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From the notebook

Bad Therapy

Abigail Shrier

Distilled Knowledge

Source contribution

Shrier’s strongest question is iatrogenic: can well-intended mental-health practices worsen distress when applied too broadly, make ordinary difficulty diagnostic, reinforce rumination or avoidance, weaken adult authority, or organize a child’s identity around symptoms?

  • Treatment should be evaluated for adverse effects as well as benefits.
  • Universal emotional interventions and repeated symptom solicitation are not equivalent to targeted clinical care.
  • Accommodation can relieve anxiety immediately while maintaining avoidance over time.
  • Schools and parents need a threshold for when distress calls for ordinary support, structured skill-building, or professional assessment.

Routes into permanent notes

Evidence boundary

“Therapy” is not a single intervention, and severe disorders can require lifesaving care. Interviews, adverse examples, and weak universal programs do not establish that indicated evidence-based treatment is harmful overall. Verify each empirical claim by intervention, population, comparator, and outcome.

Book Cover

My Summary

  • Introduction
    • Therapeutic approach to parenting to create an idea childhood with no pain, discomfort, fights or failure.
    • Schools jumped at opportunity to be “partners” in child-rearing
    • Kids now receive more psychotherapy than ever
    • Kids more fearful now, leery of risks or freedoms
    • Kids lonely
    • Mental health experts trained kids to regard themselves as disordered; infused parenting with self-consciousness and fevered insecurity
  • Chapter 1: Iatrogenesis
    • Therapy can cause harm (Iatrogenesis)
    • DARE increased substance abuse
    • “What would we expect to find if we steeped a generally healthy population in a tea of unnecessary mental health treatments? Unprecedented iatrogenic effects.”
  • Chapter 2: A Crisis in the Era of Therapy
    • Less than half of Gen Z believe their mental health is good
    • 40% of rising generation received treatment from mental health professional
      • 42% mental health diagnosis
      • 1 in 6 aged 2-8 diagnosed mental behavioral or developmental disorder
      • 10%+ ADHD — double expected prevalence rate
      • 10% anxiety disorder
    • More treatment no less depression
    • Adolescent mental health steady decline since 1950s
    • 1990-2007: mentally ill children rose 35x
    • 1950-1988: Age 15-19 suicide quadrupled
    • 62% increase over previous decade of hospital admissions for nonfatal self-harm
    • Child suicide rates rose 150% over previous decade
    • Deaths from natural disasters have declined over 95% over the last century
    • Teen girls who identify with liberal, left-leaning politics suffered the worst of all with severe mental decline
    • Deeply connected to values, worldview, ways they’ve raised them and influences around them
    • RESEARCH: The affect of nuclear war and the loss of fathers during WWII to adolescent mental health
    • Gen Z
      • Obedient to authority
      • Agreeable
      • Tied to Mom
      • Politically radical
      • Less inclined to self-aggrandizement
      • Motivated by fear
      • Less likely to date, obtain driver’s license, hold down a job, hang out with friends
      • Hour less per day hanging out with peers than 1980s
      • Least amount of sex
      • More pessimistic
      • Feeling they lack power to improve their circumstances
  • Chapter 3: Bad Therapy
    • Little evidence that one on one psychotherapy helps young kids at all
    • Step 1: Paying Close Attention to Feelings
      • Certain kinds of attention to emotions can increase emotional distress
      • What their saying: Emotions, a deeply imperfect signal, is always valid
      • Attending to emotions causes them to intensify
      • Kids focus on emotions → more emotional
      • Emotions are unstable and manipulable
      • Teach kids emotions are unreliable, skeptical of their feelings reflecting accurate picture of the world, even ignore entirely.
      • Bad to ask “how are you feeling?” induces negative feelings
      • Action orientation vs state orientation
    • Step 2: Induce Rumination
      • Therapy is rumination increasing—when they should be rumination discontinuing interventions
      • Overly prone to talking about emotional pain is itself a symptom of depression.
    • Step 3: Make “Happiness” a Goal but Reward Emotional Suffering
      • Communicate to kids that happiness is NOT the goal, the more you hunt for happiness the more you’ll be disappointed.
    • Step 4: Affirm and Accommodate Kids’ Worries
      • CBT’s exposure therapy has evidentiary track record of benefits
      • Accommodation deprives children of the opportunity to vault a challenge and renders them less capable
      • We all need practice sitting in discomfort
    • Step 5: Monitor, Monitor, Monitor
      • Always observed. No privacy
      • Observer adds stress
      • danger, discovery, dirt, blow off steam, test her limits, negotiate relationships with peers
    • Step 6: Dispense Diagnoses Liberally
    • Step 7: Drug’em
      • Less effective
      • Dangerous
      • Side effects
      • Primary effect of drugs is feeling in a medicated state and not themselves
      • “When you start a child on meds, you risk numbing him to life at the very moment he’s learning to calibrate risks and handle life’s ups and downs.”
    • Step 8: Encourage Kids to Share Their “Trauma”
      • More harmful to talk about it
    • Step 9: Encourage Young Adults to Break Contact with “Toxic” Family
      • Terrible idea: Unhappiness is traceable to childhood trauma
      • Therapist dangerous due to them convincing child to cut communication with parents
    • Step 10: Create Treatment Dependency
      • Leery of trusting self
    • Bad therapy does precisely the opposite. It engenders intensive focus on feelings, amplifies emotional dysregulation, increases a sense of hopelessness, of incapacity and a paralytic helplessness against a rising sea of feelings.
  • Chapter 4: Social-Emotional Meddling
    • Teachers, counselors and school psychologists playing shrink
    • Constantly taking kid’s emotional temperture
    • If we wanted to help kids with emotional regulation, I asked Kennair, what would we communicate instead? “I think I’d say: worry less. Ruminate less,” Kennair said. “Try to verbalize everything you feel less. Try to self-monitor and be mindful of everything you do—less.”
    • Task orientation > self orientation
    • “social-emotional learning” - pushes kids toward a series of personal reflections, aimed at teaching them “self-awareness,” “social awareness,” “relationship skills,” “self-management,” and “responsible decision-making.”
  • Chapter 5: The Schools Are Filled with Shadows
    • Shadows that follow kids in school to help
    • “restorative justice” introduced by Obama—violent kids handled with kid gloves
    • Kids behavior has deteriorated over the last decade
    • schools demand no self-discipline from students
    • anti-resilience culture
  • Chapter 6: Trauma Kings
    • No rush to suicide during many rough times in American history
    • Researchers say most people can pull themselves up from severe hardship
    • Repressed memory scandal
    • The body doesn’t keep score
    • A child’s memory is especially malleable
  • Chapter 7: Hunting, Fishing, Mining: Mental Health Survey Mischief
    • CDC surveying kids in public school
    • Media reports of suicide increased teen incidences.
      • Vienna in 1980s limit media coverage subway suicides, dropped 75%
    • Excessive thinking about self = depressed and anxious
    • Focus on others to be happy
    • “Sanity is the harmony that emerges as a consequence of being embedded in multiple social institutions”
    • “If we left kids alone to play and exist, relatively unfettered, in their social worlds—without our monitoring, advice-giving, and interruption—they would generally learn to get along with others, and they would tend to feel less despondent. We might need to interrupt rare cases of bullying. But otherwise, being part of a softball team or Girl Scouts, telling secrets to your best friend that you don’t also share with your mom—that’s the stuff that helps keep adolescents in balance, and kickstarts the freewheeling process of discovery and manufacture that ultimately produces a stable identity.”
  • Chapter 8: Full of Empathy and Mean as Hell
    • Empathy leave people insensitive to long-term consequences and blind to suffering of those not emphasized with. Biased
    • Can’t empathize with more than one or two people at a time
    • Fairness > Empathy
  • Chapter 9: The Road Paved by Gentle Parents
    • Gentler parenting isn’t effective
    • “Knock it off, shake it off”
    • “sensitive child” as a result of therapeutic parenting
    • Frictionless environments don’t prepare child for the normal chaos of the world
    • Careful nurturing entitlement in a child
    • “hold the line” — stick to the rules and consequences you set and stop endlessly accommodating
    • Parents job is to transmit their values to their children, not be a therapist.
    • Diana Baumrind’s Parenting Styles: Permissive, authoritative, authoritarian
      • The “authoritative parent,” however, is loving and rule based. She attempts to direct the child’s activities in a rational manner, encourages a give-and-take with her child, but “exerts firm control at points of parent-child divergence.” Where her point of view on a household rule ultimately conflicts with that of her child, she wins. She maintains high standards for her child’s behavior “and does not base her decisions on group consensus or the individual child’s desires.”[19]
      • In studies that still manage to chagrin therapists, Baumrind found that authoritative parenting styles produced the most successful, independent, self-reliant, and best emotionally regulated kids; it also produced the happiest kids—those less likely to report suffering from anxiety and depression.[20]
    • kids are happiest when raised in a loving environment that holds their behavior to high standards, expects them to contribute meaningfully to the household, and is willing to punish when behavior falls short. And it flies in the face of virtually everything therapists and parenting books now exhort.
    • This isn’t tiger mom–style high expectations, which may place pressure on a child to achieve, but where the ultimate success accrues to the kid herself.
    • Communicating to your child in a way it puts their decisions on them, not what it would do to you as a parent. That burden is too much.
    • Neatness in children is associated with less hostile and less delinquent kids
    • What actually makes for miserable kids? Placing them in charge. Failing to hold their behavior to high standards and not punishing them when they deliberately allow it to fall short. And, yes—according to Baumrind—what else makes for an unhappy kid? Parents behaving in a consistently “affirmative manner toward the child’s impulses, desires and actions.”
    • What were we Americans doing so wrong? “In third world countries,” Rhoda said, “parenting is very authoritarian because the leaders are very authoritarian. America is on the other side—completely lack boundaries and authority.” We needed something in between. I heard this from other immigrants: the problem with American parenting is that we do not assert our authority with our own children. We do not make it a priority to pass down our values to our own kids; we seem to expect the culture to do this for us. It’s okay to allow for some give-and-take with children, but in the end, it must be our judgment that carries the day.
    • Kids NEED adult authority, they know they need it. Boundaries are profoundly connected to a child’s sense of self and well-being.
    • Liberal parents create kids that are hungry for authority—a frequently fall for extremist groups that tell them exactly what to do and how to be.
  • Chapter 10: Spare the Rod, Drug the Child
    • ADHD not a disorder according the 4 Ds of abnormal psychology
    • Anti-anxiety drugs only as effective as alcohol and slightly more addictive
    • Antidepressants lose fullness of socialization
    • Kids won’t learn to cope on medication
    • Anxiety and depression can be good for us
    • Parenting isn’t a skill, its a relationship
  • Chapter 11: This Will Be Our Final Session
    • Small failures and injuries help rather than hurt kids
    • You don’t give a child independence any more than you give a child confidence, simply get out of their way—stop interfering—and independence takes its course.
    • Subtraction
    • Our kids were doing so much better when they had less—less distraction, less stimulation, less supervision, less intervention, less interference, less accommodation, less parenting.
    • Stop implanting your outsized worries in their heads. Stop flinging the word “bullying” around just because another girl said something mean to your daughter; that’s an unpleasantness she’s destined to face again and must learn to handle. Stop monitoring and evaluating everything your kids do and stop overpraising them for doing things that aren’t hard. You’re not spurring them to adulthood, you’re insisting that they always regard themselves as little children.
    • Stop implying their weak
    • By the time parents feel their safe to go outside and play; its too late
    • https://letgrow.org/
    • Unsupervised play, risky play, independent activity > monitored play
    • Parents hovering, preventing children from independently exploring the world = causes of anxiety
      • “Kids who don’t practice independence (yes, it is a skill that withers without practice) are less self-confident, have worse social skills, are less tolerant of uncertainty, have worse problem-solving skills, and are less resilient.”
    • Metaphor of exercise
    • Making children understand that they are connected to others—that they affect others (ex: screaming on a plane)
    • Importance of strong long term social interactions and relationships
    • Five Most Effective Traits for Higher Life Satisfaction (Harvard Study)
      • Altruism
      • Humor
      • Sublimation
      • Anticipation
      • Suppression
    • “The secret to life is good and enduring intimate relationships and friendships,” summarized Yale psychiatry professor Charles Barber, reviewing the study.
  • Chapter 12: Spoons Out
    • Transmit calm to your children, not anxiety
    • When you mute the expert advice, when you log off Slate Parenting, when you lay down rules according to your values, and insist your kids abide by them—you will be surprised by just how much you like your kids. Because the truth is, you should. There is nothing in life that comes close to the remarkable adventure of raising them.
    • The purpose of childhood is to allow kids to take risks—things that involve getting all kinds of hurt—and to practice the skills they will need as adults while they are still safely under their parents’ roofs. Childhood exists to allow kids to hazard an unpredictable friend, lose a ball game, stand up to a bully, pick themselves up, offer another kid a hand. We want them to venture out and get their hearts broken, try and fail, and at last succeed—all while we’re still in the next bedroom.

