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Debating Therapy Culture & Gen Z - Abigail Shrier

Abigail Shrier is a journalist, a writer for The Wall Street Journal, and an author. Therapy use is becoming more prevalent while mental health is getting worse. Are these two things causing each other? Or just happening at the same time? It's a lively one today as I try to get to the bottom of this. Expect to learn what is happening with modern mental health, the typical timeline of mental health for young people, what the current statistics are around therapy, which kinds of people see therapists the most, if there are any dangers to psychotherapy, why there might be an over-diagnosis and pathologisation of normal human emotions, why Abigail thinks there is such an increase in mental health disorders and much more... - 00:00 The Modern Mental Health Crisis 05:21 Are Therapists the Problem? 08:53 Do We Just Need to Connect to Our Feelings More? 14:39 Does Therapy Make Mental Health Worse? 22:17 Gen-Z Are Learning to Be Avoidant 27:31 Finding a Sweet Spot With Therapy 33:27 The Paradox in Depression Treatment 37:47 Therapy Culture Vs Bad Therapy 43:19 Are Smartphones & Climate Change to Blame? 51:23 The Impact of Single-Parent Households 55:04 Schools Making Parents Into Enemies 1:01:28 Overuse of the Word ‘Trauma’ 1:05:57 Is Mindfulness a Better Way? 1:14:34 Kids Are Too Over-Medicated 1:19:31 A Better Way Forward 1:23:35 Where to Find Abigail - Get access to every episode 10 hours before YouTube by subscribing for free on Spotify - https://spoti.fi/2LSimPn or Apple Podcasts - https://apple.co/2MNqIgw Get my free Reading List of 100 life-changing books here - https://chriswillx.com/books/ Try my productivity energy drink Neutonic here - https://neutonic.com/modernwisdom - Get in touch in the comments below or head to... Instagram: https://www.instagram.com/chriswillx Twitter: https://www.twitter.com/chriswillx Email: https://chriswillx.com/contact/

Chris WilliamsonhostAbigail Shrierguest
Apr 20, 20241h 24mWatch on YouTube ↗

EVERY SPOKEN WORD

  1. 0:005:21

    The Modern Mental Health Crisis

    1. CW

      How would you categorize what is happening with modern mental health?

    2. AS

      Oh, gosh, w- we're making it worse, with, with too much treatment, too much diagnosis, uh, and, and way too much psych meds, and convincing people who are otherwise well that they are unwell, that they have a mental health problem.

    3. CW

      Right, yeah. Apocalyptic, apocalyptic start there. So, t- take me through, how much of this an adult problem? How much of this is a, a kid problem? Is, are there some cohorts that this is worse and better in?

    4. AS

      Sure, so I, I, if I have a prejudice here, it's that adults mostly can handle their own lives, uh, and we can trust them too. So, if some adults have been made to feel worse by things like therapy they don't need, or psych meds they don't need, or whatnot, uh, I, I generally think an adult can say, "This is helping me," or, "It isn't," and push back, and, and make it change. But a child can't. So, the bigger problem, what I wrote my book about, is about why putting a child through a culture of therapy, through a school system that constantly treats them to various forms of what I call bad therapy, therapy that makes your symptoms worse or introduces new symptoms, why this is all so harmful. This constant feelings focus, this constant convincing children that they've... that, or young, young adults that they've experienced, uh, ch- childhood trauma.

    5. CW

      Talk me through a typical timeline of mental health for young people. Like, do, do three-year-olds need, uh, like have mental health problems? Like, what's the onset and, and kind of what's the arc of this?

    6. AS

      Uh, sure. So as of 2016, the CDC, which is the Centers of Disease Control and Prevention, uh, came out with a report. This is 2016. One in six American children between the ages of two and eight already had a mental health or behavioral diagnosis. Okay, and that-

    7. CW

      What, just dig into that for a second for me. What does that mean? What would that look like?

    8. AS

      Um, w- so what mental health diagnoses do they usually have?

    9. CW

      Yeah, yeah. What does that, but what does that mean? Yeah, mental health diagnoses.

    10. AS

      That means every, uh, that means a shocking number of little boys have been diagnosed with ADHD or oppositional defiance disorder. If they can't sit in their seat or they're yel- yelling back at a teacher, they have oppositional defiance disorder. Uh, a shocking number of girls now have an ADHD diagnosis. Uh, they're diagnosing all kinds of kids as on the spectrum, or having anxiety, or having d- Now, do, some of these kids are... there's, there's no question a lot of these kids are sad, and a lot of them are lonely, and a lot of them are anxious. But we are psychopathologizing a whole generation and convincing them that they are unwell, so they are behaving like they are unwell.

    11. CW

      Right, okay. So, it seems like, at least so far, there's two problems that you've got. One being there's over-medicalization or pathologization of, uh, human emotions. Some of which get into things like trauma, depression, anxiety, but others are just feeling sad or down or lonely or fearful. Like, that's not necessarily something that the DSM would find, but it's, it's this concept creep. And then the other side of this is the treatments that are coming through and the way that people are dealing with that. Is that a fair characterization?

    12. AS

      Yes, exactly. We are introducing new symptoms and making existing symptoms worse.

    13. CW

      Okay.

    14. AS

      So, normal sadness becomes depression. Normal worry becomes anxiety. Nobody, no young people even use the word worry anymore. It's all, or nervous. It's all, "I have anxiety." And they think of anxiety as something they have, and therefore have to be treated out of, or monitored by a therapist, or treated by a therapist or medication, I should say.

    15. CW

      Okay, so you mentioned there was those numbers from the CDC in 2016.

    16. AS

      Right.

    17. CW

      Have you got any idea what percentage of kids are going to therapy, are being seen by therapists? Who are therapists seeing mostly at the moment? Is it adults? Is it children?

    18. AS

      So, it's a, it's a great question. So, we know that 40% of the rising generation has been through a therapist, but I think it's much higher because you know, what I call, you know, what I refer to as bad therapy, this kind of iatrogenic therapy, therapy that makes your systems worse, right? Iatrogenesis is when a healer makes a problem worse. They're getting it in the schools. They're being treated to social emotional learning and wellness tips, and um, all kinds of emotional regulation tips that are supposed to help, but I think it's making it worse. And I can explain why but, uh, but they're also getting it from parents. Parents who are treating them based on the best-selling books of neuropsychologists and, and, and various therapists. Uh, so, so kids are just absolutely awash in therapy today.

    19. CW

      Right. Where's that 40% number from?

    20. AS

      That's a good question. Uh, I have to, I have to look it up. It was, it was widely reported, uh, a couple years ago, and I have to, um, I, I have to, I'd have to look at my notes.

    21. CW

      Okay. That's the rising generation. So, is that Gen-

    22. AS

      Gen Z.

    23. CW

      Alpha, Gen Z. Right, okay.

    24. AS

      Gen Z. So, we're talking, you know, people born between the ages of 1995 and 2012, so yeah.

    25. CW

      Okay, and the numbers that you found was 40% of those, so nearly one in two, have seen some form of therapist?

    26. AS

      Uh, yeah, at some point. So, yes, exactly.

  2. 5:218:53

    Are Therapists the Problem?

    1. AS

    2. CW

      Okay. Do you think that the issue is kids' mental health or the way that therapists are treating it?

    3. AS

      So, I think you have both issues. So, I think that kids are suffering from bad lives, that bad things in their lives are making them sad, um, and they have good reason to be sad, uh, and, and not, and feel lonely, and feel anxious. I think they have good reasons for those things, and it has to do with their lives. And I think that therapists are going in and asking over and over, and it's either the school counselor or an actual therapist, or a teacher playing counselor, or their parents be, aping the techniques given to them by, by therapists. And they're saying, "Tell me how you're feeling. Monitor your feeling. Let's talk about your feelings." And inevitably, it turns to negative feelings. A hyper-focus on their feelings will elicit negative responses primarily, for any of us by the way, and the hyper-focus on the feelings with these kids who don't have the best lives, um, is making their unhealthy lives worse and making them feel worse.

    4. CW

      Is it not a case that the modern world is mentally tough, things have changed an awful lot, the generation previously which is now trying to raise and understand the world in which Gen Z is growing up, digitally native, always online, not seeing as much sunlight, obesity rates going up, all that stuff. Is it not just a case that the modern world's mentally tough and people are seeking treatment? They're just, things are harder mentally for people, and they're looking for a way to fix that?

    5. AS

      Well, i- in a way, so you could say that. You could say, "Well, things are h- tough." But it's a question of what we're talking about, okay? So if you go back generations, we're not living through the Blitz, they're not facing Nazi Germany, right? They're not, um, living through a world war, Great Depression, things that, you know, traditionally you would expect to encourage a great deal of anxiety in kids. But there are environmental contaminants, right? And there are things that naturally make us unhappier, like isolation from friends, like no touching, you know, online porn, all these things, they're so unhealthy. But here's, here's the thing to know, that if you have an unhealthy life, if you're out getting drunk, partying every day bu- every night, but not making real connections in the world, okay? If you spend all your li- time online, with online porn and online friends, and you're unhappy, if you go and delete that signal, you don't have bad mental health that you're unhappy. That's good mental health. It's a natural signal of the body saying, "Stop. We have to fix something about this life." You don't want to delete that signal. Now, I'm not talking about major depressive disorder, because there are these things that are organic and chronic and severe, and have nothing to do with anything you're doing, and that maybe should be treated with all kinds of things, like psychiatric medication. But if you're in a high-pressure job and you're feeling anxious, and you delete that signal, that's not, m- that's not a mental health problem. That's your mental health operating correctly. Just like if you lost a loved one and you felt really sad. Gosh, that's a mentally healthy response. But instead, we're diagnosing the mental health as illness, and we're giving it, and we're over-treating it in ways that are really going to make you worse off.

