Just Tell Me What To Do
Why many of my clients are desperate for direction.
A few years ago, one of my clients set aside her pride and said: “You know, sometimes I just wish you’d tell me what to do.”
Because telling clients what to do is so against the therapeutic creed, I asked if we could revisit the topic next week, and then promptly took my dilemma to supervision. Supervision is where a therapist goes to get answers from their supervisor, usually a wizened veteran of the trade. In this case, it was group supervision, meaning some of my colleagues—by now my friends—were there too.
When I finished describing my predicament, my supervisor asked what the predicament was.
“Well, I can’t just tell her what to do,” I said. “That’s not my job.”
“She told you what your job is, at least with her.”
“But what if she never learns to make decisions for herself?” I was thinking of the aphorism about giving someone a fish versus teaching them to fish.
“It sounds like she’s making too many decisions already.”
As usual, he was right, something I had to admit after a few hours of being annoyed. This client was indeed making so many decisions that what she needed most was to have some of them taken off her plate. So, at the beginning of our next session, we talked about the kinds of things she wanted answers for, and our therapy improved. Nor was it lost on me that I ended up doing what my supervisor said.
Over time, I began to see that this client’s desire was not unique. Only her forthrightness was. Many clients are overburdened by the number of major decisions they have to make and want someone to tell them what to do, at least for some of them. I started wondering why this was the case and eventually settled on my favorite answer of evolutionary mismatch. In the modern world, you see, there aren’t many institutions, organizations, or cultural narratives that tell us what the good life is. Or, rather, there are far too many.
In WEIRD societies in particular, individuals must cobble together a sense of meaning from an overwhelming amount of underwhelming options. Each person must decide for themselves what the good life is. And this is celebrated far more often than criticized. Indeed, if Americans cherish anything, it is individual freedom and choice. But is this à la carte style really what people want? I’m not so sure anymore.
Different Ways of Explaining the World Beyond our Senses
Humans rely on many sense-making methods to patch together an understanding of the world around them. One of these methods is, of course, our senses. If I touch a bush and get pricked, that’s enough information for me to avoid that bush in the future. However, if I want to know how the bush came to be prickly, then I must rely on more than my senses. I must instead rely on something like religion, culture, or science. I think of these as sense-making institutions; they try to explain what our built-in senses cannot.
Science and religion are competing ways of explaining the originally inexplicable.1 The benefit of science is truth, or information that can be built upon to eventually produce superior results. For example, if I understand sickness to be the result of microscopic germs, then I have an avenue for preventing, curing, and even eradicating disease. However, if I understand sickness to be the result of evil spirits, then I do not have an avenue for preventing, curing, or eradicating disease—even though I might think I do.
Indeed, it is comforting to have an answer, especially one shared by others, even if that answer is wrong. As Edmund Burke writes: “We know, and what is better we feel inwardly, that religion is the basis of civil society and the source of all good and of all comfort.”2 Strangely enough, the comfort of something like religion endures even when the answers it provides—or responses it demands—are otherwise discomfiting. I can’t tell you how many times I said my Hail Marys as a kid, knees screaming on a wooden pew, only to arise much lighter; cleansed. Everything else aside, it was nice to have a bona fide answer for clearing my sins, to be told unequivocally what to do.
Comforting ways of understanding the world beyond our senses, which have predominated throughout most of human history, are quickly giving way to accurate ones. Science has made incredible progress especially in the last few hundred years; religion and culture have diminished. For example, below is a chart of religious importance among Americans from 1990-present:
That’s a mind-boggling change in only thirty years. What is the impact of this and related trends on how people understand the world around them? Ultimately, the modern person might possess a more accurate, less comforting outlook than people of the past.
Take death as an example. People throughout the ages have told each other fuzzy stories about what happens after life. Some have maintained that the dead come back as another person or life form. Others have believed in a halcyon place where the deceased reunite with loved ones. Even today, people still routinely indulge in the fantasy that the deceased is “here with us,” “watching over us,” or that we’ll be with them soon. Often these beliefs are a mixture of religion, culture, tradition, and so on.
Science, however, has penetrated the clouds and looked deeply into space. It has blasted rocks, felled forests, and plumbed the depths of the earth. No heaven or higher power—nothing escaping mechanistic explanation—has been found. Science has also combed through time, sifted the soil’s record, and knocked humans off their high horse. We are merely one of trillions of organisms that have existed on this planet. As Fitzgerald so eloquently puts it, we are “hairless ape[s] with two dozen tricks.”
On the question of death, then, the scientific worldview offers this:
As with death, so with many other big questions concerning the soul—a concept that has itself disintegrated under the withering glare of science.
