I need to be honest with you about something, and it’s not easy, because what I’m about to say implicates me.
I am a board-certified clinical psychologist. I have spent over 20 years in this field. I have the letters after my name. I have the license on the wall. I sat through the advanced graduate seminars, completed the internship hours, passed the exams, read the research, contributed to the research, jumped through every hoop this system asked me to jump through. I am, by every measure the industry recognizes, one of its own.
And I think the whole thing is absurd.
Not the suffering. The suffering is real. Not the desire to help another human. That is genuine (in most cases). The system we built around it is the joke.
Let me walk you through what we’ve created. A human being walks into a beige room with a noise machine outside the door and a box of off-brand tissues on the side table. They may be carrying grief. Trauma. Fear. Spiritual disconnection. Existential confusion. Financial stressors. Deep loneliness. The weight of things they cannot name and have never been given permission to speak.
Whatever they’re carrying, the system has the same answer. They sit across from a stranger. And for the low price of a copay, a diagnostic label, and whatever is left of their dignity, they will receive what modern civilization has determined is the appropriate container for human suffering.
Forty-five minutes. On a Tuesday. At 2:30pm.
Who decided this? Who determined that the human psyche operates on a 45-50 minute therapy cycle? Was there a study? A summit? A breakthrough in neuroscience that revealed the soul opens and closes on a billable schedule?
Of course not.
The 45-minute hour exists because it lets a therapist see enough clients in a day to make their student loan payment. We could have made it three hours. A half a day a few days a week. But the insurance companies had a meeting, and 45 minutes apparently tested well.
But here’s where it really gets cruel. Let’s say you’re in session and something extraordinary happens. The thing you buried at age seven surfaces. Your body starts shaking. Tears are coming from somewhere ancient. The energy of a traumatic event locked in your nervous system for decades is finally, mercifully, beginning to move. This is what the body was designed to do. This is healing happening in real time.
Your therapist glances at the clock.
“We’re going to have to stop here.”
Stop. Here. Because Dylan has the 3:15 slot and he’s already in the waiting room scrolling TikTok and frankly his insurance reimburses at a higher rate. So your therapist teaches you a “grounding technique,” which is where you name five things you can see, four things you can touch, and one reason you thought this was going to be different. You shove all that energy back into your body where it will stay, compressed and unresolved, until next Tuesday at 2:30. Then you walk to the front desk and swipe your card while your hands are still trembling.
This is what we call the therapeutic process.
Consider what psychotherapy actually is. It is a practice born in late 19th-century Vienna, rooted in a Western, secular, materialist worldview. Freud took the inner life of a human being, the deepest territory there is, and made it a clinical object. Something to be analyzed. Diagnosed. Treated by an expert. He professionalized the conversation that used to happen between a person and their spiritual advisor, their community elder, a trusted family member, their God, and he handed it to a man in a chair with a notepad and a theory.
And it’s worth remembering who that man actually was. A cocaine enthusiast who promoted it as a miracle cure. A theorist who told women that their distress was hysteria and their trauma was fantasy. When his own patients told him they had been sexually abused as children, he believed them, published it, and then, when polite Viennese society recoiled, reversed himself entirely. He decided they were fantasizing. That their memories were wishes.
The father of psychotherapy had the truth sitting in front of him and chose his career over the people in his chair. He built a movement that functioned like a cult, excommunicating anyone who questioned his ideas, and constructed theories that were designed to be impossible to disprove. If you agreed with his interpretation, he was right. If you resisted it, that was just your resistance, which also proved he was right. This is the foundation. This is where it all started. And then came the assumptions that nobody ever seriously questioned.
That excavating memories is the same as healing. That everything worth knowing about your suffering can be found in your childhood if you just dig long enough. That a trained professional can mine your past like an archaeologist, pull something to the surface, hold it up and say, “There. That’s why you are the way you are.”
