The title of this new book by Matthew Loftus signals that things are about to get interesting: “Resisting Therapy Culture: The Dangers of Pop Psychology and How the Church Can Respond” (InterVarsity, 2026). Loftus is a family physician who works at a mission hospital in Kenya. He is also a member of a PCA church, and he writes widely on topics of significance for people of faith.
In this book, he tackles the problem of “therapy culture” and its destructive impact on society in general and the church in particular. Although I was eager to read this book, I found myself getting annoyed as I worked through Loftus’ excellent arguments (I’ll come back to that momentarily).
Book Summary
Loftus describes therapy culture as “the extension of therapeutic language and ideas far beyond the therapist’s couch that purveys a distorted vision of how we ought to live our lives and is downright toxic to our flourishing as human beings” (3). Therapy culture views life through the mental health lens. Hence, normal emotional and spiritual experiences are medicalized, and everyday activities are judged by their impact on mental health, which ends up diminishing personal agency. Loftus writes that after he noticed this fad infiltrating churches, he felt compelled to write the book.
The first chapter catalogs how mental health buzzwords have taken over Western society. They are “bandied about and applied to interpersonal relationships, regardless of how appropriate they are for a particular situation” (11). People naively accept these mantras because of their aura of medical authority.
While it’s easy to see through the platitudes of self-help gurus, the most dangerous forms of therapy culture are more insidious. As Loftus writes, “A church’s Statement of Faith may not have changed over the past twenty years, but their language and practices on a week-to-week basis have. Talk of identity, emotional health, and self-care start on the margins and then slowly move to the center.” It’s death by a thousand cuts, and just like that, the therapeutic framework has replaced “the distinctive doctrines and moral requirements of the Christian life” (12).
If psychological health is life’s highest goal, the gospel will soon be set aside, if not abandoned completely. Preaching and counseling will “leave out any portion of the Bible that can’t be shoehorned into a therapeutic mindset” (21). In fact, secular commentators have been issuing similar warnings against therapy culture. According to a social media influencer cited in the book, “Discomfort is mistaken for danger. If a conversation makes you uneasy, it must be toxic. If a person challenges you, they must be unsafe. If a situation feels hard, it must be harming you. Boundaries are also being used as walls” (15).
Loftus also discusses problems associated with medicalization and iatrogenesis (Chapter 2). Here he gleans insights from earlier books like Ivan Illich’s “Limits to Medicine, Medical Nemesis: the Expropriation of Health” (1976), and Peter Conrad’s “The Medicalization of Society: On the Transformation of Human Conditions into Treatable Disorders” (2007). “Medicalization” refers to normal aspects of life being interpreted as medical problems, while “iatrogenesis” describes how medical treatments can cause harmful side effects. Thus, poorly-done psychotherapy fosters codependent relationships that encourage “patients ‘to stay mired in dysfunction,’ especially when the focus of that therapy is more about affirming someone’s feelings than challenging them to change their lives” (33–34).
Also, profit-driven drug companies market psychotropic drugs to keep people thinking they need them to be healthy. Loftus cites Illich’s assessment that cultural iatrogenesis destroys “the potential of people to deal with their human weakness, vulnerability, and uniqueness in a personal and autonomous way” (35). Loftus’ examples from the opioid crisis and youth transgender medicine are as compelling as they are troubling.
In Chapter 3, Loftus addresses the interaction between mental illness and moral agency. He acknowledges the reality of “disordered agency,” how the capacity to make moral choices is curtailed by mental illness: “Finding the balance of gentle encouragement, stern accountability, firm boundary-setting, and patient forgiveness that constitute love to people with disordered agency is an enormous challenge for people who love them” (53).
It’s not just mental illness, notes Loftus; all of us experience disordered agency, though to a lesser extent: lack of sleep, for instance, can make one more prone to sin. The same goes for upbringing and genetic makeup.
The problem, however, is that therapy culture radicalizes these insights, encouraging people “to give up on their agency altogether” (54). If my problem has a “diagnosis,” then small group, Bible study, or regular exercise “won’t or can’t make a difference” to my mood or emotions (55). In the logic of therapy culture, our problems can only respond to therapeutic measures; the means of grace and the work of the Spirit are left high and dry.
The next two chapters review the highs and lows of psychiatric diagnosis and treatment (Chapter 4) and the tangled relationship between Christianity and modern psychology (Chapter 5). In the rest of the book, the reader grapples with many areas of life corrupted by therapy culture: suffering and mental illness (Chapter 6), stress and self-care (Chapter 7), attachment and parenting (Chapter 8), trauma (Chapter 9), and addiction (Chapter 10). Each chapter is brimming with hard-earned wisdom and clear-eyed theological analysis. Loftus knows what he’s talking about, and his writing is compulsively readable, crackling with energy and passion.
Tightrope Walker
So far, I may have given you the impression that Loftus is Jay Adams 2.0, a nouthetic counselor in a tuxedo. Hardly. Loftus repeatedly affirms the reality of mental illness and the value of mainstream psychological and psychiatric research. He wants to affirm the common grace insights of therapy culture (our frailty, disordered agency, the ravages of mental illness, etc.) while exposing the dangers of therapy as idolatry.
On the one hand, Loftus issues a strong critique of therapy culture as it wraps every facet of our lives in its deadly embrace. On the other hand, he also pushes back on simplistic anti-psychiatry and anti-psychology perspectives. Authors typically take one of the two sides, but Loftus holds them together, walking a tightrope with Solomonic poise. Here and there, readers will quibble about whether he gets the balance right, but Loftus always has his eye on this tension. In one instance, he writes, “We must reject this simplistic, meme-driven approach to mental illness . . . We must also reject simplistic, antitherapy solutions: our choices matter, but few cases of mental illness are cured just with different choices” (102). Such lines permeate almost every chapter.
