#therapy

The Paradox of “No-Kill” Animal Welfare Policies

It felt like a good summer for animals. In mid-August Julián Castro became the first (and so far only) Democratic presidential candidate to release an animal welfare policy statement. In September, Michigan became the second U.S. state to announce it had reached “no kill.” (Delaware was the first.) After years of the Trumpian death machine, it was like a rush of fresh air into a suffocating, fetid room.

And yet in the real-world context of dog and cat rescue, one couldn’t help but feel a bit … underwhelmed. “No kill” was “an amazing first for our state,” said the chair and founder of the Michigan Pet Fund Alliance. It was “a different path,” offered Castro. “My hometown of San Antonio achieved no-kill status in less than a decade.”

If only it were that simple. America as a whole has been working toward a “no kill” goal for decades, reassured every few years that we’re about to arrive. We haven’t. There are reasons why—and they’re why, as a current call to action, those words are almost meaningless.

To be clear: Criticizing “no kill” isn’t calling for an end to adoption and rescue or a return to the truly terrible old days when rampant killing of shelter animals was just a fact of life. As recently as the 1970s, loose animals—both strays and pets—roamed America’s streets, and otherwise decent people thought nothing of dropping the resulting litters at local shelters to be “put to sleep.” Somewhere between 13 and 23 million cats and dogs died yearly back then, and that no one knows the exact figure is another sign of how little anyone cared: No national reporting structure even existed. Today, shelter euthanasia rates are down dramatically—as much as 90 percent —thanks to the spread of sterilization followed by increased advocacy for adoption and rescue. There are around 14,000 rescue groups of different sizes and focus in this country, and a 2017 paper published in the journal Animals confirmed what these hard-working people already knew: that for dogs, rising adoption rates had helped to bring the killing down.

Credit “no kill” advocacy for some, maybe many of these changes? Sure. Whoever first coined the term, it was brilliant—immediately graspable, a slogan, philosophy, exhortation, declaration of moral outrage, and promise, all in one. Millions of animal lovers have gathered under its umbrella. But the simplicity that makes the phrase so compelling has also made it difficult in practice.

On the most basic level, there’s no consensus on what it means. Most extreme believers say that no animals should be euthanized unless they’re terminal or irredeemably suffering, and that with enough effort, homes can be found for all the others. (Those few deemed unadoptable can be sent to “sanctuaries.”) More common are those who believe in “mostly don’t kill,” that while some animals are sick and screwed up enough to justify putting them down, an array of efforts can save the rest: increased spay/neuter campaigns, adoption promotion, fostering, rescue group alliances, transporting animals from places of oversupply, shelter management changes. Within this vision, a shelter (or city or state) reaches “no kill” when at least 90 percent of the animals it takes in come out alive.

Concrete numbers may be reassuring, but they can be slippery. In a 2018 Psychology Today piece, Hal Herzog, Professor Emeritus of Psychology at Western Carolina University and long-time researcher on animal-human relations, offered his own analysis of the Animals study data. Herzog reported that (as most rescuers already knew) euthanasia averages mask huge geographic variation. Within the U.S., for example, far more animals are put down in the south than in the north; in California, euthanasia is higher inland than it is on the coast; in the Los Angeles metro area, it’s higher in shelters run by the county than the city, and higher in some city neighborhoods than others. Even as Michigan celebrated its new status, the Pet Fund Alliance chair acknowledged that “we still have a few communities struggling.”

The reasons behind these differences add a further layer of complication. Animal policy is set locally, so even within a single county separate small cities may have different laws—for how much it costs to license an intact versus sterilized animal, whether or not to impose mandatory spay and neuter laws and how rigorously to enforce them, how shelters are funded and what programs they adopt. (For example, only 32 states require dogs adopted from a public shelter to be sterilized.) Communities vary culturally in how animals are viewed and treated, how aware pet owners are of available resources, how accepting of practices like sterilization. Herzog, for instance, notes that “states with higher rates of gun ownership had more dog deaths,” maybe because “people in the South don’t like restrictions on the sex lives of their pets any more than they like zoning or gun laws.”