Nobody stopped to ask the obvious question: if you send someone looking for a wound, they will find one. If a therapist spends six months asking about your relationship with your mother, eventually your mother becomes the problem. If every silence is interpreted as avoidance and every denial is interpreted as resistance, the patient learns very quickly what the therapist needs to hear. And they will give it to you. Not because it’s true. Because the entire dynamic is designed so that agreeing feels like progress and disagreeing feels like pathology. Dig long enough, with enough authority, in a relationship where one person is paying the other to explain their suffering, and you will always, always strike gold. Whether it was ever actually there is a question the field has never had the courage to ask.
And every school of thought that followed, no matter how much it disagreed with Freud, accepted his most dangerous premise without question: that the human soul is a secular, medical/psychological problem, best handled by a credentialed professional in a controlled setting, for a fee.
That is the foundation.
Everything built on top of it, the hundreds of “theoretical orientations”, the insurance codes, the diagnostic categories, the 45-minute hour, inherited that original sin. We didn’t just build a flawed system. We built a system on a flawed understanding of what a human being is.
Now let me tell you about the person sitting in the other chair.
They might be 26. Graduated last spring with a master’s in social work or counseling. Their program taught them to administer screening questionnaires and use the word “psychoeducation” without flinching.
Now, this is not to say they are incapable of empathy or that they could never authentically help another person who is suffering. They might. But consider the likelihood.
Consider a therapist, shaped entirely by a secular, Western, corporate, medicalized culture, trained inside a system that has already decided what suffering is and what to do about it, and ask yourself how probable it is that this person is equipped for what is about to walk through their door.
They may have never buried a parent or any loved one. Never raised a child. Never had a marriage fall apart over something that can never be unsaid. Never watched addiction hollow out someone they love. Never held a dying person’s hand. Never been bankrupted. Never been betrayed by someone they would have taken a bullet for. Never white-knuckled it through a dark night of the soul where the only question was whether to keep going. Never sat in the kind of silence that makes you wonder whether God is real or if it’s just you and the void. But they read a textbook chapter about some of these things and never even considered others.
So they’re basically ready.
They have unlikely studied ancient wisdom under the guidance of a wise elder. Never sat with the Stoics or the Sufis or the Desert Fathers. Probably never been exposed to philosophy in any meaningful way, certainly not the kind that asks the questions that keep you up at night. They have not had enough life, enough time, enough solitude, enough failure to fully contemplate the deepest questions of human existence. What they had was a two-year program, a DSM, and a supervisor who had 15 minutes between sessions.
But here’s what they were given: a normal. A template. A baseline for acceptable human functioning handed down by the institution. And anything that deviates from that normal is a disorder. Their job, as they understand it, is to make you normal again. Not whole. Not wise. Not awake. Normal. Compliant. Functioning within the parameters. Sleeping seven hours. Scoring lower on the questionnaire than you did last month.
When a mother walks in carrying the unspeakable weight of a lost child, this person will consult their training. When a combat veteran sits across from them with a thousand-yard stare, they’ll flip through the treatment manual. When a teenager who’s been sexually abused finally says it out loud for the first time, then whispers that they’ve thought about ending their life, this person may panic. Not because they don’t care. Because their training taught them to fear that sentence more than to hold the person saying it. They were taught liability. Documentation. Risk assessment. Safety contracts. They were taught to manage the moment, not to meet the human being inside of it. But they’re licensed. And in this system, that’s what matters.
Think about what we’ve done to parents. For the entirety of human history, when a child struggled, families turned to grandparents, aunts, uncles, elders who had actually raised children and could offer wisdom that only comes from doing the thing. Now you hand your child to a 28-year-old with no kids and a graduate degree. Within three sessions, your child has a diagnosis. Within six, a treatment plan. Within a year, possibly a prescription. And you finally have what you were looking for: someone with a credential to tell you your instincts were wrong and your child’s brain is broken. Progress.
One of the most reassuring things about this industry is that nobody in it agrees on how any of this works. There are what appears to be hundreds of recognized schools of psychotherapy. If you’re a CBT therapist, the problem could be your beliefs or your behavioral choices. Psychodynamic? Your mother. Jungian? Your shadow. IFS? You’re not even one patient anymore. You’re a committee, and half of them need their own therapist. There are many other acronyms.
