The medical word for when the cure itself becomes the injury

A month before Abigail Shrier was due to get married, her therapist dropped what felt like a bomb. "I'm not sure you two are ready to get married," the therapist said. "We may need to do a little more work." Shrier had been seeing this woman for a year, after moving across the country for a boyfriend and needing, as she put it, a stand-in for the best friend she'd left behind. The therapy had been good company. It had also, without her quite noticing, become a habit of agreement: whatever she brought in, the two of them found fault in the people around her rather than in her.

But faced with a professional's verdict on her own engagement, Shrier realized something simple: she didn't agree, and she didn't need permission. She left a grateful voicemail and took a break. She was, as she puts it, an adult in therapy, with enough self-knowledge and enough life behind her to push back on an expert's opinion of her own relationship.

Children and teenagers rarely have that footing. And this is where a word borrowed from medicine becomes essential: iatrogenesis, from the Greek for "originating with the healer." It describes harm caused not by malice or incompetence but by the ordinary risk built into any treatment. A patient having a kidney removed can end up with the wrong kidney gone, or a stray infection, or a bad reaction to anesthesia, even when every step was performed correctly. Mental health treatment carries the same exposure. Decades of study found that the standard "psychological debriefing" given after disasters, plane crashes, and combat left police officers more prone to disaster-related symptoms eighteen months later, not less. Burn victims came out of therapy more anxious than those who received none. Breast cancer patients in peer support groups reported feeling worse than those who skipped the group. Grief counseling for ordinary bereavement often made mourning harder, not easier.

None of this means treatment is worthless. For a genuinely sick patient, the risk of an intervention is usually worth taking. Shrier's point is narrower and sharper: for a well person, the calculation flips. The risk of an unnecessary intervention often outweighs whatever small improvement it might deliver. The question worth asking before any therapy, diagnosis, or medication begins isn't just "could this help?" It's "does this person actually need it?"

Before you agree to any mental health intervention for your child, ask yourself plainly whether there's a real deficiency here, or whether this is simply what childhood looks like. Resist judging a therapy by how relieved you feel walking out the door; look instead at whether the actual problem, the grades, the sleep, the friendship, has genuinely improved. Treat unnecessary treatment the way you'd treat an unnecessary X-ray, and skip it unless there's a documented need. And when you do sit across from a therapist or doctor, ask directly whether their methods can cause harm. The ones willing to answer honestly, and to tell you when treatment should end, are the ones worth trusting with your child's mind.