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A
Hello, and welcome to another episode of the City Journal podcast. I am your host, Rafael Mangual, and today is a very special day because we are joined by my brilliant colleague, Abigail Schreier. Abigail, welcome to the show.
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Thank you so much for having me.
A
I'm so excited to be talking to you today because I'm a massive fan of your work, and I think your background is super fascinating. I don't think a lot of people know this about you, but you're a lawyer by training.
B
I am.
A
So, I mean, walk us through that, right? I mean, Yale Law, Federal judicial clerkship. How'd you end up as a public intellectual in the think tank world?
B
Well, I left the law firm I was working at when I started to have kids in 2010 for a few years. And actually, when the kids were little, I wasn't working for a number of years. I was writing fiction, actually a bunch of unpublishable novels. And then I started to get back into journalism. And I hadn't done journalism for a bunch of years, but I got back into it, and one of my pieces I wrote for the local Jewish press. And one of my pieces, a Wall Street Journal editor saw, and she reached out to me and said, you should submit to us. And then in 2018, I published, I think it was 1312 or 13 op eds in the space of a year for the Wall Street Journal. So right away, they liked everything I was doing. And one of those pieces bec a story that turned into my first book, Irreversible Damage.
A
Awesome. I mean, that's. It's an incredible story. I've been reading you since you've been writing for the Wall Street Journal. So, I mean, this is an incredible privilege for me. You know, going from the Wall Street Journal and the journalism world into the think tank space is different. I'm always curious about, like, how people view the differences. Right. I mean, what made you want to make the transition into a policy think tank, like the Manhattan Institute? And why the Manhattan Institute out of, you know, all your.
C
Well, growing up, a lot of my heroes worked here.
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I mean, you know, Kay Heimowitz, Theodora Dalrymple.
A
Kay Heimowitz was the very first person I ever read at City Journal. It was like a piece on, like, Manning up that she wrote, like, in the early 2000s. And I was like, oh, this lady knows what she's talking about.
B
Exactly. I think I used to read in Commentary as well. Like, you know, these were a lot of my heroes. And.
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And then, you know, I'll tell you, I have a slightly different role than
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other people at the Institute as a journalist.
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And that is, I sort of go into areas first.
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You know, I sort of go into the cave first with a torch, and I find the problem areas, and then other people come in behind, you know, behind me, and then try to fix up the policy.
C
But that.
B
That first step of going in and doing the investigation and finding out what's going on, that's my favorite part. And getting able to do that Manhattan Institute has really been a dream. I mean, it's been wonderful. And I get to work with the most incredible colleagues, like you and Chris RUFFO and Heather McDonald, who I've been reading for years, and Jason Riley. So it's really been absolutely wonderful.
A
It's an amazing place, and it's significantly better off now that you're here. So we're very happy about the work that you do. So, I mean, one of the most recent issues that you've investigated is through your book Bad Therapy, which I want to get into. But before that, I mean, one of the other things that's on your resume that I think is just also super fascinating is you are an advice columnist, and I'm a fan of your advice column. I've never read an advice column at any point in my life before, but I read almost everything that you write for the Free Press in that space. And I'm just always curious to sort of go get tastes of people who do that kind of work. Like, is there. I feel like you have probably a particularly accurate vantage point of where society's at through that work. Is there sort of a common thread that you see?
B
Sure, there is a common thread.
C
And what I try to provide people
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is a little bit of, is a moral framework. Not the sort of supercilious framework that we're all used to getting from advice columnists, but an accurate one. And I think that,
C
you know, I love it.
B
I really have enjoyed this. Barry asked me to do it, and it's been. It's a great joy.
C
But I'll tell you sort of why
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I started it, and that was that. When I first wrote Irreversible Damage, I wrote it in 2019. It was published in June of 2020. And the first editor I was ever assigned, I went to meet him for the first time at my then publisher, and he said to me, he said, to be honest, you know this. I know it's a book about kids transitioning, young girls transitioning, changing their bodies. The truth is, I would never read a book like this. I don't think. I mean, the whole topic is yuck. And that stuck with me all these years today because he's a wonderful man,
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he's a brilliant man.
