It’s a little weird becoming an older therapist. I have more freedom to practice the way I believe therapy works just as the mental health field seems to be making that freedom harder for everyone else. I couldn’t write this twenty-five years ago. I’m no longer trapped in a structure that demands I push myself to schedule thirty sessions a week. I set my own days now, seeing maybe fifteen clients a week— a caseload younger therapists would love to have, if they were even offered the choice, and I have zero worries of running a practice.

I know that’s a privilege, mostly earned by seniority (I’m in my sixties) and time in the field. The tension between the business of therapy and the art of it is something I don’t have to worry much about anymore.

But I see younger mental health workers coming up and it concerns me enough to write from the perspective of someone who’s been around long enough to notice the changes, at least here in the U.S.

Early-career therapists today are expected to carry a caseload double mine, often through community mental health or large group practices that need volume to make their numbers work. Some are coached to market themselves, find a niche, something they can put on a website or Instagram. They’re handed productivity quotas dressed up as accountability: session counts, notes that must justify medical necessity. They’ll call it professionalism, evidence-based practice, and how the field works now.

But what this “efficiency” really does is shrink the essence of psychotherapy: developing the therapeutic relationship. A container — the built trust between two people that makes deep work possible. A tool to manage symptoms gets handed to young therapists in a training seminar to be deployed the following week. A container takes years of craft, and nothing can make it go faster. So when the math doesn’t work, what goes first? It isn’t the paperwork. It’s the container.

Most newer therapists aren’t choosing to do this. They’re absorbing that pressure and calling it their own shortcomings, and doubting themselves. That’s the part that concerns me — not that the field has commercial pressure, but that it’s suppressed enough to be mistaken for personal incompetence. As if there’s something wrong with them, not the system. One of my first major lessons in grad school was building trust, not meeting quotas. Trust is key to building the container.

A twenty-eight-year-old clinician who can’t allow themselves to slow down enough to build a viable container isn’t failing at therapy. They’re being nudged to prioritize the caseload numbers given to them, and then only secondly to develop their therapeutic skills. I’ve felt that myself. Some bolder therapists push back — turn down that extra intake, quietly say “fuck you” to the quotas, and accept the lower income that comes with protecting the container, and it costs them something very real.

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I was thinking of writing an essay about my AI dilemma. The dilemma is this. I worked very hard at overcoming reading and writing problems developed early in life.

A lifetime.

I was often shamed for my poor written grammar, particularly by adults who were earning their livelihoods teaching language. My reading was spotty and my writing nearly impossible to logically follow. I was told to read more. Graphic novels were not yet a thing and comic books were looked down upon as garbage for the intellectually challenged. I think to my credit I kept making efforts to improve. I did read more and I wrote more. Imperfectly. Badly at times. Avoided. So when AI tools became available to help make my writing more coherent and sensible I leapt into that opportunity as if it were an Olympic-sized pool on a hot muggy afternoon in a Pittsburgh August. My writing appeared to be more coherent and clean. But then I ran into another problem. My writing began to sound too clean, too structured, too coherent that it was labeled by AI detectors as completely 100% generated by AI. Why is this a problem? Because it’s simply untrue. AI detectors are not capable of knowing whether something is written by a human or machine. They work on probabilities, identifying patterns in writing. So, if a person writes too cleanly, it matches a robotic pattern and will be flagged as AI generated. But AI generated sentences are now generally viewed as coherent trash. Fake, or at least suspect and then ignored. A commenter on one of my essays actually said it would be a shame if I had published a piece using AI. Particularly when writing about authenticity. This is now the context we’re writing in. There’s a kind of cultish certainty some readers seem to be looking for, perhaps nostalgic for, the pre-AI world. At worst it’s ableist. As if writing were somehow so much better if it was less direct and coherent. So, here I am, caught between the old world and the new. Damned if I use AI and damned if, well you already know.

What I do know is that AI has helped me write more, nearly every day. It often sparks new ways of thinking. It allows me to go off on creative tangents and down deep rabbit holes and not get so lost that I can’t find my way back to basic sustainable ways of living in the absurdities we find ourselves today. Ironically, it was electronic technology that first gave me fuller access to the kinds of stories that taught me how to think, and I was shamed for it. They called it The Boob Tube.

I spent much of my childhood absorbing stories of the world through the visual images of television of the late 1960s and early 70s. I can see now this was something I did because of my early struggles with the written word as well as painful family issues. I was learning a visual language and I resonated with much of what I was seeing on black and white tv sets, often a little 12 inch that I could carry to different rooms for more undisturbed viewing. And learning.

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Fellow Substacker , writing this past February, described standing in a stranger’s kitchen at three in the afternoon, holding a glass of tap water “like it was a moral alibi.” Nothing bad had happened. Everything had been consented to. And yet she drove home certain that something had gone quietly, unnamably wrong. Her essay ends on a line that stays with me: consent is not the same thing as being cared for.

Williams is diagnosing a specific and gendered cost. Drawing on Eva Illouz, she argues that casual sex doesn’t just reflect the shedding of repression —it reorganizes intimacy according to a market logic that prefers portable, self-managing, emotionally autonomous subjects, and that this logic falls disproportionately on women, who are trained from childhood to do the relational work that frictionless encounters ask everyone to suspend. When that training meets a script demanding detachment, the capacity for attunement doesn’t disappear. It turns inward. It becomes a private burden mistaken for a personal flaw. covers adjacent ground from a different angle — less concerned with market logic than with what happens, socially, to women who decline to supply what the male gaze expects of them.

I want to take her diagnosis somewhere she doesn’t go: into the therapy office where I work.

Because the same disciplined inhibition she describes — the same demand that care be suspended so an exchange can stay frictionless — shows up in psychotherapy too, dressed in different clothes. It’s a field that is roughly seventy percent women, and that isn’t an accident. It’s the same sorting that assigns relational labor to women generally — and turning that labor into a manualized protocol is simply what happens once it becomes billable. It doesn’t show up as sex, but as symptom management. Not as a hookup on an app, but as a treatment protocol.

A client arrives wanting relief, and increasingly, the field is organized to give it to them fast, cleanly, and without residue: a technique, a worksheet, a diagnostic code matched to an intervention matched to a billing cycle. No claims on time. No claims on history. No claims on the relationship itself, which is treated, at best, as a delivery mechanism for the actual treatment happening elsewhere in the algorithm.

This can look like progress. It can even feel like progress, the way that kitchen encounter must have felt, in the moment, like freedom. But there’s a difference between her situation and mine, and it’s no small one. Two people leaving a kitchen owe each other nothing in particular. A clinician and a client are not equals negotiating a frictionless exchange between consenting parties. One of us is licensed, trained, and paid specifically to provide a kind of care the other person cannot easily get elsewhere. If consent turns out to be insufficient even between equals — if Williams can do everything right by the rules of the encounter and still come home diminished — then what does it mean when the asymmetry is built into the relationship by design? A protocol like CBT or ACT can be entirely consented to, entirely evidence-based, entirely defensible in a chart note, and still leave a person having quietly misplaced themselves somewhere between the intake form and the discharge summary.

