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Talk therapy is inherently problematic because it’s bounded by what you can and cannot say

Morality, norms, and Overton windows have caused more harm than good

Imagine being homosexual and in therapy before 1987. 1987 was the year that the American Psychiatric Association dropped homosexuality from the Diagnostic and Statistical Manual of disorders. Your experience would have been akin to what we now call “gaslighting.” The therapist would labor to deny you something that deep down you know to be true, thus making you doubt your sanity.

Or consider being a marijuana-user in the early 1990s, at the height of the War on Drugs. You would have spent years in therapy to be cured of your addiction. Now, marijuana is being microdosed as an anti-depressant and prescribed as a safer alternative to pain-killers.

If you were in therapy today, it would be hard to know if you were being gaslit, as therapists are bound by the norms of the time. According to social models of psychology, many neuroses are the result of conflict with norms, so any situation where a patient conflicts with a therapist’s norms are liable to get trapped.

The marijuana and homosexuality blind spots seem benign because they affected a small percentage of patients. Plus, those norms have fallen out of favor. By definition, we are naturally blind to current norms that are on the wrong side of history, so we believe those traps are no longer with us. But the most important norm, the norm against selfishness, still applies to some degree to everybody. Therapists would have a hard time encouraging selfishness. For example, at no point did Tony Soprano’s therapist in The Sopranos suggest to him to be more selfish and to commit more crimes. Tony was Catholic, and so guilt came along with his selfishness, a guilt that his therapist couldn’t absolve.

Or consider the norm of political-correctness. Political-correctness is the bane of a large portion of the American population, based on its success in some political platforms. Therapists are likely even more politically correct than average because they must protect their reputations. It’s worrisome, then, that in couples therapy, that even the suggestion of a solution that emphasizes differences between the genders is verboten. The only possible way to have that conversation is to couch it in cute symbols, such as saying men are from Mars and women are from Venus.

If neuroses are the result of a dysfunctional relationship with the social, then the fact that psychotherapy is a social activity means there’s some risk that that dysfunction could be compounded in sessions.