In the end, someone like me—someone who cares about the truth and was taught how to find it—is forced to admit that there is likely no existence after life, no higher power, no grand purpose, and nothing special about me, my family, or my country.3
All else besides, how can the replacement of stories built for comfort with those based on truth not make people sad? I’d much rather believe that losing my friend was for a reason, but it just isn’t true. Not, at least, as far as science can tell.
And that’s another thing. In addition to sadder answers, the predominance of a scientific worldview means we have fewer answers, too. Because science must rely on truth, it can’t just make stuff up. (That is its beauty and its curse.) Indeed, for most of the questions humans really care about—for most of the problems my clients lay at my feet—science is strangely silent:
What is the meaning of life? What’s my purpose? What should I do with my time? What will be my legacy? Questions of existential angst.
How can I find love? How will I know once I’ve found it? What do I do with a broken heart? How do I come back from losing a loved one? Quandaries of love and loss.
How do I navigate suffering? Why am I sad right now? Happy? What is this specific emotion I’m feeling? Why am I feeling it? Ruminations of a sentient being.
How should I hold myself? What do people think of me? How should I treat a stranger? Is my friend true? What does it mean to be a good person? Dilemmas of a social species.
How did the world begin and how will it end? Will I go somewhere after I die? When will I die? Will there be anyone to greet me? Mysteries of the beyond.
It’s really kind of amazing, when you think of all that science has accomplished, how little it says about our most important questions. (And when it does have something to say, how uncomforting the answer is.) Sense-making institutions such as religion, myth, tradition, and culture might be wrong, but at least they have something nice to say.
So here’s the big picture. Science has stolen like a fox into the henhouse and killed many of our ancient ways of making sense of the world around us. For some questions, science has provided more accurate answers which tend to be less comforting than those made, at least in part, for comfort. For other questions, science has discredited existing answers without replacing them. It’s up to those in the modern world to fill in the blanks. To some extent, all of us are playing Mad Libs.
Obviously, the increased accuracy, transparency, and choice that science offers can be good. At the same time, the shifting, open landscape that it creates can be deeply confusing and disorienting. It often leads people to seek shelter, to cast around for something—or someone—to tell them what to do.
Dishwashers and Discipline
Have you noticed that in the span of a few decades in the U.S., the acceptability of an adult disciplining a child they don’t know has shifted from normal—even encouraged—to something they could be jailed for?
Allow me to draw a parallel to my favorite subject, household appliances.
These days, loading a friend’s dishwasher is, well, kind of hard. Turning on their oven is nearly impossible. And why are there so many potential sources of water?
Fifty years ago, there were only a handful of models for dishwashers, ovens, refrigerators, and so on. Water came from a single source in the kitchen—known as “the sink.” Now there are dozens, if not hundreds, of models for each appliance. Each works slightly differently and many come with different features. All this variety makes it less likely that my dishwasher is the same as someone else’s…or even similar enough to prevent me from looking like a moron when I offer to clean up after dinner.
The same thing has happened outside the home. I can’t discipline a random kid on the playground for misbehaving for the same reason I can’t figure out how to get water from my friend’s fridge—because everybody is working with a different model. For all I know, that kid’s parents might practice gentle parenting and refrain from saying “no,” which happens to be the very thing I want to say. So it’s best to just keep my mouth shut and guard my own keep.
What’s behind this trend? Ultimately, technology. We have science’s side-kick to thank for differentiating our experience.
Science and technology are a classic example of one hand washing the other. Science provides reliable truths that technology can leverage to gain further truths. For instance, a scientific understanding of optics paved the way for technological breakthroughs in telescopes which continue to expand our scientific understanding of space.
As Jon Haidt, Jean Twenge, Robert Putnam, and many others have argued, technology has the effect of isolating or individualizing members of a society because it makes reliance on the group less necessary. The most common example might be when someone whips out their phone in a group of people—I don’t need you to entertain me—but the list is endless. Just as I don’t need my grandpa to teach me how to fillet a fish, I also don’t need him to tell me what happens after I die. And I certainly don’t need a stranger to tell me how to raise my kids.
As Rob discussed in Coordination Part V, sometimes it matters less what the rules are than that everyone agrees to follow them. Their content is less important than their compliance. In the modern world, however, our values and views are becoming individualized along with our products. The same forces that have made my dishwasher different than yours—thereby preventing me from cleaning up effectively at your house—have fragmented our social norms, too, thereby preventing me from disciplining your child at the playground. (Your loss.)
If science robs us of comforting views, technology robs us of shared ones. As Freya India puts it: “All the things that have traditionally made life worth living—love, community, country, faith, work, and family—have been ‘debunked’” by this brutal combination. She continues:
Sentiments I hear often from peers:
Love — “Monogamy is so outdated.”
