Therapy is about as much of the American experience these days as baseball, pickup trucks, and apple pie. Professional counseling is now seen as more than just a last resort for psychological distress, but as a healthy, essential path for resolving personal issues. In 2019, nearly 20 percent of Americans received some form of mental health treatment ranging from medication to therapy. Over 40 percent of Americans have seen a counselor at some point in their lives.

Recently in the New York Times, journalist Susan Dominus asked an important question, especially given that the U.S. is in the grip of an ever-worsening mental health crisis: "Does therapy really work?"

On one hand, dozens of studies confirm the value of talk-based therapy. A landmark 1977 study, for example, found that those with significant psychological distress "fared better than 75 percent of those with similar diagnoses who went untreated." University of Wisconsin-Madison researcher Bruce Wampold put it, "the fact that you can just go talk to another human being and get effect sizes that are measurable" is kind of miraculous.

Other research, Dominus explains, is less clear. A 2021 study found that more than half of depression patients saw little or no benefit from talk therapy, and only one-third found their depression receding long-term. Another study found that only 50 percent of patients responded to cognitive behavioral therapy regarding anxiety disorders. The uncertainty has led some to push for alternative treatments, including more prescriptions of drugs like psilocybin, the active ingredient in so-called magic mushrooms. One prominent researcher mused, "Maybe we have reached the limit of what you can do by talking to somebody."

Of course, the results of therapy depend on a number of factors. While counseling is a powerful tool, it can only aim at the question, "What's going on inside of me?" Often missed, which is especially consequential for a culture in a crisis of mental health, are the fixed reference points outside of ourselves by which we can be known and orient who we are.

Psychology is one of the many areas of modern life that has taken what sociologists call "an inward turn," characterized by radical individualism and reliance on self-definition. Rather than pursue healing or the restoration of relationships, counseling can devolve into endless rounds of affirmation, a sort of perpetual re-baptism in the church of self-expression. This is just one way that therapy has replaced religion for many seekers. Self-discovery is the new salvation, and therapists the new priests. The key feature of psychology as religion, however, is the self as the new deity.

This has only enabled, as Lisa Selin Davis observed recently at The Free Press, so many of the West's top schools and institutions to embrace and employ Critical Race Theory rhetoric and LGBTQ politics. The American Counseling Association now divides counselors and clients into either "privileged" and "marginalized" groups with a dedicated script for each and little mercy for those who dissent. More states have passed so-called "anti-conversion-therapy" laws, which threaten professionals who do anything other than only affirm a client's proposed gender identity.

As a result, deeper mental health issues are never addressed, and anyone who speaks up can find themselves out of a job. One therapist in training put it, "My concern is that we're not helping people heal and transcend. We're just helping people live in their victim mentality." In a tragic irony, the inward turn has made it harder, not easier, for the struggle to know themselves.

There are some, many of them Christians, striving to rethink psychology and counsel others by looking outward as well as inward, to know themselves by first knowing what is true and good. We can only know ourselves by first knowing reality, ultimately God and the world He made. Any mental health journey without that fixed reference point is destined to harm more than it helps.

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