The therapeutic world tells us a story for us to live in. It tells us that the goal of life is to find peace, that the problem in the world is whatever causes us pain or discomfort, that the world is a dangerous place full of exploitation and trauma, that the way to find peace from those things is purely utilitarian—whatever works for you is fine, and that the best thing we can do is to minimize as much discomfort as possible. The path to the good life is through “doing the work,” and if you do all the things you’re supposed to and don’t find peace, then it’s simply because you didn’t master the right technique and should try something else.

There have been numerous pieces published by secular media outlets and influencers lately warning of the rise of “therapy speak.” While hard to define, you could loosely say that it is the prescriptive use of psychological and therapeutic terms in everyday language to describe one’s experience, identity, and the various situations in life. You hear it most in the overuse of words like “trauma,” but it shows up in many other places. Shame, attachment, inner child, trigger, holding space, gaslight, anxious, depressed, narcissism, boundaries, vulnerability, PTSD, OCD, self-care. The list of these words and phrases seems nearly endless and, more importantly, suddenly ubiquitous in the lexicon of the average Millennial and Gen Z person today. 

The important thing to say immediately is that all of these mental ailments are real, which is why it’s almost impossible to write a critique of a therapeutic culture without sounding like you’re diminishing the reality of these experiences. In no way do I wish to say that these things aren’t legitimate. They are. But the fact that these things are real is almost the point. The “prevalence inflation,” as Derek Thompson at The Atlantic called it, leads to people who don’t actually suffer from clinical mental health disorders seeking help they don’t need and drains resources from those who actually do.

Take one example that was reported by The Verge—the rise of self-diagnosed Dissociative Identity Disorder (DID; previously known as multiple personality disorder) on TikTok. Doctors across the country realized that they were beginning to see patients who were seeking confirmation for a self-diagnosis regarding the disorder after they had learned about it on TikTok. Many of them didn’t have it. One doctor said, “I’ve had people cry in my office because I told them that they do not have the diagnosis that they think they have.” The patients were sad when they realized that they didn’t have dissociative identity disorder. You would think it would be the other way around.

This led the doctors to worry about the patients who had convinced themselves that they had a mental health issue that they didn’t actually have, but also to worry for those who did have it. Harvard Medical School’s largest psychiatric facility, McLean Hospital, said about this phenomenon, “We are sincerely concerned that this trend on social media will further marginalize individuals living with DID, while also doing a disservice to those who are living with another treatable but misidentified disorder.” Self-diagnosis of mental health disorders on social media is a lose-lose for both the person who has self-diagnosed and for the person who actually has the disorder.

While I imagine that most of us don’t know someone who has self-diagnosed with DID (though maybe you do), the prevalence of therapy speak as a native language has become an increasingly live issue for many folks as they talk with their children, siblings, friends, coworkers, and church members. For many, psychology culture is becoming their defining social narrative. Going to therapy is a sign that someone is “doing the work.” “Healing from trauma” means that someone is finally “getting healthy.” But is this producing the results that people are hoping it is? It doesn’t seem like it is. Not because therapy is bad or it doesn’t work, but because the ideas of what therapy is and is supposed to do have changed. It’s become more important to appear as if you are “doing the work” than to actually do it.

From Derek Thompson, quoting Darby Saxbe, a clinical psychologist at the University of Southern California, in The Atlantic again:

“That’s a big problem because this modern idea that anxiety is an identity gives people a fixed mindset, telling them this is who they are and will be in the future.’ On the contrary, she said, therapy works best when patients come into sessions believing that they can get better. That means believing that anxiety is treatable, modifiable, and malleable—all the things a fixed identity is not.”

That, in a nutshell, is the shift that our therapeutic culture has caused. The shift from mental health disorders being largely “treatable, modifiable, and malleable” to being an “identity” that “gives people a fixed mindset, telling them this is who they are and who they will be in the future.”