    6. CW

      I remember

  3. 8:5314:39

    Do We Just Need to Connect to Our Feelings More?

    1. CW

      in Johann Hari's book, Lost Connections, he talked about how grief is such a reliable, uh, inducer of depression, that I think it, m- maybe the DSM or maybe it was just advice for healthcare professionals, uh, mental healthcare professionals, that someone who'd lost a close loved one, um, you basically can't diagnose them with depression. I think it was for maybe four weeks, and then, then it got extended out, and then it was eight weeks, and then it was, it was 12 weeks, and they kept on doing this because depression or low mood is a natural response to a sad situation. One of the things that I'm struggling to thread the needle of of your thinking here is, on one hand, we have emotions that are natural and normal, they are responses to an environment and the stresses that that environment gives us. You're saying it is not good for us to ignore those, to try and delete those, but surely that is understanding emotions, integrating emotions, being able to talk about them, actually being able to feel your emotions and feel them in a safe way, and think, "Okay, how am I feeling now? I'm feeling anxious." And does that mean that there's something wrong or can I talk to someone in a safe space and actually feel like, "Huh, well, maybe it's because, you know, uh, Mom sort of said this thing earlier on and it made me feel a little bit of a way"? It seems to me that a potential solution to having lots of emotions is not deleting them, but the, uh, process of therapy, which is being able to talk about them in a safe place with someone who listens.

    2. AS

      So I think it matters whether you're talking about an adult or a child. So an adult can absolutely say, "Listen, I feel rotten. I don't care what you call it. I just got through a divorce, I feel terrible and I want to take a pill." I'm fine with that. I'm fine with that not only 'cause I don't consider it my business, but also because an adult can start that and stop it, and knows, and has a life history to know how he's feeling and what he wants out of life and what he wants to do. A child doesn't know those things. So if a child, if you go in and delete a child's sex drive before the child has a sex drive, that's a problem. You're making a profound change in a child's life that they have no way of evaluating, okay? So you do that to a teenager, and that's what I'm... When I say child, I incl- you know, teenagers, young people, people who are just sorting themselves out, right? An adult who goes through a divorce or a death and feels like they need to take something or feels like they need to talk to someone, look, by all means, they should do it, but I want to say, an adult can talk to a, a therapist for important reasons, for severe problems, but also for trivial ones, and get a lot out of it. Why? Because they don't have a, th- they don't face the same risks. See, if, if, if you or I went to therapy, we probably wouldn't be e- able to be convinced by a therapist that we were transgender, and we probably wouldn't be able to con- be convinced very easily that our ch- that our parents were toxic and we should cut them off, or that we had experienced childhood trauma when we didn't. But a child is very, very easy to convince of those things.

    3. CW

      How common is it for therapists... I- I understand the, the, the conversation around, um, psychiatric medication, I think, "Let's go very steady on that." I, I-

    4. AS

      Mm-hmm.

    5. CW

      I don't know any healthcare professionals that would say th- (laughs) well, uh, like, not over-diagnosing. Um, but when it comes to the talk therapy, and I think that that's, like, specifically what I was getting at...... integrating your emotions, understanding something, uh, whatever it is, 60% of children growing up in, in broken homes, um, 100x mortality risk if you have a non-biological parent in the house. Perhaps there's risks of abuse, whether that's physical or emotional, and it can be sort of really, um, subtle kinds of abuse, like just not showing love in the same way, or not paying attention from the, the step-parent in the same way. Not necessarily abuse, but i- neglect, you know, like, very sort of banal, normal neglect that no one's ever gonna get sent to prison for, but could emotionally affect a child. I wonder how they are in a much more difficult environment, much more broken homes, all the rest of it. I wonder how they're supposed to regulate that. I... agree, psychiatric medication should be, like, the 70th thing that you go to, unless it's a, a, a, a really serious scenario. But, um, learning to integrate emotion seems to be quite smart. What is the, w-

    6. AS

      A- abs- absolutely. Absolutely. So the question is, what are they going to the therapist for, and who are they going to? Okay? So a child in the circumstance you describe may need extra support from an adult, okay? The question is, is the dult gonna convince them that they've been through trauma? Is the gul- dult gonna convince them to regularly rehash their trauma and dwell on their trauma? Is the dult gonna leave them with a sense of inefficacy, like, "I can't do for myself without checking in with this adult"? Because those are all side effects of therapy, common side effects that can happen through therapy, and I think they're especially, uh, uh, and children are especially susceptible for, to them, 'cause they have no, they don't have enough life experience to push back.

    7. CW

      Mm. There's a sense-

    8. AS

      And the thing is, our natural re- our natural resources for overcoming even bad childhoods are remarkable. So it doesn't mean that ext- kids don't need extra support, and they certainly need better lives. So changes in their lives, absolutely. And support, probably they need that too from an adult. The question is, what kind, right? Is it rumination? Is it sitting around thi- rehashing their, their, their sad memory of their parents' divorce? 'Cause that could make them feel a whole lot worse.

  4. 14:3922:17

    Does Therapy Make Mental Health Worse?

    1. CW

      So in your opinion, does therapy make people better or worse in terms of their mental health?

    2. AS

      Depends if they need it, and depends who we're talking about. So for people who are there for a prescribed problem, absolutely it can be very, very helpful, even life-saving, okay? Now, for adults who are there to work on something, that can be very helpful too, because they are motivated to participate and get to the bottom of things. They wanna do the hard work of therapy. And then there are people who maybe lead high-profile lives, or for whatever reason, don't feel comfortable shar- you know, unloading to those around them, and that can be very helpful too. But that's not what I'm talking about. I'm talking about mass prophylactic therapy that's being dumped on children who didn't ask for it. The difference there is, first of all, you don't start out with a patient who's game to work, right? So you have to kind of pander to them to get them, to get them involved, 'cause they didn't choose to be there in the first place. But second of all, they might be doing just fine. They might not want to think about their parents' divorce or their mo- mother's death right now, because Tuesdays at 2:00 PM might not be a time when they're ready to do that. But nonetheless, through school counselors casually da- dabbling in this, and even therapists regularly asking about it, that's not necessarily helpful. And, and of course, there's a lot of research bearing this out, that the, that, uh, that therapy can make people sadder and feeling less capable in their lives.

    3. CW

      What's the results of that research? What did you find?

    4. AS

      Sure. So they did these great studies with, um, there's a lot of it, um, burn victims, first responders to catastrophe, b- breast cancer survivors, um, all of them m- uh, those dealing with natural bereavement, uh, grief f- from the death of a loved one, all of those people were led... They had actual control groups, so they actually tested this, and they were led to feel worse. The group that went to therapy felt worse afterwards than the group that didn't go. Why? Because we're built to recover from grief from a loved, from the loss of a loved one. Which doesn't mean that every one of us will, because some of us might need extra help. The majority, the default assumption should be that, hang out with friends, see people who love you, do some good in the world, you know, get to work on a project, you will feel better. Do exercise, which is remarkably helpful. I mean, God, that we don't start by getting kids to exercise who are sad is, is kind of criminal when you see the wonderful benefits of exercise as, b- p- held up against things like therapy and psychiatric medications.

    5. CW

      Yeah, there was a great study that came out recently talking about the effectiveness of SSRIs compared with exercise. I'm sure that you saw it. You see what the specific modalities of exercise were that they said were the most effective?

    6. AS

      So they showed, uh, uh, it was, uh, uh, I believe it was a meta-analysis, so they used all kinds of exercise. That's the one w-

    7. CW

      But did you see what the, did you see-

    8. AS

      Yeah.

    9. CW

      ... what the number one-

    10. AS

      Oh, dancing?

    11. CW

      ... form of exercise? Yeah, dancing.

    12. AS

      He asked me about dancing. (laughs)

    13. CW

      Yeah.

    14. AS

      That was amazing, wasn't it? Dancing.

    15. CW

      Yeah. The fact that, th- the fact that I've been lifting heavy things in a-

    16. AS

      (laughs)

    17. CW

      ... a s- a sweaty warehouse for the last 15 years, I should have just been doing salsa. So-

    18. AS

      I mean, that's right. And, and how do we not start with that? Start by asking, "Before we put you on a drug, let's talk about it. What exercise are you doing? Let's start there."

    19. CW

      Look, I think... I, I, I'm completely on board with that. If you don't have... and this is for a child as well, a stable sleep and wake pattern, a diet that isn't too full of sugar and processed foods, some friends that make you feel like you're a part of something, a physical practice, and a bit of sunlight, you're basically a plant with feelings.

    20. AS

      Mm-hmm.

