Psychology Has Failed Us. It Needs to Change.

The dangers of optimizing mental health

In the late ‘90’s, I was a first year doctoral student in clinical psychology. I felt green and inexperienced pretty much all of the time, not just because I was new to the program, but because I was new to psychology. Only three years prior, I was training to pursue my (admittedly unusual) dream career - to play the oboe in a professional orchestra. After my pivot to psychology, the thought of doing something other than music was still intimidatingly foreign to me. As a graduate student, however, I had no choice but to put my nerves aside and jump feet-first into the coursework. I did so with the zeal of the newly converted, for I truly believed that I was on my way to becoming a healer of the soul. 

A Mind of Metal and Wheels

Early on in the program, we learned to use the DSM, the Diagnostic and Statistical Manual of Mental Illnesses. The DSM is among the most accepted methods for diagnosing mental illnesses. Mental health professionals use the DSM, this refined and powerful diagnostic tool, to impose order on the chaos of insanity, classifying people’s suffering into meaningful categories, reducing emotional distress to its component parts, bounded and contained. From there, professionals can divine which aspects of a person’s psyche have broken down, specify the mind and body mechanisms through which that breakdown occurred, and provide a manualized therapeutic protocol for fixing what’s broken. Of course, I realized, this is why therapists are called shrinks: They shrink bedlam and confusion into tidy packets of understanding. Beautiful.

As I listened, rapt, to the lecture, I couldn’t help but think that one day soon I would join this honorable guild whose members, on a daily basis, perform a miraculous feat: they eradicate suffering. This wasn't just a job. This was a calling, one that transforms the world into a better place. With science and therapy advancing at lightning speed, the next millennium would be a Renaissance, a New Age of wellbeing. This cringe-worthy, naive optimism pervaded all five years of my degree.  

Was that optimism warranted? Fast-forward a quarter century. By certain metrics, we are indeed in a mental health Renaissance. The premier U.S. mental health research institution, the National Institute of Mental Health, awarded over 40 billion dollars in grants during the first two decades of the 21st century on research topics ranging from the genomics of bipolar disorder to the efficacy of community-based interventions. During this same period, mental health awareness has vastly improved, and stigma has started to lessen. We’ve developed and refined a stunning array of cutting-edge treatments for mental illness: cognitive behavioral therapies, pharmaceuticals, neurofeedback and neurostimulation, digital health technologies, and validated holistic remedies, all existing in an ubiquitous self-help culture. Has this mental health utopia succeeded in enhancing our quality of life and ushering in a new era of psychological well being and enlightenment? 

The opposite seems to have happened instead. According to estimates from the 2021 National Survey on Drug Use and Health, more than one in five U.S. adults live with a mental illness in a given year, such as anxiety and mood disorders, post traumatic stress disorder, OCD, eating disorders, and schizophrenia. In our lifetime, over half of us, including youth, will have a mental illness. Being distressed, depressed, addicted, distracted, disconnected, self-harming, or suicidal has become the rule, rather than the exception. Instead of living in wellbeing blue zones, we feel we inhabit three-alarm, red-hot dumpster fires. You can’t say the words ‘mental health’ without following it with the word ‘crisis.’ You can’t say ‘physical health’ without thinking, ‘opioid crisis’ or wondering if you should take Ozempic. We’re lonely. We’re suffering. Our kids seem to be suffering even more. 

I look back on that hopeful and naïve graduate student, and have to ask - How did everything go so wrong?

I have come to believe that key to what went wrong lies in the very vocabulary of mental health that I learned to use in graduate school: broken, precise, method, illness, tools, order, classify, categories, reduced, bounded, contained, mechanisms, manualized, protocol, and eradicate. We think of the mind and the spirit like machines. These words have seeped into our collective consciousness. They reflect deeply held beliefs about mental health and human thriving, ones that are fundamentally flawed in ways that make us mentally and emotionally sicker. These flawed beliefs can be summarized in one word: Optimize.

The Optimization Mindset

Optimize /ŏp′tə-mīz″/: The goal of making as fully perfect, functional, efficient, or effective as possible. 

The optimization mindset is a way of thinking that frames life as the perpetual pursuit of self perfection, as a series of upgrades to be better, faster, and more. Optimization convinces us that our lives are good only when they and we run like well-oiled machines - efficient, frictionless, and productive. Because optimization calls on us to always improve and strive for peak performance, we must adhere to a strict schedule of self-assessments, repairs, and improvements. The greatest good, the highest virtue, according to optimization is progress.

On the face of it, optimizing mental health is a great idea because its aim is to promote some of the best stuff in the world: well being, productivity, self fulfillment, good relationships. But here we are, in the 21st century, and optimization has gone too far. 

First, we have to notice that optimization is subtle and sneaky. You don’t have to be optimizing at the extremes for it to influence you on a day-to-day basis. Indeed, once you start looking for optimization, you will see it everywhere - in advertisements, schools, spas, at home, on social media, in the news headlines, in children’s books, and in grocery stores. Are these messages familiar?:

Optimize your workout to boost your mood

This productivity life hack will change your life!

Burn belly fat with this 3-minute exercise

These 5 healthy habits will unlock your best life

The secret to billionaires’ success everyone can steal

 This new superfood will heal your gut biome

Take a moment for some summer self care

50 easy ways to be a fantastic parent

Strengthen your happiness muscle

Join the Champions of Wellness Team

These 7 things will help you like yourself more

Find calm in the chaos

And they’re not just common, they’re common sense. They have become the very language of how we think about doing and living well. We take them for granted because, after all, don’t these really just boil down to our inalienable human rights to life, liberty, and the pursuit of happiness?

