Bad Therapy, Good Questions: A Therapist and Parent Responds
I picked up Bad Therapy by Abigail Shrier almost by accident. I hadn’t heard of it until a mentor mentioned the book after I referenced a completely different book with the same title. I went in blind—which, in hindsight, may have been for the best. Given the subtitle, Why the Kids Aren’t Growing Up, I expected to have reactions—and I did. Strong ones. Not just as a mental health counselor of 15 years, but as a parent of a teenager navigating high school, identity, pressure, and growing independence.
The Beginning
Shrier opens the book with a story about taking her 12-year-old son to the emergency room for a stomachache and being asked to leave while a nurse screened him for suicidal ideation. She frames this as an alarming overreach and a jumping-off point for her broader argument:
mental health professionals are pathologizing normal childhood experiences, over-diagnosing, overmedicating, and encouraging emotional fragility.
The claim is intense, but there are pieces of this critique worth examining: Overdiagnosis does happen. Overmedication does happen. Therapy that avoids challenge and prioritizes comfort over growth does exist. These are real issues within the field, and pretending otherwise doesn’t serve anyone. But, where the book loses me is in its lack of nuance and its tendency toward sweeping generalizations.
Shrier introduces the concept of iatrogenesis—harm caused by the healer—and describes her own therapy experience as one where her therapist validated everything she said, diagnosed the people in her life, and acted more like a supportive friend than a clinician. When the therapist finally challenged her—questioning whether getting married was a good idea—Shrier abruptly ended therapy.
That moment stood out to me because discomfort in therapy isn’t automatically harm—often, it’s where growth begins! As a therapist, good therapy isn’t about agreement; it’s about insight, accountability, and expanding awareness. Therapy that never challenges isn’t therapy—it’s just reassurance.
Shrier goes on to cite rising rates of anxiety and depression, questioning why these rates are increasing if therapy is effective. It’s a fair question, but an incomplete one. Increased rates can reflect increased access, reduced stigma, and better data collection, not just worsening mental health.
There’s also a piece of reality missing from the conversation: insurance. Many therapists are required to diagnose clients in order for services to be reimbursed, even when someone doesn’t neatly meet criteria for a disorder. That doesn’t mean the person is “pathologized” in practice—it means that outside requirements for therapists can, and do, distort data.
Trauma-Informed Care
One of the more troubling aspects of Bad Therapy is its dismissal of trauma-informed care. Shrier critiques Bessel van der Kolk (author of The Body Keeps the Score) and Dr. Gabor Maté, arguing that trauma does not permanently alter the brain and claims made about trauma being “stored in the body” are overstated/flawed. While it’s true that the brain is plastic and capable of healing, denying the impact of trauma altogether feels both inaccurate and dismissive. Trauma doesn’t excuse behavior—but it does inform it. Understanding that difference is foundational to ethical, effective care.
Shrier also criticizes social-emotional learning in schools, mental health screenings, and youth surveys, implying that asking questions about emotions, substance use, or suicide puts ideas into children’s heads. This logic echoes abstinence-only education: if we don’t talk about it, it won’t happen. Decades of research tell us that isn’t true: talking about hard things doesn’t create them, silence does.
Finding Common Ground
Where I find some alignment with Shrier is in her concern about overprotection. Children need opportunities to struggle, problem-solve, experience discomfort, and learn resilience. Constant adult intervention and emotional cushioning can rob kids of those skills. The issue, again, is balance: Good therapy doesn’t teach people to avoid discomfort—it teaches them how to tolerate it. Good parenting doesn’t eliminate hard feelings—it helps children move through them.
The problem isn’t therapy. The problem is bad therapy—therapy that avoids challenge, promotes dependency, or mistakes validation for growth. We don’t need to abandon emotional literacy, trauma-informed care, or mental health support to build healthier, well-rounded children. We need to practice therapy with responsibly, ethically, and with nuance; because the opposite of fragility isn’t silence, it’s capacity.
Closing Summary
Bad Therapy raises some important concerns—overdiagnosis, overmedication, therapy that soothes rather than challenges, and parenting that avoids discomfort at all costs. Those critiques deserve discussion. But, the book includes a sweeping dismissal of trauma-informed care, emotional literacy, and the value of reflective, evidence-based therapy. Nuance is missing and extremes replace balance.
Despite Shrier’s claims, we don’t need less care—we need better, more thoughtful, grounded care. We need conversations that allow for complexity and nuances, not fear-driven backlash, because good therapy doesn’t make people fragile—it builds capacity. Good parenting doesn’t eliminate discomfort—it teaches kids how to move through it.
Check out Sabrina’s Podcast on Bad Therapy:
Health Hope Harmony: Navigating Wellness, Embracing Every Body, and Healing Minds
If this episode stirred something for you—agreement, frustration, curiosity—I’d love for you to read the blog, send me your thoughts, or continue the conversation with your own therapist.
Let us support your journey by connecting with one of our trauma-informed therapists in Cedar Rapids, Des Moines, or virtually anywhere in Iowa!
