Through our data repository, we found that the current quality of mental health care varies widely. An average of two-thirds (66%) of people who begin a 12-week course of outpatient behavioral health services do not reach remission for anxiety or depression. Roughly four out of five patients do not experience any clinically meaningful response to therapy, regardless of their remission status.
America Has Reached Peak Therapy. Why Is Our Mental Health Getting Worse?
Even as more people flock to therapy, U.S. mental health is getting worse by multiple metrics. Suicide rates have risen by about 30% since 2000. Almost a third of U.S. adults now report symptoms of either depression or anxiety, roughly three times as many as in 2019, and about one in 25 adults has a serious mental illness like bipolar disorder or schizophrenia. As of late 2022, just 31% of U.S. adults considered their mental health “excellent,” down from 43% two decades earlier.
Cognitive Behavioral Therapy for the Marginalized
CBT, a popular form of psychotherapy, often centers on addressing and changing negative patterns of thinking and behavior in individuals. Its strength lies in focusing on factors within an individual’s control, thus empowering them to change their reactions to external events. However, the authors suggest that such a focus might be detrimental when applied to those facing structural discrimination. By focusing too intently on the individual’s response to oppressive experiences, CBT may overlook the more significant systemic issues at play, unintentionally placing the onus of change on the oppressed rather than addressing the oppressive systems themselves.
Can Individual Focus of CBT Harm Those Facing Systemic Discrimination?
Mindfulness
Climate Anxiety
Great article on heat and how it affects mental health:
People often turn to cognitive behavioral therapy, medications or other strategies to cope with difficult emotions. But “when it comes to the climate crisis, those interventions fall apart, because the threat is real,” not just a matter of perception, she said.
Thoughts on Mental Illness and Teen Girls
Mental illness is rising, but teen girls have taken the worst of it. My take is different than most people’s:
Mixed messages about their worth as human beings. Innate worth or no is the soul’s inner ear. You have to navigate the world with it one way or the other, you can’t navigate it by switching back and forth. Modern psychology seems to think a human’s innate worth is axiomatic when it is, in fact, aspirational. Humans having worth was a Judeo-Christian ideal rooted in God’s commandments and was always something one strived towards as a part of sanctification. It was never a given and one could opt entirely out of this.
Modern psychology took the innate worth ideal and made it a centerpiece of their philosophy not realizing that it’s something people had zero incentive to opt in to. The worth of a person with nothing to offer will not be seen unless the person doing the seeing is commanded to do so and obeys the commandment. Outside the Judeo-Christian system, the command still might be there but it’s more toothless because it comes from modern psychology whose rules are optional rather than Judeo-Christian whose rules are commanded. On a more practical level, it means there is a chasm between how people expect to be treated (as if they have innate worth) and how they are treated (as they don’t). The imperative to value people beyond what they offer becomes an unfinanced mandate.
Lack of kindness in the world. A kinder world is worth more than all the therapists in the world. A culture that doesn’t see people as moral agents suffers because it can’t even measure the problem. Modern psychology wants us to believe that humans are basically good and this sets us up for misery when expectations of people’s behavior don’t match reality. Kindness has been conflated with weakness and is discouraged in many circles. The world is more competitive so one must often play dirty to get ahead.
The other issue is the internet amplifies all the existing unkindness. Bullies used to not have access to people once they left the schoolyard but now with Instagram, they have access 24/7. It doesn’t help that a lot of men are checking out of relating to women in a healthy way and finding misogynistic communities like Redpill/Incel.
Mixed messages about being your “authentic self.” It’s like flooring the gas and the brake. There has never been a time when one was expected to conform and be their “authentic self” simultaneously. You can’t have a blank avatar, you must dress it up, but you have to do it in such a way that expresses your individuality while simultaneously appeasing your peers. And navigating ever-shifting norms handed down by an amorphous authority driven mainly by algorithms.
Young people are kept from ascertaining the blowback of being their “authentic selves.” In the past teens would make the calculation to suppress part of themselves to fit in but that doesn’t happen as much anymore. This is because individual expression is the highest good and being closeted is the worst thing a person can be. I think there is some truth to this, but one must make the calculation carefully which many people aren’t encouraged to do by society anymore.
More knowledge. You would think more knowledge would be good, but it’s not. Part of teen girls’ mental illness struggles stem from seeing how women are treated in society, for example, #metoo. Also, being connected online with older generations, they see how tough it is to make it in the world and how hard finding a good relationship is.
