What teens need to be happy, healthy and successful
On a professional level I've become increasingly more and more aware of how and where the mental health industry has developed some issues. One of our problems is that we just don't have enough people within the industry asking the tough and important questions about how we practice therapy. The major elephant in the room is that perhaps therapy is neither helpful nor effective for most people who seek it. I've heard many people talk about this and have had many people share how they had to go through multiple therapists before finding one that was actually helpful. We just aren't getting the results or the outcomes for people that they are seeking and wanting. There just aren't enough therapists out there raising these important questions.
As a seasoned professional, I find myself becoming more and more acutely aware of these issues. The unfortunate conclusion is that no, therapy isn't that helpful nor is it that effective and I say that as a general reference. I believe that in some cases, therapy is both effective and helpful but it's usually because of the therapist approaches therapy and they have become relatively rare and quite unconventional. If you ask me, there are conventional ways to approach mental health and then there are unconventional ways of doing it and the conventional ways just aren't effective. In reality, they are almost always a waste of time and money. I'm finding a greater need and urgency to push the limits of those conventional boxes in regards to what therapy is and how it's practiced. If you seek a typical therapist you're going to get typical results.
Therapists causing harm
In 2022 I learned from my professional organization, the Utah Mental Health Counselors Association (UMHCA) that mental health professionals received more professional complaints than any other profession in the state of Utah. This knocked me back just a bit. I knew we had problems but I never imagined that we could be worse than family lawyers which was truly disheartening for me. The public complaints against therapist had gotten so bad that the governor appointed a special committee to investigate the entire industry and figure out why they were doing more harm, potentially, than any other profession. When I heard about this, I decided to become more involved with the organization and quickly became disenchanted. They censored me when I became more vocal about this issue. I believe that we need to be open, honest and transparent about the problems and the risks that come with seeing a therapist and they were not friendly to the idea and I quickly distanced myself from them. More and more I find the mental health industry going down roads that I'm not able to follow.
I recently went down a rabbit hole and took on the audio version of a book by Abigail Shrier called Bad Therapy: Why the Kids Aren't Growing Up. Abigail is a journalist and an author and in her book Bad Therapy, she asserts that bad therapy practices have become mainstream and normal but the core of her argument is that therapy has become harmful to children and teenagers. I'm nearly halfway through the book and I have to say, honestly, I am quite disheartened. Her criticism of therapy for kids is damning, to say the least. I have to take the book in small chunks because of how discouraged and disheartened I feel when I listen to it. I have to admit that the issues that she raises are correct and I agree with about 90% of what she has to say, at least as far as I've gotten into it.
Therapists are harming kids, no doubt about it. Her list of grievances is a long one from reinforcing mental health issues to unnecessarily retaining kids longer than needed to keep their income stream alive, Shrier's complaints are extensive. Despite feeling disheartened and sad about the whole thing, it has also strengthened my resolve to provide a good therapy service to anyone and everyone that comes through my office, child, adult and everything in between. The book is tough to listen to though it's a badly needed gut check and I'm becoming more and more certain of one thing. Conventional therapy is bad therapy and in order to be a good therapist, one must move away from what the conventional standards which is something that I'm determined to do, especially in regards to the therapy that I provide for kids.
Harmful practices
Shrier outlines many harmful practices in her book but I wanted to outline some of the ones that I agree with and the ones that I find to be the most damning and the most concerning.
