Saturday, March 2, 2019

Marketing Therapy to the Millennial Generation

Let’s be crystal clear. Peggy Drexler’s Wall Street Journal article about millennials in therapy is marketing. It is not science. It does not show that therapy helps. At its best, it shows that a generation of young people—especially Manhattanites—has been raised by therapists. It shows that they have nowhere else to go for help. 

Drexler notes that divorced parents use therapy as a stop-gap to make up for their derelictions. She does not note that many of these therapy patients have been neglected by their parents.

And, of course, Manhattan is not the world.

When Drexler says that therapy has become normalized, thus destigmatized, she is encouraging young people to go to therapy. That these young people, having been brought up by therapy, still need more therapy tells us that therapy has not been very effective. Of course, Drexler suggests that young people should be in therapy forever… because it’s better for business.

She opens with a case:

Kristina, a 27-year-old publicist living in Manhattan, has been in and out of therapy since she was 9, when her parents got divorced. Back then, she says, “I had a pretty pragmatic view of what was happening, and so did my parents—going to therapy was just something you make kids of divorce do.” During her first year of college, Kristina (who requested that only her first name be used) suffered a sexual assault. Again, she says, therapy afterward was a given. “I figured I would use therapy to get through my trauma and then be done,” she says. “I eventually learned that’s not really how it works.” She has had four or five different therapists since then. So have most of her friends.

Therapy is the thing to do. Everyone is doing it. The only purpose of such palaver is to encourage people to go into therapy and to stay in therapy… regardless of the outcomes. At a time when cognitive therapists are overtaking insight-oriented therapists, and where they are emphasizing short-term, outcome-determined treatments, Drexler seems to believe that old fashioned endless useless therapy needs better marketing.

In these cases, therapy is the problem, not the solution. Parents of millennials went into therapy themselves. Then they got married and went to couples counseling. They they had equal careers and neglected their children. They they sent the children to therapists. Thus, they created the kind of addictive dependence that only therapy can soothe.

Raised by parents who openly went to therapy themselves and who sent their children as well, today’s 20- and 30-somethings turn to therapy sooner and with fewer reservations than young people did in previous eras.

Naturally, Drexler believes that therapy does not really need to work. She believes that those who expect good results simply do not understand therapy.

Some young people think “that the therapist is going to provide an answer rather than help them discover the answer within themselves,” says Dr. Cohen, the Manhattan psychologist. Dr. Cohen recalls one recent 20-something client who was unsure about whether to stay in a relationship. “It really felt like she had gone from therapist to therapist looking for one that would tell her what to do,” says Dr. Cohen. “I think the therapist’s natural instinct to listen and not give advice can be challenging and threatening to millennials.”

And note, the goal of this marketing campaign is to entice young people into lifelong therapy… the better to find meaningful help:

Apps and online services such as Talkspace and MyTherapist offer therapy by phone, chat, video and message board, making it more likely that young people will opt for superficial bromides over meaningful long-term help. 

How better to encourage young people to do therapy than this:

Elizabeth Cohen, a clinical psychologist in Manhattan, [said]: “The shame of needing help has been transformed to a pride in getting outside advice.”

Naturally, this leaves us hungry for some real information, not a collection of vapid anecdotes, gussied up in pseudo-science, in a marketing campaign.

We can find some of it by looking at the generation that is following the millennials. These would be college students and adolescents. They are, to coin a phrase, all over therapy. So, we want to know whether these young people seek out therapy because they are now more aware of the fact that they need it or whether they have been rendered dysfunctional by a culture that relies on therapy, not only to cure mental illness, but, more often, as a guide to conducting your life.

Michael Strain reports on a study on the mental health of college students and millennials:

According to a 2017 report from the Center for Collegiate Mental Health at Penn State University, which compiled data from 147 colleges and universities, the number of students seeking mental-health help increased from 2011 to 2016 at five times the rate of new students starting college. A 2018 report from the Blue Cross Blue Shield Association found a 47% increase between 2013 and 2016 in depression diagnoses among 18-to-34 year-olds; the report attributed the rise largely to the fact that far more young adults are seeking help.

Strain addresses the right question. Are students seeking more mental health treatment because they have been enlightened about their need for it? Or are they seeking it because they are having more serious problems:

In a January essay in the Guardian, psychologists Jonathan Haidt and Pamela Paresky report that anxiety and depression are on the rise.

Mental health statistics in the US and UK tell the same awful story: kids born after 1994 – now known as “iGen” or “Gen-Z” – are suffering from much higher rates of anxiety disorders and depression than did the previous generation (millennials), born between 1982 and 1994.

They address the two concerns I mentioned above:

This alarming rise does not just reflect an increase in teenagers’ willingness to talk about mental health; it is showing up in their behaviour too, particularly in the rising rates at which teenage girls are admitted to hospital for deliberately harming themselves, mostly by intentionally cutting themselves. Large studies In the US and UK using data through to 2014 show sharply rising curves in the years after 2009, with increases of more than 60% in both countries. A 2017 Guardian study of more recent NHS data found a 68% rise in hospital admissions for self-harm by English teenage girls, over the previous decade.

Even more tragically, we also see this trend in the rate of teenage suicide, which is rising for both sexes in the US and the UK. The suicide rate is up 34% for teenage boys in the US (in 2016, compared with the average rate from 2006-2010). For girls, it is up an astonishing 82%. In the UK, the corresponding increase for teenage boys through to 2017 is 17%, while the increase for girls is 46%.

Self-harm, cutting, suicide… to say nothing of depression and anxiety. We live in a culture that has overcome traditional ethics, the kind you find in Scripture and in the great philosophers. We have replaced that culture with one that has been concocted by therapists.

How’s all that therapy working out for the younger generations?


Ares Olympus said...

Stuart: She does not note that many of these therapy patients have been neglected by their parents.

That is an interesting question. Neglect can be a form of abuse where you may not know you're doing something wrong. Or what does it mean to be neglected in the era of helicopter parents? In the olden days kids could be neglected because families were large so individual kids had to compete for attention. Maybe neglect now means single children in the exurbs with a phone, computer and video games, and parents expect nothing from them as long as their grades are good?

Having someone to listen to you seems important, better someone who isn't going judge, mock or dismiss you. It just doesn't make clear sense to me that this is a $100-$200/hour skill, with no clear measurable outcomes, even if it's much cheaper than 24/7 prison on a weekly basis. They say best parenting is a skill that ideally makes you eventually obsolete, so certainly therapy should have a similar goal.

Anonymous said...

Can't hit a target you won't (or cannot) define.

Ever hear the profession extensively describe or catalog mental HEALTH?
Not to my knowledge.
Big book of (marketable) diseases, though.

Sam L. said...

Hi. I'm Sam, and I'm "Hooked On Therapy". (Sings)"Please release me, let me go..."

I'm better now. I went to "Brother Al" (a young man who LIVES by the GOSPELLLLL), who laid his HANDS on ME and I was HEALED!!!! /silly

Anonymous said...

Sam -

I know you're being humorous, but then again...

"And the light shineth in darkness; but the darkness comprehended it not."

- shoe

UbuMaccabee said...

Well, that's a lot less competition for me. If I have to go up against chronic dope-smokers, video game escapists, and heavily medicated, crybaby therapy addicts, I'm going to keep my high-paying gig for a couple more decades. After some compulsory behavioral training, I'll make useful slaves of all of them.

Guys like Jim Jones would have a field day in this target-rich environment.

Sam L. said...

Shoe, I try to be humorous, and sometimes I'm just trying people's patience.