AI Summary

Based on the search results, here is a summary and the main ideas of the book “Bad Therapy” by Abigail Shrier:

Summary

In “Bad Therapy”, investigative journalist Abigail Shrier argues that the mental health crisis among youth is being fueled and perpetuated by the very measures and professionals that are supposed to help them. She contends that the mental health industry is overmedicating, overdiagnosing, and overpathologizing normal childhood experiences and behaviors.

Shrier criticizes therapists, schools, and parenting experts for adopting a “therapeutic” approach that encourages children to obsessively focus inward on their emotions. She believes this heightened self-monitoring and sharing of feelings is counterproductive, increasing anxiety and a sense of helplessness rather than resilience.

The book posits that by recasting personality variations as mental disorders, the mental health establishment has convinced a generation that they are “sick”, minting patients faster than curing them. Shrier argues for allowing children more independence, responsibility, and freedom to experience failure as a natural part of growing up.

Main Ideas

  1. The mental health industry is causing iatrogenic harm (harm from the treatment itself) by overmedicating and overdiagnosing children[1][2][6][10].
  2. Schools and therapists are training kids to ruminate excessively on negative emotions through routines like “emotion check-ins”, fostering anxiety rather than resilience[7][8][9].
  3. Parenting experts promoting “gentle parenting” and an overly therapeutic approach are disempowering parents and stunting children’s emotional development[7][8].
  4. Children need more unsupervised free play, responsibility, and opportunities to experience failure as part of normal emotional growth[1][7][10].
  5. The rising generation has an increasingly external “locus of control”, believing they cannot improve their circumstances[10].
  6. By pathologizing normal childhood experiences, the mental health industry is creating a perceived need and market for its services[2][7][10].

The book has drawn criticism for its derisive tone, lack of empirical data, and conflating different groups like therapists and parenting influencers[5][9]. However, it raises provocative questions about potential overreach by the mental health establishment.

The PDF cites several scientific studies to support various ideas across different chapters. Here’s a breakdown organized by chapter:

Chapter 1: Iatrogenesis

  1. Studies showing that psychological debriefing after traumatic events can worsen PTSD symptoms instead of helping[1].
  2. Studies indicating that therapy can lead to iatrogenic harm in up to 20% of patients, such as exacerbating depression, compromising resilience, and undermining self-efficacy.

Chapter 2: A Crisis in the Era of Therapy

  1. A peer-reviewed paper titled “More Treatment but No Less Depression: The Treatment-Prevalence Paradox” highlighting that increased availability of treatments for depression has not resulted in lower prevalence rates across Western countries.

Chapter 3: Bad Therapy

  1. Studies suggesting that focusing on and verbalizing emotions can amplify negative emotions and undermine emotional stability.
  2. Research indicating that rumination (dwelling on past injuries and problems) is a significant iatrogenic risk of therapy.
  3. Studies showing that accommodation and avoidance in therapy can deprive individuals of opportunities to develop coping skills and resilience.
  4. Research on the phenomenon of “hypochondriasis” and how attending to physical symptoms can amplify them.

Chapter 10: Spare the Rod, Drug the Child

  1. Studies suggesting that repression and not talking about traumatic experiences can be a useful psychological tool for moving on with life, even for significantly traumatized individuals.

Chapter 11: This Will Be Our Final Session

  1. A large-scale national survey indicating a recent increase in the phenomenon of family estrangement, with nearly 30% of Americans aged 18 and older having cut off a family member.

The book primarily cites these studies to support the central argument that the widespread adoption of therapeutic interventions and mental health treatments, particularly for children and adolescents, has paradoxically contributed to a decline in youth mental health and emotional well-being.

Highlights

Introduction: We Just Wanted Happy Kids (Page 0)

But as millions of women and men my age entered adulthood, we commenced therapy.[ 3] We explored our childhoods and learned to see our parents as emotionally stunted.[ 4] Emotionally stunted parents expected too much, listened too little, and failed to discover their kids’ hidden pain. Emotionally stunted parents inflicted emotional injury. (Page 0)

accommodate their opinions when making a family decision, and, whenever possible, anticipate our kids’ distress. We would cherish our relationship with our kids. Tear down the barrier of authority past generations had erected between parent and child and instead see our children as teammates, mentees, buddies. (Page 0)

therapeutic approach to parenting. (Page 0)

Successful parenting became a function with a single coefficient: our kids’ happiness at any given instant. An ideal childhood meant no pain, no discomfort, no fights, no failure—and absolutely no hint of “trauma.” (Page 0)

Schools, especially, jumped at the opportunity to adopt a therapeutic approach to education and announced themselves our “partners” in childrearing. (Page 0)

How did the first generation to raise kids without spanking produce the first generation to declare they never wanted kids of their own?[ 5] How did kids raised so gently come to believe that they had experienced debilitating childhood trauma? How did kids who received far more psychotherapy than any previous generation plunge into a bottomless well of despair?[ 6] (Page 0)

They speak of “resilience” but what they mean is “accepting your trauma.” They dream of “destigmatizing mental illness” and sprinkle diagnostic labels like so much pixie dust. They talk of “wellness” while presiding over the downward spiral of the most unwell generation in recent history. (Page 0)

With the charisma of cult leaders, therapeutic experts convinced millions of parents to see their children as challenged. They infused parenting with self-consciousness and fevered insecurity. (Page 0)

Part I Healers Can Harm (Page 1)

Chapter 1 • Iatrogenesis (Page 3)