Your therapist was trained in one of these, maybe two, and will apply it with the confidence of someone who has discovered the one true map of the human soul. They will not mention the other maps. They’ll just say, “Let’s explore that,” and write something in their notebook.
And here’s the part nobody wants to say out loud: the system needs you to stay in it. A therapist who “heals” their clients has no clients. A therapist with no clients can’t pay rent. Your therapist has a therapist, who has a therapist, all the way down like a Russian nesting doll of billable hours.
So the industry has created its masterpiece: the professional patient. This is the person who’s been in therapy for 12 years. They can name their attachment style, their trauma responses, their nervous system state, their inner child’s unmet needs, and their Enneagram number. They say things like “I was really activated today” and “my parts were blended.” They are no better. They may be worse. But they are committed to the process. And the process is committed to their credit card.
The more therapy language you learn, the more you see yourself through the lens of pathology. Every bad day becomes a depressive episode. Every argument, a trauma response. Every moment of self-doubt, your anxious attachment. You’ve been handed an entire vocabulary for your own dysfunction, and it never occurs to you that the vocabulary itself might be the cage.
And when the talking finally doesn’t work? Drugs. Your therapist will gently suggest you “talk to someone about medication,” which is the softest possible way of saying: we’ve exhausted my limited knowledge… so let’s try chemicals. You’ll see a prescriber for 15 minutes. They’ll ask how you’re sleeping. You’ll say “badly.” They’ll prescribe an SSRI that flattens your emotional landscape into a smooth, gray, manageable surface. You’ll cry less. You’ll also laugh less, but nobody measures that. The clinical trial measured “symptom reduction,” and your symptoms will be reduced in the same way that unplugging a smoke detector reduces the noise.
The pain was a signal. The anxiety was a signal. The depression was a signal. Your body and soul were screaming that something was deeply wrong with how you were living. And the system’s answer was to mute the speaker so you could go back to functioning inside the very machine that was grinding you down.
Here is what haunts me. Historically speaking, human beings healed without any of this. They healed in tribes. In families. In the presence of wise elders who earned their authority by living, not by passing a licensing exam.
No… scratch that. “Healing” is not even the correct word. That’s the system’s language sneaking in. The journey is the learning. Nothing is “healed.” It’s integrated. Absorbed. Woven into the fabric of who you are. You don’t get repaired. You grow. You expand. And if you’re lucky, if you’re surrounded by the right people and the right conditions, you grow in love.
That’s what happened in tribes. In families. Grief was held by the village. Pain was processed through movement, ritual, ceremony, and the presence of people who loved you and were not watching the clock. Children were raised by extended families who could absorb the chaos without pathologizing it. Elders who had walked through fire sat with those who were burning and said, “I know. I’ve been here. Let me sit with you.”
Nobody needed a billing code. Nobody needed a treatment plan. Nobody needed to name five things they could see. They just needed each other.
We dismantled all of that. Every structure that naturally supported human healing, we tore down and replaced with a professional service. Then we congratulated ourselves for our compassion. Now we have a nation of people sitting alone in their apartments, scrolling therapist directories, hoping a stranger with a Psychology Today profile and a sliding scale fee can replace what an entire civilization used to provide for free.
The system isn’t broken. It’s working exactly as designed. It was designed to professionalize care so it could be monetized. To pathologize experience so it could be treated. To replace wisdom with credentials, community with appointments, and spiritual depth with diagnostic categories.
Its antihuman.
And if you ever start to wake up to this… if you ever suspect that feeling less isn’t the same as feeling better, that 12 years of therapy and three medications might not be the path to wholeness, that the human soul can’t be healed in 45-minute increments by a stranger with a stopwatch and a treatment manual…
Well. That sounds like resistance.
We should probably explore that.
You have 45 minutes.
It’s time to rebuild. I am thinking deeply about this.