    21. CW

      So you just need to do those things. And if you are entering into a serious...... mental health service without those things in place. It... To me, it's like, unless it's, "I'm on the brink of taking my own life," like, what are we doing here?

    22. AS

      Exactly.

    23. CW

      Like, let's- let's- let's take you out of there. Okay, so-

    24. AS

      Exactly.

    25. CW

      ... what- what are the harms of psychotherapy, in your opinion? What- what are the s- what do the steps of bad therapy look like?

    26. AS

      So, I think that th- therapy, bad therapy is anything that makes existing sym- symptoms worse or introduces new ones. So, here are some classic things that they're doing. Thinking constantly about your feelings, soliciting feelings. Diagnosis, the classic, um, side effect of diagnosis is demoralization, feeling limited by your diagnosis. Okay? Now obviously, if you need the (laughs) diagnosis, for goodness' sake, get it. But I'm talking about people getting a diagnosis they don't need, but nonetheless now feel permanently limited by, because of course, they can't... They... You can overcome shyness but you can't overcome, you know, major depressive disorder or something you're di- diagnosed with, or ADHD. Now you need a drug or you need a therapist to help you. Um, um, you know, treatment dependency, feeling like I can't do anything without asking an adult. One young woman I interviewed at- at- uh, she's a high school student, at the time she was a sophomore. Um, no, actually this was a- a- a senior that I asked, uh, who I refer to as Becca in the book. But she was telling me... I asked her... She'd been in therapy prophylactically since the time of her parents' divorce at age six. She was now 17 years old. And I said, "What are you working on with your ther- th- therapist?" Now remember, this is not someone who had exhibited mental health problems. She simply was put in therapy because her parents were getting a divorce. Okay? And what were they working on at age 17? She was working on how to make friends next year in college. So she was rehearsing with her therapist her ba- her attempts that didn't work out and preparing to make friends. So you see why this generation, I believe, doesn't feel like it can take a chance or take a risk or do anything for itself. It's becau- been... Because it's been told time and again by parents, by teachers, by counselors, "You can't." By mental health professionals, "You can't. You need to check in with an adult first." We've made them absolutely frantic that they can't handle a normal life on their own.

    27. CW

      How much of that, uh, can you lay at the feet of, um, over-helicopter parenting, uh, mental health professionals, and how much of that can you separate out from social media causes people to spend less time in the real world, therefore their social skills are reduced? It- it seems to me that if a typical, uh, I don't know, Gen Z, I would guess they probably spend six hours to eight hours a day on screens in- in some form or another, probably, maybe more. Um, if one hour a week of that is actually interacting with a real person, that seems like it would be a leg up and- and- and be a benefit as opposed to, it's just another hour that I can scroll on TikTok.

    28. AS

      Absolutely. They need more... That's one of the things they need. They need less time online, they need less social media. But they also need less of one of the things that social media is making worse: less diagnosis, less self-diagnosis into a feeling of illness. The reason I believe this generation doesn't feel up to the challenges of adulthood, like learning to drive, like, you know, a sexual experience or a romantic experience or all kinds of sort of adventures whether they're professional or personal, I believe it's because they... The same reason that they say over half, uh, less than half of them say they're mentally well. They are, they- they are acting like people who are unwell. They believe they're unwell. So they don't feel up to the challenges and adventure of life.

  5. 22:1727:31

    Gen-Z Are Learning to Be Avoidant

    1. AS

    2. CW

      One of the things that I've been thinking about a lot recently is the integration of emotions and, um, the importance of- of not hiding away from them. You- you mentioned earlier on, not- not trying to delete emotions, not trying to go away from them. Emotional avoidance causes depression, mental health problems. It's been linked with bowel cancer, heart disease, not feeling feelings. My concern is that without therapy or without a therapeutic practice, I don't know where people who are not familiar with feeling feelings and talking about their emotions, I don't know where they go to be able to do that. Whether you're a child or whether you're an adult, like, it's important to not emotionally avoid. It's important to integrate your feelings and use them to guide your behavior as well. Are you the stressed CEO that's- that's doing the thing? Um, but you also, you- you also, like, need to start talking about that to someone, like, where do you go if- if- if therapy isn't the thing?

    3. AS

      No.

    4. CW

      What is the thing?

    5. AS

      So- so my take on that is that what you're talking about is people who were not born in Gen Z. Because the rising generation in America does nothing but talk about its feelings. Every day at school, in every public school, which is, you know, our state schools. These are, these are not posh schools. Every kid is being asked relentlessly about their feelings and about their negative feelings. And you- you say, you know, well, I- I believe you said, you know, where would they have the opportunity to talk about that all the time? They're doing way too much of it. And here's the problem. You mentioned avoidance. What is the primary tool of a school counselor? It's helping a child avoid something that's hard for them. Avoidance is what they do. So what they do is they march into a teacher and say, "This child's having a hard time, maybe don't make him take his math test." And they're doing this over everything. Not a child who's just gone through something severe, a severe, you know, potentially traumatic event. But even over the most trivial things. If you say you're... You have a bad mental health day, in- in the eighth grade, you can get out of your tests.Okay? And that's what the school counselor will assist on. They've become tools of avoidance, which is the worst thing for mental health.

    6. CW

      But you also have a concern with therapists getting people to ruminate too much on their emotions.

    7. AS

      Sure.

    8. CW

      So, i- i- it seems like either counselors or therapists are doing both, i- in your opinion, are doing both things, they're either over-validating and, uh, getting people to, um-

    9. AS

      Oh.

    10. CW

      ... hyper-fixate on them, or they're getting them to talk about them too much. Like, it can't, it, it can't be both.

    11. AS

      No. No, no, no. Sorry. Let me, let me clarify. So when I said avoidance, I don't mean avoidance of emotions. They're letting them avoid the hard challenges of life, which of course makes things like anxiety worse. They're not tools of avoiding their emotions, they're obsessing over emotions. And by the way, this is a generation that's getting their bosses fired over their emotions, right? Their emotions are, couldn't be more dysregulated. That's what we're seeing. And by the way, that's, that's one of the other things that bad therapy does, it makes you more dysregulated by hyper-focus on your emotions, okay? So when I say that the counselors have become tools... school counselors are tools of avoidance, I mean avoidance of hard things that kids can overcome, like getting through a test. And rumination, yes, they're all encouraging bad patterns of rev- rumination, from the teacher who's playing therapist, to the counselor, to yes, actual therapists, I believe are encouraging this in young people.

    12. CW

      There's lots of types of therapy that don't involve emotions, all right? Uh, CBT, it's pretty well tested, uh, it seems to be pretty robust. The guy that made it originally was trying to overcome approach anxiety, uh, for chatting up women. Um, it's pretty good at, uh, uh, exposure therapy also, not necessarily you talking about emotions. Is, uh, is that a modality that you think works?

    13. AS

      I do, but I ha- I have a caveat. So in general, do I think that's great? Yes. And I think there's a good evidentiary track record for those things, and I think they can be very useful. But sometimes under the name of cognitive behavioral therapy, a lot of bad practices sort of s- s- slide in, okay? So I think the r- I believe in the rigors of cognitive behavioral therapy for dealing with all kinds of things, from phobias and whatnot, and dialectical behavioral therapy for dealing with things like depression. I think they can be very efficacious and very helpful. But, um, in schools, they tried to... there were two different studies, one in Australia and one in, in England, and one of the things they were teaching supposedly was emotional regulation techniques and cognitive behavioral therapy techniques. Now, what were they doing in practice? They were getting kids to focus, uh, r- incessantly on their bad feelings, and in both sets of studies, while they did these social/emotional exercises with the kids, one, one set was anti-bullying. They did a, a... one was a meta-study, so it looked at several different things, um, the, the constant focus on kids' bad emotions left kids more anxious, more depressed, and more alienated from their parents.

    14. CW

      It's interesting,

  6. 27:3133:27

    Finding a Sweet Spot With Therapy

    1. CW

      it seems to me that the primary problem is with bad therapists as opposed to therapy itself. It seems like you're saying that therapy, when done right, can be very successful, but that sneaking through the cracks is, um, i- i- it's advertised as CBT, and behind the scenes, it's just ruminate about your problems. It's advertised as exposure therapy, and it's making enemies of your parents.

    2. AS

      That's right.

    3. CW

      And I think, at least as far as I can tell, and I, I wish that I had this when I was a kid, there is a difference between validating someone's right to feel an emotion and make them feel safe in feeling the emotion while still stress testing whether that emotion is appropriate or not. Like that, to me, seems to be the sweet spot. But it's delicate, right? That's a really delicate balance. Like you feel this thing right now. Talk to me about that, like where's, where's that coming from? And do we think that that's an appropriate response? And w- how could that be wrong? You know, like that looks like healthy emotional discourse to me.

    4. AS

      That's brilliant. I love the way you put that, because you're the first person who's ever said to me that there has to be a balance between, you know, um, "Tell me about your emotion, and also let's talk about whether that emotion is appropriate," and I'll tell you why. And, and no one, and I... so few therapists in America seem to think that you ever are allowed to say, "Is that emotion appropriate?" And here's the problem, they're directing a lot of parents, and, and, and school teachers. And you know what? A child who shrieks and screams on a plane because he didn't get the snack he wanted needs to be told, "That's not appropriate." Not only is it not appropriate to scream, but i- and when they scream, "I'm angry," you wanna say, "That's not something to be angry about." Why? Because it's not an adult. You have to actually educate the emotions a little bit-

    5. CW

      Mm-hmm.

