Friend Prostitutes

“NEW RULE: Let’s call therapists what they really are: friend prostitutes. Because when a friend tells you to see a therapist, it’s just their way of saying ‘I don’t care about your breakup. Why don’t you rent someone who does.’”—Bill Maher, Real Time with Bill Maher (February 17, 2018)

There are scenes that stick with you long after you’ve forgotten the rest of the movie. This scene, from Crash (2004), is one of them. Sandra Bullock is crumpled up in pain at the bottom of the stairs. It’s not life-threatening but she can’t get up. Clearly something’s broken. She calls 9-11 but to no avail. They’re dealing with a multi-car pile-up and won’t be able to get to her for hours.

The operator says she should have a friend drive her to Emergency. So she calls her friends and her husband. But they’re all too busy, or can’t be bothered. She’s finally helped by her Mexican maid. The scene’s message is clear: this woman’s rich, she lives in a mansion, her husband’s the mayor of L.A., and yet she’s utterly alone in the world. She has no friends. Not even one.

The basic problem that bedevils us, avers Epicurus, is anxiety about the future. Having friends who we know we can depend upon in times of need, friends who we can lean on if need be, helps to alleviate this anxiety. Friendship bonds are signed in an invisible ink legible only by the light of a really bad day. But if you’ve got money in our society, you can pay people to do many of the things that are normally done for free by family and friends. For instance, if you’re going through a rough patch, you can pay a therapist to help you get through this difficult period. But is this really such a good thing? I don’t think so.

Although we spend billions on it, talk therapy seems to help, at best, one in four. Numerous studies have demonstrated this: it simply does not work for most people. What’s odd, to my mind, is that nobody who knows what they’re talking about seems to dispute this, not even the profession’s most vocal apologists. And yet for some strange reason, our collective faith in the promise of therapeutic salvation remains stronger now, perhaps, than ever before.

Despite this abysmal track record, most of us reflexively advise our friends and relatives to “get some help” when they’re going through a tough time. Most of us believe, in a lazy, unthinking way, that seeing a therapist whenever life hurts is, well, you know, just what normal people do. The 1950s viewed getting milk from your mother’s breast much as we view getting therapy from your friend’s kitchen table.

Those who fail to seek professional help when they’re “in a bad place” are viewed with suspicion. At best, we think them eccentric, quirky, and odd, like that weird old friend who still doesn’t have a driver’s license at 43, or that funny middle-aged aunt who lives alone, makes her own hummus, and refuses to use underarm deodorant. At worst, we begin to resent their refusal: “I can’t believe she still hasn’t seen someone! I mean, seriously, at this point, I’m starting to think she wants to be miserable.” “Ya, I know what you mean, my brother’s the same way. It’s like he just doesn’t wanna be happy.”

Peer pressure to “get help” can be surprisingly strong in the 21st-century West. We’ve probably all found ourselves in its orbit at some point or another; but none have felt the terrible tug of its gravitational force more than the parents of bratty kids and troubled teens. Most give in to the zeitgeist’s demands regardless of whether or not they think it’s going to help. And they are richly rewarded for their conformity: they and their wayward children shall be washed in therapeutic grace. Schoolyard sins shall be forgiven. These parents—who get their little monsters “the help they need”—are deemed decent, upstanding, responsible, virtuous, and good. But those who stubbornly refuse to seek professional help for their problematic offspring are subjected to a tsunami wave of righteous indignation.

If Dante was reincarnated today as a mommy-shaming helicopter parent, my guess is that he’d reserve a particularly nasty place in his new and improved Inferno for suburban heretics who refuse to find therapists for their difficult kids. These parental outlaws will share a spot on Hell Crescent with crackheads who gave their kids beer for breakfast, working parents who slipped peanut butter sandwiches into school lunches, and that coked-up celebrity who sped down the highway in a red convertible with an unsecured baby on his lap.

Of course all of this social pressure to “get help” is predicated on the assumption that therapy works—that it can fix you, fix your kid, fix your marriage—however, as I mentioned from the outset, numerous studies have demonstrated that therapy simply does not work for most people. Some find healing, no doubt about that; but most of those who show up broken, leave broken. That being said, my concern, here, isn’t, first and foremost, with whether or not therapy works; it’s with therapy’s side-effects.

I suspect that many of those who find healing in the therapist’s office trade in old problems for new ones. What’s worse, I suspect that many who show up broken, leave more broken. There are three reasons for this: (1) talk therapy often erodes social skills; (2) most talk therapy is based upon a discredited model of the mind; and (3) talk therapy often undermines friendship.

