Is the first job of a therapist not to be absurd?

In a world this strange, sanity is worth its weight in gold.

It is said that the Eskimos have many words for snow because they encounter it so often. By a similar logic, I use many words for idiot—moron, imbecile, blockhead, mouth breather—because I encounter idiocy daily.

The thing is, I don’t actually think that people engaging in moronic behavior are morons. I rather think they are normal people operating in an abnormal world. An absurd world, come to think of it. Modern people are like rabbits in the ocean: although a rabbit can tread water well enough, its legs obviously did not evolve for swimming.

Absurdity’s Roots

What is absurdity? In The Office, characters will frequently include the audience in the joke by looking into the camera. In many cases, their faces are incredulous and seem to ask of the audience: You’re seeing this too, right? I’m not crazy?

See Jim Halpert at :53 and 1:10 for examples:

To my way of thinking, absurd situations are those that cause a person to look around for confirmation of their sanity. (And finding a pair of sympathetic eyes is one of the sweet, underdiscussed joys of life. I can still remember, in college, locking eyes with a crush after a classmate confessed to reading more than we were assigned.)

Absurdity is not new. Albert Camus was writing about it back in the 1940s, most notably in his essay The Myth of Sisyphus (1942). But surely encounters with the absurd have only grown more common since then, as humans have continued to fabricate the world around them into something ultimately foreign. Plus, Camus’ essay was itself absurd. It begins with the very practical and urgent question of whether a person should kill themselves, but eventually devolves into such a word salad that the average reader is left hanging. I very much recommend his novels and travel essays instead.¹

So, absurdity isn’t new, but it may be on the rise. Here are a few of my own encounters with the absurd over the past six months:

1. When I call my orthopedist’s office, its interactive voice response system (a term I had to look up just now) provides nine prompts. Not until the fourth prompt am I given a chance to make an appointment. This comes directly after: “To schedule a worker’s comp appointment, press 3.” How does this make any sense? I’d bet that for every 100 calls to book an appointment, there is one call related to worker’s compensation.²

2. I recently received a bill from my insurance for the orthopedist appointment I eventually managed to schedule. An item on the bill reads: “What you owe or have paid.” How is this helpful at all?

3. On the street the other day, I told a stranger who had stopped me for a friendly chat the nickname of my recently-born daughter. Wanting to be polite, I asked her if she had a nickname for her son, whom she had already referenced. She broke down and began crying, saying she no longer speaks to him, and launched into the saga of her life. But I cut her off: I had a therapy session beginning in five minutes, for which I was being paid about three dollars a minute.

4. American politics.

5. I not infrequently listen to podcasts that critique the attention economy—right before cutting to ads. Likewise, did you know that the trailers for movies aren't made by the same people who make the movie, and therefore serve as no proxy whatsoever for the movie’s quality? That’s bullshit!

6. I went to the orthopedist—and podiatrist, neurologist, physical therapist, allergist, and so on—because I had been experiencing severe foot pain. After seeing about eight different professionals, and being subjected to over ten tests or procedures, I had my most informative conversation with ChatGPT. It was the only thing that spoke directly to my condition. It put my primary care physician, in particular, to shame.

Modern Absurdity

Not all sources of absurdity are modern. Surely in-laws, for example, have always been a problem.

In fact, social life has probably been confusing from the start. Some have even argued that it is because of social complexities that the human brain is so big and impressive. So, I tend to think that as long as humans are around, there will be opportunities to look at the camera.

Still, much of today’s absurdity undeniably stems from our WEIRD existence, and many of these modern sources were only beginning to emerge—or didn’t even exist—when Camus was writing less than a century ago. To name a few: digitalization, globalization, and specialization.

Digitalization allows for the following absurd scenarios. First, my brother worked at a company for two years during COVID and never once saw his coworkers. On his first Zoom call, he turned on his camera, only to find everyone else had theirs off. He followed suit, and that was the norm until the day he quit. Second, a client of mine and her partner are in couples therapy, but everyone calls in from a different location. A few weeks ago, my client and her partner took the call together—from the same device—and apparently the session was one of their most productive. You think?

Globalization is responsible for the growing tendency for people to end lifelong friendships over events happening halfway around the world—like the Israeli-Palestinian conflict—that will likely have no direct impact on either of them. That seems absurd to me. Globalization is also behind the disorienting experience of traveling halfway around the world only to get into a cab and hear Miley Cyrus on the radio or see Starbucks out the window. So much for sixteen hours on a plane.

Specialization is not new, but I would argue that it has reached absurd heights only recently. It’s one thing to specialize in baking bread or fixing shoes, but quite another to specialize in creating insect noises for nature documentaries (Foley Artist for Insects), sniffing armpits to judge deodorants (Odor Tester), or ensuring manufacturing tolerances are exact (Metrology Engineer). These positions are absurd due to a combination of specificity and unfamiliarity. Not only was I unaware of Metrology Engineers until about a minute ago, I can’t even imagine how they go about their work. Even if I know almost nothing about baking, I’ve at least used an oven and tasted bread.