    6. AS

      ... which I know is completely verboten in therapy culture, but of course you do. A child needs to be told, "It's not appropriate to feel rage at your mother because she made a d- something for dinner you didn't like, or you preferred something else." There's, there's a time and place for rage, but that's not the place for rage. And then they sort of think, "Oh, okay," you know? (laughs) "I get it, that I should be frustrated, but not m- not full of fury."

    7. CW

      I think it's, i- uh, a lot of it is regulation. Uh, you know, I see... I worked in nightlife for a decade and a half, and one of the most interesting, uh, dynamics would be especially a, a girl that got thrown out. So we, we run events for 18 to 22-year-olds. It was a thousand people, they'd pay £5 each, it was one-pound Jagerbombs. It was like cheap and cheerful young people partying in the UK. One of the most interesting things that I would see would be a young girl who gets ejected from the nightclub, uh, either rightly or wrongly, uh, the door staff make a decision, "We're not gonna go and check the video camera to see if it actually was her that swilled some other girl because she looked at my boyfriend over there," or whatever it is. Rightly or wrongly, somebody gets ejected, and they would come outside and they would-... protest. They would start saying, "No, no, no, it wasn't this thing, it was her, she's a bitch, she's doing that thing," or whatever, whatever, whatever. And then you would watch, it usually took about maybe f- 30 seconds of that, and then very quickly, it would turn into pouring with tears. And i- it was pretty reliable. And I could just watch this person, and alcohol is involved, but I could watch this person just slowly dysregulate over time, and just move through different emotions. And then they would get, after the crying had finished, they'd move into resentment, they'd probably come back and have another swing at anger. Um, I mean, some, I'm not kidding, some people, mostly guys, guys were more persistent than girls, especially because it was the northeast of the UK and freezing cold, so, uh, the girls weren't dressed. If you've ever seen girls from the northeast of the UK, they don't wear many layers.

    8. AS

      (laughs)

    9. CW

      And, uh, but I, there's been guys that had stood outside of nightclubs they'd been ejected from, where I'm stood on the door with, with the team and, and the bouncers, for like three hours, just hurling abuse at the door staff, telling them why it's wrong, explaining to them why it is. And I'm like, "Look, mate, it, uh, it didn't work for the first five minutes, it's not going to work for the remaining two hours and 55 minutes. Like, just, you c- g- go home or go somewhere else, or d- do whatever, like, but you're not gonna come back in here." Um, but watching that dysregulation happen in real time was so fascinating to just see s- sort of someone grapple with this. It's an extreme situation. You've had, someone's had their hands on you. Like, uh, what other area of life does a big 45-year-old, 55-year-old Geordie man-

    10. AS

      Right.

    11. CW

      ... with massive hairy hands grab ahold of you and say, "You're now leaving the place that you are in, your friends are behind you," maybe blah, blah, blah, and then dump you, dump you in a different place. Um, but that was really, really interesting. And I, that makes me think about what teachers deal with in, in classrooms.

    12. AS

      Yeah.

    13. CW

      You know, like, w- uh, uh, uh, an incident occurs, and the kids need to learn to regulate, they need to learn to regulate their emotions.

    14. AS

      Right. And the question is, do they learn it from a class on regulation, which usually means talking about a time when you were sad, or in pain, or rejected, or felt unloved? Or do you learn it from life? You try out for the basketball team, you don't make it, they let you get cut from the team, and you figure out, "Do I really wanna play basketball? Or should I practice harder?" That's where you learn the emotional regulation. Everybody, ask anybody, you know, as you I'm sure know, it's the failures you learn from, right? And we all have them. And the problem is, the rising generation was kept from a lot of failure, and so they are completely dysregulated. They've been told every time they're disappointed that it's the most important thing in the world, and now they're showing up at the workplace and they feel disappointed or their feelings are hurt. So, they think they have to get their boss fired, because that to them seems an appropriate response to their emotional injury.

    15. CW

      Talk to me about the treatment

  7. 33:2737:47

    The Paradox in Depression Treatment

    1. CW

      prevalence paradox.

    2. AS

      Sure. So there's a, uh, wonderful study that, uh, happened while I was writing my book, and it was, um, about a bunch of researchers who noticed that, you know, there was this paradox in the treatment of depression across the West. Wherever there is grea- pervasive treatment and great accessibility of treatment, we should see point prevalence rates of any disease or disorder go down. Okay? This is true from everything from dental care being more available and seeing less toot- tooth rotting and tooth decay, to, um, maternal sepsis, or all, all number of diseases. You know, um, c- childbirth, death in childbirth, things that you would expect to see, uh, go down, uh, with, or treatment early, ch- uh, spotting of breast cancer, uh, you would, you know, screening, you would expect to see, uh, rates of death from breast cancer go down with better treatment. Instead, across the West, with more prevalent treatment of, uh, depression, and more access to treatment for depression, that has coincided with a stark rise, a rapid rise, in rates of depression. And the question is, why? Are these two things just coinciding? Is that just happenstance? We know at the very least the treatments don't seem to be effective. So, my contention is that actually a lot of the tre- this, what flies under the he- you- you know, the rubric of treatment is actually making things worse.

    3. CW

      Where have you drawn that direction of causation from? Is there any research? Is there any evidence on that?

    4. AS

      Yeah, sure. So, um, a few places. So, um, why, why do I think, um, that, that it's not just, um, they're not just coinciding, they're making it worse? Because, um, the language, first of all, we've seen, um, there are a few reasons. Um, first of all, we've seen a rapid, rapid rise in treatment, with no dent in, uh, depr- rates of depression. But it's more than that. It's not just that tre- depr- depression isn't going down. It's that more people are exhibiting the behavior of depression by talking about their pain, by ruminating about their pain, by sharing and dwelling on their pain. That's the biggest symptom of depression, and that is exactly what we'd expect to see from people who are induced in the practice of cultural therapy. Meaning, not necessarily, you know, many of them are getting it from an actual therapist, but some of them are just getting it from their teacher. The idea of constantly sharing with, uh, their, th- their problems. But also, you see it in their language, the way they're understanding themselves and each other. You're seeing people who are pathologizing normal life, who are seeing themselves as unwell and sick all over the place. And when they say they're unwell, they sound like amateur shrinks. They're using the language of psychotherapy. So, at the very least what we're seeing, I, I think it's very clear, is that young people understand themselves, each other, and their entire lives through the lens of psychopathology. So, I think it absolutely is related to the behavior they're exhibiting, which is, "I'm unwell. I, I feel lack of efficacy in the world. I, I feel like I can't take a risk. I'm full of phobia and anxious." These are all things we would expect to see bec- from too much...... you know, what I call bad therapy. These are the classic iatrogenic harms of therapy. So, I- I- I don't, I don't believe it's an accident. I think they're intimately, intimately related. And as you mentioned on social media, these p- these young people are identifying with their diagnoses. So, you might say, "Well, how do you know that their diagnosis had that impact on them? That it really did have that iatrogenic effect of limiting them?" Because they believe it. They believe it. They're the ones who introduce themselves by their diagnosis. That's proof of demoralization, meaning the- the coming to identify and feeling like you are so limited by your diagnosis, it's the most important thing about you. So, I think just listening to their talk and the way they describe their pain and the way they describe their lives is the biggest indication that, yes, it is therapy that's playing a huge role in all this.

  8. 37:4743:19

    Therapy Culture Vs Bad Therapy

    1. CW

      Certainly, therapy-speak has become a, a huge culture online. There's a, a great psychiatrist called Seera Chawla. I had her on the show. She is super anti, um, Instagram therapy, self-diagnosis, therapy culture-speak. I mean, we saw this with, uh... Do you remember Jonah Hill broke up with his girlfriend about six months ago?

    2. AS

      Ah. Okay.

    3. CW

      These, um, these screenshots of the breakup were, uh-

    4. AS

      Oh, that's right.

    5. CW

      ... were released, and it was... There was kind of this sort of semi-therapy-speak, talk about boundaries and-

    6. AS

      Right.

    7. CW

      ... and, and, and regulation and, and, and stuff like that. And, um, I- I- I do think that there is definitely a... I mean, I would 100% agree, the pathologization of normal human emotions, one of the reasons I believe that that's happening is, if you give something bad a name, it makes it feel more like it's in control. Because, "I'm not sad, I have depression," removes a, a good amount of the agency from how you can have contributed to, or how you could be in control of getting yourself out of the other side of this. I think that huge, huge problem.

    8. AS

      Right.

    9. CW

      The other side of this, to steel man sort of the opposite argument-

    10. AS

      Sure.

    11. CW

      ... you would say, well, we know that especially young people's mental health is in decline, whatever it is, 60% of 12 to 16-year-old girls say they have persistent or regular feelings of hopelessness and listlessness or whatever-

    12. AS

      Mm-hmm.