Then there’s the huge issue of human economics—or more specifically, the fact that truly helping needy pets requires helping their equally needy owners. The Animals study data showed something else rescuers and shelter workers already knew:  States with lower average incomes kill more domestic animals than wealthier ones, and so do shelters in low-income neighborhoods. Shelters in low-income neighborhoods also have higher rates of owner surrender. Behind those figures: poverty.

In low-income areas, spay/neuter services or routine veterinary care may be unaffordable or inaccessible—in some rural areas and inner-city neighborhoods, there literally are no veterinarians. The animals of the economically challenged are far more likely than those of the affluent to be impounded by animal services (for instance when they escape a badly-fenced yard), then trapped in the system when reclamation fees and fines are beyond the family budget. (These escalating fees mirror other “poverty penalties,” such as license suspension for drivers who can’t afford to pay traffic tickets.)

Staying housed while caring for a pet can be an ongoing struggle. Women without means trying to escape domestic violence find few shelters that will take animals. (Even as research shows that abusers frequently threaten to hurt or actively harm their partners’ beloved pets as a means of control.) For homeless pet owners, sociologist Leslie Irvine observed in My Dog Always Eats First, the choice often comes down to keeping a beloved pet or being housed—traditionally, homeless shelters have not accepted animals. Similar choices face low-income families. One of the key findings in a 2015 study published in Open Journal of Animal Sciences was that pet owners with incomes below $50,000 were significantly more likely than those with money to re-home animals due to cost, particularly of medical care, and housing issues like lack of access to pet-friendly housing ability to pay housing pet deposits. In fact, other surveys show that among the top reason Americans surrender their pets are moving, cost, and a landlord who doesn’t allow pets.

The very real connection between pet ownership and rental housing issues—landlords’ use of previously unenforced “no pets” clauses to push evictions; the shortage of apartments that allow pets makes Julián Castro’s call for pet-friendly policies in federally affordable new housing construction a good start to a necessary conversation. It’s too bad he offered a plan that didn’t address existing housing. Around 4.8 million households receive federal rental assistance, and both private landlords offering Section 8 housing, and public housing authorities can and do restrict pets, whether banning them all, or just specific breeds — most typically pits, Rottweilers, and chows. Human economics also governs what animal welfare efforts can realistically be. Cutting euthanasia by finding pets new homes requires human capital—a roster of volunteers, local rescues and available foster homes — and budgetary support that may be beyond a city’s reach. Just two hours south of Castro’s No Kill San Antonio, for instance, is the city of Edinburg, in the impoverished Rio Grande Valley. Its Palm Valley Animal Shelter, was once described by Best Friends CEO Julie Castle as among those “that are so dramatically under-resourced and over-burdened that they might as well be operating in the 1970s.” A partnership between that mega-organization and the shelter has reportedly raised its save rate from 36 to (a still not great) 51 percent, and even that success had setbacks: During an effort to hold, then transport 800 puppies and small dogs out of the area, many developed distemper—which is endemic in the Valley—and had to be euthanized. Some got sick after they were in their new homes.

To tangibly help these struggling communities, Castro called for the establishment of a $40 million Local Animal Communities grant program within the USDA to “expand access” for vaccinations and spay/neuter in underserved communities, as well as support adoption programs and efforts to reduce thousands of existing feral cat colonies through the strategy of Trap, Neuter, Release (TNR). Activists I spoke to heard that figure and laughed. The year Austin, Texas, a much-celebrated “no kill” city reached its goal, the shelter budget went up more than $1 million and the next year, it requested a million more in “emergency” funds.  TNR remains both logistically difficult—a big percentage of skittish felines must be caught to bring any colony’s birth rates below replacement level—and controversial. A 2013 analysis from the Smithsonian conservation biological Institute and the Fish and Wildlife service estimated that domestic cats kill around 2.4 billion birds in the Continental U.S. each year. In late August, the New York Times reported that a toxoplasmosis infection responsible for killing up to 8 percent of California sea otters had been traced to outdoor domestic cats. It also costs big bucks. According to a 2010 study prepared for Best Friends Animal Society, even supposing the use of volunteer labor and veterinarians offering a discount rate, eradicating the national feral cat population through TNR would cost $8.7 billion.

