“Has IRBC written a book review or helped pastors think through Abigail Shrier’s recent book, Bad Therapy?”
When this request from a pastor landed in IRBC’s inbox several weeks ago, my mind immediately began to recount my own reading and personal reflections from this important book. Like her previous title, Irreversible Damage: The Transgender Craze Seducing Our Daughters, Bad Therapy is an exposé from a journalist pounding the pavement to uncover trends and testimonies in order to answer the question bothering everyone concerned about the rising generation of children and youth, “What is wrong with our children?”
Now, concerns about the next generation are not new. Neither are the perennial signs that reflect the often turbulent transformation of children into adults. But recently, something more has seemed off with our youth and teens. Teens gripped with depression and anxiety. Teens failing to launch. Teens lacking the motivation to leave the house and socialize. Teens not doing typical teen things. This phenomenon demands an explanation, and Shrier’s investigative journalism lands on an unexpected culprit.
It’s the therapy. Rather, the therapists.
Despite its clickbait title, Shrier does not reject every and all forms of therapy, psychology, and psychiatry. In the “Author’s Note,” she is clear that there is a group of young people who suffer from profound mental illness who “require medication and the care of psychiatrists.” These individuals “are not the subject of this book” (xi). Furthermore, the discerning reader will note at times that Shrier quotes psychological research against psychological research. She pits, for example, Richard McNally and Paul McHugh against Bessel van der Kolk and Gabor Maté (Chapter 6), and American parenting trends verses “free-range” parenting (Chapter 11). She references the Harvard Grant Study for the “five most effective traits associated with higher life satisfaction” (235). Rather than an anti-psychiatry tirade, Shrier’s work is a laser-focused challenge of therapy culture and its stranglehold upon Western society. In other words, the book is not against All Therapy, but Bad Therapy.
Should pastors and Christian parents read this book? Yes, and here are three personal reflections from reading Bad Therapy.
Reflection #1: Therapy, or even biblical counseling, is not always helpful
Shrier introduced me to an important word that I have used in many settings since returning this book to its shelf, and that is the word “iatrogenesis.” Iatrogenesis shares with psychiatry the Greek root “iatros” or “healer.” “Psychiatry,” as opposed to “psychology,” is the “healing” of the soul, not the study of the soul. Thus, iatrogenesis is when a problem, or, in the realm of counseling, a disordered functioning or distressing symptom, has its origins (“genesis”) in the care (more accurately, mis-care) of the therapist.
Shrier reveals that most other disciplines recognize the reality of “iatrogenesis.” She writes, “Iatrogenesis is everywhere—because all interventions carry risk” (7). Your surgeon can nick the wrong organ as he makes his incision. Your primary care physician can assign the wrong medicine with harmful side effects. Your chiropractor can shoot pain up your spine after a faulty adjustment. That is why your doctor is covered by a large insurance plan and why you sign waiver forms. But in her reporting, Shrier shares that most therapists are “a little touchy” about the possibility of iatrogenesis (12). Why? Because, in distinction from a surgical or other medical intervention, the therapist himself or herself “is” the intervention—sitting down with an expert who, through conversation, is expected to provide a therapeutic service and achieve the desired result of the client (6).
Iatrogenesis touches upon another important insight that should not surprise us. Even with someone experiencing troubling symptoms such as chronic depression, anxiety, or identity issues, talking and ruminating upon those issues for extended hours in counseling might make the problem worse.
In a lengthy quote backed by research, Shrier writes,
Therapy can lead a client to understand herself as sick and rearrange her self-understanding around a diagnosis. Therapy can encourage family estrangement—coming to realize that it’s all Mom’s fault and you never want to see her again. Therapy can exacerbate marital stress, compromise a patient’s resilience, render a patient more traumatized, more depressed, and undermine her self-efficacy so she’s less able to turn her life around. Therapy may lead a patient by degrees—sunk into a leather sofa, well-placed tissue box close at hand—to become overly dependent on her therapist. (8)
There are many people who benefit from sitting down with someone and parsing out confusing and mixed thoughts, emotions, desires, and memories. But close at hand is another risk. In the plunge with a therapist or counselor into the inner workings of a tender soul, it is possible that the rumination required for counseling can actually prolong symptoms and struggles that would alleviate naturally with less introspective habits. “Venting may produce relief, but rehashing the same hurt can become pathological” (48). Shrier is also insightful to note that, while many adults are able to sift through the potential oddities of their counselor and their comments, our youth and children are much more impressionable (5). There are far too many stories within churches of Christian parents losing their children to the fanciful whims and blatantly sinful guidance of secular therapists and counselors.
Shrier concludes that psychotherapy should come with a warning label, and this is not bad advice (7). This counsel reveals an unexpected question for the church: Is biblical counseling cultivating within the church a Christianized version of “therapy culture”? Around the same time of reading Shrier’s book, I came across Carl Trueman’s pointed article titled “The Therapy of the Word.” Herein, he asks the pointed question, “does the rise in biblical counseling, and the growth in the number of biblical counselors, signal a crisis in confidence, not simply in the pulpit, but in the Word of God to achieve its purpose?”1 Now, it is clear that Carl Trueman, and myself, are not against discipleship, pastoral care, and counseling. The problem is that, as Trueman himself recognizes, it is possible that the increase in biblical counseling may signal a lack of confidence in the means of grace—the preaching of the Word, the sacraments, and prayer—to sustain and restore the health of the soul over time. Is biblical counseling becoming an evangelical fad? If so, biblical counselors, like therapists, may overlook the potential of iatrogenesis in their counseling ministries, especially if counseling is elevated to the neglect of the other ministries of the church.