    13. CW

      Some apocalyptic language the CDC released last year. Um, that should, if that's the case, and if it's... Let's say it's not because of therapy. If it's because of obesity, if it's because of economic concerns, if it's because of broken households, if it's because of these things, you would expect to see an increase in facilitation to try and treat that, right? Because you have opened up a market.

    14. AS

      Right.

    15. CW

      So, the two things can happen in unison, even if one isn't necessarily causing the other. And the, the cultural use of therapy-speak, to me, seems a lot like a cope that is being used by people that have never been to therapy. I think that that is super prevalent.

    16. AS

      Oh, that, that may be. There m- many of them may not have been, you know, to actual therapy. That's possible. But let's just say they're getting a lot of treatment in various forms. I mean, the classic, when you brought up to-

    17. CW

      Treatment from In- Instagram.

    18. AS

      Yes, that's right. It might be from Instagram or one of these AI treatment (laughs) ... I mean, and now there's these, you know, apps that'll treat you through AI, that's right. But, or it's self-diagnosing on the internet or whatever. But, uh, but you- you just brought up I, I think a fascinating example, which is the Jonah Hill, "I'm setting a boundary." So, why do I think that therapy is playing a negative role? What language is that? "I'm setting a boundary with you." You're not talking to a person now. You're talking to a therapist, right? That's the language supplied to you. Now, you're no longer friend to friend, husband to wife, whatever, spouse to spouse, whatever you are. You are a therapist and patient (laughs) , right? And we all use... We're all playing therapist. It's way too much. It makes our relationships stilted. It alienates you and, uh, uh, from, from each other, but it does something else. Uh, which you just said, um, it undermines agency, the feeling that I can do anything about it. It's a horrible thing to do to a young person, telling them they have a diagnosis and now it's up to a pill, there's nothing they can do.

    19. CW

      Yeah, there's... I'm trying to really split apart therapy culture-

    20. AS

      Mm-hmm.

    21. CW

      ... from the impact of therapy, because I think-

    22. AS

      Well-

    23. CW

      I think that there is definitely this, this, this language that's being used.

    24. AS

      Right.

    25. CW

      Talk of anxiety, talk of trauma, talk of codependency.

    26. AS

      So... Okay, so let's steel man it for a second. So, is therapy this wonderful thing, like communism, that the truest form has never been tried (laughs) . Is that what we're saying, that there's this wonderful therapy that's out there? Now, I'm not talking about therapy for actual disorders, but wonderful preventive mental health care that has yet to be tried? I'm doubtful. And let me say, I know some wonderful therapists out there, and they tend to work with actual prob- people with actual problems. And, uh, when I say y- sorry, young people. Adults can go to a therapist for any reason and get something out of it. And I have to tell you something, I'll sit next to someone on a plane and get something out of that, too, for a conversation, because adults are capable of extracting what they need from social circumstances. And what they need might just be a conversation with, uh, someone who's willing to listen.

    27. CW

      And trusted, yeah, I just-

    28. AS

      And tru- trust, and trusted.

    29. CW

      Yeah, okay.

    30. AS

      The problem with the adult, with the adult-young person relationship, in terms of therapy, is the power imbalance is much different.

  9. 43:1951:23

    Are Smartphones & Climate Change to Blame?

    1. CW

      How much of this is just downstream from smartphones? You know, Jonathan Haidt was on the show recently, his new book, fantastic.

    2. AS

      Yeah.

    3. CW

      Um, uh, how much of this can be laid at the feet of technology, screens, smartphone use?

    4. AS

      So I think they work together. I think they, they both are parasitic on the same problem. I, I, I mean, look, the smartphones, I, I think Jonathan Haidt's done absolutely wonderful work, and I think that smartphones are a huge problem. And my last book was about the mental health, you know, social contagion that was spead- spread through the smartphones largely. But it was also spread largely through the therapists that these girls went to see, 'cause most of these girls who decided they were suddenly transgender in the seventh grade had therapists they were working with on their anxiety, okay? And the reason I think it goes beyond the smartphones is because of the s- things like the statistic I cited to you. You know, one in six American kids between the ages of two and eight have a mental health diagnosis. Now, that's not a social media problem, that's a life problem. And that was back in 2016 when they definitely weren't on social media. Now, to, uh... This is not say I'm a... The, the, the social media has so many problems, uh, uh, for kids. It's so inimical to, to good, you know, mental health. But one of the reasons it's, it's so inimical is because of the things, the very bad things that, um, bad therapy does, like, um, allow you to avoid hard challenges, accommodate your every whim. Those are, those are bad things. Take you further from all the things in life that are actually gonna make you feel good, like other people and exercise, right? And devotion to, to something, you know, bigger than yourself or focus outward. A, a, a soc- a pho- so- smartphone, what is the problem with the smartphone? The biggest problem with the smartphone is it's a me device. It focuses you constantly on yourself in isolation. That's the same thing that all this cultural therapy is doing as well, and yes, some of it from actual therapists, a lot of it. Uh, focus on you, how are you feeling, think about yourself, think about what you're doing, on and on and on. These are terrible habits.

    5. CW

      What do you think about the reason, uh, quite often put forward that climate change is causing an awful lot of anxiety for young people?

    6. AS

      Well, I, I don't think it is, uh, not, not climate change on its own. Um, maybe as presented to children, so in other words, yes, adults, if they scare the heck out of children about climate change, children will manifest climate anxiety and then they can go to a climate therapist, which there is now a growing... (laughs)

    7. CW

      Climate therapist?

    8. AS

      Yeah, sure. Growing number of therapists are now climate therapy- therapists, and they go around saying, "Wow, there's a lot of climate anxiety. Have I mentioned climate anxiety?" They're inducing the problem they pla- they, they are claiming to treat, right? That's not an organic problem. You know, we have had so many climate challenges, let's call them, or environmental challenges over the course of human history, and in recent history we've been very aware of them. So why is this the first generation that suddenly has climate anxiety? It's because we're obsessively telling them they should be terrified because of the climate. And there are a lot of trends going in the right direction, by the way, on the environment, like deaths from natural disaster, which are way, way down worldwide. So, the climate itself isn't the cause of the problem. (laughs) It's the way we're scaring young people.

    9. CW

      I would, uh, certainly agree that the narrative around climate change is, is... I understand, again, to try and steelman the other side, I understand why people who are concerned about the future of the climate want to make it as big of a deal as possible, because they think, "This is the only way that I can galvanize anyone to care about kind of this unseen issue," that, uh, they believe is going to creep up on us and, and, and then cause a catastrophe in future. The problem I think, and there's a couple of problems with that, um, first one, it causes people to excessively worry, which actually damages the quality of life of the only people we know actually are going to fucking be alive, which are the ones that are right here, right now. Second thing is, if you overblow, like if you're spray-painting a Monet painting or if you're gluing yourself to the M25 in London or doing whatever, I, I think that you cause so much agitation that it, it causes people to push back even more so. It's the classic, um, v- vegan activists park outside of a KFC so people tweet on social media, "Just because of that, I'm going to go and eat another burger." Uh, it's like that kind of fuck-you response gets activated. So I'd, I'd, I'd, I think it's, I think the, the rhetoric around it, totally wrong. I also think that we very rarely hear, as you alluded to, uh, the benefits of climate mastery. This is some of Alex Epstein's work where he says the number of climate-related deaths have declined by 98% over the last 100 years. That's good.

    10. AS

      Okay.

    11. CW

      That's a reason for, a, a reason to be hopeful. Does that mean that there are no problems with the climate? Absolutely not. But the concern of climate activists is if we were to tell people about some of the things that are good that are occurring as a byproduct of the, uh, freer, cheaper use of energy, um, that is going to make people less motivated to get on board with my particular agenda, which is to do this thing. So it's, it's nuanced. It's a, it's a balance between the two.

    12. AS

      I'm not sure it's nuanced, because there's a word for what you just described, okay? Not telling people the good because you want them to act. It's called lying, and it's wrong. So I don't think it's terribly nuanced. (laughs)

    13. CW

      Okay, what about, um, economic instability? People are worried about economic instability. Is that causing-

    14. AS

      Absolutely. Oh, does it cause... You know, is that a major driver of young people's... I think a couple of things. First of all, the student debt is a big deal. I don't dismiss that. It's a big deal to leave school with that kind of crushing debt. We have real challenges in this country and, and throughout the West, major challenges, okay? Are they worse than they've ever been? Maybe some of them are, but a lot of them aren't. And I will t-... I promise you this, the most unhelpful response is to say, "We're all doomed. I have so much anxiety. I'm now going to sit on my parents' couch for the next decade," 'cause that's not helping anybody. So where are the people who are saying, "I'm going to help with climate change. I'm going to help create new-"

    15. CW

      They're glued, they're, they're, they're glued to the M25.

    16. AS

      Right. They're glued to the Mona Lisa, claiming they're doing something for the climate. Now if you believe that (laughs) , that the person who glues herself to the Mona Lisa does so because she cares so deeply about the Earth, I, uh, forgive my skepticism. You know, that's n- certainly not a way to behave if what you care about is the climate.