Even all the money in the world “isn’t enough,” says Lori Weise of Downtown Dog Rescue, who has been working for over 20 years in L.A.’s most challenged neighborhoods. “Money doesn’t help without a plan.”

Another unfortunate reality of the 90 percent “no kill” goal is that even when reached, it may be less real than it appears. Shelters under public and political pressure to have “good” euthanasia numbers also have the incentive to play good numbers games, whether that means adopting out sick or potentially dangerous animals to avoid having to put them down or conversely calling them “untreatable” so they can be euthanized without marring the live release rate. In June, for example, Gothamist reported that Animal Care and Control in New York City (which was supposed to have reached “no kill” five years ago) was excluding from its euthanasia rate statistics owner-surrendered dogs and cats with “problems” like mouthing on their leashes, jumping, and cowering in fear. “Transport”—sending shelter animals from one state to a (presumably better) other, also can be subverted. One “coalition partner” in L.A.’s current “no kill” effort proudly describes its contribution as moving small breed dogs from local shelters to … New York City.

Another strategy: policies that deliberately limit shelter intake. In “no kill” San Antonio, says a source long involved in that city’s rescue world, a “diversion” program allows anyone who finds a stray to keep it at home, while classifying the animal as a shelter impound. “Then, if it’s given away—to whoever— or even escapes, it can be counted as a successful live release.” San Antonio also requires residents to make appointments before surrendering animals, and its website warns that if the shelter is full “you may be asked to seek alternate arrangements.” In practice, says the source, “people turned away just abandon the animals when they leave.”

Or the statistics race leads to not looking too carefully at adopters. The growth of disreputable rescues and outright rescue scams is a constant source of anguish in the rescue world; social media warnings like “There is a Reckless Rescue that has been taking dogs from L.A. Shelters. Please BEWARE!!” appear daily. Worse are organizations that take in more animals than they can properly care for, and individuals who use the guise of rescue to mask hoarding. Yearly, thousands of dogs and cats are removed from “rescue hoarders”—Someday Acres (Tennessee), Tiggy Town Senior Dog Rescue (Arizona), Road to Home (New York), Elk Grove Animal Rescue (California) … A much-celebrated “live release” from a shelter may land a dog or cat in a fate worse than death. At the Elk Grove rescue, animal service workers found 58 dogs and sick, dehydrated puppies living in a barn “with a strong odor of urine and feces” who hadn’t been been given food or water for 24 hours, as well as “a large Pit Bull dog inside a plastic crate that was not large enough for the for the dog to turn around in, its head was crouched inside, and it was unable to extend its tail.” Road to Home was closed after whistleblowers released a video of over 100 dogs living in a dilapidated warehouse, locked 24/7 in cages filled with urine and feces.

Finally, even when adoption efforts successfully move adorable puppies and apartment-friendly small “fluffies” to new homes, legions of the less desirable—seniors, overbred pit bulls, middle-aged chihuahuas—are left behind. This past June, TV station KVUE in “no kill” Austin reported that the city’s three shelters were at “critical capacity” with nearly 800 dogs and cats, some of which had been held over 3 years. Animals were being housed in pop-up kennels placed in meeting rooms and offices because, said the Austin Animal Center’s communications manager, “we have nowhere for them to go.”

The contradictions of “no kill” are no secret within the rescue world, debated (sometimes quietly, sometimes very loudly) by rescue groups and rescuers, shelter managers, vets. In 2018, an editorial in the Colorado Veterinary Medical Association journal denounced the movement as “destructive” and called for a new model, “socially conscious sheltering” with similar animal welfare goals, but without a numerical end point. Any shelter could save 98 percent of the pets that came in, the authors noted, but only if it was to “manage to a single statistic, and not to the best interest of animals.”  In August, 2019, those principles were adopted by the Los Angeles County Department of Animal Care & Control.

