The Worst Dystopian Young Adult Novel Ever Written
A review of Suzanne Young’s “The Program”
Back in the summer of 2012, I reviewed the vanity press published novella* Save the Pearls, which was, at the time, the worst book I had ever read. I honestly didn’t think I could read a more problematic, troubling, and poorly thought out attempt at science fiction. I was wrong.
I suppose to be fair to Ms. Young, this book is far better written, has some moderate internal logic, and, at least, isn’t a racist mess. It’s published by Simon Pulse and, as a result, has the big advantage of an editing staff behind it, unlike Foyt’s work which was a self-published effort. That said, I’m genuinely shocked that a reputable publisher (Simon Pulse is part of Simon and Schuster) was so eager to jump on the dystopian bandwagon that it didn’t stop to really think about the ramifications of publishing something like this that directly targets teens.
Alright, so enough with the shock and awe, let me get to the basic gist of the book. This book takes place in the near future (it feels honestly no more than 10–15 years from now, although it’s never fully specified). At this point, there’s a massive epidemic of teen suicide sweeping the nation. In the United States, one-third of teenagers have killed themselves. It’s gotten so bad that a pilot program has been developed by the government in some Northern Pacific town (never specified) in order to help rehabilitate at-risk teens and keep them safe. However, this isn’t just a regular hospital stay. No, to aggressively combat these issues, the government has made being sent there mandatory (before the age of eighteen). There are government handlers who patrol schools and anyone who seems to be acting depressed can be reported to these men in white coats, who act as a mental health gestapo. The opening scene is a dramatic reveal of one girl being dragged out of the classroom. She’s cut and starts bleeding profusely while being dragged out, and the horror of that leads to the teacher calmly just going about the lecture afterwards and scrubbing the blood clean as she talks.
Here, in an Orwellian nightmare for anyone who can’t vote yet, we find our heroine Sloane. Over a year ago, her brother, Brady, killed himself by jumping into a river while they were both on a camping trip along with Brady’s best friend (and Sloane’s secret boyfriend), James. Now, over a year later, James and Sloane are trying to keep themselves from succumbing to their own depression and being shipped to The Program, a facility where successful treatment basically revolves around rebooting a person by erasing their most stressful memories and most of their previous personalities. Basically, we’re working off of an “Eternal Sunset of the Spotless Mind” scenario in the final act of the book where a newly “rehabilitated” James and Sloane rekindle their true love all over again, despite being tabula rasa.
Technically, they do have some mild discussions about wanting to stop the Program but it’s perhaps not as dystopian yet as The Hunger Games and Divergent. It seems that the revolutionary process doesn’t actually start until The Treatment, and this might disappoint genre fans if only because it’s more sedate than the other alternatives and mainly consists of brooding as opposed to fighting or training. Frankly the plot, such as it is, barely involves no more than upset cuddling.
So why is it so awful?
Because it has a fundamental misunderstanding of psychology, depression, suicide and effective treatment and ethics, which then leads the novel to misrepresent mental health therapies.
Yes, I do understand that this is a sci-fi book and that it’s “fantasy” and a “what if.” However, there are two things about this particular novel that, unlike The Hunger Games, really make it more vulnerable to criticism. First, this is very clearly a near-future and its built closely out of our own culture, traditions, and current ethos. We aren’t talking four hundred years in the future where we have phenomenal and fantastic machines that reboot your personality in a blink. Second, it very deliberately chose to deal with teen suicide as a spring board for its plot and, as a result, has a social responsibility to address the actual mental issues with some factual basis. Frankly, the blatant lack of research or reality present in this novel make suspension of disbelief impossible.
Again, this isn’t an accident. On the Audible edition of The Program, there’s an interview after with Ms. Young. She admits that this book combines several plot threads together that she couldn’t make coalesce before in separate books — suicide, memory wiping pills, and how to deal with the death of someone you’ve lost. She also further admits that she chose to address suicide as an internal conflict that the characters couldn’t escape from so that the stakes were very high. Well with high stakes also come high expectations.
And she failed to meet any of them.
First, her world building is lazy at best. In the first chapter, Sloane gives us an infodump about the epidemic, but she only spends a few pages offering any possible reasons for why the teen suicides have started. Granted, she’s just a layperson and a child in the middle of an epidemic that scientists don’t yet understand. However, this is all the explanation we ever get in over four hundred pages and, more alarmingly, they echo the kind of sentiments against mental health and medical treatment that are so deadly today. One of the possible theories is that vaccines might have caused this. Frankly, for me, this smacks far too much of the anti-vaxxer conspiracy theories that have deadly consequences in today’s world. Since the anti-vaccination movement really took off, we’ve started seeing an appalling increase in measles deaths both here and in England as well as children dying from whooping cough and other perfectly preventable diseases.