    17. CW

      What about an externalized locus of control? That seems to be... If you were to describe much of the language, like semantically, if you were to probably do a, a, a, an analysis, there is very much this, "I don't get to impact my future. I have very little agency in the world. I am at the mercy of forces that I have no control over."

    18. AS

      That's right. And you know what you, why they have so little agency? Because they believe they're unwell. People who believe they're sick don't believe they're up to the challenges of life. Because when we're sick, we're not up to the challenges of life, right? Even normal things that we could fix and we could make better, and that's the most disturbing thing of all of this generation, the lack of agency. And do I think that's just because of social media? No, I think social media plays a role, but another huge part is they think they're unwell, but they're not unwell. Their, it's their life that's the problem, not a diagnosis, and we're way, way over-treating kids who have lives that need improving.

  10. 51:2355:04

    The Impact of Single-Parent Households

    1. CW

      I think that the, the, the one area I would really love... many areas I'd love to sort of stress test some of this research on-

    2. AS

      Sure.

    3. CW

      ... but one of the areas I'd love to look at is to try and track what's happened with mental health with what's happened with broken homes. Uh, I think that it is such a sleeping, sort of giant factor in this, because no one really wants to point the finger at single mothers. Like, God, this poor woman who's working two jobs to pay for two children. Maybe the father is or isn't involved, uh, l- like, in terms of physical support, maybe they are or aren't involved in terms of financial support, like, who wants to do that? No one. It's... The, the least popular thing-

    4. AS

      Yeah.

    5. CW

      ... on the internet would be to say, "Um, this is because you chose wrong. Like-

    6. AS

      Mm-hmm.

    7. CW

      ... you chose the partner that was wrong." And that... What's that woman supposed to do? Go and un-pregnant herself? Like, go and, go and, uh, like, put the baby back? That's not something that you can do. But that, that sort of toxic compassion, which is, "We don't want to tell you what may be a big contributor to this, because we don't want to make you feel bad," it's important. Like, look at what's happening with climate change. The point with climate change is to, uh, climate change activists, "We will focus on the things that are bad in order to warn us and, and, uh, steer us toward a, a better route for the future." That's their, th- their sort of rubric. The same thing has to be true in other areas as well, and I think single-parent households, like, so reliably must... I, I've not seen any research about what it does emotionally in terms of mental health outcomes, but it has to have a huge impact, especially on young girls. I had Anna Matien on the show who did a, a, a, a phenomenal book about the importance of fathers in the raising of children, and you often hear about how important it is for, uh, fathers to be in the lives of boys, to sort of regulate their aggression and, and, and, and teach them how to do rough and tumble play, uh, and it does seem to be very important that fathers are in the lives of boys up to sort of their teenage years. But the really important period in her research was sort of 11 to 16 for girls, that that was a really important time to have Dad around. So I would love to try and, uh, work out what is the impact, and could you track some of these mental health trends along with the declining, uh, dual parents household and, and sort of decline of, uh, increase in divorce?

    8. AS

      Okay, so I didn't look at the increase of di- divorce per se to be able to tell you what, what e- eras it started and, and what rate we're at now, but here's what I'll say. Would I deny anything that you're saying? No, of course not. I totally agree. Of course, um, all those things are contributing factors, but here's the difference: how do we deal with them? I have met parents, and I think we all know these people, who are raised by single mothers and are remarkable adults, strong, good people. They are p- reliable employees. They're not taking mental health days off of work. They're showing up. So can you raise a good, uh, a good child to adulthood in very difficult circumstances? Absolutely. But can you do it if you've told the child he's been traumatized and he'll always be living with trauma? Maybe not. Maybe now you're making it impossible to raise him to do much of anything.

    9. CW

      Certainly having a child being raised in a single-parent household by a mother or father that needs to work more, which means that they give them less time and then saying, "Oh, by the way, you don't have any control over the outcomes in your life, and the climate's gonna kill you, and you're never gonna be able to own a house," no, n- no. No, I mean, that's, uh, th- it's a breeding ground for people to be unhappy. What

  11. 55:041:01:28

    Schools Making Parents Into Enemies

    1. CW

      do you mean when you talk about social-emotional meddling? Like, what is that?

    2. AS

      So these are the, you know, they have the social-emotional programs in schools in England as well as America, but it's all over America. And it's... In, in theory, the idea is that they're going to teach emotional regulation, uh, through a series of discussions about emotion.We'll introduce concepts of emotion, and we know things like having a big vocabulary about emotion is a good thing, right? It's good for people to be able to separate frustration from anger so that they can realize, "Oh, I'm not really angry right now. I'm just frustrated," which is different.

    3. CW

      Mm.

    4. AS

      Right? So with this theory in hand, they're making a lot of problems for kids. Why? Because in practice, however it was intended, in practice, in order to get going a discussion of emotional regulation, what teachers are doing is they're saying, "Okay, let's talk about a time when you were happy." Not much to talk about in terms of emotional regulation, right? No one's worried about regulating people's happiness. Now let's talk about a time when you were bullied, sad, left out, when you felt lonely, when you felt, like, neglected. Now we're cooking. So they spend a lot of time inducing rumination in kids, this bad pathological th- practice of rehearsing your past pain. And there's something worse too. When you go into a school and you get kids to talk about their pain, not only are they gonna naturally try to one-up each other with pain. Not only are they gonna m- likely to misremember, uh, things, uh, uh, past events as worse than they actually were, but who was in charge of keeping them safe? Naturally, it leads to the conclusion that Mom or Dad failed me in some way. So you're also... This is the reason you're seeing kids leave these programs more alienated from their parents.

    5. CW

      That's interesting. So that's one of the f- one of the first things that I think, um, seems to be an obvious difference between an adult doing therapy and a child doing therapy.

    6. AS

      Yes.

    7. CW

      If you have a relationship... It seems to me that reminding a child that their parent is there to protect them and to keep them safe while they're still in their care, that seems like a smart idea. Obviously, you don't want to pull the wool over their eyes. There are abusive, uh, you know, whatever it's called-

    8. AS

      Of course.

    9. CW

      ... the action, action things where you need-

    10. AS

      Mm-hmm.

    11. CW

      ... to actually get the child out of the home and put them-

    12. AS

      Right, of course.

    13. CW

      ... with grandparents or whatever. Um, but certainly, as an adult, you can talk about what happened in childhood, uh, with distance because you no longer need to believe that this, you know, benevolent house leader person, i- i- they're not stealing control of your life. So certainly while you're a child, degradating, uh, uh, degrading the, um, quality of trust from child to parent I think is super dangerous-

    14. AS

      Absolutely.

    15. CW

      ... because you're asking a young person who is gonna be struggling to rationalize this. Self-regulation isn't really going to be there in, uh, as good of a quality. And, like, the one place that they want to be able to feel safe is at home with mom and dad, mom or dad. And if you... I, I think that that's a, that's certainly a big difference between dealing with children and dealing with adults. If you're 25 and have moved out of the house and are no longer reliant on that and had a complex relationship with your parents, you can... You give yourself not only, uh, like temporally, geographically, emotionally, you give yourself distance. You can look at that, and you don't need to still be at the mercy of that relationship. But if you are a child and that relationship between yourself and your parents gets degraded or, um, you start to lose faith i- faith in them and stuff like that, I can see how that would cause them to be more fearful and just be like, "Well, I, I, I, I... No one... I can't trust any adults anymore at all."

    16. AS

      That's right.

    17. CW

      Uh, that would increase fear.

    18. AS

      Because if you think convincing a child who has okay parents, not even great parents, okay parents, just good enough parents, that their parents are no help to them and might have let them get hurt. If you get them to mistrust their parents on the idea that the school counselor is going to be there for them, you're setting them up for a lot of pain. Why? Because the child may have a problem over the summer or during spring break, or a million other times that the school counselor is not there for them. It's, it's so... It's such a lie that the, that school systems are there to save kids from neglectful, slightly neglectful parents. Now, in an extreme circumstance of abuse, of course you need to go in there and get the child out, but that's not what we're talking about, right? We're talking about this dumping of therapy on every child. But I'll say something else that occurred to me, Chris, when you were talking about, you know, how good therapy can be for an adult. Look, it also really depends on th- the adult because a lot of young adults, there's no question, therapy is participating in their alienation. Young adults, the h- the oldest members of Gen Z, are alienated at parents and cutting them off in higher numbers than they've ever, we've ever seen before. And they're doing it for reasons, not because they were physically or sexually abused or anything dramatic or severe, but usually, like, "I fel- I wasn't emotionally supported by my mother." It's things that, gosh, you know, if you raised children of your own, you might think that you could excuse because it's really hard to raise kids actually. It's pretty hard, and it's really hard when you have a job and you've got, you know, things you've got, so many worries of your own to constantly be there for every single ch- thing your child may or may not need in the future. It's hard. It's a hard job. And therapy, therapists have been participating in convincing, uh, young adults to cut off their parents in higher numbers. There's something else too, Chris. You know, you talked about how wonderful therapy was for you, and I, and I just... And I, and I can tell you, I found it very, very useful at different times in my life. But here's the thing, it also is because of you. So I have a feeling you're the sort of guy who could get a lot out of talking to a bus driver for an hour too, right? Or talking to, uh, uh, your grandfather or anybody else. You'd probably get a lot out of that. So the question is, do therapists as a profession, are they doing more help than harm? Well, with kids, I think they're doing more harm than good.

