Dear Therapist:
I am wondering if you can help with the following question that I frequently wonder about. Why is there more of a need for therapists today than a generation or two ago? Somehow we managed fine in the past. I am not, chas v'shalom, against therapists, especially those who follow Da'as Torah. I am just seeking to understand.
Response:
Your question is one that bothers many people. It can be viewed from a theological, psychological, philosophical, ideological, or pragmatic perspective. Of course, these and other perspectives often overlap. For instance, one might point to the loss of community insularity (and the resulting almost universal access to enormous amounts of information) as a cause of more increased mental health issues. Because of this, someone might feel that we are being punished for the way in which we access and use this information. The person may then question this and ask himself whether an underlying sense of guilt is leading him to feel that anything bad that occurs must be a punishment for something that he did. A more logical analysis can then lead him to a clearheaded decision about how to respond to the problem. He would thus have begun from an ideological view, transitioned to a theological one, moved on to a psychological perspective, and finally ended with a pragmatic understanding.
I am not a philosopher, a theologian, or an ideologue. However, like many people I have given this topic some thought. Your question is based on the assumption that there is a greater need for therapy in this generation than in generations past. This is likely true to some degree. Recognize, however, that in previous generations people didn’t talk about their issues with the openness with which they do today. If someone had an issue, he often suffered in silence. In addition, people who were depressed might have been identified as morose; those with ADHD were considered to be difficult or multi-taskers; and anxious people were viewed as dramatic or simply annoying. This makes it very difficult to compare the incidence of mental health issues in the past with that from today.
The fact that we are a more open society today can be a double-edged sword. Certainly there is much greater acknowledgment of problems that can be improved through therapeutic intervention. We have many more resources to help people identify issues and to educate them as to treatment. We have referral agencies, teachers, physicians, and rabbonim who are much more knowledgeable and understanding about mental health issues. We have a vast array of therapies and techniques with which to help people to overcome their problems.
A possible negative aspect of the more open nature of our society is the increased tendency for people to identify normal feelings as mental health problems. For instance, more kids today are open with their parents and discuss issues that most children in past generations would never have discussed. This can lead parents to believe that their child has a major issue that needs to be dealt with professionally. When parents give their kids the sense that their feelings are problematic, this can itself lead to emotional problems. The sense that “abnormal” feelings need to be “corrected” can in turn lead to increased discussion about “problematic” feelings, thus continuing the vicious cycle.
Those of us who grew up in past generations often point to the fact that most of us didn’t need therapy as children. What we fail to recall is that we had similar feelings and insecurities, but that we didn’t necessarily discuss them with our parents. We often normalized our feelings and dealt with them on our own. Although this may not have always been the best solution, it tends to give us the impression that previous generations were more emotionally healthy.
There are many factors that likely contribute to an increase in the incidence and severity of mental health issues. In the 1940s, Abraham Maslow proposed what he termed a “hierarchy of needs.” Basically, his theory was that people tend not to focus on higher needs like self-esteem and self-actualization (essentially feeling good about oneself) until they have met more basic needs like physiological and safety needs (putting food on the table, paying bills, etc.).
In past generations, most kids were given chores. They were expected to be responsible for many of their own basic needs. If a child wanted something done, he often tried to do it himself. If he wanted to buy something, he would work to earn the money necessary. Today’s parents often try to insulate their children from adversity and hardship. Many kids are not being given a sense of responsibility and a chance to develop responses to their more basic needs. In effect, these kids are often forced to contend with higher needs at an age when they are not mentally prepared to do so. This can lead to frustrations and insecurities that were less common among the children of past generations.
-Yehuda Lieberman, LCSW
psychotherapist in private practice
Brooklyn, NY
author of Self-Esteem: A Primer
www.ylcsw.com / 718-258-5317
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