Children and adolescents are not typically equipped to say these things. The power imbalance between child and therapist is too great. Children’s and adolescents’ sense of self is still developing. They cannot correct the interpretations or recommendations of a therapist. They cannot push back on a therapist’s view of their families or of themselves because they have no Archimedean point; too little of life has gathered under their feet. (Page 5)

Parents often assume that therapy with a well-meaning professional can only help a child or adolescent’s emotional development. Big mistake. Like any intervention with the potential to help, therapy can harm. (Page 6)

With interventions, a good rule of thumb is: Don’t go in for an X-ray if you don’t need one. Don’t expose yourself to the germs of an ER just to say hello to your doctor friend. And—just maybe—don’t send your kid off to therapy unless she absolutely requires it. Everyone knows the first two; it’s the last one that may surprise you. (Page 7)

therapy. Study after study has shown that this bare-bones process is sufficient to make PTSD symptoms worse.[ (Page 8)

Therapy can lead a client to understand herself as sick and rearrange her self-understanding around a diagnosis.[ 10] 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.[ 11] 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.[ (Page 8)

And counseling sessions for normal bereavement often make it harder, not easier, for mourners to recover from loss.[ (Page 8)

An embarrassing number of psychological interventions have little proven efficacy.[ 20] They have nonetheless been applied with great élan to children and adolescents. (Page 10)

follow-up studies revealed that D.A.R.E. may have actually increased substance and alcohol use among teens.[ (Page 10)

In the last decade, therapists promoted the gender dysphoria craze, which led to a 4,000 percent increase in diagnoses for teen girls.[ 29] (Page 11)

Why don’t therapists typically admit that their methods can cause iatrogenic harm? A group of researchers considered the question and concluded that, unlike the doctor, the “psychotherapist is the ‘producer’ of treatment,” and is “therefore responsible, if not liable, for all negative effects.”[ 35] (Page 12)

The therapist often doesn’t want to acknowledge that the medicine isn’t working—because she is the medicine. The admission is a little personal. (Page 12)

Shrinks are badly incentivized where iatrogenesis is concerned. A doctor may decide that a patient would no longer benefit from thyroid medication, discontinue it, and keep the patient. A therapist gets paid by the dose. Once she decides you don’t need therapy, she loses a customer. Actually, it’s worse than that: it’s in therapists’ interest to treat the least sick for the longest period of time. (Page 12)

What would we expect to find if we steeped a generally healthy population in a tea of unnecessary mental health treatments? Unprecedented iatrogenic effects. (Page 13)

Chapter 2 • A Crisis in the Era of Therapy (Page 14)

The mental health establishment has successfully sold a generation on the idea that vast numbers of them are sick. Less than half of Gen Zers believes their mental health is “good.”[ 2] They do not believe mental health is something that arises typically, in the normal course of a balanced life, but like a boxwood tree, requires constant tending by the gardener you hire to prune it. (Page 17)

The rising generation has received more therapy than any prior generation. Nearly 40 percent of the rising generation has received treatment from a mental health professional—compared with 26 percent of Gen Xers.[ 3] (Page 17)

Forty-two percent of the rising generation currently has a mental health diagnosis, rendering “normal” increasingly abnormal.[ 4] One in six US children aged two to eight years old has a diagnosed mental, behavioral, or developmental disorder.[ 5] More than 10 percent of American kids have an ADHD diagnosis[ 6]—double the expected prevalence rate based on population surveys in other countries.[ 7] Nearly 10 percent of kids now have a diagnosed anxiety disorder.[ 8] (Page 17)

therapeutic parenting. (Page 18)

instead of using moral language to describe misbehavior, educated parents had begun employing therapeutic language.[ (Page 18)

And yet as treatments for anxiety and depression have become more sophisticated and more readily available, adolescent anxiety and depression have ballooned. (Page 20)

The authors note that treatment for major depression has become much more widely available (and, in their view, improved) since the 1980s worldwide. And yet in not a single Western country has this treatment made a dent in the incidence of major depressive disorder. Many countries saw an increase. (Page 21)

Instead, adolescent mental health has been in steady decline since the 1950s.[ 30] Between 1990 and 2007 (before any teens had smartphones), the number of mentally ill children rose thirty-five-fold.[ 31] And while overdiagnosis or the expansion of definitions of mental illness may partially account for this rapid change, it is hard to dismiss or contextualize away the startling rise in teen suicide: “Between 1950 and 1988, the proportion of adolescents aged between fifteen and nineteen who killed themselves quadrupled,” The New Yorker reported.[ 32] Mental illness became the leading cause of disability in children. (Page 21)

Therapists are helping young people, they insist. Young people today simply face more formidable challenges than did their predecessors. (Page 22)

Tags: blue

Eight years have slipped by since Twenge and Haidt[ 36] (and four years since yours truly[ 37]) first warned the public of the dangers of social media and smartphones to teens.[ 38] That ought to have provided our eager mental health experts with an obvious mandate: treat social media like cigarettes. Call to restrict smartphones from middle school and high school campuses. Urge companies to place a black-box warning on social media, if they were really feeling feisty. (Page 22)

Tags: pink

Nobody has made any serious effort to block teens’ smartphone use—not parents, not teachers, and definitely not mental health experts—because smartphones have become one more mental health accommodation we disburse to the young. We know it isn’t good for them. We know the long-term consequences run from dark to dire. We know the devices are addictive, sleep-depriving, and pathology-inducing. But for right now, they provide unbeatable palliative care—soothing as any blankie. (Page 24)

Tags: pink

There’s no point in bringing your kid here if you’re going to let him keep smoking. (Page 24)

Tags: orange

In truth, before the novel coronavirus had escaped China’s borders in 2019, nearly a third of Americans between the ages of eighteen and thirty-five said they were experiencing a mental illness.[ 49] Hospital admissions for nonfatal self-harm were up 62 percent over the previous decade,[ 50] with nearly 20 percent of girls ages twelve to seventeen reporting having had a major depressive episode in the previous year. Child suicide rates rose 150 percent over the previous decade.[ 51] (Page 26)

Nature, the medical journal The Lancet, and NPR all agree: depression is merely a rational response to the greenhouse gases’ smothering fug. (Page 27)

“Deaths from natural disaster have declined over 95 percent over the last century. Actual disasters themselves have gone down over the last twenty years. Disasters are measured strictly as deaths and damages from extreme weather events,” said Michael Shellenberger, a longtime environmental activist and author of several books on the environment. “We’re more resilient than ever.” (Page 28)

teen girls have seen a severe mental health decline, those who identify with liberal and left-leaning politics have suffered worst of all.[ (Page 29)

It’s deeply connected to the values and worldview we’ve given our kids, the ways they’ve raised them, the influences around them. (Page 29)

Tags: pink

They’ve just never been made to do anything on their own. (Page 30)

Tags: pink

I asked Beth how many of the thousands of students she treats mention climate change or systemic racism as a reason for their distress. She told me flatly—none. Not a single one. “I don’t think anyone ever. Like they might make some an offhanded joke about it?” (Page 31)

Tags: orange

A lot of their distress, Beth says, falls into the category of social interactions gone very bad—things they said or posted online that they later regret and can’t seem to stop reliving. The boy who dumps them or leaves their texts “on read.” They want to get over it. They believe they can’t. (Page 31)

Tags: pink

Turns out, when young people are not in the throes of severe distress, they offer reasons that will seem rational to the adults around them and garner the sympathy and attention they want or need.[ (Page 31)

Researchers often graft onto the young whatever explanation seems most rational to them, based on their own political biases. For conservative researchers, the rise of fatherlessness, the decline of marriage, or decreased religious affiliation—all of which coincide with climbing rates of mental illness—might seem rational explanations. For liberal researchers, climate change, school shootings, systemic racism, economic inequality, and the politics of MAGA provide favored candidates.[ 59] (Page 32)

just as schoolkids in 1962 were more worried about nuclear war with Russia than schoolkids today. (Page 32)

The rising generation is strikingly different from those prior, according to academic psychologist and author of several books on Gen Z, Jean Twenge. It isn’t simply the rates of diagnosed mental illness that makes them so distinctive. They are far more obedient to authority, agreeable, and tied to Mom. More politically radical (more likely to favor far-left positions) and much less inclined to self-aggrandizement than, say, millennials. Actually, what seems to motivate a large portion of Gen Z, born between 1995 and 2012, is not hope or optimism or belief in themselves—it’s fear. They are arguably the most fearful generation on record. (Page 32)

Tags: pink

Gen Z, Twenge told me, is far less likely to date, obtain a driver’s license, hold down a job, or hang out with friends in person than millennials were at the same age. (Page 33)

high school seniors spent up to an hour less per day hanging out with each other than those of the 1980s. (Page 33)

reluctant to cross the milestones at which previous generations eagerly launched themselves. (Page 33)

They are also far more pessimistic than previous generations— (Page 33)

more pessimistic than millennials, (Page 33)

“Locus of control” (Page 33)

The rising generation has moved toward an external locus of control, (Page 34)

social critic Christopher Lasch once observed that therapy “simultaneously pronounces the patient unfit to manage his own life and delivers him into the hands of a specialist.”[ (Page 35)

Tags: orange

Big Tech is already revolutionizing mental health, creating apps that will soon have the capacity to provide therapy to every single child. (Page 36)

