Book Review: Resisting Therapy Culture: The Dangers of Pop Psychology and How the Church can Respond by Matthew Loftus

Matthew Loftus is a physician who practices medicine and believes that mental health treatment can be helpful. His main concern is what he calls “therapy culture”: the infiltration of therapeutic concepts into ordinary life, moral reasoning, parenting, the church, and Christian discipleship. The book was published by InterVarsity Press in August 2026 and is 224 pages.

THE CENTRAL THESIS

Loftus's main argument is: Therapy can be good; therapy culture can be harmful.

He identifies three major aspects of therapy culture:

1. Medicalization: turning ordinary human experiences such as sadness, conflict, disappointment, stress, or suffering into psychological disorders.

2. Therapizing institutions: judging churches, schools, families, relationships, and other institutions by how they make people feel emotionally and psychologically.

3. Loss of agency: seeing ourselves as passive victims of diagnoses, trauma, brain chemistry, attachment histories, family systems, or other forces beyond our control.

The deeper concern is that mental wellness can replace holiness, discipleship, worship, obedience, suffering faithfully, and life before God as the ultimate goal. He emphasizes the distinction between emotional wellness and holiness. A person can become psychologically healthier without becoming more holy. A faithful Christian may experience psychological distress precisely because faithfulness involves suffering, sacrifice, repentance, confrontation, and endurance.

From this thesis, Loftus charts a course where the church and therapy can each stay in their own lane, each doing what they are called to do.

CHAPTER BY CHAPTER SUMMARY

Introduction: What Is Therapy Culture?

Loftus establishes the basic problem. Psychological concepts have entered ordinary conversation: “I'm traumatized.” “He's a narcissist.” “She's gaslighting me.” “That's toxic.” “I need to protect my mental health.” “ “I don't feel safe.” “I need to go no contact.”

The problem isn't necessarily that these words are always wrong. The problem is that clinical psychological concepts have become everyday moral categories. Normal sadness becomes depression. Discomfort becomes harm. Conflict becomes toxicity. Disagreement becomes unsafe. As a result of this, personal responsibility is replaced by explanations about one's psychological condition. 

Christianity can become reduced to “How can Jesus make me psychologically healthier?” Instead, Christianity asks much bigger questions: Who is God? Who am I? What is sin? What is salvation? What does God command? How should I love my neighbor? How should I suffer faithfully? What does it mean to worship God?

Chapter 1: What's Gone Wrong? Church and Therapy Culture

Churches feel pressure to provide: emotional safety, psychological wellness, therapeutic preaching, trauma-informed ministry, self-esteem, emotional validation, conflict avoidance, and individualized pastoral care.

The danger is that the church starts evaluating its success according to psychological outcomes rather than faithfulness to Christ. A sermon becomes successful because people “feel better.”

A small group becomes successful because nobody experiences discomfort. A pastor becomes successful because people feel emotionally validated. 

But biblical ministry sometimes produces discomfort. Jesus confronts. Conviction is not necessarily psychological harm. Loftus argues for what he calls the “good enough church”: a church that doesn't attempt to become a therapeutic institution but faithfully worships God, proclaims the gospel, administers the sacraments, loves people, bears burdens, and participates in ordinary Christian community.

Chapter 2: Medicalization and Iatrogenesis

This chapter examines what happens when ordinary human experiences become medicalized.

Iatrogenesis refers to harm caused by medical intervention itself. Loftus argues that medicine can unintentionally create problems when it expands its categories too broadly. The question is: When does identifying a problem help someone, and when does identifying a problem actually make the person worse?

For example: “I am experiencing grief.” can become: “I have a pathological emotional problem.”

Or: “My marriage is difficult.” becomes: “I am in a toxic relationship.”

The danger is that diagnostic language can become an identity rather than a description of a problem. It is helpful to make distinctions between: illness and suffering; symptoms and identity; diagnosis and personhood; treatment and cure; vulnerability and helplessness.

