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One Nation Under TherapyReview - One Nation Under Therapy
How the Helping Culture is Eroding Self-Reliance
by Christina Hoff Sommers and Sally Satel
St. Martin's Press, 2005
Review by John D. Mullen, Ph.D.
Aug 3rd 2005 (Volume 9, Issue 31)

The short version of this book is that the American nation-state is under the sway of therapism and that therapism is having important deleterious effects upon the U. S., particularly by eroding the self-reliance of its citizens.  The authors' description of therapism is:  "...[therapism] ... valorizes openness, emotional self-absorption and the sharing of feelings ... that vulnerability, rather than strength, characterizes the American psyche; and that a diffident, anguished, and emotionally apprehensive public requires a vast array of therapists, grief counselors, workshoppers, healers, and traumatologists to lead it through the trials of everyday life (5)."   In fact this definition is a good deal narrower than their actual working concept of therapism.  Under the category of therapism the authors oppose the ideas that:  an important goal of life is to reach one's own highest level of emotional fulfillment, self-esteem is the foundation of such fulfillment, human problems and suffering are foreign to a happy life and like medical diseases should be treated clinically, the venting of feelings is effective at relieving emotional problems and repressing such feelings is self-defeating, trauma victims are naturally prone to serious long-term after-effects; hurt feelings are a very serious problem and thus are to be prevented whenever possible, the correctness of moral values is relative to cultures and/or individuals, antisocial behavior (for example child sexual abuse) is pathological rather than morally reprehensible and thus as subject to therapy.   

The book's authors, a philosopher and a psychiatrist, are scholars at the politically conservative American Enterprise Institute, which has supported some excellent public intellectuals.  Ben Wattenberg and Norman Ornstein come to mind.  And there are things to like about the book, particularly its treatment of venting therapy and its applications to grief and trauma.  Mainly though, the book is superficial, politically slanted and in places contradictory.  It makes almost no attempt to show that the silly abuses it chronicles have adversely affected America's citizenry and indeed it provides evidence to the contrary.

First the good stuff.  The denouement of the film "Good Will Hunting" has the therapist Robin Williams holding the sobbing boy-genius Matt Damon as the latter lets out the repressed feelings of his battered childhood.  Could anyone resist the idea that the hero has overcome an important barrier to his emotional health?  Our authors could, and provide some good reasons for their seeming cold heartedness.  The chapter "Emotional Correctness" tells a story that deserves to be more widely known.  It contains a summary of good research suggesting that "venting" is not always good for one's mental well-being and is sometimes harmful.  Of course the idea that repression can be more than temporarily useful is pretty familiar but the existence of empirical research supporting the idea is not widely known.  California students who focused upon their emotional states suffered more anxiety and depression from the effects of an earthquake than those who adopted a coping style of distraction (120).  Israeli heart attack victims who repressed their feelings enjoyed better emotional lives than their expressive counterparts both immediately after the attack and seven months later (121).  Montreal heart patients of the repressor variety who received monthly phone calls inquiring of their emotional state were more likely to be prescribed tranquilizers and visit emergency rooms than repressors who received no such calls (121).  Depressed people who are encouraged to "ruminate" are more likely than their depressed counterparts to interpret their experiences in terms of negative memories.  So emotional ignorance, willed or otherwise, may after all be bliss.  To the extent that therapism contains the idea that the venting of feelings is always the treatment of choice (perhaps itself a straw man), the authors have scored a point or two.  And they do a good job questioning the motives and effectiveness of the grief trauma industry, its practitioners' lack of credentials, and the procedure of critical incident debriefing.  There is material in these sections for a good, tightly-written small book.  But the authors have other opponents to take on, some already pulverized by previous assailants.