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But I kept thinking we have this problem because good people think this is yuck.
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And I think tax policy is incredibly important. I think legislation's important. But I also think the moral dilemmas that this country is facing are critical. And the things that the people care most about, those are the things we
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should be addressing too.
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And there's no shame in it. In fact, it's a real responsibility we have. And so from the time I went
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in and looked at the teen trans
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phenomenon and why all these young girls were transitioning and exposing the social contagion of it, that has really been a passion of mine, is trying to meet Americans where they are and shed light
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on the problems that are most critical to their lives.
A
It's such an important, important insight because I find it in my work too. One of the other topics that I write about besides crime is child welfare policy. And I often find that it's very hard to sort of get people to engage with some of the stories that I cover. And I think a big part of it is this sort of disgust factor. No one wants to think about a four year old boy being starved to death, as just happened last year in East Harlem. No one wants to think about a two year old beaten to death by their own parent. How do you get through something like that? How do you overcome that instinct that people have to sort of pull away from the things that make them uncomfortable?
C
It's so interesting.
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You know, when I was writing Irreversible Damage, it was very hard because I
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was talking to hundreds and hundreds of
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parents and no one would listen to their stories. And they were telling me they were predominantly liberal. These were not religious people, they were secular liberal. That's really who the trans phenomenon hit the hardest with these young girls, because all of their teachers were in agreement,
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all of their thinking. They didn't have any counterweight at all. And when they went online, they couldn't find anything. They literally couldn't find before irreversible damage. There was no place to look, to get another side of the story, of the medical story, of what they were doing to their kids. Every therapist, every not only therapist, every therapy organization, the American Psychiatric Association, American Psychological association, was saying, affirm the kid.
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Affirm, affirm, affirm. Gender identity. You must go through a transition.
C
So parents were reaching out, hundreds of parents. Once I wrote the piece for the Wall Street Journal, Then there was in the New York Times, and that author, Jenny Boylan, got hundreds of responses to her column attacking mine. And Jenny Boylan's commenters were mostly on my side. So that's when I knew I had a book. And I was talking to hundreds of
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parents, and they were saying to me
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they were coming to me, and they were saying, what do I do?
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And almost all of them cried on the phone. They would sob.
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And it was very hard because I would say to them, look, I'm just a journalist. I can expose what's going on. I can talk to the elderly experts. But it's very hard for me to tell you what to do. But that became a theme, which was just. I really decided, here's what's going to be my job. My job is to expose it. And then the people who want to come in after and figure out what policy needs to change, what healthcare needs to change, I'll leave that to them. So I didn't go around.
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I was invited to testify in all the trials that have come after many of them.
C
And I didn't go around testifying.
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I just moved on to the next topic. And that's generally what I do as a journalist. I try to go in, do the investigative work, expose it as rigorously as I possibly can, and then move on to the next problem.
A
I mean, I think that's admirable. It takes discipline as well. And I think it's important for public intellectuals to do that kind of work, to understand their own limits, which I don't think is always the case. Right. I mean, I think sometimes people get into an issue and then they want to become, you know, the sort of foremost expert, even in the areas in which they don't have training to really address it. So, again, just, you know, incredibly appreciative of how you go about the work that you do. So after that book, you wrote Bad Therapy, which I read cover to cover and was just fascinated by, I always say if I could go back to school and do it again, I would have studied psychology. It's just a fascinating topic to me. But I want to just give our listeners a sense of your argument in that book, because I think we live in a time in which therapy is sort of regarded as something between a luxury and a necessity. Right. Like everyone who has the money should, of course, be in therapy. Right. I mean, this is a. It's an unalloyed good. Do it. And I think you make a very interesting argument, which is you suggest that, you know, there is a subset of the population for whom therapy is not just unnecessary, but a net negative, likely. How do you take us through that?
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Sure.
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So every book I write, I start with a question. My question with bad therapy was, why
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was the generation that received the most
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mental health treatment, over 40% of them had been in therapy.
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Over 42% of them had. 40% had been in therapy, over 42%
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had a mental health diagnosis.
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Why was the most treated generation also the most miserable? Why did they have so many mental
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health problems and diagnoses?