Our hyper-specialized economy leads to absurdities of a deeper kind, though—Kafkaesque absurdities, in which teams assembled for a general purpose, such as in-vitro fertilization, are comprised of such narrow-minded experts that the consumer becomes lost in a kaleidoscope of bureaucratic reflection. This has been happening to my friend, a social worker who wants to have a baby with her wife. Each time she asks a question—for example, “Since I’m a social worker, can I skip the psych eval?”—she ends up getting different answers for different reasons from different people. In a hyper-specialized world, so many crumbs fall through the cracks that the value of generalism—the ability to step back and keep an eye on the big picture—becomes painfully obvious.

I would argue that specialization leads to a third and final kind of absurdity: not understanding much of the world around us. When my wife and I honeymooned in Uganda, I was surprised by how calming it was to trace where things came from. Most of the houses were made of straw and brick, and lo and behold, we saw brick chimneys by the side of the road and holes in clay mounds nearby. We ate goat one evening, and the next day we passed a child, no older than ten, herding goats. People wove baskets from sticks and reeds, or tended small gardens near their homes. For the first time in my life, I was able to draw a circle around my material reality.³

When we returned to Philadelphia, one of the first questions to pass through my mind was: What is glass, really? Ditto with how street signs are made, how my phone works, and where my tax dollars go. Of course, the Internet has these answers, but I find that unsatisfying compared to the alternative of picking my head up and looking around. Anyway, I hardly think that books like The Way Things Work would become best-sellers if any of us had a clue.

Human arrangements tend to settle into reasonable positions eventually, but it may be that the forces of digitalization, globalization, and specialization are changing the environment so quickly that absurdity is allowed to prosper. More broadly, as the mind confronts more stimuli it didn’t evolve to recognize, absurd experiences are bound to abound.

Wherefore Therapists?

So perhaps absurdity is growing, but that’s okay, because we have therapists to help people make sense of their lives, right? Well, not exactly.

In my opinion, therapists add to the circulating level of absurdity in the world by insisting on versions of reality that are almost certainly wrong, such as the idea that not talking about something is unhealthy, or that a person’s mental health is determined more by their personal history—say, by how they were parented—than their genes or current circumstances.

Unsurprisingly, these versions of reality fashion mental health professionals into experts and heroes. Because I went to school for a few years—where I learned virtually nothing—and sat with clients for so many hours without breaking an ethical rule (never mind whether I was effective), I am now qualified to fix someone’s way of being, which is WAY more complicated than fixing someone’s foot.

This is an absurd expectation, and mental health professionals who pretend otherwise are only adding to the pile of things an average person scratches their head at.

For a variety of understandable reasons, though, therapists tend to subscribe wholeheartedly to their chosen orientation—it’s hard to do such slippery work without a firm hold of something—and foist its implications on the hapless client, who isn’t in much of a position to disagree. Indeed, toward a skeptical client, a therapist must only raise their eyebrows and ask: “How has that skepticism been working for you?” The same could be asked of any trait or quality; the answer from the supplicant client is going to be the same: “Obviously, not too well.”

This requirement to “buy in” to a probably false version of reality in order to receive support isn’t limited to individual therapy. Alcoholics Anonymous (AA), the world’s most popular support group, asks its members to acknowledge a higher power.⁴ Is this because acknowledging a higher power helps with recovery? Not really. The requirement would better be described as an artifact of AA’s Christian roots, similar to how Adlerian Therapy’s emphasis on birth order is an artifact of Adler’s interest in it. (Birth order, by the way, has been shown to have negligible impacts on personality and intelligence.) Yet for a person to become a member of AA and access the help that it can undoubtedly provide, they must first drink the (non-alcoholic) Kool-Aid.⁵

A more outraged writer would call this brainwashing.

Let’s come at it from a different angle. Suppose someone is going through a hard time and decides to give this thing called therapy a try. They go to Psychology Today (PT), the main website for clients looking for therapists, and maybe peruse some of the articles, which include: How Your Job Stress Affects Your Dog, What Other People May Think of You When You Buy Fast Fashion, Can Self-Hugging Reduce Anxiety?, Trauma-Sensitive Yoga May Help Military Sexual PTSD and Spark Your Creativity with a Nap—in which one of the key points is “Taking a ‘creativity nap’ requires practice and diligence.”

Is this what mental health means now—filling your head with this drivel?

Anyway, let’s say our person manages to ignore all that and remain focused on finding a good therapist. Their query for a therapist in Philadelphia returns thousands of results. Fortunately, PT’s search criteria can help them whittle this down. In addition to searching by sex, insurance, format (in person or online), and other basic criteria, clients can also search by:

• Type of Therapy, including Attachment-based, Brainspotting, Neuro-Linguistic, and Psychobiological Approach Couple Therapy;

• Specific Issue (Specialty), including Codependency, Dual Diagnosis, Medical Detox, Open Relationships, and First Responders; and

• Therapist Details, including ethnicity, faith, and sexuality.

