Having loved her bestseller Irreversible Damage, and having watched a couple of author interviews regarding her new book, I was very keen to dive into Bad Therapy… The topics that Shrier writes about in this book will be unnerving and confronting for many parents. She pushes back against the increased usage of therapists/experts, medications, and psychology for the normal issues faced by children. Her arguments are against medicalisation and against pathologizing children. She argues in favour of parents exercising judgement, enforcing boundaries, and taking active ownership of their role:“An embarrassing number of psychological interventions have little proven efficacy. They have nonetheless been applied with great élan to children and adolescents.”Two definitions are required to comprehend the thesis of her book. Shrier defines bad therapy as anything “that introduces new symptoms, or makes existing symptoms worse”… Additionally, iatrogenesis occurs when patients suffer adverse outcomes or harmful complications because of their doctor/healer/therapist. For example, a nervous or sad child is drawn into a hasty and inaccurate diagnosis. The child is encouraged to ruminate on emotions, which are interpreted as symptoms by the adults around them (some of whom have conflicts of interest). Then the child is labelled with a mental health condition, such as anxiety or depression, medicalised, and suffers adverse side effects.Here are some examples of iatrogenic effects:“Police officers who responded to a plane crash and then underwent debriefing sessions exhibited more disaster-related hyperarousal symptoms eighteen months later than those who did not receive the treatment. Burn victims exhibited more anxiety after therapy than those left untreated. Breast cancer patients have left peer support groups feeling worse about their condition than those who opted out. And counseling sessions for normal bereavement often make it harder, not easier, for mourners to recover from loss.”“Actually, it’s worse than that: it’s in therapists’ interest to treat the least sick for the longest period of time. Ask any therapist what it’s like to treat a bipolar or schizophrenic patient. Answer: extraordinarily difficult. (Many refuse to treat such patients for this reason.) But sit with a teenager once a week who has social anxiety? The family pays on time, the teen’s problems are small, nobody’s getting violent during your session. It’s little wonder why, having acquired such a patient, a therapist may be reluctant to surrender her.”Shrier ponders the paradox of an exponential rise of mental illness, during several decades of massive expansion of therapeutic treatment:“More widely available treatment ought to abate the rate (and severity) of disease… And yet as treatments for anxiety and depression have become more sophisticated and more readily available, adolescent anxiety and depression have ballooned.”Her observations on empathy are nuanced and insightful:“The most selfless acts a mammal commits she does on behalf of her children. The most violent, in their defense. Where empathy rules human interactions, we see a remarkable nurturing of insiders alongside cruelty and indifference to interlopers.”Her concluding chapter includes this summary of the book’s thesis:“Stop allowing interlopers to insert themselves between you and your kids. Adolescents who are suffering with anxiety and depression are obviously not being helped by the current and pervasive mental health treatments. Healthy adolescence can be mercurial and maddening; we know this because we lived it. Today, normal teens are being made ill by the unnecessary treatments our mental health experts dispense indiscriminately. Perhaps most insidiously, the experts insist on habituating our kids into a never-ending confrontation with the one question no therapist can resist: And how did that make you feel? When looped in a young mind, it’s a question that increases dysregulation, inhibits growth, turns teens into toddlers and young adults into the never-quite-ready.”I was strongly persuaded by Shrier’s overall thesis, and found her range of evidence/argument to be compelling. It has given pause for thought in the conversations/interactions with my own children (less rumination on feelings, more action). After reading the book I’m less likely to take them down a path with therapists/medication.Shrier’s book offers persuasive takedowns of Social Emotional Learning in schools, trauma-informed care, and Gentle Parenting. I found Bad Therapy to be highly persuasive and insightful, while being slightly less compelling and not quite as well written as Irreversible Damage. I would certainly recommend this book to all parents, teachers and school administrators, as well as people who strive to provide value-adding services for children.Check out these excellent videos at YouTube:- How Bad Therapy Can Harm a Generation (Mark Manson podcast with Abigail Shrier)- Debating Therapy Culture & Gen Z - Abigail Shrier, on Chris Williamson’s Modern Wisdom podcastComment from @OUpsychChick: “I have been fully immersed in this therapeutic nightmare with my two very hyperactive boys. One boy was kicked out of a preschool, and I was told to get him play therapy. We tried it, and we also tried a few of the therapeutic like parents coaching intensives. Some of these ideas work, some don't, and most make parenting feel exhausting. We stopped all this. Removed every screen in our home that was accessible to them, told them to go outside, setup rules and boundaries we enforce for proper behavior at, for example, the dinner table. Sometimes, they are still energetic and crazy, but our lives are all much less stressful. The meltdowns are now infrequent, they can sit quietly at the dinner table to eat. They play with toys. After reading Abigail's book, I had my older boy (the one who was kicked out of pre-school) order from the meat counter and check out. We are planning to have him get some groceries this summer when we have a planned vacation. Expectations, no screens, and time outdoors playing mostly unsupervised in our yard has been a God send for our sanity.”Comment from @wumbomaster1395: “I’m a social worker who works with children and adolescents and the most common thing that I see that is causing issues is fatherlessness. 90%+ of the kids that I see (if I were to guess) don’t have a father, or their father is abusive. They are labeled with oppositional defiant disorder and/or ADHD when in reality, they are not given the care, patience, attention, etc. that they need from a father. ODD is a dumb diagnosis, in my opinion, because it labels the kid as ‘bad kid’ when the truth is that they are a stressed/scared/attention-starved kid. I’ve never met a kid labeled with ODD that had a solid parental foundation.”According to Merriam-Webster dictionary, iatrogenesis is the “the unintentional causation of an unfavorable health condition (such as disease, injury, infection, or an adverse drug reaction) during the process of providing medical care (such as surgery, drug treatment, hospitalization, or diagnostic testing)”.