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And you asked, you know, how did I get started with this? And it really began with, I really just wanted to know what was going on. These should have been the most robust. They'd had the most wellness, the most therapy, and instead we were seeing the reverse. And one of the things I explored
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in the book is the idea of iatrogenesis.
C
And the idea of iatrogenesis is that a healer can harm.
A
Sure.
C
We've known this is a very old concept. Right. And what is bad therapy? Bad therapy is unnecessary therapy that introduces new symptoms or makes existing symptoms worse. And the problem is that by definition, every single intervention, if it is efficacious, if it has the potential or the power to help, it can by definition, also harm. Right. A trip to the er. Now, if you need a trip, if you need to get stitches, then the risk of picking up MRSA or another infection, it's worth the risk. You're bleeding. But if you're not bleeding, we don't give you X rays. You don't hang out in the er. Why? Because you can always pick up something that's in the er. The same thing as therapy. The same thing with therapy. Therapy can be efficacious. Of course it can. And sometimes it's necessary. We need it to stabilize really unstable kids, kids who are suffering with anorexia, with severe ocd, with all kinds of problems. The problem is it's become a prophylactic. Parents were using it for everything. The death of a cat, I was told. And, oh, it's gonna be a hard transition for her to middle school. Just in case, I'm gonna set her up with a therapist. And the problem is, what was happening was that it was introducing problems. All of a sudden, every minor deviation from a norm was getting diagnosed.
A
Right.
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And the problem is when you hand a diagnosis to an adolescent, so you hand a diagnosis to an adult. And I was told this by adults. You know, I had a therapist who
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said I might have PTSD from my childhood.
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I'm not sure that's right.
A
Right. Right.
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But you hand a diagnosis to a child, to an adolescent, and you forever change that child's view of himself or herself. And that's what we were seeing. We were seeing kids handed a limitation and told, there's something wrong with you and only science can fix you.
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Right.
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It's out of your control. Now, that's a devastating thing to tell
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a child, especially when it's unnecessary.
A
And it also sort of becomes part of their identity. Right. I mean, and I think that's actually particularly problematic in the time that we live in now where everyone seems to sort of be vying for position in the oppression Olympics to some degree or another. Right. Like having a diagnosis. If you are a. Well to do, you know, white male or female, upper middle class or wealthy family, you know, you have privilege that you have to check. Right. You're going to be seen as problematic in a lot of the spaces that, you know, you want to be accepted in. The second you get a diagnosis, you now have something that sort of puts you on this victim totem pole somewhere.
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That's right.
A
And I think that's probably problematic.
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It's hugely problematic because it becomes permanent, a permanent limitation. You're defined by it.
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Remember, if you think of yourself as
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shy or lazy, we all know those are things you can overcome.
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You might never naturally be an extrovert if you're shy, but you think, I can fight this. I'm a little shy, but I can work through it. The problem is, if you're told you have ADHD now, you know you need
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a stimulant, that's the only thing that can help you have an official medical problem. That's a very different thing to tell a child. And if it's not necessary, if you
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can work around it, you know, that's much better than handing a kid a limitation and telling them, no, there's something
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wrong with your brain.
A
Right, Right. I'm very interested in this idea of these sort of iatrogenic effect of therapy because we see this in criminology as well. Actually, there's a paper I just read, a preprint that's fascinating. It's about the atrogetic effect of criminal justice reform. So people who get released early have a higher risk than of being killed by police.
B
Wow.
A
Because they're still in the midst of a criminal career, of an active criminal pattern that they will then repeat when they get released and they come into contact with police and they end up being on the receiving side of a use of force. And they were able sort of Empirically, you know, show this, that actually, for some people, the early release actually puts them directly in harm's way. We see this all the time with, you know, other categories of offenders who, you know, are targets themselves from other gang members, and they get released and they're back out on the street. But, like, you know, I think not enough people, especially in the policy world, really consider the fact that, like, even something that is meant to be helpful and that can be definitionally helpful also has the potential to put people in positions where they're gonna face new harms that might actually overwhelm the potential benefits.
C
Yeah.
