Why has mental health got worse given the prevailing emphasis on self-care and accurately knowing and expressing oneself? And why do people and groups most inclined to focus on their identity appear to be the most distressed, confused, and mentally unwell? Is it possible that the new therapy culture and the emphasis on introspection is actually making things worse?

I am not the first to notice these developments—Abigail Shrier’s new book Bad Therapy has carefully delineated a similar argument. Her arguments are elsewhere supported by research on semantic satiation and ironic uncertainty, the effects of mirror gazing, the effects of meditation, and how all this relates to the constant introspection encouraged by therapy culture and concept creep.

Satiation and Its Effects

Semantic satiation is the uncanny sensation that occurs when a word or sentence is repeated again and again, until it appears to become foreign and nonsensical to the speaker. You may have done this as a child, repeating a word in quick succession until it no longer seems to be recognizable. It’s a highly reliable effect—you can try it now. Repeat a word to yourself quickly, out loud, for an extended period, and really focus on the word and its meaning. Under these circumstances, most people experience semantic satiation.

This well-studied phenomenon—sometimes called "inhibition," "fatigue," "lapse of meaning," "adaptation," or "stimulus satiation"—applies to objects as well as language. Studies have found that compulsive staring at something can result in dissociation and derealization. Likewise, repeatedly visually checking something can make us uncertain of our perception, which results, paradoxically, in uncertainty and poor memory of the object. This may also occur with facial recognition.

Interestingly, a similar phenomenon can occur in the realm of self-perception. Mirror gazing (staring into one’s own eyes in the mirror) may induce feelings of depersonalization and derealization, causing distortions of self-perception and bodily sensation. This persistent self-inspection can result in a person feeling that they don’t recognize their own face, that they no longer feel real, that their body no longer feels the same as it once did, or that it is not their body at all. Mirror-gazing so reliably produces depersonalization and realization (and a wide range of other anomalous effects), that it can be used in experimental manipulations to trigger these symptoms for research purposes.

This effect doesn’t only occur with visual self-inspection, but with mental introspection too. I call this "identity satiation." It has been studied for thousands of years and it is the basis of many Buddhist and other spiritual practices. It has long been understood that extended periods of introspection and self-contemplation result in a sense of identity-loss and a disorder known as "depersonalization-derealization" with eerily familiar symptoms. Depersonalization-derealization affects "your ability to recognize your thoughts, feelings and body as your own."

When Therapy Makes Things Worse

Spending time with friends and family, exercise, and volunteer work are often more helpful than long conversations about one’s anxieties and grievances.

Quillette•Abigail Shrier

Buddhists developed practices designed to induce this feeling, such as the sustained practice of trying to "find" where the self is located in the body until, unsuccessful, the individual experiences identity loss, depersonalization, and derealization. This process can be like trying to tightly grip a slippery bar of soap—the more you try to perceive yourself, the harder it becomes. Other practices encourage practitioners to focus on or "listen" intently to their own thoughts for extended periods of time, until they no longer identify with their train of thought, and come to feel entirely separated from their internal monologue. This is identity satiation at work, and it occurs through this persistent introspection.

It should not be surprising, then, that rumination—a persistent introspection and compulsive focus on one’s internal sensations, thoughts, or identity—is a hallmark of anxiety disorders of various kinds, including depersonalization-derealization. People who engage in compulsive introspection can become increasingly uncertain, anxious, and confused.

These phenomena provide an explanation for the worsening mental health outcomes of young people—particularly those encouraged to reflexively explore and inspect their own feelings and identities at a time when their bodies and identities are in a state of flux. The school curricula and social dialogue now dominant in the West feature endless discussions of identity and encourage constant introspection. This replicates thought patterns shown to result in poorer understanding and more confusion, and inadvertently broaches complex topics (such as cartesian dualism) that have preoccupied serious philosophers for centuries. The likely result is identity satiation, both through the semantic satiation of the words associated with various identity concepts, and through whatever mechanism drives the depersonalization-derealization effects of meditation and rumination.

In other words, the proliferation of therapy culture and compulsive introspection, intended to encourage self-knowledge and mental well-being, may in fact be more like the poison than its antidote.

The Satiation of Gender Identity

The number of people identifying as non-binary or trans has skyrocketed in recent years, and a growing number of schools are now teaching gender theory and discussing it with children—sometimes in kindergarten, more often in primary school, but especially in middle- and high-school (though in other schools it is entirely banned). While this may be beneficial for those already struggling with gender confusion, it may also present an avenue for other children to ruminate and become confused via "identity satiation."

Understanding the Rise of Transgender Identities

The social dynamics of girls’ and women’s friendship groups, including a desire to fit in and avoid conflict, may make them more susceptible to social contagion.

Quillette•David C. Geary

The kind of gender theory increasingly taught in schools encourages children to spend extended periods of time ruminating on self-concepts that most would not otherwise have struggled with. They are given exercises that encourage them to doubt their own unconscious intuitions about themselves, and to ruminate on questions like "Do I feel like a boy?" and "What does it mean to feel like a boy?" and "I thought I was a boy but what if I am not?"

Such questions are often confusing to answer and difficult to express, even for adults unaffected by gender dysphoria. But asking children to ruminate in this way may lead to confusion and depersonalization-derealization via the mechanisms described above. "Identity satiation" may then lead them to decide they are non-binary or trans, especially when identifying as such is rewarded with social recognition and social support. Many people who subsequently de-transitioned have described this process: "I never thought about my gender or had a problem with being a girl before."

Decades of psychological literature on neuroticism and mental illness, the well-established literature on rumination and mental health, and concepts from cognitive psychology such as semantic satiation all support the idea that the modern obsession with identity and self-knowledge is likely misguided and harmful. Persistent introspection is the hallmark of many psychological disorders, and may actually make self-knowledge more difficult.

Increased self-awareness and introspection are humanity’s primary innovations over the other animals, but this ability should be used sparingly and strategically. One’s awareness should be primarily directed outwards (entire schools of therapy are focused on teaching people how to replace an inward-facing focus with an outward-facing focus to decrease distress and anxiety). We should not be encouraging young people—or anyone, really—to spend inordinate amounts of time trying to consciously grasp who or what they are through pure introspection. It is generally counterproductive and may actually make one more uncertain of who they are.

As ultra-social animals, our identities are socially negotiated. Our social interactions and our interactions with the external world provide most of the information informing our self-concept. We should therefore encourage young people to just be, and let their identities emerge through their interactions with the world, through play and social interaction with others, and from only occasional introspection and exercises in "self-knowing." For most people, identity-formation is a sub-conscious process, and it should remain so.

• Science / Tech
• Psychology
• Gender Dysphoria
• Identity

Brandon McMurtrie

Brandon McMurtrie is an assistant lecturer and PhD Candidate in psychology, and a writer focused on psychology, culture, and literature.

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