Tags: blue

Chapter 3 • Bad Therapy (Page 39)

problems, Ortiz says, individual therapy has almost no proven benefit for kids. “The evidence is pretty clear that parent-based approaches are more effective.” Meaning, a therapist should treat a kid’s anxiety by treating the kid’s parents. Parents often unwittingly transmit their own anxiety to their kids. And parents are in the best position to help a child deal with her worries on an ongoing basis. (Page 40)

Tags: orange

very little evidence that individual (one-on-one) psychotherapy helps young kids at all.[ 1] (Page 40)

Tags: pink

“If your therapist doesn’t talk to you about termination [of psychotherapy] during your first session, it’s probably not a good therapist.” (Page 41)

Tags: orange

However hard we work to “destigmatize” therapy, the message to any child patient is twofold: Your mother thinks there is something wrong with you and Your problem is above her pay grade. Almost necessarily, the presence of the intermediary will alter a parent’s relationship with her child, whether the parent realizes this or not. (Page 42)

Tags: pink

demoralization (convincing a young person there’s something wrong with her) and undermining parental authority (Mom can’t handle your problems, so she’s hired someone who can—someone who has better judgment about you than she does). All for a process with doubtful chance of working. (Page 42)

Tags: pink

Bad Therapy Step One: Teach Kids to Pay Close Attention to their Feelings (Page 43)

“I am an emotions researcher,” the pixieish Soviet émigré said as we toured her lab. “Emotions are highly reactive to our attention to them. Certain kinds of attention to emotions, focus on emotions, can increase emotional distress. And I’m worried that when we try to help our young adults, help our children, what we do is throw oil into the fire.” (Page 43)

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A rich emotional vocabulary can help children describe their feelings. But many of our therapeutic interventions with children, she says, go far beyond supplying one. “We are basically telling them that this deeply imperfect signal”—that is, what they are feeling—“ is always valid, is always important to track, pay attention, and then use to guide your behavior, use it to guide how you act in a situation.” (Page 43)

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Placing undue importance on your emotions is a little like stepping onto a swivel chair to reach something on a high shelf. Emotions are likely to skitter out from under you, casters and all. (Page 43)

attending to our feelings often causes them to intensify. Leading kids to focus on their emotions can encourage them to be more emotional. (Page 44)

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The anger you feel does not necessarily indicate that you are in the right or that someone treated you unfairly. You may feel envious of a friend, even though you would not actually want what he has. You may feel loved by someone who mistreats you or resent someone who’s only treated you kindly. Feelings fool us all the time. (Page 44)

Adults should be telling kids how imperfect and unreliable their emotions can be, Chentsova Dutton says. Very often, kids should be skeptical that their feelings reflect an accurate picture of the world and even ignore their feelings entirely. (Gasp!) You read that right: a healthy emotional life involves a certain amount of daily repression. (Page 44)

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“Asking somebody ‘how are you feeling?’ is inducing negative feelings. You shouldn’t do that.” (Page 45)

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If you track a person’s emotions over the course of a day or even a week, Linden told me, happiness is actually a very rare emotion, statistically speaking. (Page 45)

Psychologists have studied the states of mind that tend to make us more successful, whatever the challenge. There are at least two we can adopt: “action orientation” and “state orientation.”[ 3] Adopting an action orientation means focusing on the task ahead with no thought to your current emotional or physical state. A state orientation means you’re thinking principally about yourself: how prepared you feel in that moment, the worry you feel over a text left unanswered, the light prickling at the back of your throat, that crick blossoming in your neck. Adopting an action orientation, it turns out, makes it much more likely that you accomplish the task. (Page 46)

No winning head coach asks his players to consider their feelings at halftime because thinking about yourself shatters your ability to get things done. (Page 47)

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Bad Therapy Step Two: Induce Rumination (Page 48)

“Trying to get the patient to consider their past and how it went wrong, and what could have gone better and how should it be different, what can happen, what’s the most likely outcome and so on—a lot of these different interventions are actually worry-and rumination-increasing interventions,” he told me over Zoom. Instead, when patients present with depression or generalized anxiety disorder, therapists “should be doing worry and rumination discontinuing interventions.”[ 5] Meaning, a good therapist should do what cognitive behavioral therapists do: prove to a patient that rumination is an unproductive mode of thought and train them to stop. (Page 48)

being overly prone to talking about your emotional pain is itself a symptom of depression. “If you do this”—habitually give voice to your negative thoughts or personal problems—“ you’re co-ruminating at least. But I believe they are ruminating more. And rumination is the major predictor for depression.” (Page 48)

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Bad Therapy Step Three: Make “Happiness” a Goal but Reward Emotional Suffering (Page 49)

Hang around families with young children for an afternoon, and you’ll hear parents check that their kids are enjoying their ice cream, excited about school the next day, that they had fun at the park. In so many ways, we signal to kids: your happiness is the ultimate goal; it’s what we’re all livin’ for.[ (Page 49)

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If we wanted our kids to be happy, the last thing we would do is to communicate that happiness is the goal. The more vigorously you hunt happiness, the more likely you are to be disappointed.[ 7] This is true irrespective of the objective conditions of your life. (Page 49)

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By insisting that happiness be their goal, we place kids in a crucible. On the one hand, “chasing positivity” tends to make them more depressed. Then feeling depressed gets socially rewarded, Chentsova Dutton said. So, kids are naturally “amplifying their signal of how much they suffer.” (Page 49)

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Bad Therapy Step Four: Affirm and Accommodate Kids’ Worries (Page 50)

therapists can reinforce a child’s or adolescent’s outsized fears. Therapists can make kids’ anxiety worse. (Page 51)

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The best way to demolish this maladaptive belief is for your kid to have direct and repeated contact with precisely the thing she is afraid of.[ (Page 51)

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“Exposure therapy” is CBT’s escalating method of encouraging patients to confront things that make them uncomfortable. It is among the few therapies with an evidentiary track record of benefits. (Page 51)

Accommodation deprives children of the opportunity to vault a challenge and renders them “actually less capable,” (Page 51)

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We all need practice sitting with discomfort, Ortiz emphasized—emotional as well as physical. (Page 52)

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I asked neuropsychologist and author Rita Eichenstein why we’re seeing so many phobias and so much anxiety among kids today. “There’s sensory deprivation. The minute the kid goes home from the hospital, they’re in a car seat, facing backwards,” she said. “The pristine nursery. That’s all quiet now. They’re all using sound machines. They’re not getting dirty. They’re not outside in the dirt. They’re not getting that normal chaos.” (Page 52)

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Banishing normal chaos from a child’s world is precisely the opposite of what you would do if you wanted to produce an adult capable of enjoying life’s intrinsic bittersweetness, the small pleasures you might never notice if your life were a theme park, all cotton-candy jingles and frictionless rides.[ (Page 52)

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We’re making our kids more fearful and less tolerant of the world. (Page 52)

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Bad Therapy Step Five: Monitor, Monitor, Monitor (Page 52)

“At home, the parents are watching them. At school, they’re being observed by teachers. Out of school, they’re in adult-directed activities. They have almost no privacy.” (Page 53)

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Actually, Gray said, adding monitoring to a child’s life is functionally equivalent to adding anxiety. “When psychologists do research where they want to add an element of stress, and they want to compare people doing something under stress versus no stress, how do they add stress? They simply add an observer,” Gray said. “If you’re watched by somebody who seems to be assessing your performance, that’s a stress condition.” (Page 53)

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Real play, of the developmentally beneficial sort, involves risk, negotiation, and privacy from adults:[ 14] the fort or treehouse built to block adults’ view. (Page 54)

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Things that are joyful to children: danger, discovery, dirt. Games whose rules they invented with that ridiculous cast of characters they call friends. Their hearts aren’t fooled by Mom’s carefully arranged simulacra: the hypoallergenic, nontoxic “slime” she begs all the kids to make with her from a kit that arrived from Amazon. Isn’t this fun? It’s so gross! Right, girls?! Harmless enough, but it doesn’t help a kid blow off steam or test her limits or negotiate relationships with peers. It doesn’t help her learn about herself and, in the process, discover what sorts of activities or people she might one day come to love. (Page 54)

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Bad Therapy Step Six: Dispense Diagnoses Liberally (Page 55)

Bad Therapy Step Seven: Drug ’Em (Page 56)

“You want to be very careful starting children and adolescents on antidepressants,” he told me. He’s even more adamant about antianxiety medicines like Xanax and Klonopin. “Anything that makes you feel better within thirty minutes is going to be at least psychologically and physiologically addictive, and it probably is going to be both.” (Page 56)

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With children and adolescents, there’s far less proof of antidepressants’ efficacy than for adult patients.[ 19] The evidence base is far smaller than it is for adults.[ 20] And kids are, by definition, a moving target, undergoing changes so rapidly that doctors run the risk of medicating for circumstances soon to be in the rearview mirror. (Page 57)

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primary effect of the drugs themselves: placing a young person in a medicated state while he’s still getting used to the feel and fit of his own skin. (Page 57)

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When you start a child on meds, you risk numbing him to life at the very moment he’s learning to calibrate risks and handle life’s ups and downs. (Page 57)

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Bad Therapy Step Eight: Encourage Kids to Share Their “Trauma” (Page 58)

One of the most significant failings of psychotherapy, Byng says, is its refusal to acknowledge that not everyone is helped by talking about their problems. Many patients, he says, are harmed by it. (Page 58)