In discussing the origins of therapism the authors focus in on "the sixties", a favorite bete noir of American conservatives.  Robert Bork mined this territory in Slouching Towards Gomorrah: Modern Liberalism and American Decline as did Roger Kimball in The Long March: How the Cultural Revolution of the 1960s Changed AmericaAnd of course Bill Bennett has made a career of sixties bashing.  I must say that I have little respect for this genre of political promotion resting as it does on no mention of the incredibly brave black children who faced down police dogs in the south, northern college students who filled busses to head south in voter registration projects, the million or so draftees who sloshed the jungles of Vietnam because they were told that America needed them there, and the hundreds of thousands of baby boomers who marched against an unnecessary war that was killing their generation. 

In our authors' case the original villains turn out to be Abraham Maslow's promotion of self-esteem and peak experiences and Carl Rogers' therapeutic ideas of total patient acceptance and schools as centers for personal growth.  These gave rise to individual experimentation (sex, drugs, ...), the eminently bashable Esalen Institute, and Timothy Leary's experimentation with the therapeutic value of LSD.  The authors conclude the chapter with the claim that the human potential movement, " ... lives on in the form of therapism" and promise to show in the next what's wrong with that movement's request that we be, "tolerant and 'nice'" (76). 

Because of the bad notions of Maslow and Rogers, victims of therapism have swallowed the ideas that it is a rather simple matter to bruise another's feelings, and to do so is to create something close to calamity.  Our authors believe on the other hand that people are far more resilient and that, in any case, sadness and hurt should be accepted as a part of everyday life so people should just suck it up.  This could be an interesting corrective to contemporary ideas, the classically tragic ideal of the Greeks versus the perfectionist Christian morality of suffering.  The authors could give a nod to Nietzsche and apply it to contemporary culture.  But rather than this, they give us a superficial list of innocuous stupidities and rely upon common understandings to appreciate their foolishness.

Yes, there are schools that have placed dodgeball in a "Hall of Shame" for its aggressiveness; and the NEA has recommended a version of tag in which no one is ever "out" so that no one will feel excluded; and there are ill-trained grief counselors who want nothing more than to hug perfect strangers whose loved ones are newly dead from airplane disasters; there are fire and police departments that foist therapists upon their brave men and women who have seen their compatriots killed; and yes, the school systems of Dallas and Phoenix adopted a post-September 11 text called "9/11 as History" that emphasized the exploration of feelings over lessons about the greatness of America; and perhaps worst of all, Gwyneth Patrow really did describe a minor illness following her Academy Award as, " ... post-traumatic stress from the adrenaline shock my system suffered (174)."  I wonder how the authors missed the foolishness of the parents at Daniels Farm Elementary School in Trumbull, Connecticut who rose up united against the use of red ink for grading children's work on the grounds that red is too stressful a color?  None of these anecdotes is very noteworthy except for those of us who receive hints of sweet pleasure at reading about the inanities of others. 

On a deeper plane however the philosopher-author at least has let us down and not just by remaining so doggedly on the surface of things.  Philosophy began in the West with Socrates' requirement that the power of reason be directed first in the service of truth, including the whole truth, and that this epistemic demand must never be set aside for politics or any other reason.  The philosopher Sommers fails this test.  She objects to these practices because they rest upon an exaggerated assumption of human vulnerability, that children and adults need to be protected from practices that common sense tells us wouldn't harm a fly.  Where on our philosopher's list is Dr. James Dobson's campaign against SpongeBob as a threat to our children's sexual identity?  And where is the Reverend Joseph Chambers' objection that Bert and Ernie of Sesame Street live together and have effeminate characteristics to boot?  Where is the same Reverend's charge that Barney is a tool of Satan?  Where is the moral majority's Jerry Falwell's attack on the Teletubby named Tinky Winky for carrying a red pocket book?  And where is an account of the Republican members of the House Committee that oversees the Corporation for Public Broadcasting who objected to a potentially new Sesame Street character with HIV?   If the authors really believe it silly to think that danger lurks in dodgeball, why are they silent on the indefensible idea that gay marriage is a threat to the very existence of the American family, that the battle against gay marriage is, in the words of Dobson, " ... our D-Day, our Gettysburg, our Stalingrad."  Granted it's foolish of the overly sensitive crowd ("liberals", I suppose we are to think) to try to stamp out hurt feelings but why do our authors give right wing stupidity about bogus threats to America's citizenry a pass?  To be clear, no one should object to reason's use in service of an agenda.  Socrates surely had his.  The point here is to avoid sophistry in Plato's sense of putting greater value on the agenda than on the truth of the matter.