Reinforcing an identity of mental illness - Teenagers go through a crucial stage in their development as they seek an identity and as they seek to discover and define themselves. As a professional and as a human who is on his own journey of personal growth and happiness, I've found the need for a strong identity and sense of self to be of the most paramount importance. Knowing yourself and forming your identity is profoundly important for long term happiness and contentment in life. It's rare to find mental health practitioners who even bring this up or value this through the therapeutic process and I know that it's usually because of how many of them are so entirely lost in this regard themselves. It's a house that most of them have never built. They don't have a grasp on this concept and they don't have any idea on how to help a lost teenager find their way through this challenge of identity. They're just as lost on it as the kids they are treating. The part that I find really troubling is that modern teenagers are finding identity in their mental health problems and their disorders. They are latching onto things like trauma, anxiety and ADHD, for example, as their personal identity. They're latching onto dysfunction and making it the core of their identity. Schools have gotten into the bad habit of trying to unnecessarily diagnose kids with mental health disorders when those kids are experiencing the normal bumps on the road of growth and development. Parents have brought their kids to me because the school deemed that the kid was having problems that are easily chalked up to the challenges that come with puberty and the following years. It's bumpy and messy. It always has been and we need not pathologize these normal experiences of growth and change. I've found myself sitting with young teenagers and working to show them that what they are going through is normal and that there isn't anything wrong with them. I wish I could send out a memo to schools and teachers and insist that they stop pathologizing growth and development. One teacher complaint was that a child was often looking at the clock before school was over for the day and the teacher was concerned for that kid. Sorry what? What kid doesn't watch the clock? What kid isn't looking forward to being cut loose from this boring regiment and spending their time with friends or playing video games? Parents are reporting to me that peer groups are grabbing onto things like anxiety disorders and ADHD as a way to relate to a peer group and belong to the point that it's almost become a competition. The one with the most problems, the most diagnoses and on the most medication is the winner and they're building their identity on it. What's worse is that therapists are reinforcing this issue. Starting in their early teens, kids are getting it through their heads that they are broken, defective and dependent on other people and medications to hold them together and it's mentally crippling them. And sadly... therapist aren't helping. They're making it worse. Depression or anxiety aren't issues that kids are working to overcome, it's become who they are. Therapists need to paint this problems in a light that affirms that they can overcome these problems and thrive beyond them but they aren't doing that.
Feeding the problem - Shrier specifically cites the issues of ruminating on problems instead of helping kids find ways to manage them or overcome them. Therapists are turning kids into helpless victims. We don't serve kids by teaching them that they aren't capable and that the problems in their lives are insurmountable. The issue is that therapists are so focused on the problems instead of the solutions and they obsessively help the kids ruminate on them. It's like walking down the road, coming across a hill of dirt in the way and reaching for the closest shovel and piling more dirt onto it. Therapists are feeding the problem. Anxiety and depression are the types of things that can easily get worse just by becoming focused on how encompassing they are. We can easily bury kids deeper into anxiety and into depression just by talking about how anxious and depressed they are. Conventional therapists aren't teaching usable or effective tools and skills that help them with it. Most therapists buy into the nonsense that anxiety and depression are just part of who you are and that they are just built into you because you were born defective and that your best hope is to take pills and sit around and talk about how depressed and anxious you are. A common myth about trauma is that you "work through it" by ruminating on it and talking about it over and over again when research has shown that this doesn't help provide positive outcomes. In fact, the opposite is true, it makes things worse. Trauma has to be worked through, no doubt about it but the method is of crucial importance. A therapist must insist that this is not what defines the person and most of them aren't doing anything close to that. They honestly don't know better because they aren't taught better. I practice differently because I have insisted on finding what actually works and what is actually helpful rather than repeatedly forcing broken and unhelpful approaches and methods. Research indicates that ruminating or staying mentally stuck on a problem only makes those problems worse. Their functioning decreases as well as their overall wellbeing. The more we overthink a problem, the more it seems as though we can't overcome it and unfortunately, this has become the ballad of conventional mental health treatment.