The unthought known doesn’t show up on a symptom checklist. It shows up slowly, in relationship, over time that no protocol is built to accommodate — because protocols, like dating apps, are optimized for throughput, not attachment. The client who wants to be known rather than managed is not being difficult. They’re identifying, correctly, that something essential has been quietly redefined as inefficiency.

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The spring air in Tokyo’s Chiyoda ward was crisp, carrying the faint, sweet scent of cherry blossoms from the imperial moats. Inside the pristine exhibition hall, however, the atmosphere was thick with corporate wealth and ancient prestige. This was the annual Imperial Bonsai Convention—but the miniature trees weren’t the only things being meticulously pruned tonight.

A tech mogul with deep ties to the Ordo was hosting a private viewing. His goal was to unveil a newly “discovered” imperial scroll that conveniently rewrote a major branch of his own family’s genealogy, tying his modern financial empire directly to a legendary samurai lineage. It was a flawless forgery, designed to grant him unprecedented political leverage over local cultural assets.

Martha and Sophie moved through the serene, minimalist space like two distinct currents. Sophie wore a tailored black evening suit, her dark hair pinned up with a pair of sleek, matte-black carbon-f…

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I once wrote a poem about a child who truly loved learning but was misunderstood, as if they themselves were a strange poem lost in a book on a dusty shelf in a long-forgotten library. For decades, our underfunded educational systems in the U.S. have operated on a rigid, behavioral assembly line. We set academic standards—memorizing multiplication tables, achieving reading fluency, mastering spelling lists—and measure children against them with robotic precision. When a child appears to stumble, the machinery of the school system is quick to diagnose failure. We ask what’s wrong with the student. But when it comes to the complex inner lives of children navigating chronic stress, this question misses the point. Too often, students are pathologized as lazy, unmotivated, or even cognitively impaired and become victims of a serious systemic error: an ableist misattribution of environmental overwhelm as individual deficiency rather than systemic limitations.

More recently, the COVID-19 pandemic served as an X-ray for public education, laying bare the structural fractures of a system that routinely mistakes compliance for capability. By disrupting the physical routines of the school day, the crisis revealed how domestic instability and chronic stress can undermine cognitive bandwidth. The pandemic amplified a truth that academic recovery is unlikely without first addressing basic nervous system safety, demonstrating that standard educational models remain dangerously unequipped to support children carrying invisible burdens.

I’m not saying that organic pathologies don’t exist. There are certainly children with significant developmental delays outside of environmental factors. But we need to differentiate those internal needs from the external ones. To understand why an overwhelmed child may struggle with fundamental academic tasks, let’s look at what happens to a brain under persistent chronic stress. When a child lives in a chronic state of domestic unpredictability or emotional distress, their developing nervous system naturally redirects its limited cognitive energy away from higher-order learning toward survival. The brain becomes hyper-vigilant, constantly scanning the environment for invisible threats typically beyond the conscious awareness of the child.

This state of constant alarm can have a heavy physiological toll, particularly on working memory and the hippocampus—the brain structures responsible for temporary storage and information consolidation. Working memory acts as the mind’s mental Etch-a-sketch, holding the intermediate steps of a multi-part math problem or the unfolding narrative of a storybook. Chronic anxiety shakes up that Etch-a-sketch. When a child’s bandwidth is entirely consumed by the quiet, exhausting work of managing an unpredictable home, there’s little cognitive room left to retain basic academic facts.

Yet, children have no developmental framework to articulate this. We cannot expect a seven-year-old to pause in the middle of a failed spelling test to explain in an adult-like manner that their cortisol levels are elevated and their working memory is offline. More developmentally realistic, they internalize the breakdown. Children are inherently egocentric. They will search for explanations for their failure and often make a devastating conclusion: “I am bad at math,” “I can’t read,” “I am stupid.” “I must have brain damage.” I must be the problem.

This self-blame is painfully tragic. A temporary state of cognitive overload caused by environmental stress is mislabeled as an inherent personal trait. Low self-efficacy takes root, generating anticipatory anxiety that ensures the next academic challenge will likely trigger a more intense stress response. The loop closes tighter: anxiety increases the risk of memory failure, memory failure often creates the false belief of low aptitude, and that becomes a deeper shame. A wound.

Tragically, adults whose job is to support healthy developmental scaffolding will often rub salt into this wound. Teachers, administrators, and even parents often misjudge the student’s behavior through the lens of certainty or their own unaddressed chronic stress issues. Zoning out, (dissociation) avoiding tasks, or missing deadlines are misread as deliberate defiance or a lack of moral character. Rather than asking what has happened to the child, adults under stress in the system will ask what’s wrong with the student rather than ask what might be not working well in the system. Struggling readers and overwhelmed math students often meet a system too stretched to assess them well — and inadequate assessment means inadequate placement. Rather than landing in a setting suited to what they actually need, they’re hurried into specialized tracks that pathologize their symptoms, leaving the real source of their injury unacknowledged.

When trusted adults in authority reflect back an image of the child as broken or lazy, the student internalizes that judgment as an absolute truth. Guilt whispers, “I made a mistake,” but shame insists, “I am a mistake.” Many unconsciously learn to mask their pain behind a protective armor of apathy, and act as if they don’t care about school at all, simply to shield themselves from the painful vulnerability of trying and failing yet again when in truth it’s the school that has failed.

Consequently, these children become caught in a closed educational system —a system that measures compliance and quantitative output while remaining ignorant of nervous system regulation. It’s not surprising that school often feels like a kind of odd prison to them, or a kind of Limbo where they must wait. If a child’s invisible burden can’t be easily quantified, it’s legislated out of existence. The system applies a label, prescribes a superficial intervention, and when the child continues to struggle within that rigid framework, points to the failure as proof that the original diagnosis was correct. Unless they find solid developmental scaffolding elsewhere.

Untangling this tragedy requires a fundamental shift in thinking. Instead of asking what's wrong with this child, we need to ask what's right with them. We need to help children realize that their brains aren’t broken, but that they’re likely carrying a heavy invisible load that was never theirs in the first place. Therapy and supportive teaching need to act as sanctuaries where excessive demands are stripped away, micro-successes can take root, and mistakes are treated as ordinary data points rather than certain proof of inadequacy or organic pathology.

Ultimately, a child caught in the crosshairs of domestic stress and institutional blindness resembles an unread poem—an intricate, delicate composition waiting for someone to slow down, look beneath the surface, and really listen.