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There's two things we've done with kids in the last generation. We haven't given them the good things that they need in a healthy life. And we've introduced all kinds of harm in the form of gender ideology, in the form of unnecessary therapy and unnecessary diagnosis, of course, unnecessary medications as well. We have little kids being put on SSRIs left and right.
C
And the thing to know is, what do kids need?
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We actually have great research on this.
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They need three things. They need parental authority. They need relational stability. People who love them over a lifetime. Not hired people who are paid to love them, or the perfect expert. People who actually love them over a lifetime. And they need independence. They need to be able to do
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stuff on their own without the constant monitoring. We have withdrawn all three, and so
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the kids are suffering more. The problem is what we're pouring in to fix them is not making things better.
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And that's mental health therapy and intervention. It's not helping. It's pouring it into an unhealthy life.
A
I think that's right. It's almost as if we're sort of over medicalizing the everyday experiences and emotions of kids. Right. Like a kid's anxious, a kid's sad, a kid's unhappy or frustrated. And we have to put a label on this, and we have to treat it as if it's not a part of normal life. And it sort of puts people into this pattern, which I. Which I think is dangerous. I mean, do you see that as part of the problem? Because, I mean, I think about my own life, right? I'm turning 40 this year, which I'm having a hard time with.
B
Nice.
A
And, you know, probably the first three decades of my life, I don't. I could count on one hand the people that I had met who had ever been to therapy at any point in their life. And in the last 10 years, I think I've lost count of all the people I know. Who have been in and out of therapy, some of them, for, you know, decades. And it can't be the case that, like, at a national level, our mental health has just fallen off a cliff, can it? Or, you know, is there something cultural about this where we're kind of over medicalizing a lot of just normal life?
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So I think both things are true. I think we're leading more unhealthy lives, lives that make us more atomized and sad, and we're over medicalizing problems. So people will now say, and you hear this, oh, that's my trauma.
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Right. Yes.
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I can't go by now as if
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it belongs to you, like it belongs
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to our treatment of soldiers.
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Combat veterans who've been through PTSD has this problem.
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When you spell out the symptoms of
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PTSD to soldiers, and we've done this in America, when you give them the
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symptoms, you tell them to look for it effectively, all of a sudden, lo and behold, they decide they have ptsd. They effectively talk themselves into it in much higher numbers. And they've tested this. Much higher numbers of people identify as having had PTSD than even saw combat. So we know that some percentage of those who believe they have PTSD have no real reason, or at least the
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reasons they're coming up with don't make very much sense.
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Right.
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But if, you know, we know this, and Paul McHugh, the wonderful psychiatrist, is
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the one who did the work and
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explained this to me, and that is that in other countries in Israel, they
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don't treat soldiers who have been through a traumatic incident the same way. What they do is if they see their. Their combat colleagues hurt or killed, they take them out of the war, out of combat for some period of time. They go home to rest for a few weeks, then they come right back and rejoin the troops. They rejoin their men.
A
Wow.
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They don't. What do we do in America? We take them out, we sit them with a therapist. We say, your country did this to you. You have been injured. You now have a brain problem, and
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lo and behold, they never come off disability.
A
Right? Yeah. No, I mean, it's actually a big problem that more and more people are talking about the degree to which people who separate from the military are finding themselves on permanent disability for all manner of things, even though in a lot of cases, they're perfectly fine. I'm really interested in something that you said about when you're talking about what kids need to lead a healthy life, one of the first things that you said was parental authority, which implies some degree of structure, which I think is just both one of those things that's obvious, but one of those things that we miss all the time. Right. Like everyone feels like it's nice to give kids choices, but choices are incredibly overwhelming. Like, I see this if I'm scrolling Netflix sometimes. Like I have 10,000 choices of what. I almost missed the days when we didn't have cable and we had four channels that we could spin the dial through. And it was like, all right, well, this is what's on at this time and this is what I'm going to watch. I'm going to be happy. And I feel like I was happier with it. I think the same thing goes for kids. I mean, when they don't have structure, there's this sort of unlimited world of choices before them. And that's actually anxiety inducing because how do you make the right choice about which step to take when you have seemingly infinite ones?
