Mental health pandemic

Insane times call for insane measures

This life coach I know tells me what he tells all his clients, even though I’m not one of them. He says therapy is like shaking up a snow globe. All the gunk that’s settled at the bottom gets loose. Fills the globe. It’s messy and unpleasant, but it’s inevitable. This is how you heal. First, you relive your trauma. First, you kick up a fuss. I wonder how he tells the difference between when the coaching is working and when it’s not. If there’s gunk everywhere, then it’s working, right? But, when the gunk is re-settled, then it’s also working? I wonder how the re-settled gunk is any different from before all the shaking up happened. Isn’t it awkwardly convenient that whatever happens can be taken as a sign that the therapy is working?

We have a mental health pandemic on our hands. It plays up in different ways depending on where you are in the world but there’s no doubt it’s pretty widespread. Mental health has gone viral. I don’t mean the thing so many are talking about nowadays; the fact that we’re faced, apparently, with a mental health crisis, with more anxiety, more depression, and the like. I mean that “mental health” itself is a plague on all our houses. The warning signs are everywhere. We have climate anxiety. What the hell is climate anxiety?

Mental health has been destigmatised, and as a result, everyone’s talking incessantly about their inability to cope with the basic fact of being human. Philip Rieff saw this ages ago when he suggested that society has become therapeutic. People tend to see themselves in this era of ours not as subjects of religion, state, or civilisation, or even as subjects of work. We are now subjects of therapy. Psychological selves. Psyop selves.

People aren’t offended or upset anymore; they feel unsafe. People aren’t mean and nasty either; they’re lacking interpersonal effectiveness. We know about concept creep—the way harm-related notions have undergone semantic expansion. Now, almost anything can be traumatising. Everyone’s traumatised. Also, isn’t it odd that therapy-speak is indistinguishable from system-speak? The bureaucracy is your therapist and your therapist is a bureaucrat.

We don’t shop, we take part in retail therapy. We don’t get sad, we become emotionally dysregulated. We don’t tell people to back off, we set boundaries. We gaslight. We suffer cognitive dissonance. We provide trigger warnings. We offer empathy. We are trauma-informed. We validate. We are mindful. Work may be less a place where things get done than a support group for the unhinged, a socio-emotional Petri dish for airing grievances and delicately scapegoating and ruining the lives of people who don’t suffer the same ideological conformity syndrome as we do. Schools and Universities are being turned into mental health facilities. Environments for learning have become training grounds for the therapeutic society.

“Remember,” says this one psychology bot, “while so many widely used concepts have therapeutic origins, they are now part of our everyday language, reflecting a growing awareness of mental health and well-being in our society.” Is that what’s happening here? Mental health seems not so much to be a clinical issue as it is a revolution; a paradigm through which we might view ourselves more incoherently, albeit under the guise of coherence. Are we experiencing a growing awareness of mental health or are we increasingly blinded by all the debris that the therapeutic society has kicked up in our socio-emotional snowglobe? It seems to me that what’s going on is that we’re experiencing a deepening entrenchment in a particular ideological milieu.

Let me be clear here. I don’t want to attack all therapies. I do not deny that psychological interventions are often appropriate, necessary, or even vital. There are two categories in play here (and a third somewhat in the middle): on the one hand, we have people who suffer, often terribly, from mental illness; on the other hand, we have a social construction of the self as the self-of-mental-health. In the sort-of-middle are those going through a dark time and need support while they find their way back to the light. These people, and those who have ongoing mental illness, really do need support and help, and I’m all for that.

But those who see themselves as mental-health-selves, whose identities have become inextricably linked to therapy-speak, need saving from the ideologizing of mental health. For a lot of them, having mental health problems is an identity marker, if not a signal of sophistication. It’s a way to say, “Look, I’m self-aware; I’m in the know. I have climate anxiety.” But it is, in reality, a sign of unhealth. Many of the students I’ve taught who claim to have mental health problems are just stressed out because life can be stressful or sad because life is often sad. Often the line between self-awareness and self-absorption is thin.

Again, in support of the first and middle categories of people above, I am more than a little interested in psychology as a field. I also have a rather large number of very sensible friends who also happen to be therapists. I am not attacking the disciplined study of how people might make sense (logos) of the soul (psyche). I’m all for improving the lot of people by attending properly to mental health. But I’d still like to take a moment to attack the psychologisation of everything. Can we stop squeezing everything through the dialectical meat grinder called mental health? You are a person. You have a mind. You have a psyche. But that doesn’t mean that everything you do is reducible to mental health or some mental health problem.

I’ve already suggested that the spread of therapeutic ideology plays out differently in different places. I know how socio-emotional learning/engineering is applied in some South African schools and it’s pretty sensible, even if it’s not what I’d recommend. I know about social workers and counsellors here who do a solid job and help people. Perhaps there are more guard rails up in South African mental health care than there seem to be in, say, America. I know about the training teachers get. It’s all pretty mild, what I know about here, even though it is all unquestionably tied to a certain American movement that has become pretty unhinged, as seems to be the case from Abigail Schrier’s reporting in her book Bad Therapy (2024). 

The trend is everywhere, though. You open your inbox, and your employer has just sent you an invite to a workplace wellness workshop, a place you can go to air your workplace worries and have your story heard. You look at an ad on a bus stop offering a kinder approach to the legalities of divorce—a softer approach to ripping your family to shreds. Your kid’s school has a counsellor who, for all you know, means well, even while they may inculcate a strong sense in your kid that you, the parent, are their real problem.

