No Mercy / No Malice: The Cult of Therapy

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I'm Scott Galloway, and this is No Mercy, No Malice. America's mental health crisis is a multi-dimensional challenge with multi-dimensional remedies.

However, online, all remedies lead to the same place, the same recommendation. Therapy.
The cult of therapy, as read by George Hahn.

Don't read the comments, I tell people just before I have a drink and read the comments.

I knew my book, Notes on Being a Man, would spark controversy, as you get the most flack when you're over the target, and some of the criticism likely misses the mark.

The comment that hits home: I reverse-engineer what's worked for me, economic security, relationships, to masculinity and don't acknowledge other paths to fulfillment.

Fair.

Many others offered constructive criticism, and some of the criticism has merit.

What surprised me was how many of the commenters were therapists parroting talking points along the lines of, before anything, men must work on themselves, i.e. get therapy.
This

is nonsense.

I want to be clear. Therapy is a good thing, especially for the 23% of American adults who experience mental illness.

But mental health influencers positioned therapy as a prerequisite for a better life, rendering it a Birkenbag for your feelings, i.e.

a luxury good, and position many of life's obstacles as traumas to be addressed for $200 an hour.

This is a misdirect. I believe America's mental health crisis is a multi-dimensional problem largely shaped by economic precarity.

Five of the world's 10 happiest countries are Nordic nations with strong social safety nets.

Costa Rica and Mexico, ranked sixth and tenth, achieve comparable happiness scores thanks to their strong family and social ties. My solve?

A.

Detonate a mental health bomb in America and invest in programs that increase material well-being.

A $25 an hour minimum wage, affordable housing, universal health care, and a stronger social safety net. The free gift with purchase?

Reducing financial stress would mean Americans would worry less, socialize more, start families, and if they struggle with mental health, pay for therapy.

Doctors currently believe there are 227 symptom combinations that can lead to a diagnosis of depression, but there are no blood tests or imaging scans to aid that diagnosis.

In an estimated 15% of cases, antidepressants provide benefits beyond the placebo.

Talk therapy also helps, but the range of modalities make it difficult to quantify the impact of treatments.

As neuroscientist Barbara K. Lipska wrote in 2018,

mental illness remains deeply enigmatic, its causes generally unknown, its cures undiscovered.

And yet, social media feeds are overrun with mental health influencers peddling therapy as the answer.

Writing in The New Yorker, Katie Waldman observed in 2021 that Therapy Speak had left the couch and conquered social media. It's only gotten worse.

Scroll through your feed and you'll see posts about self-care, coping mechanisms, codependent relationships, and avoidant attachment styles.

Centering ourselves, setting boundaries, sitting with our discomfort, and being present don't require explanation. These terms are as essential to internet culture as LOL.

For many, this vocabulary screams privilege.

According to Waldman, the confessional performative nature of social media results in the language of suffering often finding its way into the mouths of those who suffer least.

Scaled beyond its intended domain, therapy speak is corrosive.

According to psychotherapist Jonathan Alpert, the rise of therapy culture has turned a tool for meaningful change into a comfort industry that's making Americans sicker, weaker, and more divided.

We live in an era where disagreement is treated like trauma and emotional reactions are weaponized for political gain, Alpert writes. On social media, vulnerability is currency.

On TikTok, influencer therapists dish out instant validation in 30-second bursts. The most anxious voices often hold the most influence.
Complex issues get reduced into content.

Millions watch, but few get better.

One 2022 study of mental health videos on TikTok found that 83% were misleading, 14% provided potentially damaging advice, and only 9%

were produced by content creators with relevant professional qualifications.

Similar to supplements, therapy is a good thing that's easily exploited by hucksters.

But if supplements are a pipeline to getting red-pilled, therapy culture is a sinkhole of misinformation, manufactured fragility, and needless suffering.

I've had limited experience with therapy. Before my divorce, my wife and I saw a couples counselor.
I've also tried ketamine therapy. The session was illuminating, but I haven't gone back.

There was a time when a couple in a bad marriage would have talked to a priest.

But the share of adults who say religion is an important part of their daily life has dropped from 66% in 2015 to 49% today, according to Gallup, closing off one avenue of talk therapy for many Americans.

Sharing your troubles with your local bartender has also fallen out of fashion.

Talking to your friends remains an option, though friendship rates are declining, with 12% of people today saying they have no close friends at all.

Alcohol consumption is at a 90-year low, with Gen Z driving the abstinence trend, robbing young people of one vital form of social lubrication.