Until our schools evolve from factories of compliance into sanctuaries of real safety, we will continue to lose brilliant, feeling minds to the cruel fiction that they simply didn’t have what it takes to learn.

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The story most of us tell about AI detectors is that they catch cheaters and reveal AI slop. The truer story under all of that is that what they catch is a style — and the style they catch belongs, disproportionately, to people who were never trying to hide anything.

Neurodivergent writers — autistic and ADHD writers especially — are flagged as AI-generated at higher rates than the general population. Why? Not because their writing is less human. Because it’s more structured. More direct. Less prone to the meandering, the tangent, the grammatical stumble that a detector has learned to read as proof of human presence. That might seem to be a paradox, given the stereotypes of ADHD. Clarity, the thing these writers like myself often worked hardest to achieve, is exactly what gets mistaken for machine work. I worked hard to overcome my learning deficits as a child and all of my misuses of language. Add a grammar tool or a word-prediction aid — the kind of accommodation that lets someone write at all — and the “polish” compounds the suspicion. The support becomes the evidence against them. That’s my dilemma.

But non-native English speakers also face the same bind from a different angle. Simpler sentence structures, a narrow vocabulary, more repetition of stock phrases — all features of language still being learned, and all features a detector reads as fake. One study found well over half of TOEFL essays by non-native speakers were scored as AI-generated. Not because the students cheated. Because the tool has no way to tell “still learning the language” from “never really learned it at all.” These LLMs do not comprehend language.

What both groups share is this: an AI detector doesn’t measure whether a person wrote something. It measures how much noise is in the writing — how much unpredictability, mess, idiosyncrasy. The same stuff I was told was garbage writing and a reflection of my learning problems. My early writing was drowned in a sea of red ink by my teachers. And that was humiliating. Were they just bad teachers? Not really. A human is defined, by a machine’s own logic, as someone who wanders. Writers who don’t wander — because directness is now how their mind works, or because they’re still building fluency in a second language — get treated as the anomaly, when they are in fact the ones speaking the truth most plainly.

So what do we do with a tool that mistakes clarity for being fake? Let’s try to understand what this tool is doing.

Stop treating its results as an absolute verdict. A score is not evidence — it’s one badly calibrated guess, and several universities have already pulled them from their academic integrity process for exactly this reason. LLMs fake comprehension. They have no consciousness. Platforms adopting AI for the same purpose Substack has should publish their false-positive rates broken down by the populations most affected, the way any rigorous scientific drug trial would have to disclose who it failed. Writers, in the meantime, might do what I did without entirely meaning to: keep the drafts, keep your process visible, treat the provenance as something you can show, not something a black box gets to certify.

None of that fixes the deeper problem, which is that we’ve started asking machines to answer questions they were never built to understand — not “does this resemble machine text” but “is this a real person.” That question doesn’t have a technical answer. It never did. The sooner platforms like Substack admit that, the fewer people we penalize for writing exactly, and honestly, as who they are.

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*Note- AI detectors will likely scan this as 100% generated by AI. I can assure you it wasn’t. However, I do use LLMs to edit my work, and that is what is picked up.

The other day I posted this cartoon on multiple social media platforms. Waldo — that now universally recognized figure in his iconic red-and-white stripes, perpetually lost in a sea of chaotic detail — makes for a fun piece of professional humor. We all relate to him. Stretched out on a therapist’s couch, being gently invited to explore the idea that Waldo might actually be hiding from himself, resonates because good humor carries a kernel of serious truth. While my posting of the cartoon was meant to bring a smile to fellow mental health professionals, it touches on a dynamic that therapists see every day. Many people decide to enter therapy because, much like Waldo, they’re fundamentally unaware of how they may be hiding from themselves, unconsciously undermining their own well-being simply because they do not understand something about who they are.

We often spend a lot of energy hiding in plain sight. We blend into the background of careers, family expectations, and social scripts, becoming masters of adaptation. This camouflage can start early in life as a necessary survival strategy. Long before we have language for any of it, we learn to play Peek-a-boo and Hide ‘n Seek: that disappearing can be a way of staying safe, and that being found is something we can control. In environments where authenticity felt risky, unaccepted, or unsafe, that playful game hardens into a deeper strategy. Keeping parts of oneself tucked away protected the vulnerable ego from judgment or rejection. Over decades, however, these protective layers become second nature, and the game stops being a game. We don’t see it anymore. We move through the world fulfilling roles and meeting external demands, while our own authentic desires, boundaries, and inner voices remain completely obscured. Unconscious. We’re present in our own lives physically, but psychologically, we’re missing — and we are the ones who arranged our own hiding place.

The irony of self-elusion is that the hider always knows where they are, even if they pretend not to. Maintaining that internal distance takes a toll. The exhaustion of keeping oneself at arm’s length frequently manifests as a vague, persistent sense of emptiness, chronic fatigue, or a quiet existential restlessness that defies easy diagnosis. People come to therapy suspecting anxiety, relational friction, or professional burnout. Underneath those presenting concerns often lies something harder to name: they have become strangers to themselves, unable to say with any confidence who they are apart from what the role requires.

This is where a familiar clinical picture — Imposter Syndrome — can take on a different cast. We usually think of it as a mismatch between external success and internal self-doubt. But for someone who has hidden from themselves long enough, the fraudulence isn’t about competence at all; it’s that the competence seems to belong to the role rather than to them. They can perform the part fluently and still feel, underneath it, faint and unaccounted for — as if the person everyone keeps mistaking for them is doing an excellent job of it.

This is where therapy serves a vital purpose. The privacy and containment of a therapist’s office offer something exceedingly rare today — a liminal space free of performance, evaluation, or social obligation. In a curated world constantly demanding productivity and conformity, the therapeutic relationship provides a quiet sanctuary where an individual can finally drop their defenses and just say, f*ck it.

Here, the question of what you’re hiding from ceases to be an accusation or an interrogation. Instead, it becomes an invitation to explore your inner landscape with child-like curiosity rather than shame or embarrassment.

Finding ourselves requires a willingness to welcome back the parts of the personality that were packed away long ago because they were deemed inconvenient, too intense, or unacceptable. It means untangling the self from the roles we play and the expectations we carry. In the safety of a judgment-free space, a person can begin the mindful work of self-discovery, taking off the distracting patterns they’ve worn for years to look at who they actually are underneath those stripes.

But the game doesn’t end there, and I’m wary of any account of therapy that suggests it does. Waldo, found, is still wearing the stripes — that’s the joke, and it’s also the truth. The habit of hiding doesn’t dissolve the moment it’s named; it just loses some of its intensity. Most of what I’ve watched happen in three decades of doing this work isn’t a triumphant unmasking so much as a slower, more modest thing: a person starting to notice, in real time, the exact moment they begin disappearing again, and choosing, this time, to stay.