Two more examples.  Sommers and Satel relate a story of a federal official who was approached sixteen months before 9/11 by Mohammed Atta seeking a loan to purchase a crop duster.  When confronted with the paperwork Atta became abusive and threatening while the civil servant expressed only her sympathies.  He demanded she sell him her own aerial photograph of Washington's monuments and even asked how she would feel if someone destroyed them.  Still she was calm.  The authors' point? " ... her desire to understand Atta and attend to his inner needs rendered her incapable of recognizing a wolf even when he was wearing wolf's clothing (78)."  Could the authors be insinuating that had it not been for therapism the towers might still be standing?  Would it be unfair to insinuate back that had it not been for rightwingism our authors might have caught the irony of highlighting this woman's missed long-shot while ignoring George Bush's paralysis just one month before 9/11 when his daily briefing titled "Bin Ladin determined to strike in U. S." mentioned attacking Washington, D. C. and hijacking aircraft?

The second example:  The authors object to the idea that addiction should be conceptualized as a disease.  In their arguments they actually veer in the direction of speaking ill of a Republican.  But look what happens then.

President George W. Bush's drug czar, John Walters, has stated that "drug addiction is a disease of the brain" (though in private Walters seems reluctant to use the vocabulary of disease and is vigilant about detracting from personal responsibility) (100)

As women who accept that life is suffering, Sommers and Satel like their men silent and strong.  No Jerry Seinfelds for them.  Imagine then their horror at Tom Cruise's version of the paraplegic Vietnam vet Ron Kovic in "Born on the Fourth of July".  I can't dislodge the image of the two of them reciting in unison that all Kovic needed was a good slap in the face from George C. Scott.  Our authors don't like the young men from Vietnam who made it home but wouldn't shut up.  One only has to be reminded of the Vietnam soldiers in July 4th parades, long-haired, disheveled and not quite marching, without wondering about the horrors they endured.   And don't we owe these warriors a special form of respect for having fought so well in such an ill-formed, unnecessary and brutal war?  In this context our authors exhibit something, perhaps it is courage, though therapism-ists will call it insensitivity, in taking on the Vietnam era phenomenon of Post Traumatic Stress Syndrome (PTSD).

They do not deny its existence.  Who after all could claim that calamitous experiences don't sometimes lead to flashbacks, insomnia, depression and the like?  What interests them, I think, is how to explain all the hoopla about post-Vietnam PTSD.  After all, so many others have experienced similar calamities with silent equanimity.  They list: only a handful of children in London during the Battle of Britain experienced traumatic shock (141); Ugandans under the monster Idi Amin met disaster with hopefulness and accepted it as a challenge; only three of three-thousand Kosovo refugees in the U. S. needed psychiatric treatment and each of these had prior histories of mental illness; Bosnian refugees used mental health clinics largely for networking in preparation for their new lives (165); Rwandan eyewitnesses to massacres reported positive attitudes about their futures on researchers' questionnaires; Cambodia teen refugees functioned well despite symptoms of PTSD; the social functioning of Ugandan women who were repeatedly raped did not correlate with scores on tests of psychological symptomatology (166); a Russian woman who survived WW II stated, "I did have nightmares ... But what is this post-dramatic (sic) stress?" (167)  The point is that many do not experience PTSD and many of those who do don't let it get them down.