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A dose of repression again appears to be a fairly useful psychological tool for getting on with life—even for the significantly traumatized among us. (Page 59)

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a generation of kids who can never ignore any pain, no matter how trivial. (Page 59)

Bad Therapy Step Nine: Encourage Young Adults to Break Contact with “Toxic” Family (Page 60)

A large-scale national survey confirms a recent increase in this phenomenon: almost 30 percent of Americans eighteen and older had cut off a family member.[ (Page 60)

‘Your Biggest Threat to Your Relationship with Your Child Isn’t Parenting. It’s the Therapist They’re Going to See at Some Point.’ ” (Page 60)

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One of the most damaging ideas to leach into the cultural bloodstream, according to Coleman, is that all unhappiness in adults is traceable to childhood trauma. Therapists have made endless mischief from this baseless and unfalsifiable assertion. (Page 60)

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Bad Therapy Step Ten: Create Treatment Dependency (Page 61)

“treatment dependency” looks like. Leery of trusting herself, a patient will develop an “external locus of control” and be reluctant to attempt the sort of reckless chance from which romantic adventure and professional success might otherwise be born. (Page 63)

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Emotional Hypochondriacs (Page 64)

Bad therapy encourages hyperfocus on one’s emotional states, which in turn makes symptoms worse. (Page 64)

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Hypochondriacs are not wimps, and they are not imagining their pain. But nor do they necessarily have more pain than other people. They are simply overly attentive to the normal pains we all feel. (Page 64)

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Bad therapy does precisely the opposite. It engenders intensive focus on feelings, amplifies emotional dysregulation, increases a sense of hopelessness, of incapacity and a paralytic helplessness against a rising sea of feelings. (Page 65)

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Part II Therapy Goes Airborne (Page 67)

Chapter 4 • Social-Emotional Meddling (Page 69)

Bad therapy had gone airborne. For more than a decade, teachers, counselors, and school psychologists have all been playing shrink, introducing the iatrogenic risks of therapy to schoolkids, a vast and captive population.[ (Page 71)

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“Emotions Check-Ins”: Constantly Taking Every Kid’s Emotional Temperature (Page 71)

If we wanted to help kids with emotional regulation, I asked Kennair, what would we communicate instead? “I think I’d say: worry less. Ruminate less,” Kennair said. “Try to verbalize everything you feel less. Try to self-monitor and be mindful of everything you do—less.” (Page 72)

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“If you want to, let’s say, climb a mountain, if you start asking yourself after two steps, ‘How do I feel?,’ you’ll stay at the bottom,” Linden said. (Page 72)

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An individual is more likely to complete a difficult task if she adopts a task orientation—a focus on the job ahead. If she’s thinking about herself, she’s less likely to complete it. (Page 72)

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The School Psychologist Would Love to Talk to You (Page 72)

The Group Therapy Behemoth: Social-Emotional Learning (Page 75)

And here’s where things get tricky: teachers aren’t actually trained in psychotherapy, and they aren’t bound by its ethical guidelines, either. Setting up an “emotional sharing” session may sound good, but typically, therapists perform this function under ethical guidelines so that they don’t inadvertently exploit or betray their patients. (Page 77)

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Good therapists know that it may be counterproductive to push a kid to share his trauma at school. Good therapists are trained specifically to avoid encouraging rumination. But school staff who play therapist rarely seem aware that they might be encouraging rumination as they stalk a kid at lunch, waiting to see if he’ll open up about his father’s incarceration minutes before a history test. (Page 78)

For more than a decade, they 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. (Page 80)

For those ticking off bad therapy steps, schools are racking up quite a few: inducing state orientation with emotions check-ins. Encouraging kids to focus on their feelings, which can cause bad feelings to perseverate. Treating kids with in-school therapy, which can introduce all kinds of iatrogenesis, especially where it does not abide an ethical “dual relationship” boundary. (Page 80)

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Social-Emotional Learning: Teaching Resilience by Treating Every Kid as Irreparably Broken (Page 81)

SEL Should Be the Goal of Every Class—Yes, Even Math Class (Page 82)

Teaching Kids How to Be a Friend (and Other Useless Meddling) (Page 83)

A Sneak Attack on Parental Authority (Page 85)

One social-emotional learning lesson makes plain what so many others merely imply: Teens should spy on their parents and report back to their teachers. No, really. (Page 85)

Chapter 5 • The Schools Are Filled with Shadows (Page 89)

public schools assign shadows to follow kids with problems ranging from mild learning disabilities to violent tendencies, and private schools advise affluent parents to hire shadows to trail neurotypical kids for almost any reason. To help a kid make friends on the playground, to soothe a kid wriggling in his seat, to help a kid succeed and have fun at school. (Page 90)

More monitoring, more dependence on an adult, less practice handling themselves, less inducement to believe that they can. (Page 90)

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they found that when fidget spinners were used, there was an initial decrease in activity level, followed by poorer attention overall for the kids who used them.[ (Page 91)

Accommodation and Avoidance (Page 91)

School counselors—students’ in-school “advocates”—lobby teachers to excuse lateness or absence, forgive missed classwork, allow a student to take walks around the school in the middle of class, ratchet grades upward, reduce or eliminate homework requirements, offer oral exams in place of written ones, and provide preferential seating to students who lack even an official diagnosis. (Page 92)

None of Oscar’s bullies was even suspended, according to Stephanie, and by then I knew why: “restorative justice.”[ 6] In 2014, President Obama issued a Dear Colleague Letter threatening schools with loss of funding if they continued to suspend and expel a disproportionate number of minority kids. This presented schools with a quandary: How do you maintain order without punishment? The Dear Colleague Letter spelled out the solution: “restorative practices, counseling, and structured systems of positive interventions.”[ 7] Violent kids were rebranded as kids in pain. Schools stopped suspending or expelling them. And a newly invigorated era of mental health in public schools was born. (Page 94)

“Restorative justice” is the official name for schools’ therapeutic approach that reimagines all bad behavior as a cry for help. (Page 94)

Several teachers told me that thanks to restorative justice, public schools no longer hold back or expel kids in any but the most extreme circumstances. Until they commit egregious acts of criminality, violent kids are kept in school and assigned shadows, under the therapeutic ethos: treat, don’t punish. Nikolas Cruz, a student at Marjory Stoneman Douglas High School, had committed violent and menacing acts for years. He was assigned a shadow—his mom.[ 9] “The Parkland shooter” later took seventeen lives. (Page 95)

Every teacher I spoke to confirmed that the approach is failing. Therapeutic techniques are no substitute for a system that punishes violence. (Page 96)

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RAND meta-analysis showed that schools that implemented restorative justice fell apart. At the middle school level, academic outcomes worsened in schools with restorative practices. There was no reduction in incidents of violence or weapons violations, no fewer suspensions for male students, nor even reduction in arrests at these schools. “This, of course, raises the question of whether restorative practices can be effective in curbing the most violent behavior, at least within a two-year implementation period,” the authors wrote.[ (Page 96)

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“Restorative justice destroys and ruins schools,” Wisconsin middle school teacher Daniel Buck told me. “Because if kids know that they can get away with something without a consequence, they’re going to do it.”[ 11] (Page 96)

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Schools across the country are reporting far worse behavioral outbreaks in recent years. “Ask anyone who has worked in some of America’s failing public schools and nearly all of them will tell you the same thing: The biggest problem isn’t the quality of the teachers,” one teacher wrote in the New York Post in 2018. “It’s the behavior of the kids: angry, disruptive, disrespectful kids whose behavior is out of control.”[ 12] Every public school teacher I interviewed said the same: kids’ behavior has deteriorated over the last decade. (Page 97)

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Kids, at best, seem unhelped by the therapies and meds and accommodations showered upon them. They can’t or won’t control their emotional outbursts. They can’t or won’t get their homework in on time. In greater numbers than teachers ever remember seeing, they can’t or won’t do for themselves. (Page 98)

Perhaps children who have suffered what the original researchers called “ACEs” need special care. Some of them may find it difficult to shake the torment that trails them to school. The question, for such kids, might not be whether they should receive mental health support but what kind. (Page 103)

That is far from the majority of kids, and it is dangerous to conflate those who have suffered years of sexual abuse or been intentionally starved or burnt by the parents who are supposed to love them with those who have faced “adversity.” (Page 103)

Kids from Troubled Backgrounds Have the Most to Lose from Accommodation (Page 105)

What they need is also the thing so few adults in their lives are willing to supply: high expectations. “People think that if a young guy comes from a disorderly or deprived environment, he should be held to low standards. This is misguided. He should be held to high standards. Otherwise, he will sink to the level of his environment,” Henderson writes.[ (Page 105)

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There is no good reason to believe that most kids are traumatized. The best research indicates the opposite: even among victims of heartbreaking circumstances, resilience is the norm.[ 18] Disturbing events are best understood as “potentially traumatic,” meaning they may leave no lasting psychological imprint at all, and certainly not necessarily a negative one.[ 19] (Page 105)

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treating her as though she can may be more likely to encourage the result that she will. (Page 106)

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“That’s an anti-resilience culture,” Kennair told me. By treating kids as if they bear an incipient defect, educators are very likely doing real harm. It’s no wonder so many kids feel powerless to make positive changes in their lives. They’ve been told, over and over, by educators: You can’t. (Page 106)

