The Mental Health Care Dilemma; Is it Really Bad Therapy?   

Good information comes from the recent books covering the issues around mental health care that concern many families.  Patrick Kennedy’s book, Profiles in Mental Health Courage, written with Stephen Fried, traces the lives and mental health care journeys of 10 people and two families, who took charge of the illnesses.  With today’s fight to take the stigma out of seeking “mental health” treatment, this book is very important. 

Kennedy’s nonprofit fights for insurance companies to cover mental health care and addiction.  Meanwhile, we still don’t have enough beds for mental health and addiction treatment in most states! 

Like many of the books on substance use and abuse, these stories feature multiple difficult episodes, denials and deflections. Ultimately, the individuals in the book got help. Many of those profiled had co-occurring substance use disorders. The book doesn’t ask which came first, the mental illness or substance abuse. We suspect that half the people would not have had mental health difficulties had they not used substances.

The story of Harry, the son of Mark McMurray, Patrick’s cousin on his mother’s side stands out for its tragedy.  A charming and handsome teen, Harry suffered a traumatic brain injury that resulted in mental health issues for the rest of his short life.  Yet, in college, he participated in substance abuse, which led to more damage upon damage. Ultimately he succumbed to his mental illness and took his own life.

The stories beg one to recognize that avoiding drugs and alcohol would hold the mental illnesses in check.  It seems that the message could be so simple, but it’s not getting out.

A Journalist’s Critique of Child Therapy

Abigail Shrier’s book Bad Therapy critiques current trends in child rearing from the parents’ and the therapeutic viewpoints. Parents concerned about too much labeling and the “over-therapeutic” approach of today should read it. One wonders if schools are focusing on the right things while the test scores have not recovered from pre-pandemic levels. Some of Shrier’s points merit discussion, but in other cases she doesn’t have the right background for making informed commentary.

Shrier researched her book from a journalist’s viewpoint, but not with the approach a scientist may have given to the subject. A former Wall Street Journal reporter, mother of twin boys and a daughter, Shrier attended Columbia and Yale Law School.  Anecdotes of her parenting and her observations of other parents are spread throughout the book. 

What she gets right:

Surveys:  Chapter 7 reviews the widespread use of surveys in school, mandated by state agencies and authored by the CDC. These surveys ask very young children about sexual behavior and thoughts of self-harm.  While those of us in Drug Prevention also rely on surveys, the depth and subjects of these should alarm parents. The questions are inappropriate and suggestive. While parents may opt out of these surveys, parents should first request seeing the surveys. Even better, the surveys probably should be scrapped.

The pathologizing of normal variations in children, expanding the definitions and diagnosis of neurodivergence

The overmedicating of children, for ADHD drugs, anti-depressants and anxiety meds.  We have long questioned whether or not the use ADD drugs contributes to the addition epidemic.  Even if it does not, the cultural dependence of the use of these drugs is way out of control. And therapists fail to determine if trauma is behind ADD.

SEL: A large part of today’s school time is taken up with social and emotional learning while kids fall behind in reading and math. SEL, as it’s called today replaces character education.  Shrier describes a lot of bad outcomes from SEL. Social and emotional education belongs in the home environment. When and why did schools decide it belongs to them and not to the familiy?

Emphasize on feelings: There is a time and place to express feelings, but the book revealed many situations in which it was totally inappropriate. Most of what happens in life does not give you time to access feelings. The techniques and discussions put in classrooms are the same ones used in adult group therapy sessions and AA meetings.  And some times the prying into feelings of students forces thoughts on personal situations inappropriate to the school setting, and for people so young. 

What she gets wrong:

Her criticism of DARE, using only one study. DARE is no longer widely used in schools, but it if really failed as she claims, does she realize that taking drug education out of schools may have something to do with the addiction crisis over the last 20 years?   While we never agreed with DARE’s concept that self-esteem is something that can be taught, removing DARE and not replacing it with another drug prevention program was a mistake. 

Since the time of her study, DARE has been revised considerably.  Parents routinely tell us that DARE and other anti-drug education (Just Say No, MADD) worked for them!