These may seem reasonable enough—until you realize that most clients are confused by this jargon and would prefer not to learn it. Even more insidiously, the ability to search by these criteria gives the impression that they matter for therapeutic outcomes—when, in fact, they don’t. I’ve made this point time and time again for therapeutic orientations, but it’s true even for therapist ethnicity. While studies show that clients often prefer therapists with a similar racial or ethnic background, this preference does not translate into better outcomes.

So, our person goes online because they aren’t doing well and want help. Before they know it, they’re wading through a sentence like this:

I am a level 2 practitioner of Accelerated Experiential Dynamic Psychotherapy (AEDP). My work with couples integrates elements of Emotionally Focused Therapy (EFT) and Collaborative Couple Therapy. My approach is Consensual Non-Monogamy, Polyamory and Kink affirmative. I also have extensive training with Motivational Interviewing for substance use issues.

Huh?

Or how about this:

My practice is LGBTQ2IA, poly/CNM, and neurodivergent friendly and affirming. Let's get to work!

Get to work—on what?

Finally, let’s say our sufferer navigates this quagmire and finds someone they think will be a good fit. Now comes the sticker shock. The average session in my zip code costs about $150. That’s more expensive than a meal at the aforementioned best restaurant in Philly, and probably more than the homeless people on its doorstep get tossed in a year.

Is this not absurd?

An Alternate Value

The average person, it must be said, has no idea what they are talking about, and peddles many beliefs that aren’t true. What if therapists, in contrast, were humble and honest—even if underwhelming?

What if therapists began conceptualizing themselves not as experts of the brain, which is beyond current scientific understanding anyway, but as counterweights to the growing absurdity of the world, in which humans might quickly be losing the thread? What if therapists prided themselves on not being…another mindless authority with dubious ideas?

This would require therapists to reject the faith society has placed in them as unjustified and undeserved, abandon the shallow interpretations of reality the field has put forth (for example, DSM diagnoses), and level with their clients as one absurd creature to another. Therapists ought to be “partners in absurdity,” not contributors to it. In other words, therapists ought to listen to that voicemail I mentioned above and think to themselves: “I provide the opposite of that.”

Therapists could take Socrates as their model—never claiming to know what they don’t—but needn’t go full Socrates and undermine everything the client thinks they know. The goal isn’t to leave people more confused than when they arrived. If anything, therapy ought to abound in sanity—built, as ever, by two people finding common ground. Both the content and the process of slow, careful, and curious conversation can be therapeutic. “The greatest compliment that was ever paid me,” wrote Thoreau, “was when one asked me what I thought, and attended to my answer.”

If my colleagues and I saw therapy as a conversation grounded in sane, honest connection, we would avoid—at all costs—whatever made our profession indistinguishable from the noise and nonsense around it. That would mean abandoning pseudoscientific theories about the brain, otherwise known as therapeutic orientations, along with other notions we support in no small part to justify our fee. The world is absurd enough that simply not being absurd is worth its weight in gold.

Our Weight in Gold

The main value of a therapist in this absurd world is to be the opposite of absurd: to abound in common sense, level-headedness, genuineness, authenticity, humility, and honesty. I have no idea what goes on behind closed doors other than what some of my clients report, but it does not seem as if the mental health industry is currently doing this, judging by the ideas it feeds the public. (As I said in The Solution Problem, Part 3, the layperson is better off knowing nothing about clinical psychology than a little.) Instead, it seems that clinical psychology has manufactured insanity no differently than anything else in the modern world.⁶

I’m not calling for a new orientation—that’s the last thing the field needs—but rather a new way for therapists to conceptualize themselves in a world in which, for example, AI will soon do their job better than them.⁷ A world transformed, quicker every day, by the forces of digitalization, globalization, and specialization, which among other things, don’t give people much time to adjust to new circumstances.

Is it possible that what people want in this kind of world isn’t all that complicated or different? Maybe instead of a neurodivergent-supporting, kink-positive, level 3 practitioner of Accelerated Experiential Dynamic Psychotherapy to work remotely on their dual diagnosis of codependency and internet addiction, clients want to look across the room and lock eyes with someone who can confirm: No, you’re not crazy—I’m seeing this too.

---

Title image by Thomas Ruff, found here.

1. For example, Summer in Algiers.

2. If you’d like to fact check me, the number is 610.521.8970.

3. In The World Until Yesterday, Jared Diamond relates the following from a friend: “‘In Africa, if you need something, you make it for yourself, and as a result you know how it is put together and how it works. In the U.S., if you need something, you go buy it, and you don’t know how it is put together.’” (459)

4. This “higher power” used to be God, straight up, but AA has since made its language more inclusive. Although not entirely.

5. It is mainly belonging to the group that people in AA—and other groups—benefit from. This provides social support, structure, accountability, belief, and so on. See Rob’s Mostly Mindless Protests for more on the value of “being wrong to belong.”

6. Perhaps this is inevitable given the capitalist economy in which it must sell itself.

7. If it isn’t already.