Community — “I have enough friends online.”
Country — “I’m embarrassed to be an American.”
Work — “I’m quiet-quitting.”
Family — “I’m not bringing kids into this melting world.”
Faith — “My parents are such naive Bible thumpers. By the way, what’s your star sign?”
Hell, even what is considered misbehaving is an open question. Is swearing acceptable? At what age? Talking back to an adult? Stealing a toy from another? Spitting on the ground? Riding a bicycle on the sidewalk?
Nobody knows. Or rather, everyone knows better.
“Just tell me what to do”
Let’s return to my client from the beginning. Is it any wonder that she and many others have decision fatigue? That they yearn for someone to tell them what to do? I don’t think so. I mean, the modern person has to reinvent virtually every wheel anew. Precious little is dictated by tradition, religion, folk wisdom, or culture anymore. Too much falls under individual choice and control.
In the West, we celebrate this ability to forge a new path. To chart a fresh life. But surely there is a line? When I go to a restaurant, I don’t want the menu to be more than a page, front and back. Are big life choices any different? I’d like to choose some things, sure—like who I marry—but maybe not whether I should get married, how long I should stay married, whether I should look for partners outside my marriage, and so on. It might be nice to have some of those things set in stone.
The problem, of course, is that nothing ever works for everyone. That is indeed the major cost of a strong culture, that it can ruin the lives of those who cannot conform. While I am sympathetic to that, and can think of a number of ways in which the culture of my upbringing stifled me, it is worth noting that there are costs to a free-for-all, too. There are downsides to a cultural message that encourages rebellion against the culture. (I'm obviously thinking of America here with its paradoxical group appeal to individualism.)
Wouldn’t those costs be a mixture of anomie, overwhelm, uncertainty, decision fatigue, loneliness, meaninglessness, and dislocation? A mixture that we wouldn’t quite have the perfect word for?
Consider the following from an exasperated mom:
There was a time when mothers just did things the way their own mothers did, and that was that. There are plenty of downsides to that kind of cultural environment, but I’d imagine that one huge upside is that you don’t burn up half your mental energy questioning everything you do. Ultimately I’m glad that we live in an age where we’re all free to break from tradition and do things our own way. But I have to draw the line somewhere…
The author then seems to break down mid-article:
I need—desperately, seriously, dying-man-in-the-desert-level need—one area of my life as a parent that I do not have to agonize about. As a modern mother, I am required to obsess over every. single. aspect. of my children’s lives. I have to make ALL THE CHOICES about ALL THE THINGS and I am EXHAUSTED.
She sounds a lot like my client, doesn’t she? The one who asked me to stop asking questions and start providing answers?
Doctoring by Faith
When it comes to mental illness or distress, it is no wonder that therapy and medication are the go-to solutions. They are scientific, individual treatments par excellence.4 Wasn’t it kind of nice, though, when suffering fell under the umbrellas of religion, culture, tradition, and family? When, for example, you’d go to church, confess your sins through a box, and be told to recite a hundred Hail Marys?
It didn’t do anything, of course, other than mean something. (And not only to you.)
Naturally, the counter-argument is that science and technology typically lead to better solutions. Religion and culture might be comforting and sound nice, but because they don’t need to be based in truth, they can be damaging—either actively or as opportunity cost.5
The following is from Rachel Plummer’s account of being a captive of the Comanche tribe from 1836-1837:
[The Comanche] manner of doctoring by faith is amusing. When any of the men are sick, the principal civil chiefs order two of the wigwams to be joined together, though open between. A hole is dug in each of these camps, about two feet deep. In one of them, a fire is built; on the side of the other, is a lump of mud as large as a man’s head. All around the hole, as well as this lump of mud, the ground is stuck full of willow sprouts. At sun-rise, the sick man and musicians enter the camps, and the music is kept up all day. No one must pass near enough to allow his shadow to fall on the camp, or the patient is sure to die; but if everything is done right, he is sure to get well. If he dies, it is attributed to a failure in some of the ceremonies.6
Obviously, there is no recognizable medical value to this procedure. Its effect can be summarized almost entirely by placebo—as Plummer herself says, “doctoring by faith.”
Moreover, the Comanche aren’t around anymore because Europeans had better science and technology—more guns, germs, and steel. So, not only have science and technology led to better medical procedures than burning willow sprouts, they have also rewarded those who were able to leverage their advantages.
All this crystallizes in the question Wallace Stegner asks in The Sound of Mountain Water:
Is it better to be well fed, well housed, well educated, and spiritually (which is to say culturally) lost; or is it better to be secure in a pattern of life where decisions and actions are guided by many generations of tradition?7
My clients are well-fed, well-housed, and definitely well-educated. (My tagline is that I work best with those who think they’re too smart for therapy.) But make no mistake: they, as well as I, are spiritually and culturally starved. Many of them are asking for something—or someone—to guide their decisions and actions. Should I do it? Or what should I do?