So to even use a throw-away theory in a novel to continue that idea that vaccines are dangerous, when that assertion was both based on terrible science and thoroughly debunked myths is awful.
Worse, though, is the second theory that perhaps the overuse of antidepressants has caused fundamental changes in children’s brains as they develop so that they can’t process neurotransmitters thoroughly and are, thus, more susceptible to depression and suicide. Perhaps Ms. Young was thinking about how MDMA (ecstasy) after prolonged abuse can damage the brain and cause depression. However, I think the logic there (again so briefly alluded to) is that mothers who were prescribed and on antidepressants during pregnancy had drugs in their systems that affected fetal growth and that possibly led to depression and suicide rates in their kids now.
There’s a massive problem with even that possible explanation from Sloane — most psychiatrists insist that their patients go off medication for a period before they become pregnant and do not resume until after they have given birth and, sometimes, have finished nursing. There is a whole department at Hopkins devoted to women and mood disorders so that women who want to become pregnant can best navigate those waters while not being on their medicine. Thus, if this epidemic is the result of overmedicated moms, that just doesn’t wash either.
I wish this was all the science fail involved in this novel.
This is the tip of the iceberg. Just wait until we get to treatment!
Still, though, we have to talk about how terribly Young presents the symptoms of depression. The oddest thing about this book is that we follow how depression unfurls in five characters. We mostly get brief flashback glances at Brady and an opening scene in which a classmate is dragged away, but her deteriorating behavior is noted. However, friends Miller, James, and Sloane all go through the same issues in the same patterns. Depression, like most mental illnesses and also types of developmental disabilities, isn’t a monolith. Yes, there are some traditional hallmarks, but not every single person who gets depressed will do the following: withdraw and stop talking except when pressed, be driven to cutting or burning as a form of self-injury, become fully passive, and lose weight. Seriously, both Sloane and her apprehended classmate are marked as depressed due to their weight loss. It’s as if Ms. Young has never heard of either bulimia (in which most sufferers are on average ten pounds overweight) or Binge Eating Disorder. Actually, in point of fact, BED affects close to 2% of adolescents and, overall, is the most common form of eating disorder in the United States.
But, then again, if you get depressed and eat, you won’t be thin, waif-like and attractive and won’t fit into your new makeover wardrobe that the Program prescribes (no really).
Worse is that I don’t think Ms. Young understands that not every depressed person will commit suicide. There’s a correlation, don’t get me wrong, and everyone who commits suicide or attempts it has been suffering from some serious mental illness. However, it’s like saying that all squares are rectangles but not all rectangles are squares. Being depressed precedes suicide but it’s not a direct and automatic result. People may get depressed and recover without ever thinking of suicide or engaging in those behaviors. It’s not axiomatic. I suppose you could say that because of the poorly defined McGuffin of the “epidemic,” this brand of “infectious depression” (Young’s description) could be guaranteed to lead to suicide, but, overall, Young seems to understand depression very little and its relationship so suicide even less.
But in this book, it’s clearly a one-sized fits all depression.
Also, again, while she, I think, took some artistic license with how suicide works because this epidemic is viewed as being contagious, I really believe that “fiction” or not, that writing choice further muddles and stigmatizes depression and suicidal ideation. This would be easier to clarify and explain, if Ms. Young had bothered in the first place to be more clear in her world building. However, as far as I can discern, Ms. Young seems to want to have her cake and eat it too. She created a world where depression and suicide is still most likely related to a chemical imbalance (albeit one created by some pandemic and developmental oddities) but, at the same time, she keeps having the doctors and Program staff refer to it as “a behavioral contagion.” In other words, the suicidal must be watched for, reported on like criminals, and avoided lest they infect others. In fact, even after they are “cured,” those who enter the Program must be kept away from the general population until they turn eighteen, lest they risk somehow contaminating the mentally healthy.
Yeah, like that doesn’t sound Trumpian.
In Sloane’s own words after confronting an “infected” after her own therapy:
He’s right. I will report him the first chance I get. He’s infected. He can infect others.
It’s reprehensible that it’s presented this way. There is already a massive stigma against the mentally ill. They’re often scapegoated as the first reason mass shootings or violence happen, even though they’re far more likely to be victims of violence rather than perpetrators. They’re also likely to suffer economically and socially. These kids who are reading her book may honestly not yet know how depression actually works in the factual world. This may be the first place they read about it, and they might internalize this message, whether she tried to fictionalize it to an “infection” for drama’s sake or not. The Program makes depression seem catchable and stigmatizes anyone showing signs of suffering from it.