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Most American generations endured national hardships. But there was no rash of suicides among young southerners during the Civil War nor during Reconstruction. None among teens during the Great Depression, though they did see suicide among the adults of the time.[ 5] Nor was there a rash of suicide among young adults following Pearl Harbor, when so many of them were sent off to war. Not during the Cuban Missile Crisis, when the world might actually have blinked out like a Zenith TV on the fritz, nor during the endless waves of disillusionment that accompanied the Vietnam War. The Boomers who fancy themselves having confronted some of the ugliest chapters in American history—segregation, Vietnam, Watergate—are usually the first to acknowledge that they could, and did, initiate a positive change. (Page 109)

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Researchers confirm that the vast majority of those who suffer even severe hardship, left to their own devices, will be able to do just this:[ 8] pull themselves up, get back on the horse, try again. Some even posit that we can be made better off—stronger, smarter, more determined, more grateful—by the thousand natural shocks of a bumpy childhood. (Page 110)

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A Bunch of Broken Toys (Page 111)

We are, as a culture, enthralled by the notion of childhood trauma—wary of inflicting it, eager to spot it. Books that insist we all have hidden trauma from our childhoods live on bestseller lists. (Page 111)

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Harvard University psychology professor Richard McNally has called repressed memory therapy “arguably the most serious catastrophe to strike the mental health field since the lobotomy era.”[ 22] The repressed memory scandal of the 1990s resulted in false accusations and high-profile convictions, later overturned.[ 23] It represented perhaps the most notorious rash of therapist-led iatrogenesis in twentieth-century America. (Page 115)

resilience—not permanent traumatic response—is the norm. Even for kids subjected to desperate hardship—poverty, alcoholism in the family, family instability, and parental mental illness—studies showed that in all but the most persistently dire circumstances, they typically demonstrate resilience.[ (Page 119)

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subsequent studies of Vietnam vets have shown that small hippocampi are a risk factor for developing PTSD, not the result of wartime trauma.[ 41] The trauma gurus may have fully reversed the real arrow of causality between smaller brain structures and PTSD. (Page 124)

into. She found that parents who had suffered physical abuse, sexual abuse, or neglect during their childhoods were no more likely to physically abuse their own children.[ 43] (Page 125)

“Memory works a little bit more like a Wikipedia page,” she has said.[ 51] “You can go in there and change it—but so can other people.” Interviewers can press people—children especially—to believe all sorts of things through leading questions.[ 52] False memories can be just as vivid and apparently veridical as accurate ones. (Page 128)

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Flighty and labile as an actor, memory is also creative, impressionable, and fundamentally inconstant, she says. Kids especially are easily led by questioners; social influence and reinforcement can powerfully determine answers children provide.[ (Page 130)

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Chapter 7 • Hunting, Fishing, Mining: Mental Health Survey Mischief (Page 137)

Mandated by state agencies and primarily authored by the Centers for Disease Control and Prevention (CDC), ostensibly to assess student mental health, surveys are presented to public school children with all the seriousness of a standardized test. They pry into the most private details of teenage experimentation and family life: alcohol consumption, drug use, and sexual orientation, along with the de rigueur inquiry into race and gender identity. They ask kids whether they feel loved by their parents or supported by their schools, and a series of very specific questions on what types of self-harm they have tried. (Page 138)

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Because suicide and self-harm are so contagious among teens, Peterson said, adults must be extremely careful not to ask kids leading questions. “Like, ‘When was the last time you thought about cutting your wrists?’ Do you know how much information there is in that statement?” (Page 150)

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Peterson’s concern is well-founded. The virality of suicide and self-harm among adolescents is extremely well-established.[ 28] Study after study[ 29] has shown that media reports of suicide can increase incidence among teens. In the 1980s, a concerted effort in Vienna, Austria, to limit media coverage of subway suicides had a stunning effect: the number of suicides by subway dropped by 75 percent.[ 30] (Page 151)

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“Self-consciousness,” or what Peterson calls “self-reflection on the feeling state,” and neurotic suffering are virtually indistinguishable, clinically and psychometrically. “Insofar as you’re thinking about yourself, you’re depressed and anxious,” Peterson said. “There’s no difference between thinking about yourself and being depressed and anxious. They are the same thing.”[ 35] (Page 152)

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“By making our children obsessively focused on their autonomous selves, all we do is pull them out of their social context, isolate them, and make them neurotic,” Peterson said. “And so any clinician that tells you that there’s no connection between constantly harassing people about their mental health, and making them miserable … they’re clueless. They have no idea what they’re talking about.” (Page 153)

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“Sanity is the harmony that emerges as a consequence of being embedded in multiple social institutions,” (Page 153)

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If we left kids alone to play and exist, relatively unfettered, in their social worlds—without our monitoring, advice-giving, and interruption—they would generally learn to get along with others, and they would tend to feel less despondent. We might need to interrupt rare cases of bullying. But otherwise, being part of a softball team or Girl Scouts, telling secrets to your best friend that you don’t also share with your mom—that’s the stuff that helps keep adolescents in balance, and kickstarts the freewheeling process of discovery and manufacture that ultimately produces a stable identity. (Page 153)

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Chapter 8 • Full of Empathy and Mean as Hell (Page 155)

The Problem with Empathy (Page 159)

As academic psychologists who study empathy know, injustice and cruelty may even be the predictable result of placing a precedence on empathy. (Page 159)

“Empathy is a spotlight focusing on certain people in the here and now,” Yale professor of psychology Paul Bloom writes in his important book, Against Empathy. “This makes us care more about them, but it leaves us insensitive to the long-term consequences of our acts and blind as well to the suffering of those we do not or cannot empathize with. Empathy is biased, pushing us in the direction of parochialism and racism.” (Page 159)

you cannot empathize with more than one or two people at a time. Try it.”[ (Page 159)

Make fairness your guide and you lay the groundwork for treating everyone equally. But put empathy in charge—feel the pain of the “victims” in front of you—and you’re not only likely to treat the “out group” much worse.[ 9] You may even treat everyone worse. (Page 159)

This may explain why therapists sometimes inadvertently encourage a client to divorce by making relationship-undermining statements and portraying the absent spouse unfavorably.[ 10] It’s not that these therapists are necessarily callous; they may simply be empathic. (Page 160)

Empathy invariably involves a choice of whose feelings to coronate and whose to disregard. (Page 160)

People who are motivated by fairness or a keen sense of right and wrong will often treat people humanely, despite feeling no particular empathy with the beneficiaries. (Page 160)

Chapter 9 • The Road Paved by Gentle Parents (Page 164)

Moms were putting in 50 percent more time with their kids than parents did in the 1960s; dads—twice as much.[ 3] We must be doing a better job. (Page 167)

But of course, it’s also bollocks. A parent can take a kid to the park who has thrown his food on the floor. She just doesn’t want to. And she does make the rules—or, at least, she’s chosen to adopt the rules, supplied by the parenting experts. But here is the parent straining to act as therapist, divesting herself of moral judgment, refusing to chide bad behavior, pretending her hands are tied. (Page 171)

“gentle parenting,” a therapy-infused model that requires parents to give choices instead of orders.[ 7] (Parents get plenty of orders; children get none.) (Page 172)

These parents proudly declare that they avoid ever saying “no” to their children. They regard time-outs as cruel and “triggering.” Isolating a child in his room? Emotionally hurtful—and out of the question. (Page 173)

Even in response to violence, they offer almost no correction and absolutely no judgment. Instead, they announce their preferences: “I don’t like it when you hit, so I’m gonna stand up.” (Page 173)

Dad levels with the kid, issues a direct order, expects the kid to comply, and—voila!—she can. Where is the Enigma cryptology team when we need it? (Page 176)

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The people who make parenting look exhausting aren’t all that fond of the kids they’ve raised. If it’s any consolation—the rising generation’s employers and colleagues aren’t smitten with them, either. (Page 176)

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Whenever parents become “educated” in the therapeutic method, they invariably conclude that they have a “sensitive child.” Nearly every recent parenting book I’ve read prompts readers toward that notion. (Page 179)

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parents who accommodate kids’ sensitivities often inadvertently help create sensitive children. The environment they curate is so frictionless, it offers the child no preparation for the normal chaos of the world. (Page 179)

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One parenting coach, Rebecah Freeling, observed to me that when entitlement is nurtured in a child, what’s normal at three becomes unbearable in a child of seven, eight, or nine. “And in teenagers, that entitlement is dangerous,” she said. (Page 180)

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Funny, you know who also lacks “basic information” about a child’s brain? Neuroscientists. Every one of the neuroscientists and psychiatrists I spoke to impressed upon me how little we know about what goes on in the brain, or the relationship between neurological events and human emotion and behavior. The brain is astonishingly, endlessly complex, they all told me—full of feedback mechanisms about which we know little to nothing at all. (Page 181)

For thousands of years, until the therapeutic turn in parenting, societies took it for granted that parents’ primary job was to transmit their values to their children. And, of course, parents are the ultimate experts on their own values. Once parents decided the goal of child-rearing was emotional wellness, they effectively conceded that the actual authorities were therapists. (Page 182)