Maybe “socially conscious” will be a popular new model, maybe not. Maybe other Democratic candidates will declare their own support for animal welfare — if they don’t, we should call them on it. But perhaps it’s time for all of us to dump slogans and platitudes in favor of addressing a complicated, nuanced issue with similarly nuanced action. That means spending as much or more effort on keeping animals from going into shelters as getting them out. Offering humane education “is a cost-effective approach that’s barely being tried,” says Aaron Fisher, founder and CEO of Atlanta Rescue Dog Café, which teaches responsible pet ownership to children as young as pre-K, many in underserved communities. “Hardly a sliver of grant money supports it. Then we wonder why kids grow up and don’t know how to care for their animals.”

It means subsidizing sterilization services and making them easily accessible and providing affordable vet access in poor and rural areas. (Encouraging vets to embrace this effort, suggests Lori Weise, means finding a way to do it that doesn’t require them to sacrifice their own income.) It means legal services that help tenants deal with pet-related housing issues, and more programs that help pet owners with problems hold onto their pets. Shelter-based “intervention” programs, like those run by Downtown Dog Rescue and Home Dog L.A. “don’t have the sexiness that adoptions do, but we can’t adopt our way out of crowded shelters as long as animals keep coming in,” says Kerry Armstrong Lowe, HDLA’s founder and executive director. By offering vet vouchers, food, dog houses, fence repair and help with reclamation fees, since 2013 the two organizations have kept more than 15,000 dogs out of two city shelters.

“No kill” was a powerful starting point for a movement toward change, but the words have become short-hand and a catchphrase that doesn’t lead us forward in the real world. The future demands more than a number.

Los Angeles Times

Opinion: A dog, a neighborhood and a different way of seeing

Los Angeles Times

 

My chow-shepherd Casey and I have walked the same streets for almost 15 years. Every morning, every night, seven days a week, rain or shine. Like most city dogs, Casey enforces this clause of the human-canine contract with meaningful looks, insistent pawing and (when all else fails) a snout-thrust to the laptop that allows no dissent.

I’d like to describe our hundreds of hours spent wandering the neighborhood as meditative, but they have often driven me nuts. Casey chooses the same route, greets whatever dogs are out, sniffs the same bushes from five angles before deigning to pee.

Still, the ritual has shifted some. Many familiar canine faces have vanished, and Casey’s painful shuffle tells me that our time together is short.

And lately, I’ve also come to realize what our walks have given me.

When I tell people about the pocket Westside neighborhood where I live, I always say I’ve never known or felt so deeply connected to a place. I realize now that’s not because my neighborhood is special. It’s because of Casey.

He is why I know every house around me — which lawns are always overgrown and which manicured, which yards have peach trees, and which cacti: walking at a dog’s pace forced me to see them. Casey is why I know every nearby family that ever had a dog, because he pulled me into the canine social orbit — of Blue and Sarah, on the next block; of big Valentine and golden Ollie and a dozen others.

The dogs in turn brought me into the lives of dozens of human neighbors. There was Frank, whose parents’ lives were ruined by the Cultural Revolution; Dan, the dogless dog-lover who drinks beer with friends outside his apartment, a giant jar of treats at his side. Some have become real friends, like Michelle, who came via Ava, a Great Dane mix and his sweet giant pack-mate Baxter. These people watch for me, ask after me, worry if I don’t show.

Fifteen years beside Casey have given me my own slice of Los Angeles. Work and politics and my daughter’s endless soccer games introduced me to a hundred neighborhoods sprawled across the basin. But I know them only from a distance, a camera’s panorama shot of mountains, the sweep of landscape framed by a car window. Walks with Casey are close-ups. I notice the increasingly neglected look of a home newly split by divorce and waiting for sale, the car whose weekly fender-bender damage suggests its driver’s dementia is worsening. In close up, the passage of time becomes concrete — the front lawn swing gives way to a soccer net; the porch steps are replaced by a wheelchair ramp.