  12. 1:01:281:05:57

    Overuse of the Word ‘Trauma’

    1. CW

      What about the use of the term trauma? We see this banded around on the internet a lot.

    2. AS

      It's- it's maybe the worst thing to happen to this generation, is the overuse of the word trauma. Uh, there's a wonderful new study out by this woman, Cathy Wydom, who does these brilliant prospective studies. I believe she's British, but I don't know. And she does these brilliant-

    3. CW

      Brilliant, yeah.

    4. AS

      ... yeah, uh, prospective studies, which are the most rigorous kind, and she looked at kids who had documented instances of abuse as children, and then she waited and followed them, and then checked in again 10, 15 years with researchers, who were blinded as to which group they fell into. Were they k- the kids who actually experienced a trauma- traumatic event or a potentially traumatic event, or those who didn't. And what she found was the most important factor in whether they had adult psychopathology, adult mental health problems, was whether they thought the childhood incident, was whether they made that part of their narrative. For the adults who didn't think it was significant, even when they went through something tr- potentially traumatic as children, they had great mental health as adults. And the ones who had built it into their narrative, even events that weren't doc- m- may not have occurred, those people were suffering in adulthood. So it turns out the way we describe our lives is really, really important to whether we thrive or not.

    5. CW

      Would good trauma-informed care not try to unpack that and then teach you that you are a person that's outside of that, to transcend whatever it was? Is- is trauma-informed care not about casting that off from you?

    6. AS

      Well, you know, I interviewed a, a wonderful physician in England who deals with, um, uh, ex-convicts or, uh, f- in Plymouth, uh, who, many of whom experienced unspeakable abuse as children, and one of the things he said to me was, "The problem with this so-called trauma-informed care is it presumes, inappropriately, that everyone is helped by talking about their traumatic experience. Some people are able to put it behind them, and you're only re-traumatizing by making them talk about it." So what he does with- with- with a- adults who've been through a lot is sum- he waits and- and takes their lead, and some of them, he acknowledges that they went through something hard and moves on, and then they talk about today and the future. But endlessly rehearsing your- your- your past injury, even when it was an inju- even if it was something significant, you can reintroduce or exacerbate pain.

    7. CW

      It's this- again, it's this interesting blend, right, between perpetuating something, revisiting it, causing yourself to- to- to ruminate and make it worse, and also realizing that there can be certain blockages, emotionally, psychologically, that up until you decide to unpack that and actually see it- see it for what it is, deal with the emotion, right, deal with the anxiety. Why was that there? Why is it that you have this particular pattern? Why do you feel unsafe whenever any- anybody disagrees with you? It's like, "Well, (sighs) I d- I don't know." But up until the point at which you actually start to work that out, I think that people continue to repeat their patterns, and in the same breath, you can also say that dwelling on and reinforcing events from your past as a part of the narrative, there are people that the more that they talk about it, I imagine, the more that that cements itself into their character, and it's this- it's this balance. It's- it's this sort of very nuanced thing, and again, it's- the thread that I'm continuing to see here is that, like, good, capable, dextrous therapy and therapists probably are fantastic helps for the right people. Bad therapists for the wrong person is like a- a fucking curse.

    8. AS

      Right, and here's another problem. Look, nobody's tracking side effects. Nobody's measuring them or following them. No one's seeing improvement, measuring it, testing it, making sure you're improving it. See, the medical profession does that. You see if the rash goes away. You check the X-ray to see if the cancer's getting worse or receding, and then you change your treatment accordingly. That's not happening with therapy. That's a huge problem, and the reason it is is because they did do research, and what they found was even when people were getting worse, they tended to feel purged and better after they left the therapist's office. So even if-

    9. CW

      Wow, that's interesting. So there's an acute sort of relief, like scratching-

    10. AS

      Yes.

    11. CW

      ... the itch type thing-

    12. AS

      That's right.

    13. CW

      ... but potentially could damage it. I wasn't aware of that. Well, I mean, one- one of the things

  13. 1:05:571:14:34

    Is Mindfulness a Better Way?

    1. CW

      y- y- you mentioned before about, um, sort of mindfulness practices and stuff in school, mindfulness seems to be a pretty well, uh, evidence-based solution for regulating emotions, for understanding yourself, for probably, even if nothing else, just giving yourself a little bit of downtime to parasympathetically unwind. I would hope that even bad mindful... I d- I don't know if there is such a thing as bad mindfulness. It's like, "Hey, sit and do your- sit and focus on your breath for- for two minutes, kids. Like, we're gonna do mindfulness minute on Tuesday or whatever." I'm shy of kids using that as an opportunity to punch someone while everyone's eyes are closed. I would like to think that the potential side effects, the bad side effects downstream from mindfulness should be basically zero, and the upside could potentially be quite good.

    2. AS

      Well, I'll tell you why I don't think they're zero. Because kids understand the message, and the message is, "We think you're terribly dysregulated. Your mental health is a mess. We need to constantly talk about, monitor, and work on your mental health, because mental health is a continuum from- from the raving person screaming at- at- at the supermarket to you, who's nervous before a test. You're all on the same spectrum of mental m- health, a mental... and- and mental illness in some sense, and you have to constantly think about it and work on it." That is an unhealthy message for kids. It is, because they're already obsessed with their mental health. Now, if you went back in time, if we took a time machine, right, back, you know, 50 years, 100 years, and introduced mindfulness, maybe it would be really helpful. If you introduced therapy, maybe it would be helpful too. But you're talking about a totally different time. Where is the repression today?I keep hearing about the potential for, you know, repression. There's no repression, there's too little repression. Everything that goes through these kids' hearts and minds, they wanna e- e- express and complain about, and that's a problem. They don't know that some amount of disappointment and distress is normal, healthy, move on.

    3. CW

      How much of this do you lay at the feet of modern parenting styles?

    4. AS

      It's a big part of it. It's a huge part of it. What I would say is the re- the- the reason, to the extent that I sympathize with parents, is I believe that parents have been so undercut by the mental health establishment. They're convinced them that they're not up to the challenge, because they don't understand their child's amygdala. It's a ridiculous assertion. By the way, most of these people don't understand the amygdala either. But the idea that you have to have studied the fight or flight impulse, and the, you know, instincts, and the lizard brain, you have to memorize all these things before you can raise a child is so preposterous. It's so untrue. And by the way, most of their claims are just neuro-trash. It really is a bunch of nonsense.

    5. CW

      How so?

    6. AS

      Well, um, there are a few, there are a few ways that we, that- that- that I would say this. Um... They use, very often what they're doing is relying on things like PET scans, or even fMRI scans of combat veterans, to make claims about children who have experienced ordinary distress, like being teased or picked on. Now, those are totally different neurological events. Now first of all, we don't know very much about what's going on in your brain when you have PTSD. Our ways of understanding the brain are incredibly crude, and we don't know whether the neural structures that may have made you more susceptible to PA- to PSD, were, th- that they made you more vulnerable because you had a s- molar hippocampus. We don't know which way the causality runs, or whether the PTSD cau- you know, the traumatic incident, the IED blowing up your buddy caused a change in your brain. But it's very, it- it- it seems likely that it may be the former. But let's just say we don't know. Nonetheless, we know nothing about what's going on in a kid who's picked on based on that. Why? Because the grinding torment of being teased over and over is just a different kind of neurological event than a sudden shock to the system of seeing your buddy blown up. Your ba- brain can habituate. As hard as it is to be teased in middle school, your brain actually habituates, and y- we are actually built to be resis- resilient to a certain amount of that teasing, as unpleasant as it is. So, the claim that you know what's going on in a kid's brain because you've studied combat vets, and when you've measured the flow of oxygenated blood in their brains, which itself is in- astoundingly crude, i- is just, i- it's really a claim without good backing.

    7. CW

      Talk to me about permissive parenting.

    8. AS

      Sure. So, um, there's these studies going back to the 1960s that say, uh, th- uh, uh, really amazingly sturdy studies 'cause they've been replicated hundreds of times by this woman Diana Baumrind, and she looked into parenting methods. And she found that parents in America basically used three different methods. They were either authoritarian... Now, this is, remember, 1960s now, cold and unloving, but rule-based. So, e- obedience was the highest virtue. Basically it doesn't exist in America today at all, as far as I can tell. Uh, authoritative, which just means parents are in charge, they have rules. But they're f- but they're loving and permissive, which is anything goes, kind of no rules, affirming a kid, being his buddy. Now today, um... A- and they found again and again what they've found, that authoritative, rule-bound, but loving is the best for kids' mental health, success in life, and relationship with their parents. Now permissive I don't think really exists in America today, unfortunately, in a certain sense, even though the outcomes weren't great. And here's what I mean. There was one virtue to permissive parenting. It gave kids genuine independence. Today you have this surveillance parenting, which is so much worse. Parents are acting like therapists with their kids, affirming and recognizing their every emotion, never enforcing rules, never saying no, never punishing, and not giving their kids any genuine independence that they could learn from.

