"Therapism" -- Additional Evidence That People Respond to Incentives

"The counselors needed clients far more than clients needed counselors."

Have you ever noticed that after some highly publicised castastrophe, there is an army of people from the "I'm okay, you're not okay" segment of the population who desperately want to go to the site of the catastrophe to help out? Part of their desire to go there may be altruistic, part of it may be ghoulish curiosity, and part of it may be a response to financial incentives. These and other incentives are explored in the book One Nation Under Therapy: How the Helping Culture is Eroding Self-Reliance by Sally Satel & Christina Hoff Sommers.

As with any book, I strongly recommend you read the reviews at Amazon.com for the many different opinions people have about the ideas put forward by Satel and Sommers. But I also strongly recommend the review by Theodore Dalrymple in The New Criterion. Here are some excerpts:

A few days ago I attended a talk by a leading member of the British psychiatric bureaucracy. It was his proud boast that he and his colleagues had persuaded the government that hospitals and health authorities should have to explain why they refused psychiatric assistance to anyone who had asked for it. The idea that some people might actually be harmed by the desired but nevertheless ineffective and unnecessary psychiatric assistance was completely beyond his comprehension. He evidently believed in a neo-Cartesian dictum: I want, therefore I need.

It is not difficult to work out that such an attitude would serve the financial interests and appetite for power of the so-called caring professionals. The psychiatric bureaucrat also cited in his talk a frequently quoted figure about the proportion, 70 percent, of prisoners who had “mental health problems”—among them, of course, unhappiness at being locked up. That slippery phrase “mental health problems” was meant to imply, though it could not prove, that a giant apparatus of care was necessary to cater to the 70 percent. When it comes to therapy, evidently, there can never be enough.

... According to therapism, everyone who has ever witnessed anything unpleasant, or experienced loss or humiliation (which is to say, the great majority of humanity), is at risk of subsequent mental illness unless he expresses his feelings volubly and often, preferably as directed by a mental health worker. As the authors point out, there is no evidence that this is so—quite the contrary. As appetites grow with the feeding, so emotions grow with the expression. In fact, the evidence is very strong that most people are resilient, and that resilience is self-reinforcing. If, however, you persuade people that they are weak and fragile, that is what they will become.

At stake is our whole conception of what it is to be human. The common-law tradition is that everyone is responsible for his actions unless the contrary can be proved. Therapism, which has already subverted law to a considerable extent, believes that wrongdoing is itself a symptom.

... Therapism has caused a decline in the quality of our culture. People are now engaged in a kind of arms race, feeling obliged to express their emotions ever more extravagantly to prove to themselves and other just how much and how deeply they feel. This leads to the peculiar shrillness, shallowness, and lack of subtlety of so much of our culture.

Therapism has also corrupted large numbers of people. The assumption that people are easily and permanently damaged by various traumas has led many of them to act the part for the sake of receiving compensation.

... Particularly disturbing for believers in therapism was the fact that, after 9/11, the population of New York was not so traumatized that it required counseling en masse, though counselors descended on the city en masse, like bluebottles on a corpse. This would have been funny had it not been so macabre. The counselors needed clients far more than clients needed counselors.

[h/t to BenS]