The close-ups hold the quiet history of the streets themselves – the scrawled initials “CS 1973” in a driveway, the tiny plaque set in the sidewalk: “WPA 1940.” In our atomized, scattered world, there may be nothing else that roots one in a way so intensely, intimately local as walking the same streets, day after day, at a dog’s pace.

In L.A., 15 years is a long time. My tech-adjacent neighborhood is shifting, its 1940s bungalows giving way to large, white “modernist” boxes, its Subarus being replaced by Teslas. I feel the new world most acutely in the passing of the generation of dogs that first anchored me here. Val, Sarah and Blue are all gone. When Ollie died, his owner walked through the neighborhood crying, hiding Ollie’s rubber balls in bushes for other dogs to find. The day Ava died of cancer, I joined his owner to grieve beside his still body.

And yet, some things hold. Casey and I greet the few remaining old-timers including Albee, a white jindo, now deaf and stiff-legged with arthritis, who has always been Casey’s fiercest enemy. When we ran into him a few weeks ago, the two dogs paused to glare, their hackles raised, then both moved on. They’d still like to kill each other, but it just would be too much work.

As the new houses are finished, we meet the dogs and people who move in. There’s a young woman with a small, sweet-faced pit, a man whose bouncy long-legged mutt has the majestic name of Titan. We navigate the familiar streets, the phone pings relentlessly and headlines pull me toward the human world and its horrors, but Casey will not be rushed. Pee on this tree? No, maybe that one.

Meanwhile, I notice the cloud of purple bougainvillea that looks especially striking against a new home’s gray wall, and the spectacularly gnarled trunk of a 79-year-old pepper tree. Time must be taken, attention must be paid. It’s the gift dogs give us, and what they leave with us when they go.

Los Angeles Times

When you find a stray dog, the best thing you can do for it is take it to a shelter

Los Angeles Times

On April 2, Doobi, a homeless man’s little brown dog, took off from the tent they shared in a West Hollywood alley. As soon as her owner realized that she was gone, he grabbed his phone to post a blizzard of “Lost Dog” notices online.

Someone found the dog nearby, and up went a photo on the local Nextdoor. A neighbor responded with the information that a homeless man was looking for the animal, and that the finder should take it to the local shelter. That’s long been basic protocol for anyone who finds a stray, and the Los Angeles Municipal Code requires that anyone who picks up a stray notify the Department of Animal Services.

But then another Nextdoor poster chimed in. A homeless man? She’d take the dog herself. Within a day, it was put on a transport bound for a rescue in New York and theoretically “a better life.” Furious local activists tracked the animal to the East Coast and raised a stink, and a week of drama followed — emotional cross-country texts and Facebook rants; the dog’s owner filed a stolen-property police report.

Another over-the-top pet world story? Yes and no. Those in the rescue movement will tell you they regularly get calls from people looking to give them found animals rather than taking them to a shelter. It’s a growing trend — and a really bad idea.

Why decide to “rescue” a dog or cat that’s not yours? Sometimes because we’re too ready to see animals as the victims of bad humans. That skinny, dirty dog roaming the street surely was “dumped” there; its fear suggests that “it was abused.” No collar, tags or microchip? Living in a tent? Not even sterilized? Obviously, it had a terrible owner! Why help send it back?

There’s also an assumption that any shelter admission equals sure death. When someone on my own Nextdoor site recently posted that she’d found a dog without identifying tags, a neighbor immediately replied, “Please, don’t take this or any dog to a shelter … it will absolutely be put down.”

But even the dogs of “good” owners — who can include the homeless — sometimes get spooked and run or escape through doors mistakenly left open. The website Petfinder, one of the nation’s major adoption clearinghouses, says that 1 in 3 pets gets lost at some point in its life. Collars come off. The majority of all pet owners (sadly) don’t implant and register microchips. And after a few days on the street, even the most well-loved pet will act skittish and look like hell.

