Psychiatrization and Concept Creep
The Parricidal Nature of Therapeutic Secularism - Pt. 4
This is the final essay in a four-part series I’ve entitled, The Parricidal Nature of Therapeutic Secularism.
In Part 1 - When Cancel Culture Comes Home, I explain that there is a growing trend amongst Millennials and Gen Zs across social media to “divorce,” “unfollow,” and “block” their parents because of offenses, despite the fact that studies show that, collectively, parents today are not any worse than parents have been, historically. Citing their own mental health needs, narcissistic or immature parents, and emotional neglect, #nocontact has become the new #metoo for many young adults. Finally, I share and engage with a lengthy excerpt by Gen Z blogger, Nia Cherie, as a representative example of the kind of activism I am addressing.
In Part 2 - From Sacred To Secular, I establish one of the major reasons for the proliferation of this egregious phenomenon is the predominance of the modern therapeutic self. In this post, I map out the complex development the modern therapeutic self within the larger cultural shift from a sacred order to a secular one.
In Part 3 - A Significant Shift in the Social Imaginary, I treat the more obscure tributary feeding the predominance of the modern therapeutic self, the subtle historical shift from what Charles Taylor calls the mimetic to the poietic understanding of the self, which burgeoned around the Age of Enlightenment. Now, instead of intuiting our perspective of reality and its meaning from the norms within the culture we inhabit, we create meaning, particularly our own identity, out of our subjective feelings. Thus, the world mere material out of which we are privileged to make our own meaning and shape our own perspective of reality.
I concluded the last post with a quote from Carl Trueman that summarizes modernity’s new condition of therapeutic secularism, an artificial condition in which there is no higher authority than our own emotions. This is the condition in which younger generations inherently understand their identity, and without having any means of seeing reality another way, or having any sense of how it is they came to understand the world the way that they do.
As a way of summarizing all that has been said so far, allow me to recount Trueman’s assessment, once again, as a launching pad for this post. He writes,
The psychologized, expressive individual that is the social norm today is unique, unprecedented, and singularly significant. The emergence of such selves is a matter of central importance in the history of the West as it is both a symptom and a cause of the many social, ethical, and political questions we now face…this new view of the self also reflects and facilitates a distinct move away from a mimetic view of the world as possessing intrinsic meaning to a poietic one, where the onus for meaning lies within the human self as constructive agent.1
With this understanding of the modern condition as our foundation, in this post I want to tackle the notions of psychiatrization and concept creep, which would be improbable—if not largely impossible—in a sacred order, but inevitable in a world where unprecedented, expressive individualism is the social norm.
Bad Therapy and Iatrogenisis
When I asserted that Millennials and Gen Zs have, collectively, brought cancel culture home and are committing symbolic parricide at an unprecedented rate, I was not exaggerating.
A recent national survey concluded that “almost 30 percent of Americans eighteen and older had cut off a family member.”2 Karl Pillemer, author of Fault Lines: Fractured Families and How to Mend Them, asserts that the percentage represents more than sixty-seven million estranged Americans; and, the number is probably a bit higher as he believes many people are reluctant to acknowledge their family estrangement, a phenomenon researchers call, the Halo Effect.
Joshua Coleman, a clinical psychologist and author who specializes in family estrangement, believes this phenomenon is largely a result of the expansion of bad therapy and iatrogenesis. By “bad therapy” he means that when parents confront adult children for cutting them off, the typical explanation given for their decision is “Well, my therapist said you were [insert diagnosis].”