Yet, even when we take them for granted, barely notice them, we feel their pull. We hear them whisper in our ears that the Good Life isn’t good enough unless we’ve made it our Best Life, and then even better. They tell us, on repeat, that the best and most successful people are those who continuously strive for self-actualization and master the best life hacks; are committed to the pursuit of happiness+; are emotionally invincible achievers of work-life balance and fulfilling personal relationships; and maintain status as a fit and attractive adherent to healthy lifestyle protocols. 

We know, we know….it’s impossible. But still…If we don’t go for self-fulfillment, peak efficiency and productivity, if we settle for less than excellent, what will happen then? If we’re not deeply determined to be deeply determined, where does that leave us? 

But here’s the thing: this certain type of person isn’t finding what they’re looking for. They might have started out just trying to improve their lives, just striving for something better for themselves and their loved ones. But now, somehow, it’s not only not working, it’s backfiring. Enough never feels like enough. After using every tool in the toolkit to achieve earthly bliss, after checking off all the boxes on the Good Life To-Do List, new boxes always appear. Progress feels like quicksand because things don’t always go so well. Goals aren’t reached, depression looms, loved ones are struggling. And that can really leave a person feeling like shit - frustrated, guilty, lost, and panicked. 

Confessions of An Optimizer in Recovery

I’m not just trashing the optimizing elites of the world or harshing on people who want to improve, achieve and succeed. I’m describing myself - and millions and millions of others, too. We know the Good Life is out there. We can picture it, smell it, and taste it, but the faster we run towards it, the further away it gets. We throw our hearts into this dream of having more but we suffer instead of thrive. We get less.

That’s because optimization offers only false promises. When we buy into it, when it prevails in our life, the more miserable we become. Optimization has reached peak toxicity in the 21st century thanks to a cocktail of modern zeitgeists: the glorification of digital technology and hacker culture, the medicalization of mental illness, and the ultra-commoditization of self help. Progress is the ultimate and only virtue in this worldview. As a result, either we’re on the road to perfection or we’re losing. And the thought of losing is so terrifying that we either GIVE UP completely, or we’re inexorably driven to compulsive doing, compulsive yes, compulsive more and more. It’s a misery-producing hamster wheel of ALWAYS BETTER AND MORE.

Yet, what we really need more of is saying ‘no’ to always better; doing less; knowing when enough is enough.

Optimization blinds us to the value of saying ‘no’ to more and better. It frames ‘no’ as weak, failing, blocked and shut down. But saying no to progress for progress’ sake is one of the hardest and most fruitful things we can do. This kind of ‘no’ requires us to devalue activity in favor of awareness. It requires us to sometimes reject to-do lists in favor of don’t-do lists. It requires us to scale down the compulsions of our era and the belief that we can consume - ideas, foods, drugs, information, emotional experiences, possessions - our way to happiness. It requires us to figure out what’s actually important to us, what matters, so that we can move beyond desperation to ‘live your best life’ to a commitment to make the best use of the life we’re living. There are innumerable rewards to reap once we get there. Doing less will get us so much more.

What if saying no wasn’t a failure? What if it was an opportunity? What would you say no to?

I’m writing from the perspective of someone who is part-and-parcel of the problem. I’m a psychologist and a compulsive ‘tip-giver.’ I’ve created those checklists, put you on a self-help hamster wheel, and then turned around and created 10 more for you to run yourself ragged on. I’ve approached human suffering like an engineering problem. Even when I’m trying not to, I’m doling out tips, sharing scientific insights, and instructing you on appropriate mental health hygiene and practices, like “brush twice a day and floss,” but for your mind. All the while, I’m thinking in the form of diagnoses and psychological mechanisms. I’m shrinking big human problems into tidy packets of meaning, just like I was taught. 

I’ve asked you, ‘Are you efficient? Are you productive? Is your life frictionless? Is your inner life full of sunshine and rainbows? If not, you CAN make your life better. You can reach peak human. Here’s the way.’

After reading all this you might think I don’t love efficiency and productivity and progress. The truth is, I do. I really do. I’m an optimizer in recovery. I love being efficient. I adore faster, better, and more. And I think we should all try for it if that’s what makes life worth living to us, personally.

But I’ve also seen this approach’s abject failure when it comes to actually helping us flourish. I know and grieve the fact that worshiping at the shrine of efficiency, data, and medicalization has profoundly failed when it comes to human thriving. It has led us astray. Our era of hyper-optimization has distorted this healthy human instinct towards betterment beyond the pale so that it’s metastasized into something invisibly poisonous. It’s like a garden of nourishing vegetables, growing in a pile of shit, and we keep on forgetting to wipe off the shit when we harvest and eat those delicious vegetables. It’s making us sick. And it’s dehumanizing us - shifting the standard of good and true to make ourselves over as machines instead of living, breathing creatures.

That’s why I’ve decided, where the optimization mindset dehumanizes us, we can fight for rehumanization.

I think it’s a good fight because since I have awoken to the dangers of optimization, I have become more hopeful. That malaise, the feeling that something isn’t right, that I’m banging my head against a wall - that’s subsided for me.

Here’s what I’m going for: You’ll pick up a self-help book or read the 50th iteration of the same advice on your Instagram feed - ‘be less anxious and depressed,’ ‘sleep better,’ ‘eat better,’ ‘raise your kids better,’ ‘reduce your belly fat better,’ on and on, ad infinitum - and you’ll think, “Ah, there it is again. I should just keep walking. I don’t have to be better in every way, all the time. Enough is enough.” 

In my next posts I’ll lay out some ideas for how we reclaim human - while creating excellent lives for ourselves. This will require new models, new ideas of what The Good Life looks like. The models show us that by doing less, by opting out of always better, faster, and more, we will reap the rewards. We will get more in return.