    9. CW

      That's interesting. Yeah, I, one of the, one of the thoughts I had in my mind is whether or not kids being in charge is good or bad. And it seems like what you're saying is kids are given the illusion that they're in charge when it comes to sort of enforcement emotionally, but the important stuff, the agentic, uh, freedom to be able to learn is actually being taken away.

    10. AS

      (laughs) .

    11. CW

      So it's kind of like some of the, some of the bad things and not many of the good things.

    12. AS

      That's right. They're, and al- they're also constantly being conned by, by these, you know, therapeutic infused t- um, parenting methods like, "Well, I'll let you dye your hair purple or green. Won't that be fun?" I mean, in other words, they're given these trivial, relatively trivial choices.

    13. CW

      Mm.

    14. AS

      "I'll let you choose the red shirt or the blue shirt." They're never given... You know, they don't have much control in the world, and they're certainly not having any abilities in the world developed, which comes from independence and a certain amount of trusting them to do hard things and face hard things. But then they're confused with these really trivial choices all the time that are meant to make them feel good and- and sort of, I think, distract them from- from hav- distract them so the parent doesn't have to punish them because- 'cause these parents don't- don't wanna punish.

    15. CW

      Yeah, it's this, again, another delicate balance, like permissive parenting, gentle parenting. Some parents want to be emotionally attuned with their kids. Maybe they're just not that authoritative as people, but there's a big difference between being gentle with your kid and allowing it to do whatever it wants.

    16. AS

      Well, you can be as gentle as you want, but you can't divest yourself of authority. You can't tell the kid you're not in charge. If you wanna do that by being as gentle or thoughtful as you can be, that's fine, as long as you're still in charge, and that's what the research shows. So it doesn't say anything about how much sort of sympathy you, you can have for your kid or what they're going through, but ultimately you don't put a three-year-old in charge. Which, which also means that if a child is having a fit, you don't stop the entire family Thanksgiving celebration to ask the child what's wrong and endlessly let them vent, right? And, and that, that's what we're seeing, and that's why we're seeing such lousy results.

    17. CW

      The

  14. 1:14:341:19:31

    Kids Are Too Over-Medicated

    1. CW

      final horseman of the apocalypse, I guess, which kind of falls in line from your last bit of work, is over-medication.

    2. AS

      Yes. These kids are way over-medicated. I mean, th- the generation's way over-medicated in all kinds of ways that we're seeing. Uh, but, but again, you know, I, I think the worst of it is that, you know, and I want people to know, it's not the same as an adult choosing to take a Xanax. Whatever you think about the anti-anxiety medications, it's totally different when you get in, when the child's trying, or the young teenager's trying to develop emotional musculature, and you get in there and delete their bad feelings and introduce all kinds of side effects, that's, that's a problem, because now you're interfering with their ability to grow up when they could just be dancing. (laughs)

    3. CW

      What, yeah, they could just be dancing.

    4. AS

      Right? (laughs)

    5. CW

      What, what is the, um-

    6. AS

      Right.

    7. CW

      ... have, have you got any stats around the, the percentage, the number of kids that are on some kind of psychiatric medication?

    8. AS

      It's a good question. I don't. It's much harder to track in, in the US because we don't have centralized medical care. But we know it's been going up a lot. We know that Lexapro in the last year was just approved for seven-year-olds. Uh-

    9. CW

      What's Lexapro? Sorry.

    10. AS

      Oh, sorry, it's an antidepressant, it's an SSRI.

    11. CW

      Okay.

    12. AS

      Seven-year-olds, that's a big deal. It's a really strong drug. And we know that, you know, the New York Times ran an article I think two years ago now or a year ago on, you know, the number of young people on 10 different psychotropic drugs. And if you interview any doctor today, any doctor in any specialty, they will tell you they cannot believe how many psychiatric drugs their average young patient is on.

    13. CW

      Why are they prescribing them then?

    14. AS

      Well, very often they aren't. Sometimes they're the OB. They're not the ones prescribing, they're just showing-

    15. CW

      What's an, what's an OB? Sorry.

    16. AS

      Oh, sorry, obstetrician. Uh, gynecologist. So a young, uh, 14-year-old, 15-year-old, 16-year-old girl shows up at her gynecologist's office, and for, you know, a regular exam or whatever it is, and, um, uh, the doctor can see what she's on. Or the 21-year-old, see, they can see what she's on. And the answer is a lot of psychiatric medication. And they look at it aghast, like, "Who put you on all this?" And very an- often the answer is the pediatrician.

    17. CW

      Outside of the, um, nerfing of emotions and the lack of opportunity to learn how to self-regulate, what are the other dangers of kids being on medication? Obviously this is something that you looked at in a slightly different vector previously-

    18. AS

      Mm-hmm.

    19. CW

      ... but with, with these kinds of drugs, these categories, what are the, uh, dangers to developing brains and young people being on them?

    20. AS

      Right, so d- all these different categories of drugs are different obviously, but let, let's take an antidepressant. So not only are, you're interfering, let's just take sex drive. So there's all kinds of problems to deleting a young person's sex drive when they're just developing it. They don't even know what they're missing. And of course there's some indication that's come out recently that it may be permanent. But, but, but here's something else too, uh, that I learned when I was doing an interview totally separate from all this. Um, I interviewed a surgeon, a transgender surgeon, and what she told me was she had worked on p- uh, victims of female genital mutilation, and one of the things she told me was that when you remove, uh, someone's sex drive, it turns out you also interfere with their ability to make intimate relationships. You're interfering... Part of our drive to form close relationships comes from a sex drive. They go together. So these are profound... I mean, I just gave you one example, but that's a profound intervention with a young person who doesn't yet have very many intimate relationships or romantic relationships. They might not know what they're missing. And then there's the whole, "Can I handle my life?" question. An adult who chooses to go on an antidepressant at least knows that they've gone through some hard things and that they probably can. But a teenager who starts on an antidepressant may never know if they can handle life, and that's the worst thing of all in a sense.

    21. CW

      You have this sort of buttress, psychological support structure, pharmacological support structure that means people never actually realize the robustness of their, like, their own capacity.

    22. AS

      Yes. Yes. If you know that you can do things in the world, if you've grown up, if you have overcome a certain amount of distress and handled it, if you have been rejected (laughs) and failed to make the team and li- and moved on, and you're an adult now, you've held it, and now you wanna choose whatever it is, you're in such a better position to do it, whether it's psychotherapy or, or medication. But if you're a child who doesn't yet know those things, you may never get to know them, 'cause you may never believe you can.

    23. CW

      The bottom

  15. 1:19:311:23:35

    A Better Way Forward

    1. CW

      line is that young people's mental health is not good, and something presumably needs to happen to do that. So what is a good route forward to improve young people's mental health in your opinion?

    2. AS

      Subtraction of all the bad stuff, so less obsession about their mental health, less focus on wellness, less focus on feelings, more exercise, more getting out into the world, more human connection, less time spent on tech, more connections with extended family, with people who genuinely love them and care if they show up, more involvement in a project bigger than themselves.... and contributing to the community, what, in whatever way they can. All that stuff, exercise, all that stuff is so, so good for you. That's what they need to be doing.

    3. CW

      Have you thought about how to operationalize this or how you would implement it? Is this something that needs to happen at a governmental level? Is this something that needs to be implemented hardcore in education and for schools to follow? Is this something that's the responsibility of parents? Like, who does, who does this fall on when it comes to-

    4. AS

      I-

    5. CW

      ... implementing this?

    6. AS

      I think it, I think it cu- falls on parents, mostly. They're the ones I trust the most to make a helpful change. The problem is, is they're the only ones totally devoted to how their children turn out. Everyone else has a self-interest in getting involved, everyone. So do I think the government's gonna sweep in with a brilliant intervention? I, I, I have a little bit of skepticism there. (laughs)

    7. CW

      Yeah, Jonathan Haidt's new book's got some interesting stuff in it. I think he wants to basically kind of put a, like an age limit on, uh, access to social media or on access to phones. There's this suggestion of cartelling, uh, families together so that you speak to the parents of your child's friends and you say, "If we all stand firm, the only reason..." It's like a tragedy of the commons thing-

    8. AS

      Right.

    9. CW

      ... that if-

    10. AS

      Yeah.

    11. CW

      If, if the way that everyone's communicating is by using phones, if none of our kids are exposed to them before the age... I think he wants, it's maybe 12 or 14 for phones, and then 16 for social media, something like that. But then he wants other, some other bits and pieces.

    12. AS

      I mean, that's all good stuff and I hope it's successful. Um, do I think that, you know... I, I, I think it's ghastly that the mental health industry hasn't put something like a black box warning on social media or come out with that kind of, uh, uh, claim or, or recommendation, I should say. But do I think it's a collective action problem? Not exactly. See, from my understanding of a collection active problem is, uh, nobody can move until everybody decides to move together. Well, I'm not sure that that's the social media problem, right? Why? Because if you get six families in a class of 60 to stop with social media, they will see an immediate improvement. And you know what? They'll have someone else to talk to in the class and their grades will be better, and they'll be generally happier kids. And then other parents will have the strength to do the same. So I'm not sure the answer is legislation. I think it's really just parents stepping up.

Episode duration: 1:24:02

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