Therapy is rarely about fixing a broken machine. It’s more often about building the capacity to keep finding yourself, again and again, in a world that keeps asking you to hide.

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GPTZero says the essay I wrote about Lord of the Flies — about moral injury, about the boys who lost their scaffolding along with the adults, about the black-and-white film I watched alone as a boy because Mr. Rogers’ Neighborhood wasn’t real to me and Golding’s island was — GPTZero says it’s one hundred percent machine. Not mostly. Not “further review recommended.” One hundred percent.

Let me be precise about what stings here, because it’s specific, not generic.

It’s not vanity. I don’t need a certificate saying 100% human-made to know what I spent on that piece. I know where the idea came from — a boy in front of a television, working something out he didn’t have language for yet. I know how long it took to turn that memory into a coherent argument about attachment theory and scaffolding and Roger’s stones deliberately missing their mark. That labor doesn’t need a machine’s approval to have happened. But I still feel the sting, because the accusation isn’t neutral — it’s a claim about where the essay came from, and it’s a wrong one, made with total confidence, about the one piece of writing I can trace back to an actual afternoon of my own childhood.

I used Claude to clarify sentences. To catch a dangling modifier, to ask whether a paragraph is doing what I think it’s doing. That’s the whole of it. The thinking — the memory of that television, the years of clinical practice that let me see moral injury in Roger and Jack and Ralph where other readings only saw savagery — that’s mine, arrived at slowly, the way anything true arrives. A detector cannot see any of that. It isn’t built to. It was built to find rhythm that resembles other rhythm, and mine, apparently, resembles something it’s decided to call synthetic.

I don’t have a neat place to put this feeling. I could say the tool is wrong and move on, but that undersells it — being told your voice reads as no one’s voice in particular is its own small grief, adjacent to but not the same as being told you’re lying or you’re a fake. I know the difference between being disbelieved and being erased, and this is closer to the second. Not “we don’t trust your account.” More like: there was no one home to have an account.

There’s an irony in this essay specifically. The piece argues that the boys on that island didn’t turn savage because savagery is what’s underneath — they turned savage because the scaffolding that should have shaped their moral sense was ripped away too soon, and nothing was there to catch them. A detector that can’t tell a lived memory from a generated one is its own small failure of scaffolding: a system built to hold a line between human and machine, deployed with total confidence, that collapses the moment it meets something it wasn’t built to do. It doesn’t know the difference. It just says one hundred percent, and moves on. Fuck that.

I don’t have an ending for this one either. I’m always suspicious of the ones that resolve. But I notice what’s happening: the tool built to catch the absence of a mind is, in practice, catching the presence of one — mistaking a lifetime of noticing patterns like this one for evidence that no one did the noticing at all.

I ran this essay through GPTZero before publishing it. It came back 86%. I’m including that number here on purpose, and I’m not explaining it.

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This can be read as a follow-up to my previous article on “hype” in mental health treatments.

We are currently living through what might be called mental health’s “Golden Age of the Protocol.” If you open your browser and search for relief from suffering, you are met with an alphabet soup of acronyms: CBT, DBT, ACT, EMDR, IFS, and a dozen others, each promising a streamlined path to emotional optimization. They come with marketing brochures, Continuing Education Units, tiered certification levels, and the implicit promise that if you just master the right framework, you can edit your internal life like a piece of faulty software.

But there’s a quieter, more urgent question buried beneath this mental health treatment noise: Why have we, as a culture, become so desperately convinced that our pain and suffering is a problem to be solved instantly? We no longer have to wait for things as we did prior to the internet. We likely also wonder if we don’t have to suffer, at least not so long. We live in a more instantaneous digital world.

The Project of the Self

We have increasingly begun to view our human experience through the lens of instant gratification and project management. In this framework, anxiety, grief, or historical trauma are not seen as integral components of a life to be inhabited, but as ‘bugs’ in the system—inefficiencies that disrupt our optimal functioning. (Tellingly, you can debug a system without ever asking how you’re treating it—whether you’d extend a friend the same impatience you extend your own grief.) When we treat our lives as a project, we naturally demand a deadline for completion.

We want a “fix” that fits into the rhythm of our digital lives: clickable, measurable, and above all, fast. This expectation of immediacy is not merely a personal preference; it’s a serious shift in how we relate to our own humanity. We have been sold the fantasy that growth is simply a matter of linear progression, a series of milestones that, once checked off, leave us finally, permanently “better.”

The Economic Incentive of Certainty

Of course there’s money involved. We cannot divorce this desire for speed from the economic reality of American business and capitalism. In a marketplace where “relational presence”—the slow, unquantifiable work of being deeply known by another—is inherently unscalable, there is little financial incentive to promote it.

Businesses and proprietary modalities, however, are highly scalable. They offer the comfort of certainty and a way of gaming the system. They provide a map, a manual, and a lexicon. A quick shortcut. When a person arrives in the therapy office with a pre-packaged diagnosis learned from a social media algorithm, they’re not just looking for help; they’re looking for a proprietary tool like EMDR or Brain Spotting that promises to bypass the “messy middle” of the therapeutic process.

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In the landscape of modern psychotherapy, we are witnessing a quiet crisis of confidence. It’s a trend characterized by a frantic search for the next “breakthrough” technique—a digital supermarket of protocols, from EMDR to Brainspotting, each marketed with the seductive promise of a shortcut to healing. Recently, a peer on Substack responded to one of my essays, in which I critiqued how some practitioners market these methods as panaceas. She noted that she uses these same tools, but only as a “container” within the therapeutic relationship. Her distinction was vital, and it struck a chord that resonates far beyond a single social media exchange. I want to stay with that word—container—because it’s going to matter later.

The fundamental issue is the rise of the “technician.” Too many practitioners, and by extension their clients, have begun to view therapy as a mechanical process: diagnose the trauma, select the protocol, apply the intervention, extract the relief. This mindset reduces the serious, often liminal, work of healing to a series of drills. When we treat the protocol as the centerpiece of care, we treat the client as a subject to be fixed rather than a person to be known.

To be clear, this isn’t an argument against the tools themselves. Some clients need EMDR. Some need medication—sometimes urgently, sometimes for years, sometimes for life. Some need a specific, manualized protocol delivered with precision. I’m not interested in relitigating what works; the evidence for many of these interventions is real, and I’d never want a suffering person to go without something that could help them because I’d rather make a point about relationship. What I’m interested in is what makes a tool usable rather than mechanical—and that has never, in my experience, been the tool alone.