What is this mental health pandemic anyway? What does it mean? I’ve just mentioned Schrier’s book and it’s a good one. Jonathan Haidt’s got another book with some thoughts on this issue, especially on the internet and social media. Both Schrier and Haidt are worth reading; their views are worth considering. They have excellent suggestions. But I want to look outside the therapeutic context to suggest at least one other thing worth considering as we look at the mental health pandemic.

I’ve said that the therapeutic society is ideological. I mean that therapy has, in a way, been deified. You can tell if socio-emotional learning is now being pushed in mathematics as if you have to feel okay about algebra and geometry before you can solve the problems you're presented with. Nietzsche famously said, “I am afraid we are not rid of God because we still have faith in grammar.” I’m afraid we are not rid of Nietzsche because we still have faith in therapy. Nietzsche himself seems to have replaced God with psychology. I know therapies vary widely; various psychologists have different approaches to healing. But there are reasons for the stereotypical view of the psychologist as someone who sits you down and asks you, “So how does that make you feel?” The tendency to encourage rumination in so much psychology, and certainly in the therapeutic society, is particularly toxic. What this means is largely, at least commonly, about getting people to fixate on their vulnerabilities and weaknesses.

In narrative theory, we learn that every protagonist has a psychological weakness and vulnerability. This is a private concern or a personal desire. On its own, it makes a character pretty dull. Let’s say, for example, the protagonist is afraid; just plain fearful. To address this psychological weakness, said protagonist seeks out safety. He thinks only about himself. He looks out for number one while the world around him crumbles. End of story. What a stupid story.

What makes a story good—better than that, at least—is when the protagonist’s weakness or desire is understood and narrated in the context of what Aristotle called hamartia, sin, or vice, meaning some severe moral (i.e. not merely psychological) deficit. He has desires tied to his weakness but he has a need that is tied to his moral deficiency. The protagonist may be, and in fact is likely to be, more than aware of his private feelings. But what makes him aware of his core vice is that, when he acts only on his feelings, others around him are negatively affected. He is fearful, say, but he sees—because morality is contextual and relational—that if he lets his fear get a grip, the others in his little drama get hurt, often badly. What makes the protagonist any good, someone we want to root for, is not that he stops being fearful, in this case, or that he finds a way to ‘regulate’ his fear. What makes him good is that he acts courageously despite being fearful. In a story full of monsters, the protagonist doesn’t have to be a badass numb to the trauma; he is someone who submits his emotional state to a virtue.

This is just a hint of a much larger discussion but I bring it up because this snippet of narrative theory exposes something at the root of psychology right at the beginning of its formalisation. Psychology should have been, because it is built into the very order of things, subordinate to morality. But it wasn’t. Freud, and many psychologists after him, tended to suggest that moral laws are not the answer to neurosis but are their cause. Much post-Freudianism has said that we should be free from virtue to be happy. In Freud, the father is a terrible figure because he represents the Superego, our conscience. On the present discussion, one problem that arises from this assumption is that, if you are rid of conscience, if you lean into your emotions, you might very well believe that being immoral is just fine. If you’re okay with being a reprobate, that’s okay! But this is akin to adopting disorder as an organising principle, which I would claim is what an awful lot of psychology has done. We could all, quite honestly, do with a little more repression. Lady Macbeth, for instance, would have been much better off with rather a large dose of repression.

One of the problems with this anti-morality is that it assumes that conscience is just a matter of some arbitrary rule that has been broken. No harm done as long as everyone consents, right? But this is not what virtue is about. Virtue is about maximising our actual powers—the actual capacities—of the soul. Virtue is not divorced from being but speaks precisely to what we are and what we are meant to be. One form of good therapy that leans into this, when applied well, is exposure therapy. It assumes that fear can be overcome. But this therapy is rooted, whether consciously or unconsciously, in a moral imperative: you are not your fear; you are not that one temporary feeling; you can be more than this.

One friend recently remarked that people have made therapists and other medical professionals the new priestly class; that people will even give their confession to said professionals. But instead of offering absolution and giving patients something productive to do about their issues, they offer drugs and affirmations of neuroses. It’s a joke that doctors are drug dealers but there’s something in this therapeutic culture that feels like it fosters a pattern that would almost certainly reinforce addictions. The real cure is to find the virtue to live up to, the capacity for doing actual good in the world. But sub-cures are found that encourage us to go back for more. A ready-made cure is likely a poison.

This is not to say I’ve solved anything, of course, and I worry I have presented too one-sided a view of what I fully recognise is a complex network of problems. But I have implied something I think is becoming increasingly clear to many others, something worth making explicit, something that needs to be sorted out and answered. The therapeutic culture isn’t generally all that sure about what it would mean to be mentally healthy in the midst of the various vicissitudes of life. What is the standard? That is the question. My suggestion: virtue. This, by the way, would be the marker, too, of where therapies are needed, including medications and the like. Virtue has always been the standard, even if many roads lead to it. I feel bad when I don’t live up to the ideal but the feeling doesn’t suggest that the ideal is the problem. Quite the opposite.

We should, at the very least, be paying attention to virtue, given that the psyche is potentially unbounded if no suitable boundaries are offered. That said, one of my therapist friends told me the other day that if he had to mention “sin” as a root problem to most of his clients and “virtue” as the antidote, they’d be out of the door in a second. Out of the door, waiting to be swallowed up by the therapeutic society, waiting for whatever other broken therapy the world has on offer. And they’ll think it’s okay. Therapy means that all kinds of gunk is loosened. Relive the trauma. Kick up a fuss. And even when they’re choking on the gunk, they’ll say, “It’s okay, it’s okay. It’s therapy. It must be working. It’s not that society is sick. We have mental health, don’t we?”