Sommers and Satel have no unified theory as to why there was so much fuss about post-Vietnam PTSD.  Perhaps it was too widely diagnosed, and too many vets lied in order to get full disabilities (they point out that only a small percentage of Vietnam era soldiers were in combat units), and veterans' magazines educated troops as to how to claim the condition, and in any case there were not as many cases as claimed by anti-war psychologists like Robert Jay Lifton.  But the real villain in the authors' minds is therapism for suggesting both that PTSD was nearly unavoidable and that its symptoms were necessarily crippling.  Therapism rendered the upper lips of our Vietnam warriors' flabby, or so our authors think.  Even vets who had PTSD should have been able to take it and move on in the manner of our stoic, "post-dramatic" lady from Russia.

I noted above that there is an inconsistency at the base of the authors' treatment of therapism.  Put simply, they oppose explaining away human sins and foibles by attributing them to concocted syndromes and proceed to concoct the syndrome of therapism as a way of explaining away a whole set of behaviors and beliefs.  Let's take a look. 

The Boston Archdiocese has been devastated by the enormity of its priests' child sexual abuse, particularly during the tenure of Bernard Cardinal Law.  Law was the darling of Roman Catholic conservatives and the Pope's point man in cleaning up what had become an overly liberal American episcopate.  But Law also averted his glance while hundreds of young boys were molested and raped by Roman Catholic priests.  He knew it was happening, he knew how it could be stopped, and he allowed it to go on.  This should be a perfect example of performing evils actions for which one accepts responsibility, a perfect example of what should not be excused by a concocted syndrome.  Why did he do it?  To shield the reputation of the Church -- misplaced loyalty?  To shield his own reputation -- false pride?  To further the likelihood of becoming the first American Pope - ambition?  We don't know of course and neither do our authors.  Yet they are convinced that he was led to a series of decisions that resulted in multiple rapes of Catholic boys by the evil syndrome of therapism.  They note approvingly that Law had come to admit "tragic mistakes", that he had come to see that he had damaged the Church (the Church?).  What was this mistake?  Therapism led him to think of the priest-monsters as ill rather than evil, to think of their behaviors as symptom rather than sin.  "When sin becomes syndrome, ethically inexcusable behavior is granted absolution ... (84)."  But of course, and without a hint of irony, the authors have employed therapism to transubstantiate Law's sin into syndrome, one that led him inexorably to his "tragic mistakes".

Finally, I have noted that the authors fail to show that therapism has had any serious social effects.  The idea that Catholic children were molested and raped because of therapism is ludicrous.  There is no showing that the exaggerations and metaphorical extensions surrounding PTSD have resulted in serious social ills.  There is no evidence that the grief counseling movement has killed, maimed or driven anyone insane. To the contrary, Sommers and Satel provide us with good reasons to think that mistakes engendered by therapism are without consequence.  The chapter on the September 11 tragedy focuses upon the irrelevance of therapism-ists' preparations for psychological disaster.  There were some who wrongly predicted post-9/11 PTSD in fire fighters.  It was a mistake to predict a resurfacing of PTSD from 9/11 among Vietnam vets.  The Oklahoma bombings did not produce widespread PTSD.  Let's assume that these wrong predictions are the result of therapism.  What's the problem?  Doesn't this show that therapism is a syndrome without consequence (except of course that it excuses Cardinal Law)?  And where is the "eroding [of] self-reliance" that the book's subtitle promises will be uncovered?  Do the authors believe that the men and women fighting now in Iraq are weak in self-reliance?  The book's index contains "Gwyneth Paltrow" but there is no sign of "self-reliance".

What bothers me most about this book is that it's a literary version of the thankfully defunct TV show "Crossfire".  In television of that stripe, representatives of the so-called "left and right" come to the table with no concerns other than to convert one more person to their side.  They shout, talk over, tell half stories, distort the table's other side and create bogus straw men.  Their intent is sophistry, the practice of " ... making the weaker case appear stronger."


© 2005 John D. Mullen


John D. Mullen is professor of Philosophy at Dowling College in Oakdale, New York.  He has written a widely read text, Kierkegaard's Philosophy: Self-deception and cowardice in the present age, Hard Thinking: A Reintroduction of logic to everyday life, and co-authored with Byron M. Roth, Decision Making: Its logic and practice.


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