Finally, in The Program’s pseudo-scientific trifecta, the actual treatment entailed by the regime is both nonsensical and beyond unethical. First, the main gist of the (impossible) treatment is to give you a pill that primes your memory centers and makes you open to discussing your distressing memories. Then after talking about them with your assigned therapist, you are given a second pill that eradicates those primed memories. It’s a selective deletion so you retain the happy ones that you want to maintain (usually of your parents since they are paying for The Program). Again, forget that this would never work and violates any basic understanding of how memories are stored. It’s completely unethical and, yes, while akin to lobotomies would never be allowed this day and age, let alone in the future. We stopped full frontal lobotomies because of their barbaric nature and the dangerous side effects that rendered people into a vegetative states. It would never be something that would come back into practice. Moreover, if one fails to comply with the Program, the treatment would escalate to flat-out lobotomies.
Honestly, I don’t know any parent so desperate they’d rather their kids be in vegetative states than suicidal/depressed. Again, this smacks of that rejection of established science and anti-vaxxer sentiment. It’s almost too easy to replace the ableist real world sentiment of “I’d rather risk my child dying of a completely preventable disease than be autistic” with “I don’t want a suicidal child so even a lobotomy is better.”
Oh but the so-called treatment gets even more nonsensical and unethical, don’t worry. After all, the reason the government justifies keeping the returning “cured” patients from the Program in a separate school and closely watched by handlers is that their minds are fragile from all the mind-wiping. It’s established that if they don’t take time to continue the slow assimilation and healing process outside, they can fracture their minds and become permanently psychotic. Again, what parent would sign up for such a risky procedure ever?
Finally, and this is the big reveal in the epilogue, The Program is far more insidious than one is led to believe and relies heartily on social interaction and behavioral manipulation. In the second act of the novel, Sloane enters the Program and, at the time, befriends whom she assumes is a fellow patient named Michael Realm or “Realm” for short (I call him Love Interest #2). Anyway, Love Interest #2 is actually revealed to be a Program graduate who was called in to fake being supportive to her in order to help with Sloane’s particularly recalcitrant case. His support includes cuddling with her in his bed at three a.m. and sneaking her Chicken McNuggets. No really. However, even when Sloane realizes The Program and Realm’s deception, he insists that this happened only because she’s such a special case.
…Except she’s not.
The epilogue involves the arrival of a new girl at the center, Ally. She sits down for a game of cards with Realm…as well as the so-called “patients” that Sloane was with weeks ago: Tabby, Shep and Derek. It turns out the entire Program is set up to be nothing but people who are in on it. Each time a patient enters, they’re the only actual patient in the center and the other inmates, so to speak, are just confederates of the Program.
Not only is this mindblowingly unethical, I honestly don’t understand how this helps at all. First of all, that seems completely expensive and unfeasible to set up to combat a problem affecting literally millions across the planet at once. Second, how is having fake patients beside you at the hospital following word-for-word the exact same playbook and script going to help? Again, not all depression or mental problems follow the same forms and nuances. It’s far from a one-size fits all solution (let alone a so-called “solution” this asinine). Finally, this is medical science’s best idea? The Program works by destroying your memories but also making sure you have an attractive boy to cuddle with at night? Do they have facilities where just female confederates play the “Realm” role for boys? Here’s one — what about a homosexual teen? Do they get a special cuddle buddy too? What about an asexual teen? Is there any treatment that doesn’t involve cuddles?
None of this computes at all. The only reason it’s in here is so that Sloane can get close to Love Interest #2 so that in Act III, she has a dramatic choice between Love Interest #2 and her true love, James, and it’s as insulting and stupid as it sounds.
So, The Program fails with how it tries to “explain” the epidemic and the bad pseudoscientific myths it tries to hand wave as reasons, its presentation of depression, and in the so-called treatment The Program even offers. I think the hardest thing to read, though, is how Sloane relates to her family after she’s “cured.”
First, to help her deal with her “new” life as a blank slate with only dim memories of her parents and no recollection of her brother’s traumatic suicide, her parents redo her room and throw out her old possessions as well as buy her a completely new wardrobe. Again, this occurs because it’s not a book for girls until we’ve had a She’s All That moment and our heroine becomes (in this case, a preppy) swan.
Second, now Sloane, as well as the “cured” James, have to live in fear that if they show any signs of not assimilating that they will be sent back to The Program for more aggressive therapy (read lobotomy). This turns their parents into the enemy more than anyone else. After she’s back, Sloane fights with her mother and grows to resent and blame her for sending her away. Note that Sloane feels sorrow for her father who has started drinking and can’t trust him but only hates her mother. (All of her “relationships” with other women are fraught in this book. Lacey, her friend, only exists to be the promiscuous one to talk about James and help her sneak out. Her therapist in sessions, Dr. Warren, is set up as a Nurse Ratched-like villain with serums and pills in place of electroshock to strip her memories, and her mother has become the enemy who refuses to hear Sloane’s pain, won’t let her date whom she wants, and is a threat to Sloane’s very freedom.) The external conflict and drama of the book comes from Sloane being so isolated from and scared of her parents that she has nowhere else to turn but to her lover, James.