I’ve seen the technician cycle play out repeatedly, particularly among those who feel disillusioned by the traditional medical model. When a client encounters a rigid, manualized approach—one that feels transactional—they rarely perceive that the delivery was the problem. Instead, they blame the framework. They start shopping for the next “hot” method, convinced that their suffering is a technical glitch that just needs the right software update. They become consumers of their own recovery, jumping from one trendy technique to the next, often finding themselves more exhausted and more convinced of their own “brokenness” when the promise of immediate relief fails to materialize—and consequently come to believe that therapy doesn’t “work” for them.

In my own practice, I work with clients who are caught in this loop—distraught, desperate for any reprieve from their internal agony. One client, in particular, spent months seeking relief through high-intensity clinical interventions that promised physiological resets. And to his credit—and theirs—something did shift. He described real moments of relief, even clarity, in the aftermath. But the relief had nowhere to go. There was no one to help him make sense of what had loosened, no relationship holding the space around what the intervention had opened up. The tool worked; the container was missing. And so he returned to our sessions heavy with disappointment, not because the protocol had failed him, but because he’d been left alone with what it uncovered. I recognize something of myself in that disappointment.

I’m fairly certain that being held in a therapeutic alliance saved my own life once. It’s a large part of why I do this work at all. So when a client sits across from me having tried everything except being known, I understand what’s actually being asked for, even when neither of us can name it yet.

In those moments, the temptation to offer a new “tool” is immense. It’s the path of least resistance. But I’ve learned to resist that urge. Instead, I stay. I witness. I act as a container—there’s that word again—for the grief of his failed hopes. We sit together in the silence of that disappointment, and in doing so, we are doing something far more radical than any protocol could achieve on its own: we’re building an alliance.

This relationship—the space between us—is not merely a delivery vehicle for a cure; it’s often the medium the cure requires to take hold at all. It’s a liminal space where the client is finally invited to stop performing and start simply existing. Where they become a human being rather than a human doing. For a client who has spent a lifetime shaped by early experiences of abuse—learning to perform to survive—the act of being with another person who demands nothing is a profound corrective.

There are, of course, residual issues that often lie beneath the surface, unconscious echoes of the past that have been “bottled up” through decades of trying to be “fixed.” These issues are rarely hacked away by a protocol working in isolation, without a relationship to give what it surfaces somewhere to land. They require the slow, grueling, and deeply human labor of trust. When I tell a client that perhaps we have already found the tool we need—that the relationship itself may be the primary instrument through which any other tool becomes usable—it is not because I am dismissing their suffering, or the medication, or the protocol. It’s because I am reclaiming the dignity of their process.

Perhaps we need to stop treating suffering as a technical problem to be solved by the latest intervention alone. The cure isn’t in the next protocol instead of the relationship; it’s in the slow, consistent, and courageous work of showing up for one another, inside of which a protocol can finally do what it was meant to do. When we prioritize the alliance over the technique, we move away from the sterile, mechanical world of the technician and into the messy, sacred, and deeply human work of the therapist. Healing does not come from a machine; it comes from the quiet realization that one is finally, truly seen.

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I’ve spent years watching people try to repair their inner worlds, and one of the most persistent pressures I encounter is the mandate to forgive, as if forgiveness were the only way to heal. Whether it comes from religious doctrine, New Age optimism, or a general cultural appetite for closure, the narrative holds that forgiveness is the final, necessary step—that no one is whole until the offender is released from the debt of what they did.

Balderdash. In my work with survivors of abuse, and in my own life, I’ve come to see the forgiveness mandate not as a path to peace but as a subtle form of spiritual bypassing. It asks the wounded person to reach for transcendence before they’ve finished the slower, uglier work of grounding themselves in their own account of what happened.

People-pleasing is a survival strategy—a way of keeping an environment predictable and an aggressor appeased. Extend that logic to forgiveness and you get something similar wearing a nicer coat. To forgive someone who never apologized, who remains unsafe or unreachable, is often to say: I am no longer a threat. I am not angry. Please don’t hurt me again. It’s a maneuver that soothes the other person’s conscience, frequently at the cost of the survivor’s own integrity.

The deeper harm is what it does to agency. A person who fixates on forgiveness—or feels pressured toward it—keeps the key to their own healing in the hands of whoever hurt them. They wait, sometimes for years, for an admission that may never come. Their healing stays tethered to the character of the very person who broke their sense of safety.

My mother took secrets to her grave about my own parentage. I didn’t learn the truth until I was an adult—until after she’d died, in fact, which meant there was no possibility of that conversation. I had been, as a child, deeply attached to her. Genuinely a mommy’s boy, despite the maltreatment she put me and my siblings through. That attachment was not naivety. It was a survival strategy, the same one that later shows up dressed as forgiveness in adults.

Twenty five years after her death, I went looking. I researched her family history and found layer after layer of intergenerational trauma—inheritances of harm she never chose and likely never understood herself. I want to be precise about what that research did and didn’t do. It did not make me forgive her. It gave me context. It gave me a fuller, more coherent account of where her behavior came from, and in doing so it gave me something I didn’t have as a child: the sense that I was the one who got to decide what any of it meant. As a child, I had no agency in that relationship—only attachment, only adaptation. As an adult doing the research, I had authorship, and literally wrote a book about it.

That’s a different thing than forgiveness, and I want to resist collapsing the two, because the culture collapses them constantly. Understanding is not absolution. It’s not even sympathy, necessarily. It’s the more modest and more useful act of building an accurate map. Once I had the map, I no longer needed her to be anything other than the human being she was. Not because I’d released her from the debt, but because I’d stopped waiting on her—dead or alive—to settle it.

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Every few years, a new savior arrives in mental health treatment. A technique, a molecule, a protocol. It fills the seminar circuit and TED talks, dominates intake interviews, and colonizes Instagram and TikTok. For a while it’s the only thing anyone talks about. Then, as if on schedule, it curdles.

Tech has a name for this: the Gartner Hype Cycle. Technology Trigger, Peak of Inflated Expectations, Trough of Disillusionment, Slope of Enlightenment. I didn’t learn it from psychology. I learned it from watching software (and other products) die the same death my patients’ treatments do, on the same timeline, for the same reason — someone needed the thing to be more than it was, and sold it that way.

Prozac was a personality brightener before it was an SSRI. We had decoded the chemical imbalance, tuned the machine, made the slow relational work of therapy optional. Then the studies caught up — modest effect sizes, a withdrawal syndrome the marketers had omitted, the sobering discovery that a molecule cannot teach a person how to carry the weight of their own life. Primal Therapy promised the same a decade earlier with an infamous visceral scream instead of a pill: one wild release and childhood trauma discharged like water through a spigot. It left behind disillusioned practitioners and patients who’d been taught to treat their own interiority like plumbing.