The Effects of a Therapeutic Culture

In light of all of this, the first question we have to ask is: Is this shift making us better? The rising consensus from mental health professionals seems to be a resounding “No.” The same article in The Atlantic cites a study of more than 8,000 students in the U.K. who participated in a mindfulness program only to find that their anxiety became worse. Because therapeutic culture constantly turns us inward, we become overly aware of every uncomfortable situation we are in and the negative emotions we feel. 

Not only that, but it trains us to believe that because we are experiencing something uncomfortable or negative, there must be something wrong—either with us or with them. Not only have we begun to diagnose ourselves, but we’ve also started diagnosing others. Armed with only what we’ve seen on a handful of TikTok videos or a graphic from a therapeutic influencer’s Instagram—without any training, experience, credentials, or professional understanding—we label other people with therapeutic labels and mental disorders because they loosely match a description of something we heard someone say one time. Either we’re anxious, or they’re a narcissist. Either we’re OCD, or they’re shaming us. Either way, it creates the perception of being a perpetual victim of either your own psyche or other people’s neuroses. 

Being a perpetual victim not only increases anxiety out of constant fear of being triggered, but it also erodes your relationships and isolates you. Because you’re constantly protecting yourself from triggers, whether from your own or from what you perceive in others, you don’t allow yourself to foster the necessary connections to develop deep relationships. Every interaction is a potential threat that could trigger discomfort, so it just seems better to stay away from as much interaction with other people as possible.

Esther Perel, Belgian American psychotherapist and host of the podcast Where Should We Begin?, said in an interview with Vanity Fair:

 “There’s a paradox. There is such an emphasis on the “self-care” aspect of it that is actually making us more isolated and more alone, because the focus is just on the self. The focus is not about the mutuality of relationships—the reciprocity, the way that you weave fabric, you know, between people who are relying on each other. On one hand, there is an importance in gaining clarity when you name certain things. On the other hand, there is a danger that you lose all nuance, that you’re basically trying to elevate your personal comments and personal experience by invoking the higher authority of psychobabble. What you call therapy-speak, we used to call psychobabble—it’s a new word for an old concept.

In the past, you could have said, “I think this, and so does the rest of the community.” So does the family, so does the church. Today you say, “I think this, and so does the DSM-5.” I don’t like what you do, so I say you’re gaslighting me. You have a different opinion, and I bring in a term that makes it impossible for you to even enter into a conversation with me. Labeling enables me to not have to deal with you.

But in the end, it creates more and more isolation and fragmentation. That is not necessarily a good thing for the community and for the social good.”

While we turn to therapy in order to heal our inner wounds, more and more people are finding themselves even more anxious and isolated than they were before. As they turn inward, they damage relationships with people who would otherwise be there to help them through difficult circumstances. This isn’t necessarily because therapy is broken but because of how we have begun to use therapy as a buffer between us and the uncomfortable realities of life when it was never meant to function that way. The more we avoid the hard knocks of life, the more we’re hurt when we’re hit by them. So, the very thing intended to help us become more resilient in a difficult world ends up making us more fragile.

Mental Health Disorders as Status Symbol

There is a second important question we have to ask about our therapeutic culture: why would self-diagnosed mental illnesses be viewed as an attractive status symbol? It almost sounds perverse to say. Obviously, those who experience mental distress don’t consciously compute it as a status symbol. And for people who sincerely have mental disorders, it isn’t. Again, this is a difficult topic to critique when you’re discussing something that is both real and distressing. Yet, that’s exactly how Dr. Saxbe characterizes it in her interview with Derek Thompson in The Atlantic. 

Darby Saxbe, a clinical psychologist at the University of Southern California and a mother to a high schooler, told me she has come to think that, for many young people, claiming an anxiety crisis or post-traumatic stress disorder has become like a status symbol. ‘I worry that for some people, it’s become an identity marker that makes people feel special and unique,’ Saxbe said.’

In a therapeutic culture, it seems like everyone has a mental health disorder. And if everyone has one but you, then you’re the weird one for being “normal.” They endow an identity to someone who otherwise doesn’t know who they are without it because they have nothing else to identify with. Even while you might feel intense mental distress, you can’t imagine your life without it. 

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