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The “authoritative parent,” however, is loving and rule based. She attempts to direct the child’s activities in a rational manner, encourages a give-and-take with her child, but “exerts firm control at points of parent-child divergence.” Where her point of view on a household rule ultimately conflicts with that of her child, she wins. She maintains high standards for her child’s behavior “and does not base her decisions on group consensus or the individual child’s desires.”[ 19] (Page 183)

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In studies that still manage to chagrin therapists, Baumrind found that authoritative parenting styles produced the most successful, independent, self-reliant, and best emotionally regulated kids; it also produced the happiest kids—those less likely to report suffering from anxiety and depression.[ 20] (Page 183)

kids are happiest when raised in a loving environment that holds their behavior to high standards, expects them to contribute meaningfully to the household, and is willing to punish when behavior falls short. And it flies in the face of virtually everything therapists and parenting books now exhort. (Page 183)

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Therapeutic parents are permissive parents who also smother and micromanage. (Page 184)

Vanishingly few American-born parents are willing to be “authoritative” with their kids, in the Baumrind sense. Even when they think they are being “authoritative,” they cajole and plead and explain. They absorb violence from first graders they would never tolerate from a puppy. (Page 184)

Doucleff even reluctantly admits that in nearly every culture around the world—including those she admires—parents give the errant child a brisk spanking.[ 22] Doucleff envies these cultures—their confident closeness with their children; the happy, competent, generous, chore-doing kids they are raising. She wishes Americans had these parenting traditions. She rarely seems to notice that until very recently, we did. (Page 185)

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The saddest part? Not only do we rarely motivate our kids to better behavior, many of our children don’t like us very much. There is more parental estrangement today than in generations past. And the young adults who are cutting off their parents in record numbers are often those raised by the most indulgent and devoted parents. (Page 185)

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The young adults who cut off their parents often say they feel crushed by the burden of serving as the buttress for their parents’ emotional lives. This isn’t tiger mom–style high expectations, which may place pressure on a child to achieve, but where the ultimate success accrues to the kid herself. (Page 186)

In ridiculing me, my father’s voice acknowledged that I was my own, independent person. His voice said, in effect: If you’re going to do something that dumb, it’s on you. As opposed to today’s parents who communicate something very different: “ ‘Oh, my God, don’t do that. Because if you did, it would ruin my life with sorrow.’ That might be a different kind of a message,” Coleman said. (Page 187)

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All of our sucking up to them doesn’t even guarantee the relationship. They are willing to tolerate it as long as we pay the bills; after that, they’re often just not that into us. (Page 187)

A kid sent to her room may use the time to self-reflect, but she may not. And she may choose to overstep the boundary again. But at least she knows it’s there. She knows there is something beyond her feelings—respect for others. And that no matter how she may feel, she must find a way to stay within the bounds of tolerable behavior. Her parents have sent her to her room because they believe she can learn to control herself. (Page 189)

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The au courant idea that even humane punishments “don’t work” is something Baumrind calls a “myth.” Baumrind also found that demands for neatness in children is associated with less hostile and less delinquent kids and that it was incorrect to assume that high expectations would result in passive-aggressive rebellion.[ 24] (Page 189)

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And while Baumrind did not advocate spanking, she found that “occasional, mild spanking” did not traumatize children.[ 25] Cue the outrage. But it’s true: studies have been unable to support supposed links between spanking and externalizing disorders.[ (Page 190)

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What actually makes for miserable kids? Placing them in charge. Failing to hold their behavior to high standards and not punishing them when they deliberately allow it to fall short. And, yes—according to Baumrind—what else makes for an unhappy kid? Parents behaving in a consistently “affirmative manner toward the child’s impulses, desires and actions.”[ 27] (Page 190)

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It’s because forty-year-old parents—accomplished, brilliant, and blessed with a spouse—treat the raising of kids like a calculus problem that was put to them in the dead of night, gun to the head: Get it right or I pull this trigger. (Page 190)

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India, the culture supports the idea that a child should treat her parent respectfully—and other parents will enforce that with their stares. In America, the onus is entirely on the parent. And we wonder: “What have you done wrong to deserve a tongue-lashing from your child?” (Page 191)

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What were we Americans doing so wrong? “In third world countries,” Rhoda said, “parenting is very authoritarian because the leaders are very authoritarian. America is on the other side—completely lack boundaries and authority.” We needed something in between. (Page 193)

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I heard this from other immigrants: the problem with American parenting is that we do not assert our authority with our own children. We do not make it a priority to pass down our values to our own kids; we seem to expect the culture to do this for us. It’s okay to allow for some give-and-take with children, but in the end, it must be our judgment that carries the day. (Page 193)

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“The majority of the kids that are sucked into supremacy, they are from families that are liberal. It’s really astonishing to see how many kids that are in white supremacy, Neo-Nazi groups, Antifa, and even Islamism come from nice liberal families.” (Page 194)

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In so many liberal American families today, she said, parents disavow their authority, give children endless choices, and constantly solicit kids’ opinions on major life decisions. But the hunger for authority and boundaries is profoundly connected to a child’s sense of self and well-being. It does not dissipate simply because parents fail to supply it. (Page 194)

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This point was famously made by public intellectual Midge Decter in the 1970s, to explain why so many kids with doting parents and capacious freedom had turned into adults who inclined toward extremist movements. (Page 194)

Today, as more than one parenting coach and pediatrician told me, kids arrive at school having never heard the word “no.” They don’t know how to conform to the expectations set by their teachers—they’ve had no practice. No one asked them to sit at the table through dinner, employ basic table manners. No one forced them to wait on a snack or an activity that they wanted right now. No one made them wait until a sibling or parent finished speaking before announcing their own desires to the household. (Page 195)

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Chapter 10 • Spare the Rod, Drug the Child (Page 197)

There are “4Ds” of abnormal psychology, Ophir reasoned: deviance, distress, dysfunction, and danger. ADHD doesn’t meet any of them. With an incidence of over 10 percent of in the United States, and an astounding 20 percent of Israeli children and young adults,[ 3] ADHD isn’t rare or “deviant.”[ 4] (Page 198)

teens placed on antidepressants might also lose something of the fullness of socialization—navigating peers, winning affection and testing it, suffering a hurt and muddling through. (Page 200)

asked Hollon what we’d expect to see in a society that indiscriminately placed moody teenagers on antidepressants and nervous teens on antianxiety medication. “Oh, they wouldn’t learn to cope,” he said. (Page 200)

Anxiety is anticipatory fear—worry about the threat of danger yet to come. (Page 201)

Depression is not all bad, either, and it, too, has a purpose: to protectively shut down the system, often after we’ve been overpowered, allowing us to retool and contemplate a different approach. So that we withdraw from the thing that caused us harm and take stock.[ (Page 201)

It’s only if you’re experiencing chronic anxiety or depression that you cannot otherwise resolve that you might begin to consider pharmaceutical intervention. (Page 202)

Put another way, antidepressants sometimes transform a short-term, acute pain into a low-grade chronic one. (Page 203)

I don’t know how to raise your kid. I don’t know your values. And I distrust, instinctively, most who would claim to know these things. I certainly don’t believe that any mental health expert does. They’ve already cocked up this child-rearing thing so badly. (Page 208)

They convinced a generation of parents who wanted to give their kids everything—who devoted more time and energy to their children than any prior—that we didn’t know what we were doing. They convinced us that parenting involved skills and expertise, things we needed them to provide us. (Page 209)

But parenting is not a skill. It’s a relationship—or, it was. Before the experts professionalized it, turning time with our kids into a loathsome chore. We aped and practiced their stilted way of speaking, disavowed our instincts, wiped out our histories, and landed here: pleading with miserable kids to perk up and behave. A lousy trick to play on people who’d wanted kids so badly. Lousier for the kids whose parents view them as a grim obligation. (Page 209)

Part III Maybe There’s Nothing Wrong with Our Kids (Page 211)

Chapter 11 • This Will Be Our Final Session (Page 213)

Experts are not the only ones getting in the way of our kids’ normal maturation; parents’ epidemic of overinvolvement in kids’ lives is by now the stuff of legend. (Page 215)

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And yet we know—not only because the best psychological research indicates it, but also from years of inherited wisdom—that kids need space from adult oversight. They thrive with independence, a certain level of responsibility and autonomy and, yes, failure. They never learn to do for themselves if we do everything for them. Risky play—rough-and-tumble, or involving heights, sharp tools, and some actual danger—not only rewards kids with joy and social competence, it may make them less phobic and better able to navigate and assess risks in the future.[ 3] Small failures and injuries help rather than hurt kids. (Page 216)

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But the advice “give them autonomy” or “assign them tasks that maximize independence” gets things backward. It only ends up participating in the problem of ruining our kids through overtreatment. You don’t give a child independence any more than you give a child confidence, however much it flatters us to think we do. In most circumstances, you simply get out of their way—stop interfering—and independence takes its course. (Page 216)

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Our kids were doing so much better when they had less—less distraction, less stimulation, less supervision, less intervention, less interference, less accommodation, less parenting. (Page 216)

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Stop implanting your outsized worries in their heads. Stop flinging the word “bullying” around just because another girl said something mean to your daughter; that’s an unpleasantness she’s destined to face again and must learn to handle. Stop monitoring and evaluating everything your kids do and stop overpraising them for doing things that aren’t hard. You’re not spurring them to adulthood, you’re insisting that they always regard themselves as little children. (Page 217)