1. How Talk Therapy Erodes Social Skills: Although some learn how to communicate more effectively in therapy, most do not. All to the contrary, talk therapy usually reinforces many of the same inept ways of relating, such as a monological manner, which contributed to the individual’s social isolation in the first place. Good conversation is based on give-and-take, dialogue, empathy, reciprocity, and giving a shit about how the other person feels. When you’re talking with a friend, even an extremely close friend, you’re always trying, to some extent, to engage them, to be funny and entertaining. But when you’re talking with your therapist, it’s all about you—and that’s, well, not that good for you.

2. Talk Therapy is Based on a Discredited Model of the Mind: We live in a therapeutic culture that’s been extolling the virtues of venting for the better part of a century. As such, we’ve all heard a great deal about the need to express our anger and talk, at length, about things that have made us angry in the past. All of this is based upon a hydraulic model of the mind that was popularized during the Industrial Revolution, a model that still relies heavily—perhaps unsurprisingly—upon steam-engine metaphors (e.g., pressure build-up, the importance of pressure-release valves, etc.). But since we’re dealing here with the received wisdom of our age, this underlying rationale is rarely made manifest, nor is it subjected to serious scrutiny.

Most of us simply assume that venting is good for us. What’s more, we assume that its benefits have been proven (somewhere) and backed up by solid research. In fact, the rationale for venting is based upon a hydraulic model of the mind which researchers disproved and discarded decades ago. As Susan Cain puts it in Quiet (2012): “The ‘catharsis hypothesis’ — that aggression builds up inside us until it’s healthily released — dates back to the Greeks, was revived by Freud, and gained steam during the ‘let it all hang out’ 1960s of punching bags and primal screams. But the catharsis hypothesis is a myth — a plausible one, an elegant one, but a myth nonetheless. Scores of studies have shown that venting doesn’t soothe anger; it fuels it.” Talking about your problems can make them worse.

3. Talk Therapy Undermines Friendship: We all like going out for dinner from time to time, and this usually involves paying a stranger to cook for us. Still, most of our meals are home-cooked by family members or friends. But imagine, for a moment, how strange it would be if we all ate out at restaurants so much that we forgot how to cook for each other. What’s more, imagine if we came to believe that it was actually dangerous and unhealthy for “non-professionals” to cook for themselves and others. That, to my mind, is where we are right now vis-à-vis therapy in our culture. Many of us seem to have come to the conclusion that the normal thing to do—Plan A, as it were—is to go to a therapist whenever something’s wrong. And that’s the problem. That’s what’s stunting the growth of our personal relationships and rendering so many of our friendships shallow and superficial.

In The Commercialization of Intimate Life (2003), sociologist Arlie Russell Hochschild maintains that an over-reliance upon therapy is one of liberal feminism’s greatest weaknesses: “While books like Women Who Love Too Much focus on therapy, ironically the actual process of healing is subtracted from the image of normal family or communal bonds. The women in Norwood’s tales seem to live in a wider community strikingly barren of emotional support. Actual healing is reserved for a separate zone of paid professionals where people have PhDs, MDs, MAs, accept money, and have special therapeutic identities. While psychotherapy is surely a help to many, it is no substitute for life itself. In the picture Norwood paints, there is little power of healing outside of therapy. In the stories Norwood tells, love doesn’t heal. When you give it, it doesn’t take. When another offers it, it may feel good but it’s not good for you. . . . If the word ‘therapy’ conveys the desire to help another to get to the root of a problem, this is a very deep subtraction from our idea of love and friendship. It thins and lightens our idea of love. We are invited to confine our trust to the thinner, once-a-week, ‘processed’ concern of the professional. This may add to our expectations of therapy, but it lightens our expectations of lovers, family, and friends.”

Though some of our deepest and most meaningful connections to others grow out of joy, most are forged in adversity: e.g., she was there for me when I was going through that terrible break-up; she was there, as well, when my mother was dying of cancer; he was there for me when I got fired; he was there, as well, when I was recovering from that horrible car accident. Every time you pay someone to hang out with you during a rough patch, you rob yourself of an opportunity to get closer to a friend or relative.

I once took a powerful course of antibiotics that wreaked havoc on my digestive system for months. Do I regret taking the antibiotics? Of course not. But I wish I had been better informed about how much damage “the cure” would do. Likewise, it’s time to have an honest conversation about the sociological side-effects of talk therapy. We need to start viewing talk therapy the way we’ve come to view antibiotics. Only a fool would say that antibiotics are useless. Likewise, only a fool would say that talk therapy is useless. But we now know that antibiotics have been vastly over-prescribed, and that this overuse has done real damage. What’s more, we now know that even when the use of antibiotics is warranted, there are harmful side-effects associated with their use which need to be acknowledged and addressed. The same is no doubt true of talk therapy.

—John Faithful Hamer, Love Is Not a Liquid Asset (2020)

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John Faithful Hamer