Take the chapter on mental illness and suffering. By God’s grace, evidence-based treatments like ACT (Acceptance and Commitment Therapy) can reduce the symptoms of chronic pain. Therapists can help relieve human suffering, and we know that suffering will be no more in the new heavens and new earth. And yet, “we worship a Savior who suffered and died for us . . . we also must allow suffering into our lives to make us more like Jesus, who we are told in Hebrews 5:8, ‘learned obedience from what he suffered.’” Again: “We are often called to even choose suffering in order to help others in a variety of ways” (98). The chapter oozes wisdom while teasing out how believers should live out this tension.
In another example of Loftus threading the needle, Chapter 10 reminds us that sin and disease are both in play with addictions. Mental health professionals usually reject thinking of addiction in terms of “sin” to avoid heaping shame on people who have suffered enough already. “This is a noble desire,” writes Loftus, “but fundamentally incompatible with a biblical understanding of life. It is also very much at odds with the reality of most addicts’ lives, which are full of misery because their desires are so disordered, and they must develop some kind of moral strength to get better” (p. 172). Yet Loftus also explains why narrowly moralistic views about addiction are inadequate. This chapter is one of the best treatments of addiction I have ever read.
This book is firmly rooted in Scripture. A case in point is how Loftus handles demonology in his analysis. In my experience, Reformed believers in the West often minimize demonology and ignore large swaths of the biblical narrative, while others, Charismatics especially, hype up the powers of darkness in reckless and sensationalist fashion. In his handling of mental illness, Loftus shows us a better way that affirms the reality of the devil and his entourage without giving them too much credit. Christians can learn from his balanced approach.
However, let me register a caution. I can imagine that church leaders who are guilty of spiritual abuse or failing to handle such situations appropriately in their congregations might see this book as a gift. Since Loftus spends so much time critiquing therapy culture, self-serving leaders might find it convenient to point the finger at “therapy culture” to distract from the abusive culture they have encouraged. Shame on anyone who tries to pull that kind of stunt here. Such abusers and enablers will find no help (or protection) from this excellent book.
Two Questions
In the conclusion, Loftus offers five maxims for “the good enough church” (181–91). That’s indeed the burden of the book, namely, to remind the church “what it means for the Church to be the Church amid a therapeutic culture” (164). Here’s the maxim I want to flag: “[The Church] doesn’t exist to fix people’s problems.” He goes on to elaborate, “It is especially not an institution that is designed to fix anyone’s mental health” (184). In context, I take his point and would agree. However, there’s a deeper question about what we mean by “mental health.”
Earlier in the book, Loftus writes: “We can say that someone is mentally ill when their mind, emotions, or perceptions are so disordered that we can no longer work or fellowship with others the way that God created us to” (49). By this definition, surely sin is a kind of mental illness. The Christian psychologist Eric Johnson calls sin our deepest psychopathology (See his “God and Soul Care: The Therapeutic Resources of the Christian Faith,” pp. 213–41; Ed Welch, the late David Powlison, and other trusted voices connected with CCEF have said similar things.) If Johnson is correct, then the church by the Spirit does exist to “fix” this deep psychopathology. Some of this may be merely semantics, but I would love to hear Loftus on this question.
My second question is nitpicky and concerns this claim from chapter 4: “Modern science requires certain assumptions about the material world to work because the scientific method can only speak about things that are observable, testable, and repeatable” (64, my emphasis). I’m skeptical. This statement reflects a Baconian view of science (or a view often unfairly attributed to Bacon) that is widely held at a popular level. But this view of science rules out paleontology, geology, biogeography, evolutionary biology, and cosmology — to name a few — which are all clearly sciences (regardless of what we think of specific conclusions within those sciences). Loftus’ definition also rules out much of modern physics which investigates things that are not observable (e.g., atoms, electrons, quarks, gluons, etc.).
Closing Thoughts
This book is difficult to review because so much of it is worth talking about. Almost every page is quotable! And most of us will feel rebuked at some point — I certainly was. For example, Loftus cautions against using psychiatric language metaphorically as that can feed the confusion of therapy culture. Consider this instance in his chapter on trauma:
As with many other mental illnesses, trivializing PTSD is bad for people who are genuinely suffering and bad for people who inappropriately use a clinical term to describe everyday adversity. If someone says, ‘that test gave me PTSD’ to describe an experience that was merely challenging and anxiety-inducing, it conflates quotidian stress with the horrifying experience of a soldier who cannot stop himself from physically assaulting his wife while having nightmares or a woman whose sympathetic nervous system reactivates as if she is being raped every time she smells a familiar cologne (156).
“Resisting Therapy Culture” would be perfect for reading groups, book clubs, and small groups. It will provoke vital discussion among all kinds of believers and, Lord willing, help us to follow Christ more faithfully.
I myself have pondered many of the issues that Loftus addresses in this book. Some of those questions stem from when I practiced medicine decades ago. For years, I’ve wanted to write exactly this kind of book. That’s why I was annoyed! But after finishing the book, I’m glad Loftus beat me to it; he’s written a book that’s far more compelling than anything I could have done. I pray that pastors and laypeople will be talking about it for many years to come.
Hans Madueme serves as professor of theological studies at Covenant College.