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When kids miss their “window” of independence—of wanting to hazard a risk and venture something new on their own—they stop asking for it. I talked to mothers who had forbidden their kids to walk around the neighborhoods when they were little. By the time the kids turned thirteen, they couldn’t be dislodged from the house. (Page 218)

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A nine-year-old who walks home by herself enters the house full of triumph. A twelve-year-old who accomplishes the same task feels nothing. He knows this is hardly a great achievement. Having been trained to accept the cramped confines of a cage, by the time the door is flung open—when he’s eligible to get his driver’s license, say—he may have surrendered to his captivity. (Page 219)

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What she sees—and studies—on American college campuses is precisely the opposite. Students tell her: “Look, by the time my parents felt it was safe for me to play outside, I was like thirteen and had no interest in playing outside. That period was completely missed. It never happened.” (Page 222)

Lenore Skenazy, author of Free Range Kids, has spearheaded the Let Grow movement, based on a simple intuition: kids don’t know what they can do if we don’t give them the freedom and risk to try. (Page 222)

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One of America’s leading academic psychologists, Peter Gray, a cofounder of Let Grow, thinks that the decline in independent activity by school-aged children and teens over the past five or six decades is a “primary cause” in the decline of their mental health.[ (Page 222)

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unsupervised play, risky play, and independent activity in which a young person contributes to the welfare of a group all produce immediate happiness and foster long-term psychological resilience.[ 9] None of those benefits come from monitored play, which, as far as psychological resilience or immediate joy is concerned, isn’t really “play” at all. (Page 222)

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Having never learned to manage social risk or harm, American students were more likely to be made anxious by routine incidents of normal life. (Page 223)

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“Americans are offering children ridiculous number of choices, completely safe choices—none of them are influential choices. What are you going to drink? What are you going to eat? Is it the red shirt or the white shirt? Giving children the sense of ‘I am calling the shots, I am in charge. I am deciding, I am influencing.’ ” But all are safe, controlled, and trivial options. (Page 223)

According to Chentsova Dutton, such manipulations may momentarily distract kids into compliance, but eventually, the subterfuge runs out. Kids know they’re being patronized. (Page 224)

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“What would be an influential choice?” “Something they’ll decide without participation of their parents that can actually result in something really good or really bad happening to them.” (Page 224)

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“When parents hover and prevent children from independently exploring the world around them, they foster many of the processes that scientists have identified as causes of anxiety,” he has written.[ (Page 224)

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“Kids who don’t practice independence (yes, it is a skill that withers without practice) are less self-confident, have worse social skills, are less tolerant of uncertainty, have worse problem-solving skills, and are less resilient.” (Page 224)

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Ortiz believes acts of independence can help alleviate even unrelated fears. Of his method with kids, he has joked, “So you’re scared of the dark? Go to the deli and buy me a half a pound of salami.” The child’s feeling of efficacy that results from completion of this sort of task, he says, makes kids stronger in every sense: braver, less anxious, more willing to try things that are hard, and, remarkably, less of a constant burden to their stricken parents. So far, he says, the results are promising.[ 13] (Page 224)

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Nature “loves small errors,” as Nassim Nicholas Taleb writes in Antifragile. Errors, in fact, beat the path to human greatness. All of education depends upon it, the scientific method assumes it, growth and evolution require it. That does not mean the elimination of standards: error means keep standards high, and let some attempts sink; let scores reflect actual ability. Moderate stress improves performance.[ 14] (Page 226)

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Chentsova Dutton grew up in Russia, another country that builds independence in children. Each year, as a birthday present, her parents increased the permitted ambit of her tramping about on her own. Each year, they allowed a little more risk, a little more chance for danger—and, necessarily, for learning and growing. Each year, they tantalized her with a slightly greater peek at the joys of the adult world. (Page 226)

When we made a point of inducting children into the adult world—through the gradual assignment of chores, after-school jobs, and an allowance of hours of unsupervised time with peers—they were eager for more. More freedom, more responsibility. But today, instead, we alter the adult world around them to make it more amenable to a child. (Page 227)

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Want to know which kids fared best in the Great Depression? It wasn’t the poorest kids, who were sometimes abandoned by parents who couldn’t feed them. Nor was it the richest, whose lives were relatively unaffected by the Depression. According to a wonderful longitudinal study of 167 elementary school kids from Oakland, California,[ 17] the kids who fared best belonged to a third group: middle-class kids who took jobs, wore hand-me-downs, took in piecework or picked up a paper route, saved their money, did extra chores. (Page 227)

“I consider it a dangerous misconception of mental hygiene to assume that what man needs in the first place is equilibrium … a tensionless state,” wrote the great Austrian psychiatrist and Holocaust survivor Viktor Frankl. “If architects want to strengthen a decrepit arch, they increase the load which is laid upon it, for thereby the parts are joined more firmly together.”[ 20] (Page 228)

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If you want to strengthen a person’s muscles, you force her to exercise. (Page 228)

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Humor is the embrace of the unexpected. And it’s among our best psychological tools for transforming life’s endless conveyor of minor disappointments into uproarious diversion. (Page 229)

Our kids don’t know that they’re connected to others—because we don’t tell them. (Page 230)

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We don’t permit kids a web of stable relationships. We choose for them the very best, hand-picked friends, based on our preferences, at different locations, as if we were collecting rocks on the beach. But when you look at societies with very high rates of pathological depression, Chentsova Dutton says, two things stand out: a high value placed on individualism and high relational mobility (meaning, lots of turnover in the characters that inhabit your life). (Page 230)

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All this, families and neighborhoods once provided. Our kids don’t have that. They don’t have a stable web of connections who care about them or really know them. Our constant emphasis on our kids’ uniqueness reinforces this sense that they need be preoccupied only with themselves. That they are their own entirely bespoke individuals. That they are very much alone. (Page 232)

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The world’s longest-running and most comprehensive psychological review of adult well-being, the Harvard Grant Study, found that the five most effective traits associated with higher life satisfaction were: altruism (focus on others); humor; sublimation (“ finding gratifying alternatives to frustration and anger”); anticipation (“ being realistic about future challenges”); and suppression (yes, keeping a stiff upper lip in the face of unpleasant thoughts and events).[ (Page 235)

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“The secret to life is good and enduring intimate relationships and friendships,” summarized Yale psychiatry professor Charles Barber, reviewing the study. (Page 235)

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Chapter 12 • Spoons Out (Page 236)

There is nothing scarier to a child than the sight of her parents overmatched and afraid. Cognitive behavioral therapists have effectively treated children’s anxiety by treating the anxiety in their parents because parents often transmit worries to kids. But we can transmit calm, too. We can be brave for them because that is what every life, if it is well-lived, requires: that we face the things that frighten us, that we try and try and try again—whether we feel up to it each time or not. (Page 240)

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When you mute the expert advice, when you log off Slate Parenting, when you lay down rules according to your values, and insist your kids abide by them—you will be surprised by just how much you like your kids. Because the truth is, you should. There is nothing in life that comes close to the remarkable adventure of raising them. (Page 240)

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purpose of childhood is to allow kids to take risks—things that involve getting all kinds of hurt—and to practice the skills they will need as adults while they are still safely under their parents’ roofs. Childhood exists to allow kids to hazard an unpredictable friend, lose a ball game, stand up to a bully, pick themselves up, offer another kid a hand. We want them to venture out and get their hearts broken, try and fail, and at last succeed—all while we’re still in the next bedroom. (Page 241)

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If school mental health experts actually wanted to repair our kids’ mental health, the first thing they would do is ban smartphones during the school day.[ 3] The evidence that social media harms kids’ sense of well-being is all but incontrovertible. But I would go further: smartphones are an accommodation, a gizmo of avoidance and rumination—the last thing our kids need while they are reaching for adulthood. Smartphones are not the only force luring teens into a vicious cycle of negative self-focus, but they are perhaps the most ubiquitous and most persuasive.[ 4] (Page 243)

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But if we want kids to register the endless bounty of life’s pleasures, we must get out of their way, and get the tech out of their way, too. Screens do not offer companionship—not the sort that fills us up, anyway. (Page 246)

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We interpret young people’s stultification as mental illness. But very often, it isn’t. It’s the malaise that sets in when they realize they’re the age their grandfather was when he married their grandmother, and they’re too scared to ask a girl out. (Page 247)

You have kids because you feel that, for you, a full life requires it. That level of self-sacrifice and continuity with the future, the tumbling joy and punch-drunk love, are not even on the menu anywhere else. Parents know this. We avoid saying so out of respect for those who don’t have kids and as a courtesy to those who can’t. But the truth is, if you’re thinking that having kids is a decision like any other, there probably is no good reason. Either your whole being inclines toward it or it might not. (Page 248)

But the desire to have kids can be inculcated, and we should try. Tell your kids: I brought you into this world to play a part in something far bigger than yourself. An indispensable strand in the cord of our family. Don’t be the cord’s frayed edge. (Page 249)

Remove the spoons: the technology, the hovering, the monitoring, the constant doubt. The diagnosing of ordinary behaviors as pathological. The psychiatric medications you aren’t convinced your child needs. The expert evaluations. Banish from their lives everyone with the tendency to treat your children as disordered. You don’t need them. You never needed them. And your kids are almost certainly better off without them. Having kids is the best, most worthy thing you could possibly do. Raise them well. You’re the only one who can. (Page 250)

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