Frequent malignant spaces. For all the criticism one could levy against traditional institutions, their spaces (schools, churches, government, etc..), while being easily corruptible, did not have corruption baked in. One can’t say the same about the spaces teen girls frequent. Instagram, Snapchat, and TikTok are all designed to keep you addicted and feed you content to get you hooked regardless of whether it’s healthy. YouTube algorithms will provide men with misogynistic Redpill content if they start watching Jordan Peterson videos. Internet companies are not held to a higher good like traditional institutions; they are accountable to their shareholders. That’s how capitalism works (something the younger generation is turning against).
Grim collective future. Modern society is exceptionally individualistic which is an unnatural state of being in the context of most of history. This means our entire mental health treatment program is focused on the atomized individual and as long as our future improves things will look up. But humans are communal creatures and deep down know the hyper-focus on the individual divorced from the larger group is an aberration. A lot of mental illness comes from experiencing and reflecting on things collectively. The lack of kindness in the world, the lack of people to look up to, the dying planet, the refugee crisis, the war on women’s healthcare, threats from AI and adversary nations, etc.. All these things can’t be swept away with breathing exercises. Even if one is well off individually this collective miasma is still playing out in the background. Mindfulness and focusing on the present and the individual self will not help much because we were meant for community and a hopeful future, and we have neither.
Therapy Speak
Great article on individualism and modern psychology.
Yet it is precisely that rejection of our communal lives that makes therapy culture — at least the version of it on social media and in wellness advertisements — such an imperfect substitute. The idea that we are “authentic” only insofar as we cut ourselves off from one another, that the truest or most fundamental parts of our humanity can be found in our desires and not our obligations, risks cutting us off from one of the most important truths about being human: We are social animals. And while the call to cut off the “toxic” or to pursue the mantra of “live your best life,” or “you are enough” may well serve some of us in individual cases, the normalization of narratives of personal liberation threaten to further weaken our already frayed social bonds. “We are a relational species,” Dr. Cohen noted, adding that we need connection “to really thrive and survive.”
Bipolar Bingo
Too hot for Facebook because it uses the S word (not that S word, the S word that involves the rope).
Psychology is a Science and its Scope is Narrow
What psychology fails to understand is that if you want all the privileges of a being a science you also have to shoulder all the responsibilities of it. That includes the admission that while what you prognosticate is based on science it only applies to the subjects experimented upon. The people experimented on are generally middle to high class, from western developed countries, educated, and mostly white. You can’t make generalizations to the population at large based on these experiments just like I can’t say my research on a COVID vaccine applies to an AIDS vaccine.
Platitudes thrown around in a culture steeped in modern psychology like, “by and large social risks and vulnerability will pay off”, “humans basically want to do right by each other”, “sex is pleasurable physical fitness”, “I am happiest when I express my identity to the fullest extent”, “people want to talk to me” sound nice rolling off the tongue. And all these phrases hold true for the demographic psychologists experiment on but far less for those they don’t. It’s like a vaccine that works far worse on variants.
Additionally practices like setting boundaries backfire for the large proportion of the marginalized who are generally in exploitative or abusive situations. In most of the world one must mute their identity just to survive. You can’t be out and proud in Afghanistan or anywhere Pentecostal Christianity has taken power. Also individualism is a luxury of rich countries. In poor ones you are stationed in webs of interdependence and if you were to go it alone you wouldn’t make it very far.
A Couple Things That Feed Depression in the Modern World
The fact that you have to perform security. Psychologists and people cutting you off will slap the “insecure” label on you. That’s all well and good but what the insecure label really means is you aren’t performing security. Let’s face it, interactions in modern life are very stratified. There is income, appearance, and power asymmetry and this makes interactions (particular for those at the bottom) fraught. Those of us on the bottom, even though we are generally regarded as little more than part of the furniture, are expected to believe the delusion that, in fact, we are in an egalitarian space and use what little charisma we have to make the room appear this way. Naturally, putting on this act is taxing and depressing for those on the bottom.
The fact that lying to yourself produces negative emotion. One thing that undergirds modern psychology is the idea that there is no absolute truth, everything is just malleable and pliable and the highest good is getting the most performance out of the self the same way with better technology they can squeeze more horsepower out of a car’s engine. A large portion of modern psychology is just you playing cognitive tricks in order to get more of what you want out of life. I even read an article that said you should try to think negative thoughts about eating ice cream when you are eating it so you eat it less. There was no mention of what this deception would do to your psyche. Cognitive reframing is another thing. You are taught by therapists to interpret people’s judgements of you as a negative of them instead of you. You can do this for a while but eventually a good friend who cuts you off is going to expose that yeah, people are rejecting you because of you, not some insecurity in them. Cognitive tricks can help in the short term but in the long run deceiving yourself is just going to net you deeper depression.
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