Chapter 1: What is the main topic discussed in this episode?
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I'm Scott Galloway, and this is No Mercy, No Malice. America's mental health crisis is a multidimensional challenge with multidimensional remedies. However, online, all remedies lead to the same place, the same recommendation, therapy. The Cult of Therapy, as read by George Hahn.
Don't read the comments, I tell people just before I have a drink and read the comments. I knew my book Notes on Being a Man would spark controversy as you get the most flack when you're over the target and some of the criticism likely misses the mark.
The comment that hits home, I reverse engineer what's worked for me, economic security, relationships, to masculinity and don't acknowledge other paths to fulfillment. Fair. Many others offered constructive criticism, and some of the criticism has merit.
What surprised me was how many of the commenters were therapists parroting talking points along the lines of, before anything, men must work on themselves, i.e. get therapy. This is nonsense. I want to be clear. Therapy is a good thing, especially for the 23% of American adults who experience mental illness.
But mental health influencers positioned therapy as a prerequisite for a better life, rendering it a Birkin bag for your feelings, i.e. a luxury good, and positioned many of life's obstacles as traumas to be addressed for $200 an hour. This is a misdirect. I believe America's mental health crisis is a multidimensional problem largely shaped by economic precarity.
Five of the world's ten happiest countries are Nordic nations with strong social safety nets. Costa Rica and Mexico, ranked sixth and tenth, achieve comparable happiness scores thanks to their strong family and social ties. My solve? A. detonate a mental health bomb in America and invest in programs that increase material well-being.
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Chapter 2: What is the main topic of the Cult of Therapy?
If I told young people to attend church, I'd likely get pushback from some quarters. Meanwhile, counseling young people to invest in their fitness and take social risks so they can make friends and form romantic partnerships are non-starters for therapy culture, unless and until you've had therapy. We're social animals.
As social connections atrophy and fray, we're becoming more anxious and depressed. Therapy is an expensive band-aid for a larger problem. But even taken on its own merits, only 9% of Americans give the U.S. health care system a grade of A or B for addressing mental illness, according to Gallup. The U.S. has a shortage of mental health care providers.
But where some see a supply problem, I see a distribution problem. including psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists, and advanced practice nurses specializing in mental health care, there are 344 mental health practitioners per 100,000 people in the U.S.,
We have more mental health practitioners than medical doctors, 297 per 100,000, and five times the number of dentists. According to the U.S. Bureau of Labor Statistics, employment for some mental health-related occupations is projected to grow by 18% over the next decade, faster than the 3% average for all occupations.
Cost is the number one barrier to accessing mental health services, according to the Kaiser Family Foundation, while getting time off work ranks second. Stigma comes in fourth behind concerns about efficacy. The two-thirds of Americans who have private insurance likely have access to mental health services, though one-third of therapists don't accept insurance at all.
If you can swing $280 to $400 a month, platforms like BetterHelp are an option. Note, BetterHelp is a Prof G podcast sponsor. Meanwhile, Americans living in rural areas likely can't find a therapist at all. According to one study, counties outside of metropolitan areas had one-third the supply of psychiatrists and half the supply of psychologists as their more urban counterparts.
People covered by Medicaid and Medicare struggle to find providers that accept their insurance because of the low reimbursement rates. Finally, underserved groups, people of color, non-English speakers, and LGBTQ communities often struggle to find appropriate services. But if you're wealthy, therapy is as easy as reserving a space at SoulCycle.
According to the Wall Street Journal, the next big thing in luxury travel is a vacation with a family therapist. The price tag? $80,000. For everyone else, AI therapy is Sam Altman's answer. Therapy companionship was the number one AI use case in 2025, up from number two the previous year.
One trial for an AI called Therabot found that it achieved an average 51% reduction in symptoms of depression and a 31% decline in symptoms of anxiety, compared with people who got no treatment. But Celeste Kidd, a psychologist at the University of California at Berkeley, who tested another therapy AI called ASH, concluded it was clumsy and unresponsive.
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Chapter 3: How does therapy culture impact men's mental health?
They are the problem. Neither attitude helps. As the left ignores the issue, the right fills the void with misogyny and racism. The result is that a significant number of young men, embracing figures like Andrew Tate and Nick Fuentes, swung right, helping elect a strong man. If strong equals corrupt and stupid.
To borrow from the vocabulary of therapy speak, young men don't feel seen or heard in spaces that are the polar opposite of the manosphere. Women are twice as likely to receive mental health treatment as men. But is that a failing of masculinity or the mental health profession where three-quarters of providers are women?
Guys are built differently, clinical psychologist John Farrell told Monitor on Psychology. They have different brains and different ways of being emotional. Male therapists understand male issues differently than females do. If that sounds sexist, change the pronouns and get back to me. Therapy has a lot to offer. It also has massive blind spots, especially around class and gender.
It's easy to sling bromides about how everyone needs therapy, but it's more productive to ask why therapy excludes so many people and too often fails to help the people it does reach. If you're looking for help on social media, understand this. Platforms and influencers make more money when you stay broken.
Life is so rich.
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