I've been criticized for saying alcohol can be additive for many young people, but the risk to a twenty-five-year-old liver is dwarfed by the risk of social isolation.

If I told young people to attend church, I'd likely get pushback from some quarters.

Meanwhile, counseling young people to invest in their fitness and take social risks so they can make friends and form romantic partnerships are non-starters for therapy culture, unless and until you've had therapy.

We're social animals. As social connections atrophy and fray, we're becoming more anxious and depressed.
Therapy is an expensive band-aid for a larger problem.

But even taken on its own merits, only 9% of Americans give the U.S. healthcare system a grade of A or B for addressing mental illness, according to Gallup.

The U.S. has a shortage of mental health care providers, but where some see a supply problem, I see a distribution problem.

Including psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists, and advanced practice nurses specializing in mental health care, there are 344 mental health practitioners per 100,000 people in the U.S.

We have more mental health practitioners than medical doctors, 297 per 100,000, and five times the number of dentists.

According to the U.S. Bureau of Labor Statistics, Employment for some mental health-related occupations is projected to grow by 18% over the next decade, faster than the 3% average for all

Cost is the number one barrier to accessing mental health services, according to the Kaiser Family Foundation, while getting time off work ranks second.

Stigma comes in fourth behind concerns about efficacy.

The two-thirds of Americans who have private insurance likely have access to mental health services, though one-third of therapists don't accept insurance at all.

If you can swing $280 to $400 a month, platforms like BetterHelp are an option. Note, BetterHelp is a ProfG podcast sponsor.

Meanwhile, Americans living in rural areas likely can't find a therapist at all.

According to one study, Counties outside of metropolitan areas had one-third the supply of psychiatrists and half the supply of psychologists as their more urban counterparts.

People covered by Medicaid and Medicare struggle to find providers that accept their insurance because of the low reimbursement rates.

Finally, underserved groups, people of color, non-English speakers, and LGBTQ communities, often struggle to find appropriate services.

But if you're wealthy, therapy is as easy as reserving a space at SoulCycle. According to the Wall Street Journal, the next big thing in luxury travel is a vacation with a family therapist.

The price tag? $80,000.

For everyone else, AI therapy is Sam Altman's answer. Therapy companionship was the number one AI use case in 2025, up from number two the previous year.

One trial for an AI called Theribot found that it achieved an average 51% reduction in symptoms of depression and a 31% decline in symptoms of anxiety compared with people who got no treatment.

But Celeste Kidd, a psychologist at the University of California at Berkeley, who tested another therapy AI called ASH, concluded it was clumsy and unresponsive.

I'm bullish on AI, but even if it eventually outperforms human therapists, I'm skeptical that big tech will provide adequate guardrails.

See Kara Swisher's interview with the parents of Adam Rain, who died by suicide at 16. They're suing OpenAI alleging that ChatGPT was complicit in their son's death.

No group in America has fallen further faster than young men. When I began talking about this several years ago, that was a controversial statement.

especially on the left, where many pathologize masculinity.

While the right has suggested the solution is to take women and non-white people back to the 1950s, the left's view is that young men don't have problems. They are the problem.

Neither attitude helps.

As the left ignores the issue, the right fills the void with misogyny and racism.

The result is that a significant number of young men, embracing figures like Andrew Tate and Nick Fuentes, swung right, helping elect a strong man, if strong equals corrupt and stupid.

To borrow from the vocabulary of Therapy Speak, young men don't feel seen or heard in spaces that are the polar opposite of the manosphere.

Women are twice as likely to receive mental health treatment as men. But is that a failing of masculinity? or the mental health profession, where three-quarters of providers are women.

Guys are built differently, clinical psychologist John Farrell told Monitor on Psychology. They have different brains and different ways of being emotional.

Male therapists understand male issues differently than females do.

If that sounds sexist, change the pronouns and get back to me.

Therapy has a lot to offer. It also has massive blind spots, especially around class and gender.

It's easy to sling bromides about how everyone needs therapy, but it's more productive to ask why therapy excludes so many people and too often fails to help the people it does reach.

If you're looking for help on social media, understand

this:

platforms and influencers make more money when you stay broken.

Life is so rich.

What do walking 10,000 steps every day, eating five servings of fruits and veggies, and getting eight hours of sleep have in common? They're all healthy choices.

But do all healthier choices really pay off? With prescription plans from CVS CareMark, they do.

Their plan designs give your members more choice, which gives your members more ways to get on, stay on, and manage their meds.

And that helps your business control your costs, because healthier members are better for business. Go to cmk.co slash access to learn more about helping your members stay adherent.

That's cmk.co slash access.

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