Psychotherapy and Ducks: Progressive Social Theory from Fred

I’ve figured it out. We’ll build a great long sliding board down a mountain in California, like a ski jump. Then we’ll catch all the psychotherapists, and write “DUCK” on them in red paint. Then we’ll grease them. Next we’ll charge yuppie duck-hunters to sit at the bottom with shotguns, and slide those slippery suckers down.

Hell, a California yuppie can’t tell a psychotherapist from a duck.

We’ve just got too many therapists. They’re everywhere, like sin and head colds. Especially on those talk shows with ugly fat women talking about relationships. I saw a huge flat-faced one who looked like a sheet of dry wall with eyes–I think it was Rosy O’Donnell–but anyway she had this therapist lady going on about something called Social Anxiety Disorder, or SAD. As best I could tell, it means being uncomfortable at parties.

Now, there’s a medical condition.

(Before we go any further I ought to say we’ve got too many disorders too: Borderline Personality Disorder, Avoidance Disorder, Relationship Disorder, Characterological Disorder, and Just-About-Everything Disorder. SAD also means Seasonal Affect Disorder. We’ve go so many disorders that they’re piling up on the same abbreviations, like dry leaves on a fire hydrant. Seasonal Affect Disorder means that you get depressed in winter when it’s cold and dark and the wind howls like a lost dog and slush gets in your shoes and freezes between your toes. I guess that’s a pretty unusual time to get depressed.)

Anyway, Social Anxiety disorder, said the therapist lady with worried solemnity, affected 20 million Americans, or 47 million, or some number. However, there was hope. All you had to do was to take a pill and . . . who would have thought it–see a therapist at $100 an hour.

It’s pretty much a therapist lady’s response to everything. Bored? Take a pill and give her $100 an hour. Can’t find your car keys? You’ve got Can’t-Find-Your-Car-Keys Disorder. Take a pill and . . .

(Tell you what. Pick your own pill. And send me the $100. I promise I won’t talk to you about your feelings. Direct deposit would be good.)

Now, it didn’t use to be that everything people did without exception was a personality disorder. No. Time was, people figured they were bored or lonely or didn’t know what life as all about. But who did? It was just life. A guy might be as in love with himself as a peacock with a new Corvette, but he didn’t have Narcissistic Personality Disorder. He was just egotistical and tiresome. How did everything get psychiatric?


Years back, there weren’t any therapists. You only had psychiatrists, who treated seriously sick people and probably made them worse, or treated seriously bored rich ones and made lots of money. Psychiatrists were mostly seriously sick themselves, but they had intimidating beards, so they got away with it.

Then some astute grafter noticed that the mass market was in mildly unhappy people in the middle class who wanted to talk about themselves. Psychotherapy leapt into existence. It wasn’t a healing discipline. It was a marketing strategy.

Problem was, suburban women weren’t going to pay $100 an hour to talk about their feelings. They were perhaps mildly irrational, but they weren’t crazy.

The trick was to get somebody else to pay the $100 for them.

As it happened, the insurance companies didn’t mind doing it, since it increased the cash flow and they skimmed off their bit. However, they only paid for medical conditions, not the distempers and minor miseries of existence. The answer of the therapy racket was to medicalize life. Nobody was normal. Everyone was sick. All behavior was a symptom.

The key to this parlor trick was the DSM, the Diagnostic and Statistical Manual, sometimes known as the Loon Book. It came to list a vast number of peculiarities, angsts, and habits that suddenly became Disorders. If a therapist could dredge the symptoms of a Disorder from a patient, insurance money flowed. Bingo. Anything in the Loon Book was billable, so pretty soon everything was in it.

Therapy spread like kudzu on a Georgia road cut. New disorders popped up daily. Some of them were splendidly wacko. There was briefly a boom market in Multiple Personality Disorder, with books and movies and chat rooms on the Internet for sufferers. (I figure if you’ve got MPD, you are a chat room. Sort of your own Internet.)

The other half of this financial thunderstorm was a pharmaceutical flowering. If Bored-With-Your-Job Disorder was a medical condition, there must be a medical treatment. Surgery seemed excessive. How about . . . yes!. . . a mind-altering drug! It was brilliant. Many of the earlier vic. . . patients had been through the Sixties, so the concept was familiar.

Sex differences erupted. A depressed man would knock back several bourbons and go look at motorcycles he would never buy. He might break things, throw a few people off a bridge, or machine-gun a kindergarten. Guy stuff. A woman wanted an answer that was approved by a parental figure, who would tell her that It Wasn’t Her Fault. Which is the principle message of the therapy trade. Doctors, being ego-struck god-figures, were just the ticket.

Whole factories began spewing pills: Prozac, Zoloft, Welbutrin, Xanax, Depacote. It got hard to find an unmarried woman over forty who wasn’t high on one of them.

The pharmaceutical companies saw yet broader vistas. The next step was compulsory disorders. Pretty soon, if you were a little boy, and not actually asleep on your desk, or dead, you had Attention Deficit Disorder, and they made you take Ritalin. (If you were asleep, you had narcolepsy, and they made you take Ritalin. If they caught you taking Ritalin without a prescription, you went to reform school. Social policy is endlessly fascinating.)

The question I worry about is: If everybody’s crazy as bedbugs and disordered, and needs enough drugs to frighten a Grateful Dead concert–how come nobody noticed it before? Five thousand years of history, everybody was crazy, and nobody knew? (Yes, yes: We’ve got Self-Loon Nonobservance Disorder. Take a pill and. . . )

I don’t know. I guess I’m just a redneck, and don’t understand things like I ought to, except camshafts. Still, if a hunting pack of therapists had come up my holler, with a pill bottle and a credit-card machine, and wanted to talk to me about feelings, I’da shot’em. But then, I have Practical-Solution Disorder.

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