Since therapists are only getting one side of the story and their primary interest is in helping the person sitting in front of them cope with their struggles—not to mention keeping the person in front of them as a paying client patient—they frequently offer advice that creates “treatment dependency” and “emotional hypochondriacs.”3
This result is a form of iatrogenesis, a term for the complications or side affects caused by medical activity (i.e., when the healer inadvertently causes harm). The Oxford English dictionary defines iatrogenesis as a condition “induced unintentionally by a physician through his or her diagnosis, manner, or treatment; of or pertaining to the induction of (mental or bodily) disorders, symptoms, etc., in this way.”4
Summarizing her interview with Coleman on the subject of bad therapy and iatrogenesis, Abigail Shrier states,
Family estrangement is a major iatrogenic risk of therapy not only because it typically produces so much desperate, chronic distraught to the cut-off parents. It also strips the adult child of a major source of stability and support-and for generations after. Estrangement means grandchildren raised without the benefit of loving grandparents who pick them up from school or temper their parents' foul moods. Worse, it leaves those grandkids with the impression that they descend from terrible people. People so twisted and irredeemable, Mom won't let them in the house. Even the homeless guy outside Walgreens gets a wave and a dollar every once and a while (sic). But the people I come from? They must have done something unforgivable. Children learn that all relationships are expendable—even within the parent-child dyad. Mom cut off her own parents. There's just no good reason to believe she wouldn't do the same to me if I did something to upset her, too.5
I personally find it interesting that Scriptural wisdom warns against counseling conflicts in the manner that these therapists are being described as practicing: “The one who states his case first seems right, until the other comes and examines him.” -Proverbs 18:17 And, “If one gives an answer before he hears, it is his folly and shame.” -Proverbs 18:13
The overarching wisdom of the sacred order is that every person tends to proclaim his own goodness and color the situation to his own benefit (Proverbs 20:6), but a wise counselor knows this, is humble, and seeks to discover the whole truth—the other side of the story.
A therapist operating without this wisdom—from a perspective where people are inherently good, society is oppressive, and expressive individualism is the norm—is like a doctor who rushes to surgery without washing his hands properly. The therapist ultimately injures the young adult by infecting his patient’s family with the very toxicity he or she [the therapist] is attempting to rescue the patient from.
Healer, do no harm!
Psychiatrization and Concept Creep
Notwithstanding the iatrogenic risks of therapy as just described, there is also an associated, but less obvious, aspect that contributes to the situation as well, psychiatrization and its cousin, concept creep.
Psychiatrization in its most basic use is “the process of treating or analyzing something psychiatrically; description in psychiatric terms.”6 In other words, it’s an inherent understanding that nearly everyone now needs therapy, the common language describing human behavior is no longer addressed in moral terms, but in therapeutic terms, and the average parent can recite from the DSM [the Diagnostic and Statistical Manual of Mental orders].7
As a phenomenon, scholars in the School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia describe the concept of psychiatrization as
a pattern of correlated societal and cultural changes that have been underway for several decades but now seem especially urgent to address. Beeker et al. s (2021) review of the field points to rising rates of mental illness, increasing mental health service utilization, and evidence of over-diagnosis, over-treatment, and over-prescription (Paris, 2020). Coupled with these changes is an expansion in the number and inclusiveness of psychiatric diagnoses that has led critics to lead campaigns to save normality from the relentless encroachment of diagnosable pathology (Frances, 2013). Beyond changes such as these in the field of mental health, expanded understandings of mental disorder have spread in the culture at large, accompanied by popular adoption of a psychiatric idiom to make sense of everyday experiences of deviance and distress.8
What these medical sociologists are talking about in their jargon-ridden medical journal is the misguided and/or over-application of therapeutic concepts.
In other words, there has been a relentless encroachment of psychological pathologies on human normality. Psychological diagnoses have rapidly expanded to include all kinds of normal human behavioral struggles, such that it’s now normal to adopt psychiatric idioms to make sense of everyday experiences of deviance and distress.
In their book, The Coddling of the American Mind, Greg Lukianoff and Jonathan Haidt have done a fair job of documenting this problem. For one thing, they have adequately demonstrated how concept creep in psychological terms like PTSD has conflated emotional pain with real trauma and expanded the concept of “safety” to include “emotional comfort.”9
Trauma and PTSD have expanded their definitions to include anything that triggers a person’s feelings or causes them unwanted stress. They further document the manner in which this novel “culture of safetyism” is largely “based on a fundamental misunderstanding of human nature and the dynamics of trauma and recovery.”10
In short, they go so far as to argue that “avoiding triggers is a symptom of PTSD, not a treatment for it.” They write,
A culture that allows the concept of “safety” to creep so far that is equates emotional discomfort with physical danger is a culture that encourages people to systematically protect one another from the very experiences embedded in daily life that they need in order to become strong and healthy.11
Note the expressions “embedded in daily life” and “in order to become strong and healthy.” In a society now grounded in therapeutic secularism, psychiatrization is inevitable. Mental health diagnosis have expanded so far as to no longer be rooted in legitimate psychological research, and they regularly include normal human behavior.
