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Shrinking of America: Myths of Psychological Change
Describes current misconceptions about therapy and its benefits, gives a realistic appraisal of psychotherapy, and gives suggestions on evaluating therapy programs
- GenresPsychology
307 pages, Hardcover
First published March 1, 1983
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October 19, 2025
A RATHER PESSIMIISTIC VIEW OF THE POSSIBILITY OF ‘CHANGE’ THROUGH PSYCHOTHERAPY
Bernie Zilbergeld (1940-2002) wrote in the first chapter of this 1983 book, “This book is about the ability of people to make changes in their personal lives, and specifically about the ability to make these changes through a variety of methods loosely called psychotherapies. Although psychotherapy is not synonymous with the American search for self-improvement … [It] offers an ideal vehicle for examining widely held beliefs about human malleability that underlie it. By studying the growth, practice and results of psychotherapy we can address such questions as why Americans have so completely accepted therapy and therapeutic thinking, how malleable human beings are, and the consequences of holding great expectations for change.” (Pg. 6)
Later, he adds, “this work does not fit into the usual categories of books about psychotherapy… My interest has been less in this or that model of counseling than in critically examining all therapies and the assumptions on which they are based, and to discover what their results can tell us about human plasticity.” (Pg. 8)
He acknowledges, “it seems reasonable to mention the sources I relied on for my information. There are four major ones: 1. My own experience as a therapy consumer (a total of about five years in a number of change processes) and therapy provider (over twelve years in a variety of settings using many different methods or formats). 2. Conversations with and observations of other counselors since my days as a graduate student… 3. The now vast research literature on the effects of therapy…. 4. Interviews conducted by me and several assistants of 140 men and women about their therapy experiences… To minimize distraction, there is no scholarly paraphernalia in the text.” (Pg. 9-10)
In Chapter 1, he notes, “Not long ago, psychiatrist Karl Menninger… asked ‘Whatever Became of Sin?’ The answer is simple: it was psychologized away. Under the new arrangement, some of what used to be considered sinful---for example, masturbation---is now thought to be good for you, and most of the rest---such as gluttony and crime---is considered to be sickness, symptoms of mental disturbance. The only ‘sin’ we seem to care about is failing to fully actualize all our potential…” (Pg. 13)
He observes, “There is nothing wrong with psychological explanations or with believing in hidden meanings. Such things can be useful. There are many instances where an explanation based on unconscious motivations ... or some other psychological model is more … helpful than a more obvious explanation. The only problem is that there is no certainty anywhere. There are so many possibilities… so many ways of understanding what’s happening. If things can be the opposite of what they seem and if what seems trivial can be fraught with significance, how can one ever figure out what is going on?” (Pg. 15)
He notes, “Courses on groups are common in therapy programs, but their focus is on artificially created therapy groups whose purpose is to undo the damage supposedly wrought by traditional groups. Counselors do not learn much about the real groups in which people spend much of their time---clubs, neighborhood gatherings, work groups, teams, church groups, and friendship circles. Of such things little is heard.” (Pg. 22)
He suggests, “As long as you believe that even one person lost weight, became less depressed, experienced more joy, found himself, or got along better with his family, there is reason to believe that the same can happen for you. I think this is one reason why people read so many self-help books even if they don’t follow the advice in them. Just knowing that the advice exists and that it has helped someone is enough to keep hope alive. If you ever decide to work on what’s troubling you, there’s a chance you’ll reach your goals.” (Pg. 67)
He states, “Affluence, even the relatively lower levels of it that many are currently experiencing, adds a different perspective to life… Millions of people today seek therapy for personal and interpersonal discomforts that less affluent societies would regard as trivial.” (Pg. 71)
He says, “greater tolerance has had the effect of making many people less sure of themselves. They find little support and legitimacy for their own ways. When society accepts everything, it supports nothing…. Not only are once-bad things now considered to be acceptable, or even laudable, but the whole function of right and wrong has come under attack. To make value judgments is widely thought to be a sign of intolerance, inhibition, and uptightness.” (Pg. 74)
He asserts, “There is no longer a rationale for saying that anything is off limits or impossible. … If someone says it is possible to live without guilt, to experience continuous joy, to love unconditionally, or to lose weight by eating papayas and pineapples after each binge, who is to say it’s not true? If someone says that a weekend course… radically changed his life, made him calmer, immeasurably happy, and able to clear up all the things that had been troubling him, who is to say it’s not so?” (Pg. 84)
He points out, “You say that therapy is what made you feel better. But a year and a half is a long time and therapy wasn’t the only thing that happened during it. Could the mere passage of time, rather than therapy, be responsible for your changed feelings?... many problems and feelings are self-limiting and improve after a while.” (Pg. 125)