EMDR currently sits in that seat. It arrived with a founding story that has always done more work than the mechanism — Francine Shapiro walking in a park, noticing that moving her eyes side to side dulled a disturbing thought. Three decades and large sets of research literature later, the honest reading isn’t that EMDR doesn’t work. It’s that the working ingredient looks a great deal like exposure therapy — repeated, structured attention to a memory in a safe frame — dressed in some sort of bilateral-stimulation apparatus that a clinician must be trained and certified, at great cost, to administer. The eye movements may be inert. The billing code is not.

That’s the detail the pill-versus-technique framing usually leaves out: someone profits from the peak, and it’s rarely the patient. A training-and-certification pipeline needs the technique to be more than exposure with a patent. A CE-credit workshop circuit needs a new modality every few years the way fashion needs a new silhouette. An insurance system that reimburses branded, step-by-step interventions more readily than plain relational work has a structural preference for whatever can be manualized, trademarked, and billed in units — over whatever cannot. The hype cycle isn’t just a psychological pattern clients fall into. It’s an economy that needs them to.

None of this means the trough is the same for everyone. For a molecule, disillusionment looks like a black-box warning. For a technique, it looks like a null result buried in a research journal nobody outside the field reads. For a client, it looks like something quieter and worse: the private conviction that THEY are the failure, because the thing that was supposed to work didn’t.

That’s the moment I’m actually interested in — not the cycle, but what a person does inside the trough. My job there is narrow. Not to offer the next frisbee or shoop-shoop hula-hoop — Wham-O’s actual ad phrase for ball bearings it added to a stalled plastic toy to manufacture a sound — not to diagnose which prior modality failed them and why, just to say: the promise failed, not you. A pill can turn a symptom’s volume down. That’s real and I won’t pretend otherwise. But turning the volume down is not the same as learning to stay present when it comes back up, to tolerate your own history, to make something out of the wreckage instead of waiting for the wreckage to be edited out. No protocol does that part. It was never going to.

I want to be careful here, because the Gartner frame itself is borrowed goods — a consulting industry’s vocabulary for predicting when to buy in and when to get out, applied to human suffering as if suffering were a product cycle too. There’s something uncomfortable about using the master’s tools to diagnose the master’s house. I’m not sure the discomfort resolves. Maybe naming a cycle is itself a kind of quick fix, a way of feeling oriented when actually you’re just watching the next thing arrive, dressed identically to the last thing, and you already know how this ends.

I don’t have a Slope of Enlightenment to offer. I’d like to tell you that once you see the pattern, you graduate to some mature, realistic relationship with treatment, free of the pull toward the next miracle. That’s not how it works. The pull doesn’t go away because you’ve named it. What changes, maybe, is smaller: you notice you’re at the Peak before you’re at the Trough. You buy yourself a little time between the promise and the disappointment. You ask, before you hand something or somebody your hope, who benefits if you do.

That’s not peace. It’s just a slightly earlier warning system, in a field that keeps needing one.

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EMDR is often whispered about in clinical circles and on social media as something close to a magic pill. Developed by Francine Shapiro in the late 1980s, it evolved from a controversial fringe technique into a gold-standard treatment for PTSD. Its efficacy is well-documented in the research, offering genuine relief to those for whom traditional talk therapy felt like an endless process with no visible end point.

But the story of EMDR’s rise is also the story of a culture that cannot resist converting a clinical instrument into a product — and in doing so, quietly stripping away what makes it work.

The Seduction of the Technical Fix

The most seductive promise made about EMDR, particularly on social media, is the promise of efficiency. Because the model relies on bilateral stimulation — eye movements, taps, or tones — to facilitate the processing of traumatic memories, it’s frequently marketed as a way to bypass the slow, nonlinear work of conscious integration. Heal faster. Process more. Clear the backlog.

This is optimization culture applied to the nervous system, and it can be exhausting.

The framing carries specific dangers. The first is the gradual devaluation of the patient’s own agency. When a model or tool is presented as something that essentially does the psychodynamic work for you, the patient’s role quietly shifts — from active participant in their own meaning-making to passive recipient of a neurological intervention. The second danger is the erasure of narrative. Processing a memory isn’t merely about lowering a distress score. It’s about integrating that memory into a coherent life story. A purely mechanistic approach risks clearing the symptom without helping the person understand how that experience shaped their world — which is not healing so much as editing.

Both of these dangers have a familiar shape. They are the same dangers present whenever a complex human process gets reduced to its most measurable components.

What Gets Engineered Out

Decades of psychotherapy research point consistently to one variable as the strongest predictor of successful outcomes: the quality of the relationship between therapist and client. Not the particular technique. The therapeutic relationship.

In the standardized EMDR protocol, the therapist often functions as a transactional technician — following specific scripts, moving through distinct phases, deliberately staying out of the way of the client’s processing. This witnessing has its own value. But over-reliance on protocol or tools can generate a sterile medical environment in which the problem becomes, implicitly, one of neurology rather than of personhood. The relational home — the space where two human beings genuinely meet — gets quietly demoted. The therapeutic value of being seen, heard, and psychologically and emotionally held by another person over time is treated as incidental and secondary rather than central, when attachment theory says otherwise.

For those with complex or developmental trauma especially, no technique substitutes for the reparative experience of secure attachment, rupture and repair. What they need is not a more efficient processing tool. What they need is a trustworthy relationship that can hold them while they reconstruct the experience of being a self.

This is precisely what often gets engineered out when therapy organizes itself around a specific technique rather than relationship — whether the engineering happens at the level of a corporate chain’s productivity metrics or at the level of a single clinician’s over-reliance on protocol. Trust is not a given. It must be earned over time.

The Risks of Speed

EMDR is celebrated, and often advertised, for its speed. But speed carries its own hazards.

The most serious is the potential for premature exposure. The timing is crucial. While the protocol includes a stabilization phase, the pressure to reach reprocessing can lead to a plowing through of defenses that exist for good reason. Trauma involves a fragmentation of experience, and the slow work of building a coherent self within a trusting relationship cannot simply be accelerated. When a therapist treats EMDR as a transactional tool for rapidly clearing fragments, they risk asking the nervous system to process more than the psyche is ready to integrate — leaving the client flooded, dissociated, or destabilized between sessions.

Speed, in other words, is not a neutral clinical value. It’s the cultural value of optimization that has been imported into clinical practice. The same logic that tells us therapy should be brief, measurable, and efficient tells us that faster processing is better processing. Neither claim survives contact with how human beings actually heal.

What Maturity Looks Like

None of this is an argument against EMDR or any other clinical tool. When practiced by a clinician who prioritizes relational presence over rigid protocol adherence, it’s a sophisticated instrument — one that allows the brain to do what it naturally wants to do. The shadow arises only when a tool is mistaken for the whole of psychotherapy, like mistaking a fine hammer for a skilled carpenter, and a person is treated as a brain to be recalibrated and optimized rather than a human being to be understood.