A Priest in a Lab Coat
When I step back and conceptualize the modern human as overwhelmed by too many (often uninspiring) ways of making sense, it becomes easier to understand why so many of my clients want me to tell them what to do. Sometimes this is practical—“take the job in Detroit”—but much more often, it’s spiritual. My clients want the clinical equivalent of a hundred Hail Marys.
Many readers probably assume that the same advances that have made the Comanche method of healing seem primitive have occurred in mental health, too. That my colleagues and I know, much better than our counterparts in the past, what heals people along spiritual and emotional dimensions. We don’t. As I will explain more fully in a future post, science is still unable to explain why therapy works—when it does.
What do I think therapy is? Religion masquerading as science. A therapist is nothing more—and nothing less—than a priest in a lab coat. This white lie (ha!) is the only way a contemporary healer can thread the needle between a growing commitment to a scientific worldview and humans’ ancient and desperate need for comforting, meaningful, shared answers.
My guess is that, in hindsight, therapy as it is currently practiced will be understood as a temporary fix—a patch for the bugs of modernity—sort of like the tension rods my wife and I have hung over our windows until we can afford more permanent treatments. Therapy has all the dressings of science, but—when done well—all the stuffing of religion and culture. It’s the hero we have, but ultimately not the one we need.
I don’t say any of this to put therapists down, by the way. Most of my colleagues are doing the best they can with the knowledge at their disposal. Instead, I’m simply trying to relay the truth. Not all that comforting, is it?
Generally speaking, we can think of religion as producing mostly arbitrary content, culture as producing a mix of arbitrary and reliable content, and science as producing mostly reliable content (the current replication crisis aside).
Or even my moment in history. Indeed, a widespread indulgence—particularly among journalists—is that this moment in history is unique and will stick out like a sore thumb from a future point of view. Most likely, it won’t.
Well, I don’t think they are scientific, but the layperson does. See Jonathan Shedler’s Where is the Evidence for “Evidence-Based” Therapy and my Exactly How Bogus is Psychiatry? for opinions on the scientific nature of therapy and medication, respectively.
And, to be fair, they aren’t always nice, either.
p. 79-80
p. 85
Excellent article - I enjoyed it immensely, for you have illuminated precisely a problem I have been trying to solve.
I have three children under the age of 5, and as an atheist, the question of how best to raise them without a religious or cultural doctrine is constantly on my mind.
I think you are absolutely right - we as a species need something more to satisfy our mental wellbeing, but how to do so without compromising our scientific rationale?
I have been trying to come up with ways that might blend “sensing” with “sense-making” to safeguard my family against the modern helpless-indecisive malaise your article discusses.
What this currently looks like:
- Celebrating annual events that demonstrate the wonder and sublime of the material world; for example going outside during the nighttime every August to watch the Perseid meteor shower, seeing the Acer trees in Autumn in our local park, and watching the sunrise on summer solstice.
- Taking part in annual events that celebrate and/or remember our national history; for example having fireworks in our garden for Bonfire Night, singing carols in the Advent season or attending a Remembrance Day service and having two minutes of silence.
Given that I believe there are no “answers” when it comes to existential questions, other than the relatively “bleak” ones that science has already uncovered (I think back to Richard Dawkins when regarding this, and his claim that science isn’t supposed to be comforting, but only true), I feel that the best I can do is to give my family a routine. One that reminds them of the wonders that surround them every day and can be found in any place, and one that reminds them of the history of their ancestors.
Is this a worthy project in your opinion? (The well-being of my children lie in the balance, so no pressure…!)
Thank you for such an interesting and thought-provoking article.
When pressed about the reticence they have about giving practical advice, I've heard some of my therapists friends reach farcical levels, like "my job is to give my patients the tools so they can make better decisions themselves". Which would be fine, I guess, if the patients were not already overwhelmed, as many of those who seek professional help are. But even then, I'm never given a satisfactory explanation of what those tools should consist of. The answer seems indeed to be something mystical.
And I think that's one of the reasons many people are veering towards coaches of all kinds. I myself only have a small blog where I talk about women to men who don't understand them, I specifically say I am NOT a coach, and yet I receive messages from men asking for help with their specific situations. Then again, most of them have no intention to put any suggestion to practice. They either want reaffirmation, comfort in knowing how things work even though they'll do nothing to influence them, or they want to be scolded and get some kind of catharsis from it, like in a religious confession.
I came to have a very pessimistic attitude towards this, so I'm glad you put it in a way that doesn't make it seem such a terrible thing in your article!