Reflection #2: Therapists and Counselors are everywhere
“What did you do at school today, hunny?”
“Not much. We listened to Timothy, Jessie, and Erin talk about their trauma in math class.”
Most distant observers may not notice how schools have drastically transformed over the last decade. As a millennial, my public high school experience ended right on the cusp of the arrival of social emotional learning and the expansion of mental health support staff—social workers and school psychologists—within public schools. On the one hand, this development is quite understandable. Like doctors, teachers are daily interacting with our nation’s youth and children. As very often the only touch point between the government and its future citizens, educators are the prime candidates to learn therapeutic tools and conduct basic mental health assessments.
At the same time, the example of teachers as pseudo-therapists raises an important issue for parents—you don’t always know who your child is talking to about their life and struggles. In California, Illinois, Washington, Colorado, Florida, and Maryland, “minors twelve or thirteen and up are statutorily entitled to access mental health care without parental permission” at school (74). Furthermore, “As long as a parent has not specifically forbidden it, a school counselor may be able to conduct a therapy session with a minor without parental consent” (74). Teachers have been “quietly increasing and expanding their interventions, transforming every school into an outpatient mental health clinic, staffed largely by those with no real training in mental health” (80). As one example, a popular social emotional curriculum instructed eighth graders to answer the following questions:
“Have you ever stayed overnight in the hospital? Has someone close to you ever died? Have you ever worried about the safety of a loved one?” (81)
With similar principles being imported into other public service providers (137–52) and the ubiquity of therapy lingo within contemporary culture, our families are encountering pseudo-therapists and counselors anywhere and everywhere. Many of these individuals may not share the same interest for your children as you do as their parent. Apart from serious cases involving individuals who would benefit from empirically supported interventions, your children may have a better chance of navigating the turbulent years of youth without the risk of pathologizing ordinary developmental responses.
Reflection #3: Therapy culture hurts those who actually need help
Shrier shares a chilling story of how therapy culture backfired for one family. Sarah is a doctor and parent of three adopted children who require qualified therapists for both learning disabilities and to process the trauma of their previous home environment—the type that brought one detective to tears (79). One of her daughter’s first memories involves eating the contents of a litter box. In addition to this horrific upbringing, Sarah has difficulty keeping her children’s teachers from playing amateur therapist with her children psychological wounds. Shrier recalls at length,
When teachers casually pry into Sarah’s kids’ past pain for the benefit of class ‘unity’ and empathy development, it puts at risk all the work her children have done in actual therapy to cope with the memories of their early childhood and cordon them off, for the length of a school day. ‘It’s not right,’ Sarah said, referring to teachers’ constant invitations that kids share their traumatic experiences. (79)
The difficulties experienced by families such as the one above reflect a hypervigilance within society to protect children from emotional and psychological harm through early detection and intervention. The issue quickly becomes a question akin to “the children and the egg.” While there are more factors today that lead to psychological distress for minors (smartphones/social media, breakdown of the nuclear family, divorce, early exposure to pornography), is it also possible that increasing talk about mental health is convincing more people that they are actually “sick”? As evidence of this possibility, less than half of Gen Z describe their mental health as “good” (17). “40 percent” of the rising generation has received some form of mental health services (17).
These factors raise an important issue. Mental health language and labels can become something of a social contagion. This phenomenon risks pathologizing normal behavior, weakening resilience to the normal adversity of life, and making it more difficult for counselors to identify correctly those who truly need help. That help may also include psychological and psychiatric care—therapy in the form of evidence-based interventions that may alleviate suffering and preserve the health and functioning of our natural life for those who have suffered serious afflictions (Canons of Dort 3–4, Article 17). Reformed biblical counselors reject the reactionary tradition of twentieth-century anti-psychiatry.2
On the other hand, the church should not be surprised by the deteriorating mental health of our current world. We are living in an age of desecration as the rejection of God results in the dishonoring of human nature and personhood.3 Guided by the broken compass of modern morality, it is no wonder that people are doing poorly from a biblical and psychological perspective. When secular values are antithetical to the law of God, the accusations of the conscience and moral law within the non-Christian will torment the soul (Rom 2:15). The counsel of our present world directs man away from his nature and design as one made in God’s image, not to mention the only ultimate help and cure of the soul’s ailments in the Gospel. In this way, Christian pastors, parents, and counselors will welcome Shrier’s analysis and warnings concerning this competitive ethos and guidance found in modern therapy culture.
Conclusion
Bad Therapy is a worthwhile read for parents looking for an “on the ground” report of the issues confronting our youth and children. These three reflections are not a comprehensive analysis of the book, nor a critical analysis of the evolutionary worldview underlying portions of the author’s assessment of human behavior. The discerning Christian parent, pastor, and youth worker will benefit from this book as they shepherd their students, youth, and children away from bad therapy.
- Carl Trueman, “The Therapy of the Word,” New Horizons (January 2010), https://opc.org/nh.html?article_id=635 ↩︎
- For further discussion concerning this point, see Jared S. Poulton, Van Til’s Counseling Movement: A Critical Analysis of Jay Adams and Biblical Counseling (Wake Forest, NC: Hanover Press, 2026), 58–61. This book is available for preorder here: https://thelondonlyceum.com/product/van-tils-counseling-movement/. ↩︎
- Carl Trueman, The Desecration of Man: How the Rejection of God Degrades Our Humanity (New York, Sentinel, 2026). ↩︎