By abandoning the sacred order and making meaning subject to our individual emotions, we have cultivated a generation of fearful, dependent, and entitled young adults. They have been deceived to believe they have some kind of moral high ground, when in reality, they have been poisoned by a therapeutic culture who may be trying to help, but are themselves unequipped to help humans flourish.
I’m going to assert something outlandish here (feel free to express your outrage in the comments). Yes, parental sins and failures are unacceptable. They need to be confessed and repented of. And, in some very limited cases setting “no contact” boundaries with parents might be necessary. Nevertheless, no parent is without sin and every parent will fail their children. This is the condition of the fallen world in which we live. From a Christian perspective, might we consider that in the Providence of God, the sins and failures of parents could actually be a gift—a personal means of sanctification—to those who love God (Romans 8:28-30)?
Carl Trueman, The Rise and Triumph of the Modern Self, 70-71.
Karl Pillemer in Abigail Shrier, Bad Therapy: Why the Kids Aren’t Growing Up (New York, NY: Sentinel, an imprint of Penguin Random House LLC, 2024), 60.
Abigail Shrier, Bad Therapy: Why the Kids Aren’t Growing Up (New York, NY: Sentinel, an imprint of Penguin Random House LLC, 2024), 60-88. Studies show large numbers of therapy patients have higher degrees of fear about normal risks and tend to avoid making personal decisions without the advice of their therapist. Furthermore, the public school systems of growing numbers of therapists on staff who establish policies for addressing student struggles and interpersonal conflicts without involving parents. Their involvement at this level as normalized the therapeutic perspective and contributed to the psychiatrization of society.
Oxford English Dictionary, s.v. “iatrogenic (adj.),” December 2024, https://doi.org/10.1093/OED/2047133105.
Abigail Shrier, Bad Therapy: Why the Kids Aren’t Growing Up (New York, NY: Sentinel, an imprint of Penguin Random House LLC, 2024), 60.
Oxford English Dictionary, s.v. “psychiatrization (n.),” July 2023, https://doi.org/10.1093/OED/1137619201.
Abigail Shrier, Bad Therapy: Why the Kids Aren’t Growing Up (New York, NY: Sentinel, an imprint of Penguin Random House LLC, 2024), 17-18. The rising generation has received more therapy than any generation previous; nearly 40 percent has received treatment from a mental health professional. Forty-two percent of the rising generation currently has a mental-health diagnosis. In 2010, Jessica Grose wrote an article for Slate in which she demonstrated that "Childhood misbehavior much more likely to be described in terms of therapeutic symptoms than character flaws [i.e., sensory integration, processing]” And “The average parent in the park can probably recite from the DSM [the Diagnostic and Statistical Manual of Mental orders], or at least act as an amateur child therapist.") Grose, Jessica, "Honey, I Shrunk the Kids," Slate, August 25, 2010, https:/ .com/human-interest/2010/08/are-the-offspring-of-therapists-really-more-screwed-up-than-the-children-of-non-shrinks.html.
Haslam, Nick, Jesse S. Y. Tse, and Simon De Deyne. “Concept Creep and Psychiatrization.” Frontiers, December 2, 2021. https://www.frontiersin.org/journals/sociology/articles/10.3389/fsoc.2021.806147/full.
Greg Lukianoff and Jonathan Haidt, The Coddling of the American Mind: How Good Intentions and Bad Ideas Are Setting Up a Generation for Failure (New York, NY: Penguin Books, 2019), 27.
Lukianoff and Haidt, The Coddling of the American Mind, 29.
Lukianoff and Haidt, The Coddling of the American Mind, 29.