In California, the shelter doesn’t mean instant death and hasn’t for a long time. The Hayden Act, passed in 1999 requires public shelters to hold stray animals for at least four business days. In Los Angeles, which has committed to achieving “no kill” status, animals are often kept far longer than the required number of days. Some dogs have lived at the Chesterfield Square shelter in South L.A., one of the city’s busiest, for nearly a year (which is another issue and story). And leaving a found animal at the shelter doesn’t have to mean walking away from it. Any finder can put a “first right to adopt” hold on a stray animal; if an owner doesn’t materialize, the finder can claim it. Any finder can reach out to a rescue organization and make their case for taking the dog from the shelter.

 

In fact, many reputable rescue groups don’t take animals that aren’t in the shelter system. “Even if there isn’t a microchip, it’s possible someone’s looking for it,” the head of one rescue, with decades in the business, told me. “You have to give owners a chance.” There may be a lot of 21st century ways to hunt online, but when a pet goes missing, the first place most owners look is the local shelter.

Doobi’s saga had a happy ending. The New York rescue group, whose president said she hadn’t known the full story, shipped her home. But the episode was costly in cash, time and grief (especially for the dog, which traveled 6,000 miles). Contrast her story with that of Nala, a 20-pound, honey-colored pooch, who went missing in West L.A. last September.

Nala’s owner, Maggie Davis, told me that she personally posted 800 “lost dog” signs, put notices on every website she could find, and for months responded to every reported sighting and lead. None went anywhere. Then in February, someone from Los Angeles Animal Services called to say that her contact information had turned up on a stray dog’s microchip. Nala was in the Valley, 25 miles away. Davis never learned how the dog got so far, but it was clear how and why she made it home: Someone found her and turned her in to the shelter.

 

Los Angeles Times

THERAPY: Seeking Cures, but Finding Anguish

Los Angeles Times

 

THERAPY: Seeking Cures, but Finding Anguish
By Carol Mithers

Last week, Connell Watkins, an unlicensed Evergreen, Colo., “therapist,” and her assistant Julie Ponder were convicted of reckless child abuse in the death of 10-year-old Candace Newmaker, who died of asphyxiation during a “rebirthing” session. Now that the two women face up to 48 years in prison, now that the nation has expressed its outrage at the radical therapy that led to the tragedy and Colorado Gov. Bill Owens has signed “Candace’s Law” banning rebirthing in his state, the temptation is to sit back, breathing a sigh of relief that justice has been done and a horror like this won’t happen again.

But it will.

As an example of therapy run amok, this incident involving a little girl wrapped tightly in a blanket, choking on her own vomit and vainly pleading for her life, was particularly grotesque, the stuff of nightmares. But it was far from unique.

For at least 30 years, stories of patients pursuing experimental treatments with similarly tragic outcomes to that of Candace and her mother, Jeane Newmaker, have surfaced at regular intervals. They all have at their center deeply troubled souls hungry not for help but cures, and programs that promised to provide them. In the 1970s, it was Synanon and the Center for Feeling Therapy, a Los Angeles program run by mostly unlicensed therapists who beat, abused, controlled and financially exploited 350 long-term patients, leaving their lives a shambles. A similar group, the Sullivanians, flourished in New York City.

The 1980s brought therapies for now widely discredited diagnoses of “recovered memory” and “multiple personality” disorders, which some therapists proclaimed the true cause of problems that ranged from depression to sexual dysfunction to obesity. In one typical case, a Des Moines woman who sought help for depression had her life ruined by a Chicago psychiatrist who encouraged her to believe she had 300 personalities, had participated in a satanic cult that plotted to kill her children, and that her father had ground human remains into hamburger for meatloaf. (Several hospitalizations and two suicide attempts later, she accepted a $10.6-million malpractice settlement.)