A relationally-oriented approach holds that technique is a servant to the relationship, never its master. Technique is not what makes the moment matter — the person wielding it does. A skilled musician can make a tongue depressor sound fascinating. Healing requires integration, not merely desensitization. The skilled therapist is a human witness and companion, an artist, rather than a technician — and artistry, like trust, cannot be accelerated.

These principles are not specific to EMDR or any other tool. They apply wherever the logic of efficiency, standardization, and scalability encounters the irreducibly slow, relational, and nonlinear process of human development. Whether the pressure comes from a private equity firm optimizing clinician productivity, a platform marketing therapy as a subscription service, or a training model that teaches protocol adherence over relational attunement — the mechanism is the same.

We keep trying to engineer the human out of healing.

The cost is always the same too.

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After thirty years of practice, I have learned that the heart of psychotherapy is not found in the exchange of information, but in the presence of a human witness. We are creatures built for connection; we heal in the orbit of another human nervous system. Yet, we are currently witnessing a profound shift: the migration of the distressed toward the algorithmic—to social media for validation and to Artificial Intelligence for clinical guidance. As a therapist, I find this trend seriously concerning, for it risks replacing the messy, transformative work of being “known” with the sterile, infinite loop of being “validated.”

The Illusion of Connection

Social media platforms are designed to maximize engagement, not foster psychological integration. For the lonely or the suffering, these spaces offer an illusion of community—a digital tribe that provides the path of least resistance. However, competent therapy often requires friction. It demands that we encounter the parts of ourselves we would rather disown, guided by a professional who can hold our shame without being consumed by it.

Social media, by contrast, often encourages us to broadcast our pain for performance rather than process. When we turn to online echo chambers, we often find ourselves in a cycle of “trauma-sharing” that functions as a digital feedback loop, reinforcing pathology rather than challenging it. We are trading the difficult, quiet work of deeper self-reflection for the instant dopamine hit of a “like” or a sympathetic comment from a stranger who knows nothing of our lived reality.

The Algorithm’s Lack of Soul

The rise of AI as a surrogate for mental healthcare is perhaps an even more dangerous development. Proponents argue that these tools offer accessibility—a 24/7 sounding board for the anxious mind. But let’s be clear: an AI is not a mind as we understand it. It’s a mirror. It’s trained to predict the next most likely word in a sentence, not to understand the weight of a soul.

When a client sits with me, I’m not just listening to their words; I am watching for the “mismatch”—the way their hands tremble when they describe a moment of joy, or how their voice flattens when they speak of serious loss. These are the nonverbal cues that carry the truth of their experience. AI, no matter how sophisticated its language modeling, is blind to the human body. It cannot regulate a nervous system because it has none—no organism that has moved through its own fear, its own attachment ruptures, its own slow accumulation of years in a body among other bodies. Co-regulation is not an exchange of information; it is one developed nervous system engaging another, and a system with no biography and no body to draw from. It cannot “attune” to a patient because it is incapable of empathy; it only simulates the appearance of empathy.

The Danger of Simulation

The risk of AI in mental health is not just that it might fail; it’s that it might seem to succeed just well enough to keep a person from seeking real, human help. An AI can be a very polite conversationalist. It can validate your feelings with eerie precision. But it cannot hold you accountable to your growth. It cannot challenge your maladaptive patterns because it is designed to be agreeable.

By turning to a machine for what only a person can give, we are effectively choosing to remain in a closed system. We lose the possibility of a “corrective emotional experience”—the moment in therapy where the client realizes, I can be my whole, broken self in front of this person, and they won’t leave. An algorithm will never leave, but it also cannot truly stay, because it has no self to offer.

None of this is an argument for abandoning these tools altogether. Used well, AI can offer real psychoeducation, help someone name what they’re feeling for the first time, or triage a crisis at 3 a.m. when no human is reachable. In the sharpest cases, that access might do something no amount of theory can dismiss: keep a person alive long enough to do the deeper work, later, with someone who can actually stay. The danger is not that these tools have no use. It’s that their use gets mistaken for the thing itself.

A Human Presence

In an era of rapid technological acceleration, we are tempted to believe that “more access” is synonymous with “better care.” But the soul is not a data point. Our capacity for resilience, our ability to make meaning out of suffering, and our potential for change are all bound up in our relationship to the other.

If you are struggling, please don’t settle for the reflection in the screen. Take a mindful risk. Reach out to a human being who can bear witness to your experience. The work of healing is slow, it’s frustrating, and it’s entirely human. It isn’t something that can be optimized, automated, or downloaded.

Your life is not a prompt to be processed—it’s a narrative to be lived, and it deserves to be heard by someone who can truly listen.

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There is a moment in a John Berger lecture where he pauses before a painting and says, quietly, that the way we look at something is never innocent. It’s always shaped or at least tinted by what we have been taught to believe, by who holds power, and by what we have learned to overlook. I’ve been thinking about that idea ever since — not in front of paintings, but in the therapy office. Berger’s insight, developed across decades of art criticism and writing, offers psychotherapy an unexpected gift: a way of understanding the “patient” that moves away from a purely medical gaze, which seeks to name and categorize a pathology, and toward something rarer — a radical witnessing of another person’s experience.

The Demystification of Symptoms

Berger’s sharpest critique of art history was its tendency toward mystification — the use of sophisticated language to place artworks beyond ordinary understanding, effectively stripping them of their political and human weight. The therapy office has its own version of this problem. When a person’s suffering is translated entirely into clinical language — rendered as disordered, dysregulated, or chemically imbalanced — something is quietly taken from them. The experience is made legible to the expert, but the person living it becomes a stranger to their own story.

A different approach treats the symptom not simply as a biological malfunction, but as a way of seeing the world that once made sense — perhaps the only sense available at the time. Anxiety, withdrawal, emotional defense strategies: these were not mistakes. They were adaptations, shaped by real pressures in real environments. The work of demystification is then a collaborative one, tracing those pressures back through the social, familial, and historical landscapes that produced them. The narrative is placed back in the hands of the person living it.

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I’ve been looking at the card again.

The cat has no wings. What I took for wings — those shapes spreading from its sides — are the arms of the sun’s smile, a grin so wide it wrapped itself around the cat on both sides, so toothy and exuberant it nearly consumed the entire face. Remove the cat from the drawing and you’d see it plainly: an enormous beaming sun, crowded with teeth, unable to contain its own happiness. The cat is just a striped cat, sitting in the grass, eyes closed in delight. Grounded. Held inside that smile rather than escaping it.

I saw wings because I was thinking of birds. I was thinking about leaving. Separation. I read her drawing the way I was reading everything that year.

The inside of the card is two halves, the way birthday cards are.