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There's wonderful psychological research on this goes Back to the 1960s by Dan Baumerind, who's a wonderful psychologist.
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And one of the things she found
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was that authoritative parenting, that's rule based but loving parenting. So not harsh and authoritarian and unloving.
A
Right.
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But rule based and loving parenting produced
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reliably the best results in terms of
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happiness, in terms of mental health, and
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in terms of success in life and even their relationship with their parents.
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And I looked at this in bad therapy and from a number of angles,
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but it turns out, you know, that
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rash of family alienation, we're seeing parent young people cutting off their parents.
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It's mostly young people who are very coddled by their parents. It's mostly not people who were dealt with harshly by their parents.
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Because actually what kids need, and this
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is very good research, it's been replicated hundreds of times.
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What kids need is rules.
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They need authority and they need to be held to account if they break the rules.
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And we've known this, we stopped doing it. And part of the reason we stopped
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doing it is we shamed parents out of it.
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We turned them into what's called caregivers. We gave them a huge demotion and their job essentially became run of. It used to be setting value, giving the kids their values.
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No, the school's gonna supply those, Right. What did the parent role become?
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Shuttling them from one expert to another? It's a very degraded role. And by the way, parents don't enjoy
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it as much either, right?
A
Yeah, I mean, I would. I mean, I'm a parent of two small kids and you know, I would Feel sort of territorial. Right. You just said like, oh, the kid, that the school will give them their values. I just thought, not in my house. You know, I mean, it's as.
B
And that's why kids from conservative families do better in mental health. Because conservatives were more skeptical of the messages from the progressive left coming in through the schools. They were much more skeptical. And liberal parents were much less skeptical and much more willing to let the school supply some of the values. Not realizing what kind of values were coming in through the schools.
A
Yeah, I mean, I think part of it too is this idea that like, I mean, I often hear, you know, parents talking, especially with older parents who have older girls, they'll say like, oh, my daughter's my best friend. And it's like, I don't know, it never sits quite well with me. Right. Cause that's a different relationship than the one I think you're supposed to have with your parent. I heard someone, I wish I could remember who, it might've even been. You recently say something that just, I thought got it perfectly right. You can be either friends with your kids when they're children or friends with them when they're adults, but you can't do both.
B
I love that. I did not say that, but I love it. I just think that's exactly right. That's absolutely right. Kids need authority. The time to give them the rules, to teach them right from wrong is when they're young.
C
And I often deal with parents who
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kind of say, look, these are my beliefs, but I didn't wanna push that on my kids. And I always say, but your kid's teacher has no problem pushing her values on your kid. So now your teacher's supplying the values and you're sheepish about it. Who's gonna win?
A
Exactly.
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And that's the problem. That's why we have a generation crying for socialism. That's at least one piece of it. And that is we let the school supply the values when it should have come from us.
A
One of the values that the schools have supplied in our society is this sort of anti risk taking disposition where, you know, anything that's deemed dangerous is now taboo. Right. Like letting your kid go to the store by themselves. I remember. You know, I grew up in Brooklyn, New York in the 80s and 90s. When I was like seven or eight years old, my mom would hand me a five dollar bill and say, go to the corner store, get milk and, you know, eggs or whatever. And I would go by myself, you know, in 1990s New York, which is significantly More dangerous than where we live, than the, you know, the million we live in today. And yet if I did that with my child, if I said, you know, here's $5, you know, go walk a few blocks to the store and come back, I would probably get a knock at the door from the police.
B
Right. So the experts no doubt made this much harder. The local laws about the kids being unable to be alone ever, or walk by themselves made it much harder.
C
But there's something else too.
B
Parents became frantic. And they became frantic not for foolish reasons. Once they saw the civilization in decline, they started watching things look worse than when they were young. It's very scary as a parent to go through that, to realizing the city around you is getting scarier, that there are more homeless people, that there is more people violating the laws, that you can't rely on police to pick this person up. And if they do pick this person up, they're just gonna be let go.
A
That's right.
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And that made parents absolutely frantic and tried to stamp out risk taking in their kids.