The ’90s brought treatment for “reactive attachment disorder,” a syndrome in which a deprived or abused child–like Candace–has difficulty forming intimate bonds. (The disorder remains controversial, because there’s no consensus on the uncertainty of the diagnosis.) The kind of rebirthing process Candace went through was just one of the experimental therapies devised to cure it; another was “rage reduction therapy,” a rough restraint of children intended to help them understand their emotional estrangement. It, too, led to excesses: A Utah 3-year-old died after her father attempted to apply the techniques, and a Tarrant County, Texas, practitioner was ordered to pay $8.4 million to a 15-year-old girl his treatment left covered with bruises. As early as 1998, Colorado medical examiners had accused psychiatrist Foster Cline, who pioneered the therapy, of grossly negligent practices.

Why do otherwise intelligent and well-meaning people embrace treatments that, in retrospect, seem so clearly mad? Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, points to desperation, tremendous guilt on the part of parents “when there’s something wrong with their child that they can’t fix.” But there’s another factor at work, too: widespread, unreasonable assumptions about what therapy should be and can do.

Nearly 50 years ago, humanist psychologists like Erik Erikson, Rollo May, Abraham Maslow and Carl Rogers challenged traditional Freudian claims that to be human was to be filled with inner conflict. Nor did they accept that the best analysis could do was help a patient understand and cope. Instead, they said, the natural state of humans is one of wholeness and joy, and treatment should aim to help everyone realize his or her full “potential.”

By the 1960s, when economic prosperity made room for more self- indulgent pursuits like examining one’s inner self, therapy, once drawn-out, exclusive and expensive, reached the masses in the form of encounter groups. The groups were frequently harsh and combative, and pushed the idea that change came fast.

By 1970, Arthur Janov, founder of “primal therapy” (made wildly popular by Beatle John Lennon), went one step further, flatly declaring that all neurosis came from infant trauma and that his therapy, which specialized in overnight transformation, could cure it.

Most ’60s and ’70s therapy programs didn’t last. But they left deep and permanent changes in the way we view our lives (we are entitled to be fulfilled and happy), our problems (they have specific, simple, diagnosable roots) and, above all, the practice and role of therapy. We now turn to therapists, whether as self- help authors, commentators or actual practitioners, for advice that in earlier times would have come from clergy, parents and community. We expect therapy to be dramatically transformative, with frequent, climactic “breakthroughs” (an expectation encouraged by the culture of advertising, which tells us that anything from makeup to a new car can turn us into a new person). We accept that it may be harsh– an acceptance, notes Caplan, that taps into fundamentalist American beliefs that suffering is redemptive. Above all, we expect it to provide a “cure.”

Although ethical, well-trained therapists refuse to go along with these beliefs, those who are less moral or more driven by their own convictions are happy to indulge. And the media, particularly talk shows, with their insatiable appetite for guests to fill airtime, help by parading every new guru who comes along, often without bothering to check out his or her credentials or the theory’s validity.

But while the pain that drives people to seek treatment is often deep and legitimate, the sad reality of life is that many problems have a complicated stew of causes and no definitive cures. A marriage can go pale and sour because of the family histories of each spouse, their gender beliefs, their feelings about themselves, their pleasure or disappointment in their individual lives. An intensive therapeutic weekend aimed at “teaching intimacy” can’t necessarily bring it back to life. Making peace with one’s inner child won’t guarantee weight loss in a sedentary, fast-food society. The despair of a man or woman stuck with a low-wage job and bad child-care options can’t be counseled away. And poor Candace, whose childhood was marked by poverty, constant moves and multigenerational family dysfunction, whose birth mother twice lost custody to social workers and who Candace said once dropped her out a second-story window, may not ever have become the well-adjusted, affectionate girl that Jeane Newmaker so craved.

Sometimes, good therapy can help us understand, face and tame our demons. Sometimes, it can greatly improve our lives. But neither it nor anything else can prevent life from being hard and unfair. It can’t guarantee happiness. It can’t guarantee cure. These are the hard lessons of adulthood, and there’s no sign that we as a culture have learned them. The next therapeutic tragedy is out there, waiting.