When I was pastoring in Miami, God burdened me for people struggling with anxiety and depression and for couples who wanted help in their marriages or parenting but didn’t know where to turn. I recruited the head of the psychology department at a Christian university, and together we launched a counseling center. This was nearly twenty years ago, and one of our biggest design questions was how to make the entrance discreet. People feared being seen as weak for going to therapy. We often told them, “It’s okay to not be okay.”
Fast forward to today, and there’s no shame in going to therapy. If anything, therapy has become a badge of self-awareness. “My therapist said…” is now a dinner-party conversation starter. Seeing a therapist is often seen as a sign of strength, even status—proof that you’re “doing the work.”
This cultural shift has many benefits. People are talking about mental health more openly, and more people are seeking help when they need it. But something else has happened too: therapy has become a worldview. Social media feeds are filled with “therapy-speak,” and hashtags like #trauma have billions of views.
Psychotherapist Esther Perel has expressed concern that this new therapeutic culture often makes us more isolated: “There’s such an emphasis on the self-care aspect of it that it’s actually making us more alone.” Psychologist Darby Saxbe at USC warns that anxiety itself can become “an identity marker that makes people feel special and unique.” What was once a diagnosis is now, for some, an identity.
The Verge published an article about people self-diagnosing themselves via TikTok, often in hopes of having an identity. Dr. Andrea Giedinghagen, a child psychiatrist, stated: “I’m glad those communities exist, but when people misdiagnose themselves, it becomes a problem. I’ve had people cry in my office because I told them that they do not have the diagnosis that they think they have.”
Even the meanings behind the words we use are shifting. The term “trauma” has historically been used to describe horrific events. Now it’s used for hurt feelings, broken trust, or stressful workplaces. Columbia University psychologist George Bonanno cautions that when everything is called trauma, true trauma loses its meaning—and those who have endured it are cheapened. Will Self wrote a long-form article chronicling the expansion and redefinition of the word “trauma.” He concluded: “Many thousands of people are becoming convinced that perfectly ordinary reactions to such commonplace problems as overbearing bosses or untrustworthy friends are, in fact, reflex responses seared into their psyches by the white heat of trauma.”
These concerns aren’t just theoretical. In Crazy Like Us: The Globalization of the American Psyche, Ethan Watters recounts well-meaning Western therapists who rushed to Sri Lanka and Indonesia after the 2004 tsunami to offer trauma counseling. Many survivors hadn’t considered themselves traumatized; they were grieving, rebuilding, and leaning on community. But after being told they should be traumatized, some began to feel worse. Helping people think about their pain more didn’t actually help.
Abigail Shirer, in her book Bad Therapy, insists that bad therapy is therapy that makes existing symptoms worse and introduces new ones. Normal sadness becomes depression. Normal, everyday worry becomes anxiety. She articulates that depression, trauma, and disorders are real and need treatment, including therapy and medication, but that we have normalized them so much as to project them on people who don’t have them. She is mainly concerned about therapy thrust on children and teenagers because of their vulnerability, as they have not yet developed the life experience to know what counsel to discard. Shirer compares the increase in therapy to D.A.R.E., the program my generation was exposed to in public school assemblies where we were told about the dangers of drugs. The post-mortem on D.A.R.E. is that it was never effective, and some studies indicate the program actually introduced teenagers to drugs. She also points to many therapists and psychological organizations ignoring clear research on the damage the smartphone is doing to teenagers, saying one clear thing therapists could be doing to help was getting kids off social media and many did not.
All the authors, professors, and therapists I have quoted believe anxiety and trauma and mental health challenges are real. They simply believe there has been an over-correction from “no one talks about this” to “we talk about it so much that some feel they need a mental health problem to fit in.”
It is still true that some people need to hear “It is okay to not be okay,” so that people who need help can cry out for help. But it also needs to be said that “it is okay to be okay.” You are allowed to be healthy. Helping people who are okay see themselves as not okay is not helping anyone. Helping people find an identity in their pain is damaging.
In my next post, I will share three differences between good therapy and bad therapy and provide a tool my team developed to help someone evaluate a potential therapist.
