The Trouble with Therapy

If you are a long time reader of my blog and my Substack, you will find the thoughts of Nikolas Serning to be strangely familiar. 

Writing in Aeon, Serning explains how therapy has failed and how he now rejects any theory suggesting that the past determines the present.

Wordsworth notwithstanding, the child is not father to the man.

Serning offers an extended critique. For now I will share some of his observations and conclusions. He explains that he no longer believes that awareness is therapeutic and that we can solve all of our problems by solving our childhood traumas. Moreover, he suggests that we should stop obsessing about feelings and emotions.

He writes:

Along the way, over years of practise, I lost faith that awareness was always curative, that resolving childhood trauma would liberate us all, that truly feeling the feelings would allow them to dissipate, in a complex feedback loop of theory and practice.

Rather than imagine that your upbringing determines how you will turn out, Serning presents a counter-argument. He quotes those theorists who have paid attention to studies of twins separated at birth. The studies show that genetic predisposition has far more influence than family life. 

It means that the effect of your family environment – whether you are raised by caring or distant parents, whether in a low-income or high-income family – matters very little when it comes to your personality. If you’ve ever had any training in therapy, this goes against everything you have been taught.

Moreover, he suggests, recent studies have shown that childhood traumas do not determine what you will become. What really happens is that when we suffer as adults we reinterpret our childhoods and emphasize everything bad that happened.

In the few longitudinal studies that have been made, where we track children and their adverse childhood experiences (ACEs) from early years to adulthood, there is no link between ACEs and subsequent adult mental ill health. There is only a link between adult mental ill health and the ‘recollection’ of ACEs. This may seem wildly counterintuitive to a profession steeped in trauma theory. ACEs have not been shown to cause mental ill health; it is rather that, when we suffer as adults, we interpret our childhoods as having been bad. I’m convinced that there are rare exceptions to this, of truly horrendous childhood experiences that do leave a mark, but even that certainty falters when I consider the fact that events that supposedly traumatise one person in a group fail to traumatise the others.

As has occasionally been noted, the nation is awash in therapy. Everyone considers it to be a cure for whatever ails our troubled minds. And yet, the population is still suffering. And we wonder how much more suffering there would be if people were not also taking medication:

If we were all doing brilliantly now, and if all the therapies that we pay so much money for worked as well as they claim to, maybe we could feel more confident in dismissing all of that. But they’re not, and surveys of happiness indicate that many Western women – therapists’ main customer demographic – aren’t doing brilliantly either.

Among the problems that infect the field is the emphasis on feeling. I have often about the matter, but here is Serning’s take:

Feelings are seen as central, when in fact they are vague and transient approximations of a situation. The whole point of parenting a child is to scaffold and develop their executive functions so that they develop adult emotional and intellectual capabilities. This means teaching them that how they feel is not necessarily how things are, and that they may be held hostage by emotions if they don’t learn to move on from them. A child’s anger should not automatically be honoured, and their resulting difficult behaviour should most certainly not be rewarded with special accommodations.

In terms I have floated through my own posts, the trick is not to feel your feelings but to learn how to follow the rules and to function as a member of a group.

And, how well does therapy work? Serning explains:

We like to see ourselves as critical thinkers, but the critical thought never seems to mention that some 10 per cent of clients get worse after starting therapy – in these cases, therapy might be not merely unhelpful but actively harmful. If you’re told that you must listen to your momentary and subjective feelings of annoyance and hurt, and view them as your truth, minor interpersonal discomforts are much harder to let go of gracefully. If you’re then told that your troubles with relationships stem from your parents’ failure to be fully present and meet your needs in childhood, the risk is that you will become more critical of your relationship with them at a time when perhaps you need that solid family bond the most. More than a quarter of Americans have cut off a family member; it is statistically improbable that most of these estrangements are for the sort of egregious abuse we might imagine merits it.

I have recently explained my own reasons for rejecting the latest the latest therapy fad-- cutting off your family. 

No other culture that I know of believes that bad events create indelible stains on our minds, stains that forever taint our experience of the world. Bad things have happened throughout time, and they were (and are) bad enough without adding to them by insisting that some ‘trauma is held in the body’ in inescapable ways. Telling people that they have been harmed forever by others in their lives creates resentment and harms relationships. If you peddle these kinds of stories, or simply believe them, consider reading up on the shaky science on which they are founded. And while therapy talks the talk about cultural competence and learning from other ways of thinking, it rarely walks the walk. We can learn from non-Western cultures’ takes on suffering, where we stay in the now, suffer in the now, and heal in the now.

You might want to take a look at Ethan Watters’ book, Crazy Like Us, to evaluate how other cultures address emotional distress.

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