I wrote this in response to a question on Tildes that asked “What changed a strong held belief?” but never posted it over privacy concerns.
I bought into the idea that psychotherapy was unequivocally good, but when someone close to me went through some difficult times in their teen years, I changed my mind quite a bit. I’m in the US, and I think part of it is that therapy is another cog in the “for-profit” healthcare machine. Many therapists seem to be reluctant to challenge their clients. Some people don’t want to be challenged, and if they’re challenged by a therapist, they’re likely to just shop around for a therapist who tells them what they like. The therapist who challenged them loses a patient and potentially has their pay impacted as a result. I don’t think therapy is very useful if therapists do nothing but bolster and validate us all the time. It became a real problem with my loved one when they decided to go looking for a therapist who would tell them exactly what they wanted to hear. Unfortunately, they found one.
I’ll admit, I had very little visibility into this situation, but this is what I believe was happening as someone who was primarily an outsider looking in through a pinhole (even though I was otherwise making healthcare decisions for this person and they were not yet of age). Their school offered therapists the students could talk to. Great, right? In theory, yes. Problem is, my loved one is bipolar, ADHD, and has depression. They’ve also suffered some trauma. They seemed to have been doing things to try to escape from their trauma, and the things their brain was telling them were the right things to do were, in fact, not. The therapist the school connected them with — and who I had no say over — was not, in my opinion, the right one to deal with these sorts of issues.
They had a therapist who was chosen for them outside of school, but that therapist pushed back sometimes. They find this therapist at the school who tells them they’re right about everything, everyone else are idiots, and they should do whatever makes them happy 100% of the time. That’s exactly what they want to hear, so they naturally love this therapist.
This was, in my opinion, one of the factors that enabled them to dive deep into addiction and shun their family for nearly a year. No one would hear from them for days and then someone would get a call from a stranger saying they had found my loved one out of their mind in a parking garage somewhere. They were living in a car with a drug dealer. They wouldn’t share the name or a description of the vehicle because they didn’t want to be found. They would send text messages that were inscrutable because they were on something when they were composed. It was some seriously scary shit, and I was certain that they were not going to make it out the other side.
So, I guess it’s really two things here: one, that having a therapist can actually push you deeper into your mental illness. It’s obvious in retrospect — there are people who are bad at anything — but you want to think there would be enough controls in an area as sensitive as this to make sure people who are bad at it are unable to practice. Apparently not. But two, allowing teens to make their own healthcare decisions is only a good thing if those teens are of sound mind. The state we lived in is very progressive in allowing teens (under 18) to take charge of their healthcare. I think this was designed to help gay and trans teens who are in religiously repressive families, and I support it in those cases. Unfortunately, the way it is implemented allows mentally ill teens predisposed to self-destruction to dive deeper into that and takes any control away from loved ones who might be able to suppress it just a little longer while their frontal lobes continue to develop or while they continue to receive productive therapy from a skilled therapist.
This person is doing much better now, but there is new damage and trauma that can never be undone. Can I attribute this entirely to this therapist? Of course not, but if my loved one had not been able to find a therapist who was willing to validate them by telling them they should be following their bliss (which was, at this point, solely in the direction of self-destruction), maybe taking that path wouldn’t have seemed so easy and so justified.
And as I type that, it also makes me think of these generic inspirational messages we like to throw around to young adults:
- It’s OK to be different
- Follow your bliss
- Don’t live to please others
All these are useful in the right context, but again, what if the way you’re “different” is that you’re abusing opiates? Is that also OK? What if your “bliss” is getting shitfaced and passing out in a parking garage? What if the way others (specifically, your loved ones) would like you to “please them” by being kind to your body and by taking your medication? Should you automatically resist that because any and all expectations of you are unreasonable? That’s what the inspirational quote said (and as a teenager, I probably want to believe that anyway because it absolves me of any responsibility to others).
We bark these out with no qualifiers, and, I get why (It’s simpler that way.), but I just feel like it can be incredibly destructive in front of the wrong audience. When you say these things, there’s a context you have in your head, but the person hearing it may be in a different context that warps your intended meaning into something very dark.
I’m not blaming any of these things for what happened, but I do think my loved one was able to collect a lot of evidence from many and varied sources to suggest the very bad things they wanted to do were in fact the right things to do. I could name several other sources too, but I’ll spare you having to read those. It was incredibly frustrating because I knew this wonderful person with incredible potential, and then I saw all these different pieces of our culture and society — even parts that were supposed to be a defense against this stuff — conspiring to make it easier for them to self-destruct.
Getting someone through troubled teen years can change a lot of strong held opinions very quickly.