Internal vs External Locust of Control - This can be a heavy one and is a bit of a rabbit hole. We seem to have collectively gathered on the illness express. We are mentally unwell and unfortunately, there's a lot of bad therapy steering this ship over the cliff. Therapists are to commonly reinforcing broken and destructive paradigms around external locust of control versus internal locust of control. There's a big difference here. Those who have an external locust of control have a view of life and the world that focuses on what they don't have control over and they see themselves as powerless to the forces, circumstances and actions of other people. They tend to be pessimistic and unwell. Those with an external locust of control tend to take a victim stance. They see their wellness as something that will only change or improve when the world and the people in it change first. Those who have an internal locust of control are those who see their lives within their ability to change and they focus on what they can change and that is simply themselves. These people tend be happier, healthier and more successful. Early research in psychology proved that this disposition is essential for wellbeing but we've lost our way. A new era of psychology and therapy has replaced even some of the most basic tenets of mental wellness and therapists are reinforcing external locusts of control and reinforcing victim mentalities. They aren't helping people overcome their struggles, they are, instead reinforcing those struggles which makes those issues and problems seem impossible and immovable. Kids are developing an extremely negative and even adversarial attitude toward the world and the people in it. Their lives are full of blame. Kids tell me all of the time about how much they hate the world and the people that are in it. Those external forces are to blame, in their minds about everything bad or difficult in their lives. It's installing a destructive software during some extremely crucial developmental years. I sometimes find myself remembering how resilient humans are how capable we are of overcome any and all of this. I think about how much I struggled when I was young and remembering that I turned out okay and yet in some regards I'm still learning and trying to get it figured out. In some regards, I'm still recovering from the challenges of childhood. Additionally, we humans continue our destructive cycles of abuse, trauma and addiction. Therapists aren't helping either. They aren't teaching resiliency. They are solidifying in kids minds that they are victims of circumstances including being born with personal defects that can only be dealt with. Learning an external locust of control and remaining in that mental capacity can permanently cripple a person mentally. They will become their own prison warder and will remain that way as long as they view themselves as victims to things that they cannot control and this has sadly become the name of the game with conventional therapy.
There are several other issues related to all of this but these are some of the most egregious things. Shrier also takes issue with some a couple other troubling facts like how the mental health industry remained silent about how the actions taken around COVID would have a harmful and detrimental impact to the social development of kids, which it absolutely did. She's also incensed how mental health professionals almost universally accept transgenderism in children and teens and accepting harmful gender affirming care when there isn't a scrap of supporting research or science behind it and sadly, she's absolutely right on both accounts.
Therapists continue to use terms like "transphobia" which isn't even an accurate use of the word 'phobia' and while we would hope and expect mental health professionals to use the word in proper contexts, many of them don't. Therapists are also using terms like "gatekeeping" which is a current term de jour these days to lob at somebody that you don't agree with. Therapists are biased in this regard and I've found it impossible to have open and honest conversations about transgenderism and gender affirming care for kids in mental health circles. They're unable to speak about rationally or reasonably and too many of them are prepared to readily tell parents that it's better to have an alive son than a dead daughter and other outrageous claims that have no scientific backing. Shrier also wrote a book about this entire issue called, Irreversible damage: The transgender craze seducing our daughters. I haven't tried to tackle that one yet, I'm frankly working to emotionally prepare myself because I know how much more damning it's going to be on the mental health industry.
When I talk to people about the issues within the mental health industry, I usually throw two of my own onto the pile of grievances. The mental health industry is dead silent on the issue of male suicide. Men and boys are taking their lives at an alarming rate but the body of mostly female mental health professionals are virtually apathetic about the entire thing. Most of the time when I discuss it with other clinicians, they quickly change the topic. They just don't care about it and we've gotten to the point that we should all be asking the difficult questions about the wisdom or the obvious lack thereof in this profession.
The last thing on my list is the over usage of EMDR. I intend to write an entire article about EMDR and all of the issues with it. EMDR has a much better reputation than it deserves. I have many concerns about it, the biggest being that most EMDR therapists are using it poorly and they are retraumatizing people and causing harm with it and my other concern is that it's used with teenagers. EMDR is hard to grasp, it's extremely abstract and teenagers get nothing from it, nonetheless it doesn't stop therapists from using it with teenagers even when there isn't any improvement from it.
The bottom line to my message is that people should be very discerning about any therapist that they choose to see but they should be particularly picky about who they take their kids to. The evidence is clear. The wrong therapist can make the situation worse. My other piece of advice is to seek a therapist that has the courage to stray from the norm. Conventional practices and approaches to mental health aren't working.
Resiliency based therapy
Most people would agree that our culture and our society just seems to be in this massive nose dive. Our overall quality of life and wellbeing are in a total freefall. It's clear that we can't just mindlessly trust what is placed in front of us or what is assumed to be true. On a collective level, our values have become skewed and more than just a bit warped. The important reason is why? Why is this happening? What's causing it? Our individual and collective system of values needs to be examined and there just frankly aren't enough people examining them.