C
And largely understandably, I know we beat
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up parents and say, oh, they're all helicoptering. But the truth is, when you can trust the society around you to behave rationally and reasonably, all of a sudden you're a lot braver of a parent. And when you can't, when there are homeless encampments all around, as there are in la, and I know there's a huge problem here in New York, when
C
you have those problems, it's much harder
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to be a parent who is allowing an independence.
A
It's hard to begin with. Right. I mean, I was at the playground the other day with my kids and my daughter, who's four now, she just turned four, there's this sort of metal ribbon thing, but it's like a climbing wall. And it goes up and then comes down, but it gets up there pretty high. And so she climbs. She starts climbing it. And I'm watching her and she's getting near the top, and I'm getting more and more nervous as she gets to the top and as she starts to try and work her way down, you can see she's. And she's sort of getting anxious and worried. She doesn't know where to quite put her feet. And I just. All I want to do is run down, run up there and grab her off and, you know, and pull her down. And, you know, my wife started to say, no, no, I've read things. We have to let her work this out. We can stand to her and catch her if she falls, but like, let her do it. And she did it.
B
Wow.
A
And it was like, it was hard. I had to make a conscious effort to push through just that. Which is pretty minimal risk, right? If she falls, it's on mulch. She probably, you know, it's hard.
B
I remember one of my son's first piano recitals. He was 4, and it was a very, very simple piece. As you can imagine, he was only four. But he started to get nervous before he was gonna go on. And I started to panic a little and think, oh, God, if this goes badly, he's gonna quit piano. He's never gonna wanna do this again. I don't want this to leave him alive. And my husband just said to me, let him be. And he got up there and it shocked us all. He announced himself. He announced his piece. And I didn't. I didn't know.
C
And in that moment he could do it. He decided that. And that became like, to him, he identified as someone who could do those things. I mean, he made it true.
A
There's a risk you take that you rob them of those experiences that actually give them confidence in the future. Right. I mean, it's a hard thing to do as a parent because you want to save your kid and no one
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around you is doing it either.
C
So it's very scary because you think,
B
oh, God, I'm gonna be the parent. Something happens and everyone's gonna say, well, she's the idiot, or let her walk home from the bus stop alone.
C
Which I did. But, you know, this is what I'll say. It's not that I'm not afraid of those things.
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I'm also afraid of the alternative. And the alternative is a young person who can't do for themselves. And now they're 12, 13, 15, and
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they're childlike and they're tied to you.
B
It's very hard to get that kid
C
out of the house because if they've never done it. You know, Yuletta, I used to say this, but it's, you know, I said this in the book and it's true. You know, when my 10 year old wanted to walk home by herself, I let her. She was proud of herself, right?
A
Yeah. I remember the first time I walked to school by myself, right?
C
And she was proud when she came in the door. If I had waited till she.
B
Maybe she started at 9.
C
If I had waited till she was 13.
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Every 13 year old knows there's no great pride in that.
C
So they don't have the impetus. And when I would interview parents What I learned was if you didn't let kids do things they can do in their window of eagerness to try, they stop wanting to.
A
Right, right. No, it's so important. I think you framed it exactly the right way. It's not that there aren't risks, it's that there are also risks associated with minimizing the risk of the thing that you're afraid of. Right. It's a double edged sword. I mean, one of the things that I'm worried about as a parent, in particular as a parent of a girl, is the risk posed by social media. I have been reading nonstop about all these adolescent girls who seem to be suffering from various kinds of mental health problems that are tied in some way to the ubiquity of social media. Right. People are just addicted to the dopamine hits that they get from scrolling. They are addicted to the, the feedback and define themselves by the feedback of their posts. Right. They're posting these selfies that, you know, and if they don't get a certain number of likes, it's like, you know, someone told them that they were a bad person and, you know, they sort of curl up in a ball. That can't be healthy.
B
No. And it's not a risk we were really evolved to handle.
A
Yeah.
B
That is so outside.
C
That's not walking home from school, which
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we know we can do.
C
We did it when we were kids. Nobody is prepared for the 1 million
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viral tweet or the 1 million person,
C
you know, or even a thousand kids
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making fun of you.
A
Right.
