Once seen as an American pursuit, therapy has become very popular here. But can it sometimes do more harm than good, asks Nadine O'Regan
The story was so bizarre, it seemed at first that it must be satire. Teachers in the US, it was reported, had uncovered a new enemy threatening their children, and its name was dodgeball - the popular game in which one team tries to eliminate the other by hitting its members with a large ball.
"Any time you throw an object at somebody, it creates an environment of retaliation and resentment," explains a school coach in Massachusetts. "It's like Lord of the Flies, with adults encouraging it," agrees a leading American educator.
Dodgeball was prohibited in several schools across the US, and red rover, relay races, tag and musical chairs - with their apparently dubious emphasis on removing weakest links - were placed under a cloud of suspicion.
If the ban sounds like an isolated incident of overprotective nuttiness, in a controversial recently published book, One Nation Under Therapy, authors Sally Satel and Christina Hoff Sommers reveal it to be a symptom of a wider, disturbing movement.
Endless therapy, the establishment of sensitivity committees and grief counselling have become the norm in the US and elsewhere and, according to Satel and Sommers, the phenomenon is extremely damaging.
The authors argue that therapism - their term for any practice that ascribes value to the sharing of feelings, and that "tends to regard people as essentially weak" - is pathologising normal reactions and fostering self-absorption.
In Ireland, interest in therapy has risen dramatically in recent years, leaving us vulnerable to exactly the kinds of problems Satel and Sommers describe.
"Everyone now believes that people should go for counselling for even day-to-day problems like bereavements or studying for exams," says Prof Patricia Casey, consultant psychiatrist at the Mater Hospital in Dublin. "There's no need for it, but people ask for it anyway."
Even those who don't want therapy are frequently advised that they need it. After September 11th, advertisements encouraged New Yorkers to seek counselling through Project Liberty, a government initiative created in response to the attacks.
Eight months on, when less than a tenth of the estimated 1.5 million New Yorkers in need of help had come forward, Project Liberty stepped up its campaign. As the Wall Street Journal commented: "Project Liberty's position seemed to be that New Yorkers were traumatised but just didn't realise it."
The Project Liberty initiative has parallels in Ireland. In the wake of the Navan bus crash, grief counsellors were brought in to the Loreto Convent in Co Meath to assist students in coming to terms with their loss. There is no doubting their good intentions, but was their presence really helpful?
Studies cited by Satel and Sommers have concluded that grief therapies are "relatively ineffective" and some even have the potential to cause harm.
"A 2000 study by Robert Neimeyer of the University of Memphis reported that 38 per cent of subjects receiving grief therapy actually fared worse than a matched group not receiving treatment," the authors write.
But it was a study that until now seems to have been ignored. The reality that grief is self-limiting and people usually heal by themselves is regularly forgotten in our well-meaning stampede to dress the wounds of society.
"There's a danger that we lean too heavily on the idea of people's vulnerabilities," says Dr Ethel Quayle, an author and lecturer in the department of applied psychology at UCC. "People are resilient and that's something we need to be aware of and build on."
It's advice that would have been worth hearing during the Junior Cert, when the media erupted into a frenzy of indignation over an English Ordinary Level exam paper that contained a reference to school buses.
With the exception of the students directly affected by the Navan tragedy, Prof Casey believes the furore was unwarranted. "It gave the impression that we're so fragile that we have to be protected from all information of any potential trauma that people might be exposed to. It erodes people's self-confidence and their capacity to cope."
Media outbursts like that one also have the effect of pushing out the boundaries of grief, deeming it a problem for everybody and, in the process, potentially drawing time and attention away from those who need help the most.
After all, if everyone cries wolf, who will listen when someone is really hurting?
Ten years ago, the renowned developmental biologist Prof Lewis Wolpert fell prey to a depression so severe he became suicidal and had to be hospitalised. "It was the worst experience of my life," he wrote in the New York Times in 1999. "More terrible even than watching my wife die of cancer. I am ashamed to admit that, but it is true."
Prof Wolpert was fortunate, however - he made it through that chapter in his life. But depression continues to haunt him.
Through a combination of anti-depressants and cognitive therapy, Prof Wolpert, who is also the author of an acclaimed book on depression, Malignant Sadness, has learned to control his condition as best he can. But it's not easy.
"I'm doing moderately, but not terribly well at the moment," he says. "Depression is a peculiar business. You enter into a strange world that bears no relation to anything. If you can describe depression, you haven't had it."
For people like Prof Wolpert, therapy of the right variety is a lifeline, a rope that can pull them from deep waters. But this is not always the case.
"Some of the people who go for therapy are not in need of therapy, but are looking for something else, which might be friendship or emotional support," says Dr Quayle. "A lot of people feel lonely and isolated."
The danger of using therapy as a panacea for such ills is that regular emotions can be pathologised. "If someone's marriage is breaking up or someone has a child who is seriously ill, it's appropriate to be distressed," says Prof Casey.
"I'm not anti-therapy when there's a clinical indication for it - I refer well over 50 per cent of my patients for therapy. But therapy can be damaging in certain circumstances. It can make people believe they have a problem that is, in fact, part of a normal reaction."
Dr Quayle believes there are measures that should be taken to assist people in their day-to-day living. "We could be doing more to promote health and wellbeing and co-operative health," she says. "We're not going to go back to the same sort of family networks that we once had, but we could generate alternatives."
Above all, though, psychologists stress that we should remember that pain is an intrinsic part of our emotional make-up. Rather than spending our time trying to avoid it, we might be best advised to learn to live with it.
"We would all love if there were magic potions and pills that would cause our sorrow to evaporate," says Prof Casey. "But that isn't the real world. We have to confront the reality of pain and suffering."
And if that means dealing with large issues, such as learning to cope with grief, or with small ones, such as realising we're awful at dodgeball, then so be it.