It’s extremely hard to get teenagers to confide in their parents. It’s understandable. There are generation gaps, the fear of disappointing them, the fear of being in trouble, and, above all, the fear that, in some cases, they may be breaking a friends’ confidence. I taught eighth and ninth graders in psychology for several years, and the hardest thing to talk about with them was suicide and self harm issues. It wasn’t because it wasn’t on their minds even at thirteen and fourteen. No. It was because they’d already experienced depression or issues themselves, feelings of worthlessness from bullying, or, most often, seen friends suffer and been conflicted on how to help them. One year, a student taking a different class in the same building I had my classroom in actually lost an acquaintance to suicide within a few days of the semester starting. That teen was devastated and filled with sadness and self-blame, but they’d wanted to keep their friend’s confidence. The hardest thing to teach kids it that its not betraying trust when you speak up. In addition, yes, your parents are here to help you because there a problems no one can solve without adult and medical intervention.
The idea that this book now presents a landscape where accessing mental health is seen as either being turned into the gestapo or a hateful betrayal by your parents is negligent, awful, and completely damaging to efforts schools and other educational bodies make to ensure that students stay safe. The fact that this woman literally is a high school teacher and should know better completely boggles my mind.
Finally, I’d like to point out three final problems with the portrayal of mental health and suicide in this novel. First, I just don’t understand how The Program’s treatment does anything. I mean it contradicts her very own logic set up in chapter one. The “contagion” is seen as something biological that has permanently altered the brains of the affected teenagers. There is no way that having a memory erasure (plus cuddle time) could do anything to help offset the long-term effects of faulty brain chemistry. None. It’s like saying “Well, I had diabetes but then I had my mind wiped and I’m feeling great!” It’s not going to affect your insulin production one darn bit. The same analogy holds for neurotransmitters, among other things, within the brain.
Second, the cured are repeatedly referred to as “zombie-like” and “numb” on their medication. This again, perpetuates the myth that psychiatric medications (especially current antidepressants) are all, universally either “happy pills” or nefarious things created to numb and zombify the populace.
Finally, there’s this disturbing undercurrent of eroticizing and fetishizing the suicide and self-harm in this novel. Ms. Young works very hard to come up with different ways for her protagonists to kill themselves — Brady jumps off a cliff, Sloane attempts to do the same thing but saves herself last minute, Realm was originally a real patient of the program for trying to slash his own throat, and there’s a drug out there called QuikDeath that teens are drinking in massive doses to end their lives. We see not one but two characters die brutally after ingesting that poison. Sloane tries to slit her wrist and, after the fact, both Love Interest #2 (Realm) and James make a practice of kissing her scar. Similarly, even though she doesn’t remember why James got his scars (self multilation), she loves to stroke and focus on them. Ms. Young glamorizes suicide and self-harm and sensationalizes it anyway she can.
Great job.
You’ve found a way to appeal to teenagers by making them sad. As Bart Simpson once said, “Making teenagers depressed is like shooting fish in a barrel.”
And it’s disgusting.
I started this review by admitting that I underestimated how bad things really could get after having read Victoria Foyt’s Save the Pearls. Like that book, The Program is filled with so much fail that I only scraped the surface. Believe me, the gender politics, misogyny, weak heroine, condependency issues, and overall poor pacing and plot could fill several more essays of their own. That said, I find this books more dangerous than Save the Pearls. It perpetuates myths about mental illness that re-stigmatize it and spreads falsehoods about what medication and treatment can do to someone (that dreaded, erroneous zombification). Worst of all, it is likely to inspire teenagers to avoid getting help or to feel comfortable coming clean with emotional issues in their own lives with teachers and/or parents. If reading The Program causes one child to turn to the glamorized self harm for emotional relief, or, worse, prevents teens from getting needed medical help, then Ms. Young has so much to answer for.
Ironically, in a novel so invested in blaming people who commit suicide for their actions (Brady’s continually referred to as “ weak” and “cowardly” for having left James and Sloane behind), its own author deserves to have much blame laid at her feet. She wanted to tackle something that would get attention and create stakes and, with that, comes real world risk and repercussions. Of course, I think a very different The Program’s history would have reminded her about the cost when media products inspire dangerous behavior and that, yes, culpability exists even in fiction.
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For more information in understanding depression, please check out Kay Redfield Jamison’s book, Night Falls Fast. Also, if you’re worried about someone you know who might be suicidal, then you can call The National Suicide Prevention Hotline. If you need to understand possible warning signs, then you can refer to them here. Finally, if you’re interested in supporting causes like “Always Keep Fighting” and “To Write Love on Her Arms, please follow those links to support them.”
*final note — I count Save the Pearls as a novella because it’s less than 50,000 words.