C
Nobody is ready for that. And in fact, we didn't evolve to handle that. We had what, 15 kids making fun of us and nobody was taking pictures
A
of it and they had to do it in person. And they said it wasn't.
C
They had to do it in person.
B
Right.
C
So it was a growing experience. So I don't think there's anything healthy about social media.
B
My kids aren't on it. You know, I don't think. I think that really is a very unhealthy. And it really is.
C
Look, we're seeing the effects of social
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media in all kinds of ways, but
C
one of the ways is the ability to herd young people and feed them, propagandize to them writ large.
B
We've never had a mechanism for this.
C
I mean, to put messages, beam them directly into the heads of tweens and teens.
B
That's a very dangerous thing because a
C
lot of people beaming these messages are very bad people.
A
Yeah, no, I think that's a massive, massive problem. One of the Other risks that I see is, I even see this with some adults is they sort of define and measure their own success up against the sort of curated feeds on their social media platforms. It's like, well, my life can't be good. Look at so and so. They're constantly on vacation or in the gym or posting these glamorous selfies where they look perfect. And it's like, hey, they're using filters. They're taking 10. Yeah, I was in the. I go to a nice gym and there's a sort of very wide range of people who go. But there's a subset of the gym going population where I work out that's like, constituted by These young, early 20s girls who are constantly taking glam shots. They have tripods set up. And I watched this one girl take it. Must have been 75 different versions of the same selfie before posting it. Wow. Between sets, like, just. It was like almost like ocd. It was like compulsory behavior. You could tell, like there was, there was. It was unhealthy in that moment. It's like, I feel like more people need to understand that what they see is what people want them to see. It's a very small slice of their actual life. Right. It's not. They don't always look like that. They don't have a filter. They don't have the ability to doctor the image in person. They're not always on vacation in Aruba or, you know, in some VIP section at a nightclub. Or like, they're taking these posts, you know, sometimes from a year ago and posting them as if it's today to give people the impression that they're living this glamorous life and it makes your life feel substandard by comparison.
B
I don't think there's any doubt at this point that the social media companies have made young people's lives worse net, you know, certainly children's lives worse. And one of the biggest harms is that they're not really enjoying their lives anymore. They're not really, really present in that.
C
And, you know, going to the gym
B
used to be a lot of things. It was a chance to meet someone. It was a chance to, you know, think about your life. I mean, you start to work out and your brain very often goes somewhere else and you work through a problem that you can't figure out, you know, and you find this calm too. I mean, that's one of the great things about exercise. You can work on. You can chew on something and chew over something, and then all of a sudden you realize the answer or what you wanted to say or what you need to do, and they're not letting themselves get to that point.
A
Right? Yeah, I think that's right. This fascinating conversation, by the way. I'm really enjoying it. I wish we could go on for another hour, but when I think about some of the problems that we've talked about, I think about social media. I think about the sort of overmedicalization of our lives, this kind of over reliance on therapy and SSRIs and ridicul and all these other things. And my instinct as a policy person is to ask, well, what do we do? What's the solution? Right. These are problems. There's gotta be a fix. And I've come around more and more over the years to the idea that there are actually some problems that are not particularly susceptible to policy interventions. And I wonder if the problems that you've covered as a journalist kind of fall into that, or do you think that there are some sort of concrete policy levers that we could pull to make things better?
B
Right, so that's a great question.
C
Some of the things we're already seeing great policy interventions.
B
Right. Certainly with the trans identification issue among teens, we've gone a long way to reversing a really, really bad trend. Lawsuits obviously made a big difference in that, too. The journalism made a big difference. But the policy really matters. And for instance, not having, you know, no longer forcing mental health professionals to affirm, which they were compelled to do, you know, that's an important reversal.
C
So some of these things can be
B
susceptible to important policy intervention.
C
But I would say that a lot of the problems with young people in the last generation are problems we introduce to. Yeah, we need to do less of that. Okay. Gender ideology was not something sixth graders were gravitating toward, not until we pushed it through every school. So we need to stop doing that. And the same thing with therapy and with medication and diagnosis of young people. We brought in mental health professionals, and lo and behold, they found diagnosis everywhere they went. We need to stop introducing harms into
B
the lives of kids.