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There’s a flag on every corner, a slogan on hats & sleeves,
There’s a man behind a podium sellin’ fear so we believe.
Great-grandma saw this movie, back in nineteen thirty-eight —
Said the ending doesn’t change much, only how long we can wait.

We have fascists in America, hidin’ behind the flag,
Coverin’ their identities so their faces don’t get tagged.
We have fascists in America, masked in broad daylight —
So we’re singing it out loud now, ‘til they can’t hide from our light.

They’re marching in formation, flags held high above the crowd,
Faces hidden behind sunglasses, afraid to say it out loud.
If you’re proud of what you’re carrying, what do you have to hide?
Real conviction shows its face — you’re just a bunch of thugs inside.

Funny how the bravest-looking are the ones who can’t be named,
Marching bold behind their masks now, so there’s no one left to blame.
You can hide your face from cameras, but you can’t hide from your kin —
Someone’s gonna see that stride, that flag, & know exactly who you’ve been.

We have fascists in America... hidin’ behind the flag...
And I’d rather show my face than march behind a mask.
We have fascists in America — so what are we gonna do?
Stand up beside your neighbor — there’s a place for me & you.

Each Fourth of July, America reenacts its founding myth: a declaration of independence, casting off the constraint of a divinely ordained monarch, the frontier pushed back by will and fire. The myth of the American psyche has long been anchored in this ideal — taming the wilderness, imposing order on chaotic nature, relentless forward progress. Manifest Destiny. Yet, as a psychotherapist, I am constantly reminded that what we attempt to conquer externally inevitably retreats inward, transforming into a potent collective shadow. The untamed wild side of the American psyche is not a relic of that founding moment; it is a living aspect of our collective unconscious, lit anew each summer in the same fireworks that once stood in for cannon fire. The fiercely independent spirit we romanticize and fear — the wild horse of the American soul, never fully broken no matter how many generations have tried — is precisely the shadow self America has spent two and a half centuries trying to domesticate, deny, or destroy.

The shadow consists of the hidden, repressed parts of the self the conscious mind finds too threatening to integrate. Individually, suppressing it leads to dysregulation and sudden, volatile eruptions of behavior. Collectively, the same rule applies. America’s conscious identity rests on exceptionalism, industriousness, rational control. But beneath this polished surface lies the “unthought known” of our national character: an innate, wild vitality that refuses to be fully civilized — and in its repressed state, mutates into hyper-individualism that borders on alienation, a compulsion toward murderous violence, and a frantic, insatiable consumption. Cormac McCarthy’s frontier novels and Martin Scorsese’s gangster films both stage the same recognition: that American vitality and American violence share a single root. We have built an impressive social structure but failed to provide the psychological scaffolding to hold the chaotic vitality of the human spirit. Treating the wild self as an enemy to be engineered out of existence severs our connection to our own instinctual wisdom.

Healing our collective dysregulation means shifting our stance from colonization to integration — not succumbing to unfettered lawlessness, but practicing a radical kind of witnessing, the kind writers and artists have already modeled. Our inner wilderness — the capacity for deep passion, fierce autonomy, untamed creativity — is not a defect to be cured but a vital organ of the self. The wild horse is never truly conquered, only ever befriended through patience, respect, and a long earning of trust. Like one in therapy learning to sit with terrifying impulses without acting them out, the American psyche needs to learn that same patience turned inward — to honor and nurture its own internal vastness rather than break it to saddle.

Wholeness is never achieved by making ourselves neat, predictable, compliant. It’s found by stepping off the marked trails of the conscious mind into the raw, variegated landscape within. We have declared independence from a king, from an ocean, from a rich wilderness we called empty but was never empty at all. We have never declared independence from our own need to tame ourselves. Whether the American psyche can learn to ride alongside its own wildness instead of breaking it, or whether we are doomed to keep signing the same declaration generation after generation — this time against ourselves — remains the question this Fourth of July still does not answer.

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There are things you leave out of a memoir not because they didn’t happen, but because they happened too late to be the story. By the time they arrived, the forming was already done. The person was already made. What followed was just — living inside that.

This is one of those things.

One autumn, years after she had left our home and ventured out to salvage what she could after her four children were mostly grown, my mother and her partner won the Pennsylvania lottery. $1,000 dollars a week for life. A guaranteed million dollars. Those words have a strange quality — not quite real, the kind of detail that belongs in a different family’s story, one with a cleaner narrative arc. Rags to riches. The luck that changed everything. That’s how local writers tended to frame it in the area newspapers and magazines.

It didn’t change everything.

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In an era of hyper-partisan media, information isn’t delivered to inform — it’s shaped to confirm. Beyond the clickbait economics of social media lies something more deliberate: ideological policy journals practicing “nutpicking” — finding a fringe anomaly and presenting it as a powerful movement.

My wife flagged a textbook case: a City Journal exposé (Manhattan Institute) on a “worrying new movement” in mental health that supposedly insists attraction to minors isn’t a disorder but an “identity to be affirmed.” She was alarmed. Reasonably — that’s what the piece is built to make you feel.

Step 1: Elevate the invisible outlier

The article’s “movement” is a small Maryland nonprofit, B4U-ACT, with no institutional backing and a budget measured in thousands, not millions. Its big symposium drew a whopping 38 people. A 2024 review of the academic literature found exactly 30 papers worldwide, across eight years, using the group’s preferred framing — out of hundreds of thousands published in the field. I’ve worked with offenders for years and had never encountered it. That’s not a tide turning. That’s a rounding error with a press release.

Step 2: Flatten nuance into propaganda

The piece also collapses a distinction the DSM-5 is explicit about: a paraphilia (an unchosen attraction) is not the same as a paraphilic disorder (which requires distress or harm). That line exists for a practical reason — abuse prevention. Shame and instant criminalization keep non-offending people from ever seeking help. Treating the impulse separately from the behavior is what lets someone walk into therapy before anything happens, not after. The article deliberately rebrands this protective clinical tool as “identity affirmation” — turning a quiet child-safety strategy into a culture-war villain.

Step 3: Trigger the emotional hijack

Center the story on child safety and you bypass the reader's critical thinking almost automatically — within minutes, my wife wasn't just concerned, she was running scenarios about whether someone above me at work might already be pushing this thinking onto the therapists who report to them. She wasn't accusing me. She was trying to find out if my employer already had. That's the hijack working as designed: once a reader's in that state, the slippery-slope logic writes itself — stop these fringe academics or medicine will legalize harm. Nuance doesn't survive that framing. You're either defending children or you're complicit.

The cost

This is the same playbook used against vaccines — one outlier, one primal fear, and trust in the relevant institution collapses along with it. The irony is that dismantling the clinical language built to keep kids safe doesn’t protect anyone; it just removes the guardrail. Outrage makes for good fundraising and bad public health policy.

I’m happy to report, however, that my marriage survived the fact-check.

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