We've come to a point where we place value in things that are based in weakness or being weak. We want to pass the responsibility onto someone else and want life to come without struggle and it's not realistic, first of all but these attitudes are working against us. If we're going to pull out of this nosedive, we need to change our attitudes to more directly reflect and strength and resilience.
Depending on your perspective, the human story is a story of resiliency or a story of trauma and violence. Teenagers are incredibly resilient as long as we provide them with proper support and tools and in case I haven't made that clear up to this point, a large number of therapists are completely missing the boat on this one. They aren't helping kids to adapt and overcome, they are ensuring that teens remain stuck in their issues. We therapists are in an important position. We can instill wisdom, support them through difficulties and trauma and we can help teach them how to adapt and overcome.
In this regard, I hold my role in their lives to be a bit sacred. What I say to them and how I treat them may have a positive ripple effect in their lives and may help put them on a path of happiness and success and the key, if you ask me, is resiliency.
It's my goal to help teenagers with three basic principles of resiliency:
Self-efficacy - Self-efficacy simply means that an individual sees themselves as capable of producing desired results in their lives through their own actions, choices and efforts. Therapists often undermine self-efficacy by focusing only on things that are completely outside of their control and we are seeing a generation of young people who see themselves and treat themselves as powerless and incapable. If a teen is struggling to make friends, for example, as many of them are these days, we are only making things more difficult for them by reinforcing ideas that this is just how things are and by helping them ruminate on the difficulty of the task. Self-efficacy supports them in learning how to talk to people differently, how to stand up for themselves and how to spot potentially harmful friends. Self-efficacy supports ideas that help them understand that they can make changes that will help get the results that they want.
Self-determination - Self-determination is very similar to self-efficacy and it simply refers to their ability to make their own choices and effectively manage their own life. Self-determination puts more emphasis on developing internal motivation. A self-determined person is one who knows what they want and why they want it independent of other people. Self-determined people are those who learn from their mistakes and failures rather than feeling ashamed and defeated. In this regard, it's absolutely crucial that kids are allowed to make mistakes, fail and fall down and it's just as crucial that we support them in learning, growing and finding their way back to their feet when they fall down. We must help them learn that no matter how many times they fall down, they have to find a way to stand back up. Self-determination is a philosophy that focuses on growth and always finding your way back to your feet.
Self-esteem - The concept of self-esteem has been around for a long time and yet it still surprises me to see how lost many people are on this important life concept. Self-esteem is simply how well a person is able to see and measure their own value and see their own self-worth. Sadly, our culture and our society has deteriorated in this manner. Kids are growing up in a world where they only believe they are lovable as long as they are living up to certain expectations or in some way doing things for other people. Love has become completely conditional and transactional. Sadly, parents fall into this mindset as well and show love and support for their kids when conditions are met and we should be considering whether or not this is love. We must help them develop and build their self-esteem. We must help them see their own self-worth and it really helps when we give them unconditional love so that they see their own value and their own self-worth without falling into the trap of believing that they have to earn it. This can be challenging in a society where love has almost become universally transactional. Most people will only care about them as long as they are doing something transactional and it's critical that they learn to see their own worth and their own value. Another challenge to this is that it's difficult to deliver this to them when we, ourselves, are struggling to see our own self-worth when we're well into adulthood.
As we continue to watch these kids struggle and fail, it's imperative that we take a closer look at what we believe is good for them and whether or not those things are working. It's important to determine the types of results and outcomes that we want for them and how those things are actually accomplished.
As a seasoned professional, I find myself embracing the difficult truth. Conventional therapy is doing a lot of harm to our kids. Conventional therapy is to focused on weaknesses, shortcomings and flaws. If we want our kids to have a better future we need to show them a better way. I don't just see myself as a therapist, I see myself as a teacher. I teach kids how to be more emotionally resilient which, I know from experience, helps them to be happier and healthier as they grow older.