We’ve all heard of the phenomenon known as the placebo effect, where the brain responds to a perceived treatment, even if no actual treatment has been administered. Now widely used in almost all randomised controlled trials across medicine, health, and wellbeing, the placebo effect is a curious reaction that we still don’t fully understand. Current beliefs suggest it is rooted in the social conditioning of those involved. For example, people can be conditioned over time to believe a treatment will work purely based on the positive anecdotes of others. This, in turn, could cause a similar response in a patient who is told they received the same treatment, even if no actual intervention was given.

Recent consensus suggests that when taking part in a placebo trial, unaware participants experience altered brain chemistry, specifically in the release of endorphins, which are natural painkillers. Additionally, the neurotransmitter associated with reward and pleasure, dopamine, floods the brain, overwhelming the individual with positive feelings. As a result, participants may experience reduced anxiety, a higher pain threshold, and improved immune function, all due to the social conditioning that makes them believe they have received something that will improve their condition.

However, this phenomenon extends beyond the positive healing of the body. A major concern related to social conditioning is the iatrogenic effects of everyday life. Defined as unintentional complications resulting from an activity, iatrogenic conditions encompass all social aspects of our daily lives. From social events to friend groups and sports activities, our brains strive to become part of the communities we immerse ourselves in, a concept known as social contagion. For the most part, this is not problematic; it’s natural for someone to slightly alter their language or behaviour when trying to fit in with different groups. However, iatrogenic effects focus specifically on the negative consequences of certain social situations, and, of particular concern to me, therapy.

Therapy, whether psychological or psychiatric, can have wonderful effects for those who need it. But for those who may not truly require it, the potential negative consequences are concerning.

In a world where increasing numbers of young people are undergoing mental therapy, I believe it is crucial to highlight the possible iatrogenic conditions that can arise. Similarly to a placebo, individuals who engage in psychiatric or psychological therapy without genuine need are more likely to report worsening depression, anxiety, suicidal thoughts, and a decline in mental health. However, determining who truly needs therapy is challenging. Some might argue that everyone could benefit from “talking to a professional,” but I disagree, and scientific literature supports this view.

Therapy, like any medical intervention, has side effects. It holds the potential to help but also the capacity to cause harm. Some studies reference side effects such as alienation from close relationships, worsening of depression and anxiety, feelings of incapacity, and the self-fulfilling prophecy of being labelled (i.e., feeling more depressed after being labelled as depressed).

Therapy with children, for instance, differs significantly from therapy with adults. An adult typically chooses to address a specific issue with the help of a professional, and you would expect them to be prepared to do the hard work required in therapy. However, a child or teenager is often coerced or persuaded into it. They are less likely to have the cognitive skills to question the therapist’s approach, and it is much harder for them to challenge a diagnosis. Without the life experience or understanding of genuine mental health conditions, children may lack the ability to critically assess the therapeutic process.

There is a sense of reinforcing self-indulgence when coercing children into therapy they do not need. This sentiment affects both the parents, who feel they are making the right decision, and the child, who now gets to spend a few hours each week talking solely about themselves. Not only is this socially detrimental to the child, but it also establishes a self-fulfilling prophecy that is difficult to break.

This is why we see so many children attending therapy for minor issues. Children, who are naturally fascinated by themselves due to their developmental stage, risk becoming overly focused on their own emotions and behaviours in a therapeutic setting. At this stage, when their sense of self is still forming, they are highly impressionable and malleable. As a result, merely suggesting that something is “wrong” with them can lead them to internalise these ideas, shaping their development around a newly adopted narrative of victimhood.

Adults, on the other hand, with fully developed brains, are much more resilient to such influences. Due to the more extensive neural connections in the prefrontal cortex, they have a greater capacity for self-reflection and can view situations through a problem-solving lens rather than internalising them. They are able to bring their life experiences into therapy, rather than relying solely on the professional to provide solutions.

However, with children, the danger lies in inadvertently reinforcing a victim mentality, which further isolates them from their peers. When children are continually encouraged to focus on their feelings and label themselves accordingly, they may become less engaged in social interactions and fall behind their peers in developing important social skills. This can lead to a cycle of dependency on therapy, with some believing they are fundamentally incapable of managing their lives without external intervention.

In this way, therapy can become iatrogenic for everyone but poses a particular risk to children, especially those who do not need it. This is why we must be cautious, understanding that while therapy can be beneficial and empowering, it must be carefully tailored to avoid doing more harm than good.