An Honest Book Review of Bad Therapy: Why the Kids Aren't Growing Up by Abigail Shrier

The only book I finished this week was Bad Therapy by Abigail Shrier, which is good because I have a lot of thoughts. This controversial book follows Shrier’s previous controversial book, Irreversible Damage, which was about the rise in young trans men. This review will be much longer, but I hope to bring the nuance that this book needs in order to critique it in a good faith way.

Note: Adding this after I finished writing this. It’s long, but I think it’s important. I dive into some statistics at the end. It shows how people like Shrier may be seeing the past through rose-colored lenses.

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Bad Therapy: Why the Kids Aren't Growing Up by Abigail Shrier

The overall argument in this book is that we’re pathologizing children too much and saying they have mental health issues rather than just letting them have a normal childhood. Abigail tells a quick story at the beginning of the book about how she took her son to the ER or an urgent care for stomach pain, which turned out to be dehydration. But before they left, the nurse asked the son some mental health questions (like have you thought about harming yourself).

I have a lot to say about this book because not only am I a father, but I’m the son of an alcoholic mom. I had an extremely traumatic childhood, and I became a drug addict and alcoholic myself. My addiction almost killed me when my son was 3, but fortunately, I was able to get sober in 2012 and have been sober ever since.

Shrier most likely wouldn’t say anything about my mental health issues, my addiction or my ACEs score. In fact (and this is important) she starts the book with a quick disclaimer explaining that she understands some children have severe mental health issues that require therapy and/or medication. She says this book is not about them.

I’m going to say quite a few positive things about this book, so don’t worry. But I do want to start out by saying I think that she put this “disclaimer” at the start of the book to give her an easy out when confronted about real-world scenarios where a child clearly needs help.

I’ll start with what I think was good about the book. Later, I may critique some of these “good” things because they’re also bad.

First off, I agree that I think that we’re overdiagnosing our children in many scenarios. Later in the book, Abigail Shrier references Randolph Nesse who wrote the incredible book Good Reasons for Bad Feelings. Not only are emotions part of the human experience but so are certain mental health issues like depression and anxiety. Another great book on this topic is Saving Normal by Allen Frances. I was actually fortunate enough to interview both Nesse and Francis on my old podcast.

ADHD and other mental illnesses are very real, but sometimes we throw potentially addictive medications at a child who is simply acting out because they’re being neglected at home or just being a child.

Abigail also brings more nuance than I was expecting to the conversation about Adverse Childhood Experience scores (ACEs). The ACEs questionnaire is very vague, and while many kids will meet some criteria for it, they are nowhere close to the same risk as severely traumatized children. For example, one question asks if a parent ever hit, beat, kicked, or physically hurt you. Two children may answer “yes”, but a child who is spanked technically meets that criteria but is not in the same boat as a child who is legitimately beaten by an alcoholic parent.

The last good thing about this book is she calls out that quack Bessel van der Kolk who is world famous for his book on trauma, The Body Keeps the Score. I’m not even a clinician, but I knew the book was filled with a ton of bad science. That book is a joke to any therapist who understands the science of trauma and how many times the book has been debunked, so I’m glad Shrier called it out.

That’s about where my compliments end. What pains me about books like this is there’s so much good information mixed with the bad. The average reader won’t know how to separate the two.

The first thing that’s apparent about this book is that Shrier cherry-picks the absolute worst of the worst to make her point. She quotes interviews or tells anecdotes about parents and schools who let their kids do whatever they want. 

The second thing that’s apparent to anyone who comes from the lower class (like me) is that Shrier tries to convince the reader that it’s a widespread problem. It’s not. This is clearly isolated to wealthy and upper-middle-class families. I’d estimate the top 10% at most.

At one point, she talks about how public schools have psychologists on staff along with teams of therapists, social workers, and counselors. If I had a drink, I’d spit it out laughing. I live in Las Vegas. My son goes to a public school in a middle-class area. I asked my son how many mental health professionals they have at school, and he said none. He said the most they have is the suicide text line printed on the back of their school IDs.

I have a good friend who is a high school teacher in a low-income part of town. These are the kids that don’t have much hope for the future. These are the kids who can barely afford school supplies. These are the kids taking care of their younger siblings because their parents are working multiple jobs. These are the kids dealing with violence and addiction in their homes and can barely do their school work because of everything else happening in their lives.

My friend would kill to have mental health professionals at her public school, but they’re non-existent. Yet Shrier would have the reader believe that talking about your feelings all day in class is the norm around the country.

What drives me nuts about these books is they contradict themselves and want things both ways. 

For example, Shrier references Jonathan Haidt and discusses how our kids have more mental health issues like depression than ever before due to smartphones. Meanwhile, the entire book is about how most kids don’t have these issues. Well, which one is it?

During her discussion of all the mental health professionals in these schools, she talks about how kids aren’t punished the right way. They’re just given in-school suspensions and a talk with an in-school counselor. She tells the stories of the violence in some of these schools and how some kid bashed another kid’s head into a locker and almost took out the kid’s eye.

Let me ask you an honest question. Would you honestly tell me that you think a kid who is that violent is mentally healthy?! Of course not.

The thing that really rubs me the wrong way about this book is that Shrier completely neglects the reality that there are bad parents out there. Many people don’t like it when I say it, but I blame the parents for everything. If your kid sucks, that’s on you. Yet Shrier expects parents to take care of all of the mental health needs of the children and not the schools. Clearly, that hasn’t been working too well.

She also completely neglects how overcrowded schools are and how parents expect the schools to do everything. Not only do most parents expect schools to do everything, but each individual parent wants the school to have their specific parenting style.

The other thing that Shrier completely neglects is the reality of mental health statistics in the United States. This book is all about the non-existent mental health issues of Gen Z and Gen Alpha. The entire book is a finger-wagging, “Back in my day, I’d get spanked and told to walk it off.” Shrier is 7 years older than me, so she’s Gen X and is talking about millennial parents. 

Well, I have some bad news: Gen X and millennials aren’t doing so hot.

In their phenomenal book Deaths of Despair, Angus Deaton and Anne Case explain why we have an epidemic of people dying from suicide, drug overdoses, and alcohol-related causes. According to the most recent CDC data, the primary ages for suicide are 25-44. After that is ages 65 and older.

If you’re wondering the primary age groups for overdose deaths, Shrier swings and misses on that one as well. The most recent data shows the highest rate of overdoses is for people between the ages of 35-44, next is 45-54 (Shrier’s age range), and then 25-34. 

And you’re trying to tell me that previous parents did it the right way by never focusing on mental health? It’s laughable to even consider that.

Not only are these people dying from suicide and addiction, but these are the parents Shrier thinks will do just fine handling the mental health of their children rather than schools.

Shrier paints this rosy picture of how great she and her generation were parented, and it’s laughable. Now that I’m getting toward the end of this review, I dislike the book even more because it’s just such a slap in the face of the reality of what’s going on in our country.

Yes, maybe in Abigail Shrier’s wealthy world of privilege these kids are doing fine and are being given too much mental health care. Maybe those kids don’t need those resources, so how about you send some to the areas that actually need it. 

But again, Shrier wrote this book as though the anecdotes in this book are the norm when it’s far from it. What really annoys me about this book is right-wing, lower-income people are going to read this book and completely agree with her that “liberals are soft”. Meanwhile, their children are dying around them from heroin and fentanyl overdoses or tweaking all over town on meth. All while thinking, “Yep. These kids don’t need no help.”

I’m done with my review. This book is annoying and potentially harmful and dangerous. There’s some good in this book, but it’s garbage for about 70-90% of the country.

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