Her dismissal of CPTSD or Complex PTSD, is wrong. She also critiques the concept of ACE Scores. From her perch of someone raised without trauma, she is ill equipped to make a statement. That the American Psychiatric Association discarded the idea of putting CPTSD in the DSM Manual, does not mean it’s non existent. Much new information has come out since the DSM-V.   Shrier simply doesn’t have the background that would familiarize her with CPTSD.  

Despite the fact that she gets CPTSD wrong, it is worth questioning the value of placing an adult diagnosis on childhood. The treatments and therapies for CPTSD were created for adults.  

What about gentle parenting?

Her critique of today’s parents is not too different from other critics of today’s parents, such as Bill Maher’s call to bring back “Trad Dads.”  He means traditional dads who will say “No means no,” requiring no more explanation than “Because I said so.” Although very irreverent, it’s worth listening to Bill’s take on “Gentle Parenting: https://www.yahoo.com/entertainment/bill-maher-wants-trad-dads-133000130.html Bill Maher is wrong about marijuana, but he has a point here.

Shrier is right that unguided play, without adult interference and letting kids work out their own conflicts is best.  She’s right that aggressive advocacy for one’s own child to get the optimal situation in class a is not creating independent adults. She’s right that earlier generations interfered less.  

But how can it change when so many families only have one or two children?

How can it change when grandparents and cousins are no longer a large part of their lives?

How does it change when social media and cell phones are such are large part of their lives?

Children need boundaries and Shrier does not think they’re getting the right boundaries in today’s soft, touch-feely world.  To thrive as an adult, a child should have both successes and failures and a mixture of good and bad.  

Cooperation between parents and schools?

Shrier doesn’t discuss it. There used to be strong understanding and respect between parents and teachers, in which each party respected their unique roles and supported each other.  More and more schools are assuming the parents are inept and believe it’s the school’s duty to impose their values. This trend is not in the children’s best interests. In short, some of her points merit discussion, while in other cases she is simply doesn’t have the background to make informed comments.

Re-Regulated for Complex PTSD

Shrier wrongly dismisses complex PTSD — which we know is a problem.  For this reason, Re-Regulated, by Anna Runkle, fills a huge gap.  Adults who experienced CPTSD  suffer for years and have triggering episodes. Many do not respond well to therapy and or anti-depressants.  Sometimes they’re wrongly labeled as ADHD, or as having other mental health disorders.  

Runkle says her book can “Set Your Life Free from Childhood PTSD and the Trauma-Driven Behaviors That Keep You Stuck. 

Runkle suffered numerous traumas, as a child and an adult.  From what is ascertained, she did not resort to heavy substance abuse.

(Harm reductionists tell us that substance abuse results from trauma. On the contrary, much substance abuse arises social pressures.  At the same time, many people with complex developmental trauma – high ACE scores – never touch drugs or alcohol.)

People manifest complex PTSD in different ways.  Runkel, who has a gives online courses and the Crappy Childhood Fairy, has great recommendations.    

So is it really “Bad Therapy” that we’ve been stuck with in our system?  Let’s hope that an improvement in our mental health care system comes in the future.  Nurture is probably a stronger determinant than nature, so you can’t claim that because a relative had bipolar or was depressed, you will inherit the problem.  But first let the experts become more keen on separating what comes from nature, what comes from nurture, what comes from complex trauma and what comes from social pressure and culture. 

A Final Word for Parents

If your child is experiencing severe mental illness, prepare to be in for the long haul.  Americans want simple solutions to complex mental health issues, but they can’t have them.  Thoroughly research the issues and don’t assume all the experts know it.  Don’t believe that a magic pill or one treatment center will work. 

The best defense against severe mental illness would be to keep your keep your child drug free!  Read our recent review of a book about cannabis and suicide.

Finally the psychiatrists and therapists need to get a better grasp at what is biologically driven mental illness, as opposed to those forms that developed mainly because of substance use, or because of extreme trauma.  Unfortunately the label of PTSD is too often applied euphemistically, and not in real causes of trauma.