He argues, “the evidence does not support the idea of a best [psychotherapeutic] treatment. Most of the well-known methods usually produce similar results for most problems… The unavoidable conclusion … is that if you’re suffering from any of the common ailments that people take to psychotherapy… you can expect about the same results regardless of which therapy you choose.” (Pg. 142)
He also notes, “The suicide rate of psychiatrists is one of the highest of any professional group, and the rate among female psychologists is also high. Drug and alcohol abuse are high among all health professionals, including therapists. And counselors seem to have as many problems in their relationships as do others. Their divorce rate is about the same, and the amount of marital dissatisfaction may be even greater.” (Pg. 164)
He summarizes, “There are some dangers, to be sure---therapy can harm, and the constant raising of expectations by therapists and others can cause greater unhappiness---but in general change methods currently available are weak and seriously limited… changes made by the presumably sophisticated methods of therapy are usually modest and not much different from what people achieve on their own or with the help of their friends.” (Pg. 221)
He states, “our lives have particular configurations which are not easily changed by therapeutic methods, though they can and do change for other reasons. One person is in the habit of sleeping as late as possible, another … just has to start the day with physical exercise. All of these people can probably change… at least for a while. But as soon as the course is over or the pressure is off, there is a good chance they will suddenly or gradually go back to what they used to do.” (Pg. 244)
He summarizes, “The obvious conclusion to what has been said so far is that there are limits to how much each of us can change. The limits of human malleability are much closer to the ground than they are to the sky… And for some people and some problems---regardless of how much effort and skill are expended---there is going to be little change or none at all… [This] also holds true in other human endeavors … but may be harder to take because we have come to expect so much from therapy. We expect it to have magical powers to fix personal and interpersonal problems, and even huge and complex social difficulties as well. I suggest that nothing is that powerful.” (Pg. 247-248)
This book will appeal to those seeking critical/skeptical perspectives on psychotherapy and psychiatry.
Bernie Zilbergeld (1940-2002) wrote in the first chapter of this 1983 book, “This book is about the ability of people to make changes in their personal lives, and specifically about the ability to make these changes through a variety of methods loosely called psychotherapies. Although psychotherapy is not synonymous with the American search for self-improvement … [It] offers an ideal vehicle for examining widely held beliefs about human malleability that underlie it. By studying the growth, practice and results of psychotherapy we can address such questions as why Americans have so completely accepted therapy and therapeutic thinking, how malleable human beings are, and the consequences of holding great expectations for change.” (Pg. 6)
Later, he adds, “this work does not fit into the usual categories of books about psychotherapy… My interest has been less in this or that model of counseling than in critically examining all therapies and the assumptions on which they are based, and to discover what their results can tell us about human plasticity.” (Pg. 8)
He acknowledges, “it seems reasonable to mention the sources I relied on for my information. There are four major ones: 1. My own experience as a therapy consumer (a total of about five years in a number of change processes) and therapy provider (over twelve years in a variety of settings using many different methods or formats). 2. Conversations with and observations of other counselors since my days as a graduate student… 3. The now vast research literature on the effects of therapy…. 4. Interviews conducted by me and several assistants of 140 men and women about their therapy experiences… To minimize distraction, there is no scholarly paraphernalia in the text.” (Pg. 9-10)
In Chapter 1, he notes, “Not long ago, psychiatrist Karl Menninger… asked ‘Whatever Became of Sin?’ The answer is simple: it was psychologized away. Under the new arrangement, some of what used to be considered sinful---for example, masturbation---is now thought to be good for you, and most of the rest---such as gluttony and crime---is considered to be sickness, symptoms of mental disturbance. The only ‘sin’ we seem to care about is failing to fully actualize all our potential…” (Pg. 13)
He observes, “There is nothing wrong with psychological explanations or with believing in hidden meanings. Such things can be useful. There are many instances where an explanation based on unconscious motivations ... or some other psychological model is more … helpful than a more obvious explanation. The only problem is that there is no certainty anywhere. There are so many possibilities… so many ways of understanding what’s happening. If things can be the opposite of what they seem and if what seems trivial can be fraught with significance, how can one ever figure out what is going on?” (Pg. 15)
He notes, “Courses on groups are common in therapy programs, but their focus is on artificially created therapy groups whose purpose is to undo the damage supposedly wrought by traditional groups. Counselors do not learn much about the real groups in which people spend much of their time---clubs, neighborhood gatherings, work groups, teams, church groups, and friendship circles. Of such things little is heard.” (Pg. 22)
