Why I Don’t Trust Therapy
I want to start with the ten-year-old, because he’s the reason for all of it, and because I think he deserves to be named before anything else in this piece gets said.
He was confused, still, at ten — still in the stage where confusion was possible, before enough had accumulated to make confusion unnecessary. He still had a child’s capacity for believing that things could be different. That this time might not be like the last time. That the pattern had an exit, somewhere ahead, if the right thing happened.
The right thing, he’d decided, was treatment. If his father got treatment — real treatment, in a real clinic, with real doctors — then maybe the pattern ended. Maybe the stomach aches ended. Maybe the air in the apartment stopped having that specific quality it got before something happened. Maybe everything that had been true for as long as he could remember stopped being true, and something else started instead.
He believed this. Genuinely, completely, with everything a ten-year-old has available for believing things.
I want you to hold that, because the rest of this piece is what happened to it.
What My Father Actually Was, Clinically
The psychiatrists who examined my father over the years described him in terms that don’t appear in most people’s case files: exceptional, interesting, charming — and dangerous. The dangerous part they understood completely. What they couldn’t do was stop him, because stopping him required conditions the system wasn’t designed to produce for someone like him. He was never institutionalized against his will. The danger he represented to his family, to us specifically, wasn’t the kind of danger that generates a court order in a functioning bureaucracy. It was the kind that happens behind closed doors, between people who can’t prove what they know, to children who have no legal standing to report it effectively.
So the system knew what he was. Knew, in the specific, clinical sense — the senior psychiatrist who treated him was not a naive man, and my father seemed, interestingly, to respect him, which was not something he offered freely or often. But knowing what someone is and being able to do anything about it are two entirely different things. The system was not built for someone who participates in it strategically.
The Clinic
At some point — I was around ten — my father decided to have himself committed to a private mental health clinic.
I want to be precise about that verb: decided. Not was committed. Not was ordered to attend. Decided. Chose. Walked in voluntarily, on his own terms, under his own power, at a time of his own selection.
He never acknowledged, at any point in his life, that he had any illness. Not then, not later, not as an old man. If you said the word schizophrenic in his presence he would laugh — the specific laugh he reserved for things he considered beneath him to take seriously. He was not sick, in his own accounting. He was extraordinary, which was something entirely different and not something that required treatment.
And yet he went to the clinic.
What I learned later — not then, but later, pieced together from things said and unsaid over years — is that he had gone too far somewhere, done something we never fully found out about, and the clinic was the response. Not to his illness. To his exposure. He had exceeded himself in some direction that had produced danger for him specifically, and the clinic was where danger went to wait until it was safe to come back out. A form of legal and social shelter, wrapped in the language of healing, performed for exactly as long as necessary and not one day more.
He played the doctrine. The recommendations. The therapy itself.
He gave the doctors what they needed to see — not crudely, not obviously, but with the specific precision of someone who had spent decades reading people and understanding exactly what each person in front of him needed to believe. The senior psychiatrist, who knew what he was dealing with, who had studied him, who was not a man easily impressed — even he could not fully separate the performance from the possibility that some part of it was real. Because the performance was that good. Because it was always that good. Because charm, deployed by someone with no conscience governing its use, is essentially unlimited in its range.
He came out when it was safe to come out. He did this twice, that I can remember with certainty.
What the Ten-Year-Old Learned
The first time, I believed it. I want to say this without embarrassment, because I think the belief was reasonable for a child of that age in that situation, and because pretending I wasn’t fooled would be its own kind of dishonesty. I was ten. I wanted it to be true. I had no framework yet for understanding that the language of recovery could be a weapon, that the performance of healing could be a strategy, that a man who wanted to get better and a man performing wanting to get better could be, to everyone in the room including very experienced clinicians, functionally indistinguishable.
I thought: this is the thing. This is where it ends. The clinic, the doctors, the treatment — something is finally happening that can change what’s true.
And then he came home. And what was true continued being true, exactly as it had been, without interruption, as if the clinic had been a pause rather than a change. Which is exactly what it had been. Not a pause in his illness — a pause in his exposure. Once the exposure was resolved, there was nothing left to pause for.
I learned something from this that I’ve never fully unlearned: that the systems designed to contain a certain kind of person don’t actually contain them. Not because the people running those systems are incompetent — the psychiatrist was not incompetent, he was one of the smartest men I encountered in that entire period. But because the system’s assumptions don’t include the possibility of someone engaging with it entirely in bad faith, for strategic reasons, with no intention of being changed by it. The system is built for people who come to it genuinely. It has no mechanism for someone who comes to it as a tactic.
Why I Don’t Trust Therapy
I want to be honest about what this actually means, because I think the broad statement — “I don’t trust therapy” — is less precise than what I actually believe, and precision matters here.
What I don’t trust is the assumption the system runs on: that the person in the room is there in good faith. That what’s being said bears a real relationship to what’s being experienced. That engagement with the process produces something that wouldn’t have existed without it.
For most people, most of the time, this assumption is probably correct. I’m not making a general claim about therapy’s usefulness for the people it was designed for. I’m making a specific claim about what it does to your relationship with that assumption when the first sustained encounter you had with it was watching someone use it as a weapon — and succeed, repeatedly, with doctors who knew what he was and still couldn’t stop him from succeeding.
What it does is this: it makes the assumption visible. Once you’ve seen the assumption exploited from the inside, at close range, by someone you knew completely, you can never fully stop seeing it as an assumption — as something that might or might not be warranted, rather than something that simply is. You can watch someone in therapy, or be in it yourself, and some part of you will always be aware that what’s visible and what’s happening are not necessarily the same thing. Not because you think everyone is performing — most people aren’t. But because the possibility of performance is now part of your permanent equipment for reading situations, installed by a man who demonstrated, twice that I know of, that the equipment is warranted.
He found the psychiatrists charming, they found him charming, and everyone in those rooms was doing their best with what they had. I don’t doubt that. The senior psychiatrist was genuinely trying to do something with an impossible case, and he probably knew, on some level, exactly what was happening — and also couldn’t prove it in any way the system recognized as proof.
That’s the trap. And the trap is still there, in every room where the assumption of good faith is the load-bearing wall, for anyone who’s learned that certain people know exactly where the load-bearing walls are and exactly how to make them hold for as long as they need them to.
