another book claiming that it was boys who suffer egregiously, with millions drowning in isolation. Neither of these assumptions about young people's fragility turns out to be true. Responsible research by psychologists and epidemiologists paints a different picture: A small percentage of kids are in trouble psychologically, but the vast majority are healthy and happy.

 

TAE: Many young people even have an over-abundance of self-esteem, you suggest.

 

SOMMERS: Our schools of education promote the idea that high self-esteem is essential to academic achievement. But the concept is too poorly understood to be an appropriate classroom objective. High-school dropouts, burglars, car thieves, shoplifters, even murderers, are just as likely to have high self-esteem as the winners of the Congressional Medal of Honor or Rhodes Scholars.

 

In May 2003, four prominent academic psychologists published the first comprehensive review of the supposed benefits of self-esteem. They concluded that there was no significant connection between feelings of self worth and achievement, success in personal relationships, or healthy lifestyles.

 

The self-esteem movement has turned many classrooms into therapy centers rather than places of learning. Learning history, for instance, especially American history, has been radically transformed by the requirement that schools provide students with textbooks that enhance their self image. California subjects prospective textbooks to a social content review with the goal of determining whether the books "promote individual development and self-esteem." California is the largest textbook market in the country, so publishers selling their books in other states still tailor them to California's specifications. What happens is that students are sedated by what one critic called "textbook happy talk," and shortchanged academically.

 

TAE: Let's move from self-esteem to self-expression.

 

SALLY SATEL: There's a notion that it is important to mental health to express one's feelings. But that is not necessarily in a person's best interest. If it is someone's natural style to be talkative and revealing, that's fine. But we marshalled evidence showing that group therapy or talking about one's illness or feelings does not extend patients' lives, as often claimed.

 

We also look at grieving. Contrary to the advice of the helping professionals, it is not necessary to pour out one's feelings; people who don't become deeply depressed after the death of a loved one don't suffer further down the road, nor is it necessary for them to focus on memories of the deceased in order to cope. People should not be misled by pop-psychological prescriptions of how to react.

 

We also examine the idea that one can resolve one's problems by thinking obsessively about oneself. Much of the data actually shows that this can entrench depression. Recent research also suggests that "venting" anger is not productive; it makes people feel even angrier.

 

SOMMERS: One serious drawback of "therapism" is that it tends to replace ethical judgments with therapeutic analysis. The Catholic Church's experience with pedophile priests is a tragic example of what can happen when sin becomes syndrome. In the 1970s, it was the fashion among certain mental health professionals to view pedophilia as a treatable form of psychological immaturity. It was thought that "talk therapy" would help the pedophile understand himself and move beyond his arrested state of development. Offending priests were sent away for assertiveness training and other treatments and came back "cured." Now the Church realizes pedophilia isn't treatable. With something so clearly a sin and a crime, what was there to learn?

 

SATEL: Therapism has also changed the way many people think about addiction. We believe addiction is a behavior over which people have control, but much of the substance abuse community now refers to it as a "chronic and relapsing brain disease." This is misleading on two counts. First, addiction doesn't have to be relapsing. One is not sentenced to be drug or alcohol dependent in the way people are saddled with schizophrenia or multiple sclerosis.

 

With its implication that addiction is something that one contracts, as opposed to a condition that one brings on oneself, the brain disease model gives the patient a free pass. The truth is, patients fare better when we build accountability into treatment. People respond when they know there will be consequences for their behavior.

 

TAE: You devote a chapter to "Post Traumatic Stress Disorder."

 

SATEL: PTSD did not formally exist as a diagnosis until 1980, when the American Psychiatric Association added it to its manual. Fear reactions are ages old. They were recognized in the Civil War; in World War I it was called shell shock; in World War II, battle fatigue. But when the diagnosis was advocated in the mid '70s by self-proclaimed anti-war psychiatrists, it took on new aspects. For the first time, PTSD was considered a normal response to stress. It was also believed to have delayed onset. A person could supposedly function well for months or years after a traumatic experience and then suddenly become irritable, possibly violent, unable to hold a job, depressed. PTSD turns out to be not as common as many mental health professionals suggest. And it is often colored by political considerations.

 

Right after 9/11, self-appointed trauma counselors flooded Ground Zero, trying to engage New Yorkers, asking how they felt. This was an astounding waste of resources. What we know historically from responses to disasters is that most people handle these things pretty well on their own. It makes no sense to intervene within the first few weeks, because intense emotional responses then are normal. If there is a pathology, it is not usually detectable until at least a month later. In some subset of recipients early intervention actually impairs recovery.

 

TAE: Are the things you discuss just fads?

 

SOMMERS: Therapism is far more than a set of fads. It is a life philosophy. But there are hopeful signs it may be losing its grip on the American mind. More and more Americans are aware that our children have too much self-esteem, not too little. Our kids score near the bottom on international math tests, yet they feel good about their skills. Parents are increasingly worried about this, and the therapeutic culture has no answers for them.

 

It is important to keep in mind that the traditional American creed of self-reliance, personal responsibility, and stoicism is still very strong. Think of the thousands of young men and women serving courageously in our military. Therapism's real hold has been on the helping professions, educators, and journalists. As more Americans come to realize the high toll therapism exacts on the nation, it will fall out of fashion. But we are in for a struggle.

 

 

 

Feel-Good is Bad

By Steve Salerno

 

The "self-help" and "self-actualization" movement is seldom recognized for what it is: a contributing factor to many of the problems now plaguing our society. It is almost impossible to assess the full magnitude of what self-help has done to America. Whether you follow self-help's teachings or not, you have been touched by it, because its philosophies bleed into every area of day-to-day life in America--the home, the workplace, the educational system, the mating dance. "Enlightened" policies aimed at protecting self-esteem increasingly add costs to businesses, and obstacles to social improvement. The celebration of self has recently infected health care, spawning an aggressive new wing of alternative medicine that shoos people away from proven mainstream treatments by persuading them that they can cure themselves.

 

The self-help movement has changed the meanings of right and wrong, good and bad, winning and losing, while attaching entirely foreign connotations to once commonly understood terms like family, love, discipline, blame, excellence, and self-esteem. Two polar camps within the movement contend for influence: the victimization camp has eroded time-honored notions of personal responsibility, convincing its believers that they're simply pawns in a hostile universe, that they can never really escape their pasts or their biological makeup. The other camp, focused on empowerment, has drilled a generation of young people in the belief that simply aspiring to something is the same as achieving it, and that a sense of "positive self-worth" is more valuable than developing the talents or skills that earn recognition from others.

 

Steve Salerno's book Sham: How the Self-Help Movement Made America Helpless, from which this is adapted, will be published this month.