He suggests, “As long as you believe that even one person lost weight, became less depressed, experienced more joy, found himself, or got along better with his family, there is reason to believe that the same can happen for you. I think this is one reason why people read so many self-help books even if they don’t follow the advice in them. Just knowing that the advice exists and that it has helped someone is enough to keep hope alive. If you ever decide to work on what’s troubling you, there’s a chance you’ll reach your goals.” (Pg. 67)
He states, “Affluence, even the relatively lower levels of it that many are currently experiencing, adds a different perspective to life… Millions of people today seek therapy for personal and interpersonal discomforts that less affluent societies would regard as trivial.” (Pg. 71)
He says, “greater tolerance has had the effect of making many people less sure of themselves. They find little support and legitimacy for their own ways. When society accepts everything, it supports nothing…. Not only are once-bad things now considered to be acceptable, or even laudable, but the whole function of right and wrong has come under attack. To make value judgments is widely thought to be a sign of intolerance, inhibition, and uptightness.” (Pg. 74)
He asserts, “There is no longer a rationale for saying that anything is off limits or impossible. … If someone says it is possible to live without guilt, to experience continuous joy, to love unconditionally, or to lose weight by eating papayas and pineapples after each binge, who is to say it’s not true? If someone says that a weekend course… radically changed his life, made him calmer, immeasurably happy, and able to clear up all the things that had been troubling him, who is to say it’s not so?” (Pg. 84)
He points out, “You say that therapy is what made you feel better. But a year and a half is a long time and therapy wasn’t the only thing that happened during it. Could the mere passage of time, rather than therapy, be responsible for your changed feelings?... many problems and feelings are self-limiting and improve after a while.” (Pg. 125)
He argues, “the evidence does not support the idea of a best [psychotherapeutic] treatment. Most of the well-known methods usually produce similar results for most problems… The unavoidable conclusion … is that if you’re suffering from any of the common ailments that people take to psychotherapy… you can expect about the same results regardless of which therapy you choose.” (Pg. 142)
He also notes, “The suicide rate of psychiatrists is one of the highest of any professional group, and the rate among female psychologists is also high. Drug and alcohol abuse are high among all health professionals, including therapists. And counselors seem to have as many problems in their relationships as do others. Their divorce rate is about the same, and the amount of marital dissatisfaction may be even greater.” (Pg. 164)
He summarizes, “There are some dangers, to be sure---therapy can harm, and the constant raising of expectations by therapists and others can cause greater unhappiness---but in general change methods currently available are weak and seriously limited… changes made by the presumably sophisticated methods of therapy are usually modest and not much different from what people achieve on their own or with the help of their friends.” (Pg. 221)
He states, “our lives have particular configurations which are not easily changed by therapeutic methods, though they can and do change for other reasons. One person is in the habit of sleeping as late as possible, another … just has to start the day with physical exercise. All of these people can probably change… at least for a while. But as soon as the course is over or the pressure is off, there is a good chance they will suddenly or gradually go back to what they used to do.” (Pg. 244)
He summarizes, “The obvious conclusion to what has been said so far is that there are limits to how much each of us can change. The limits of human malleability are much closer to the ground than they are to the sky… And for some people and some problems---regardless of how much effort and skill are expended---there is going to be little change or none at all… [This] also holds true in other human endeavors … but may be harder to take because we have come to expect so much from therapy. We expect it to have magical powers to fix personal and interpersonal problems, and even huge and complex social difficulties as well. I suggest that nothing is that powerful.” (Pg. 247-248)
This book will appeal to those seeking critical/skeptical perspectives on psychotherapy and psychiatry.
August 22, 2018
This fascinating book by Bernie Zilbergeld is a very helpful resource to understand the myths of psychotherapy. Though dated, it still unpacks the many inherent problems within the psychotherapeutic world and gives an insiders view of such. Zilbergeld brings his own research to this book, and uses his observation of the shrinking of America from his own experience and interaction with those within the field in which he was a specialist. The title itself is fascinating, given that it used to be said when someone went to see the psychologist/psychiatrist, "He went to see the shrink." The author is merely picking up on that concept to develop the changing landscape of America in how people deal with that which ailes them. I wish the author were able to do an update of this book as it would be fascinating to see what he thinks of America 30 years after the initial writing of this book.
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