Therapy as a Cultural Cop Out

Voted Best Academic Addiction Blogger 2012 by All Treatment

We all know what to do if a child -- or an adult -- is depressed, particularly if they seem suicidal. Send them to a psychiatrist. Given our modern miracle treatments for depression and other mental illnesses, along with addiction, their freefall will quickly be reversed.

Not.

Some revisionists -- including Marcia Angell, former co-editor of the New England Journal of Medicine -- believe the relationship between mental illness and therapy is the reverse. For these critics, the current rapid rise in both the prevalence of mental illness and the popularity of psychiatric therapies, particularly drugs, is due to the failure of the latter to address the former, and their tendency instead to encourage it.

Thus the results of a study in JAMA Psychiatry based on interviews with more than 6,000 teens and at least one of their parents might cause us to raise our eyebrows. Although the cultural meme is that, when a kid encounters problems, psychiatry will readily rescue them, a majority of the kids in the study who either contemplated or attempted suicide had undergone some form of mental health treatment previously. They then either remained, or became, suicidal.

The best interpretation of these data is that therapy -- as it is currently administered and experienced -- is a cultural excuse for not addressing family, social, and life problems that we as individuals, family members, and a society face but cannot deal with. We refer those who fall by the wayside out to the mental health system, and proceed straight ahead. But our confidence that those children and others will be saved -- or that they will even be better off -- as a result of our having shunted them off this way is misplaced.

Psychiatry won't save them; it can't save us. And any sound examination of the situation will tell us that.

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