A
I think that's a great place to start. I do. And a great place to end this lovely conversation. Thank you so much. Thank you for doing the show, Abigail, and thank you all for listening and watching. Please do not forget to, like, comment, subscribe, ring the bell, do all the things for the algorithm. Let us know what you thought of this episode and the others, and we will bring you a new one next week. So until then, you've been listening to the City Journal podcast.
B
Thank you.
A
Thank you. That was great. Great.
City Journal Audio
Episode: Who We Are: On Therapy (with Abigail Shrier)
Date: May 19, 2026
Host: Rafael Mangual
Guest: Abigail Shrier
This episode features journalist and author Abigail Shrier in conversation with City Journal’s Rafael Mangual. The discussion centers on Shrier’s journalistic journey, her deep dive into contentious cultural topics, most notably the dangers of "bad therapy" and over-medicalization of children and adolescents. The pair examine shifts in parental roles, the risks of overprotection and social media, and the limits of policy solutions. The tone is candid, thoughtful, and at times deeply personal, offering listeners a rigorous yet accessible analysis of therapy culture and modern childhood.
From Law to Journalism: Shrier describes leaving law for family life and fiction writing, her return to journalism, and her transition to national outlets ([00:37]).
Role at the Manhattan Institute: Shrier differentiates her journalist role from policy analysts, likening herself to someone who "goes into the cave first" to identify emerging problems before others work on policy solutions ([02:35]).
Central Question: Why is the most treated generation the most miserable? ([09:54])
Iatrogenesis in Therapy: Shrier introduces the concept that medical or therapeutic interventions can be harmful when unnecessary, especially as therapy becomes a catch-all for normal childhood difficulties ([10:33]–[12:01]).
Consequences of Over-Diagnosis: Labels like ADHD or PTSD, especially when given to young people without clear justification, can permanently alter self-perception and identity ([12:15]–[13:57]).
Therapy as Social Status and Identity: Both hosts discuss the appeal of medical diagnoses as social currency and the risk of pathology becoming core to self-identity ([13:13], [13:39]).
The current generation faces a double bind: less of what children truly need (parental authority, relational stability, independence), and more harmful interventions — therapy, medication, and diagnosis ([15:09]–[15:57]).
Normal Emotions vs. Disorders: The normalization of referring to normal life challenges as “trauma” has led to an over-reliance on therapy, distorting what’s considered ordinary adversity ([17:10]–[17:24]).
Shrier underscores the importance of authoritative (not authoritarian) parenting: love with clear rules and accountability produces the best outcomes for children ([20:09]–[21:00]).
The erosion of parental authority, the “demotion” of parents to mere caregivers, and the ceding of value-setting to schools is highlighted as a major problem ([21:10]–[21:35], [22:46]–[23:27]).
Modern parents are criticized for overprotectiveness but Shrier defends parents' anxieties, citing societal breakdown (increase in crime, homelessness) as a rational catalyst ([24:29]–[25:36]).
The conversation covers letting children face age-appropriate risks to develop autonomy and resilience. Delays in granting independence past the child's window of readiness inhibit healthy development ([28:16]–[28:43]).
Shrier and Mangual agree that social media creates novel psychological harms—especially for adolescent girls—including amplified peer pressure, exposure to predatory messaging, and constant comparison with curated, unrealistic images ([29:41]–[32:00]).
Social media’s impact extends to “herding” and propagandizing youth with unprecedented reach ([30:27]–[30:43]).
On the unique pitfalls of contemporary therapy:
On making therapy a prophylactic, not a treatment:
On social media’s risk:
On giving children independence:
The conversation is a sharp critique of contemporary therapy culture and the over-medicalization of children. Shrier and Mangual contend that children’s distress is exacerbated by adult intervention—often implemented with good intentions but harmful in aggregate. Solutions, they argue, lie at least as much in cultural self-restraint and the restoration of foundational parental authority and independence as in any set of policy initiatives.
For listeners and readers alike, this episode provides an unflinching look at modern childhood and therapy, sparking essential reflection on what children truly need to thrive in our complex era.