Review: One Nation Under Therapy

Author: Christina Hoff Sommers & Sally Satel

The book arrives at the same conclusions as the philosophy underpinning the recovery movement.  People are fundamentally well, and usually do not need help from Mental Health Professionals, unless they specifically ask for such help.  The logic used to get there will affront Mental Health Professionals.

Whilst I have enjoyed the previous work of Hoff Sommers that I have read – I was uncomfortable with this feeling she cherry-picked her examples, showing the extreme to be the norm.  It is impossible to know given I have no first-hand knowledge of the US school system, nor Mental Health System.

Regarding her thoughts of addiction.  I agree with her with rejecting the “brain disease” model, however, I also reject the personal responsibility model as the cure to addiction.  The truth is in the middle.  I have known many people professionally who experienced the most unbelievable trauma that affected the choices they made.  It is interesting she is prepared to forgive someone with schizophrenia, but not an addict.  I believe the two are more closely related than she cares to admit.  She does make some interesting and compelling points that are worthy of examination.

Her thoughts on grieving and trauma are reflective of my own, that responses to grief and trauma are complex, and that people should not be forced to talk about their feelings.  The key thing to consider is if the person finds it helpful?  If they do want to talk, great.  If they don’t that is equally fine.  I recall watching a trauma psychologist following the Beaconsfield Mine Collapse, telling the Journalist everything that she had “done” for the two survivors.  I recall feeling appalled, that this woman was the stereotype of everything I knew to be wrong about a therapist.  Nor do I recall the survivors having a word of thanks for the trauma councillors and the work they did for them.  The praise was instead for those that dug the escape tunnel.  I have no doubt that some overzealous therapists conform to the stereotype described and actually do more harm than good.  This is a problem within our industry.  

It reinforced my personal philosophy of minimalism in the treatment of trauma and distress.  If the person appears to be coping, they probably are.  There is no need for an “intervention”.  Peoples styles of coping are complex and varied, and there is no “right” one style.  The important thing is to be there when they need extra support, and withdraw quickly when that support is no longer required.

I admire that the book is well referenced and researched, but suspect it does not attempt to give the full debate, only the authors’ point of view.  Christina Hoff Sommers remains an intellectual I respect, but she does have an agenda (but so do I as a Mental Health Professional – so I might be subconsciously protecting my own turf).