Chapter 3: Mental Health and Moral Choices

Loftus asks: Where does mental illness intersect with moral responsibility? Modern psychology can sometimes encourage us to interpret behavior almost entirely through causal explanations, a hard determinism: “My childhood made me do this.” “My trauma made me do this.” “My ADHD made me do this.” “My attachment style made me do this.” “My depression made me do this.”

There are biological and psychological effects on human behavior. But explanation doesn't eliminate responsibility. This is where Loftus attempts to establish a both/and: People are influenced by things outside their control, while still possessing meaningful agency.

A Christian understanding of human beings cannot reduce us either to: “Everything is your fault.” or: “Nothing is your responsibility.” Instead, Scripture gives us the picture of human limitation, suffering, sin, temptation, biology, environment, responsibility, grace, and redemption.

Chapter 4: Diagnoses and Treatments

Loftus draws a distinction between psychiatry/psychotherapy and therapy culture. A diagnosis can be useful. It can help someone: understand symptoms, obtain treatment, access medication, communicate with professionals, receive accommodations, understand patterns of functioning, and reduce shame.

But diagnosis becomes problematic when: “I have depression” becomes “I am a depressed person.” Or: “I experienced trauma” becomes “trauma explains who I am.” The metaphor of “hammers for pointy objects” captures the danger of applying a useful clinical tool to every human problem. Not every painful experience requires a diagnosis. Not every diagnosis requires medication. Not every problem requires psychotherapy.

But, importantly, the reverse is also true: Some people really do have serious mental illness and desperately need treatment. This is the balance we should hold in tension.

Chapter 5: Christianity and Psychology

This chapter gives the historical context for the relationship between Christianity and psychology. A helpful question in this discussion is: Can psychology describe how humans function without becoming the authority that defines what humans are for?

Chapter 6: Suffering and Mental Illness

Loftus exposes two opposite errors. Error #1: “Your suffering is simply sin.” and Error #2: “Your suffering is simply pathology.” Christianity has a much more helpful category: suffering. Suffering may involve: disease, genetics, trauma, injustice, sinful choices, other people's sinful choices, ordinary hardship, providence, spiritual struggle, grief, aging, and relational loss. And sometimes we don't know exactly why someone suffers.

The Christian question isn't simply: “How can I eliminate this unpleasant feeling?” It can also be: “How might I faithfully live before God in the midst of this?” This does not mean Christians shouldn't seek treatment. Rather: treatment and meaning aren't opposites. You can treat depression while also learning endurance. You can treat anxiety while growing in faith. You can take medication while praying. You can receive therapy while participating in Christian community.

Chapter 7: Stress and Self-Care

Mental health self-care can easily become: “I need to eliminate everything uncomfortable from my life.” But Christian discipleship includes: sacrifice, service, endurance, patience, responsibility, caring for others, and bearing burdens. This doesn't mean Christians should neglect themselves. Biblical rest is real. Sleep matters. Physical health matters. Boundaries can be good.

But self-care becomes problematic when: comfort becomes the highest good. Christians should ask: “How can I be faithful?” Sometimes faithfulness requires rest. Sometimes faithfulness requires sacrifice. Wisdom is knowing the difference.

Chapter 8: Attachment and Parenting

Attachment theory posits that relationships affect development. But here, Loftus critiques the ways that attachment concepts have been popularized. Attachment theory can become: “Your childhood determined who you are.” or: “Your attachment style explains all your adult relationships.” or even: “Your parents damaged you, therefore you are who you are.” A more useful approach recognizes that early relationships matter without making them destiny.

Children inherit things from parents biologically, psychologically, socially, and culturally. But children also develop agency, resilience, relationships, communities, beliefs, habits, and identities beyond early attachment experiences. We need a corrective to deterministic interpretations of attachment.

Chapter 9: Trauma

Loftus distinguishes clinical trauma from the increasingly broad cultural use of “trauma.” Not every painful experience is PTSD. Not every difficult childhood is “complex trauma.” Not every interpersonal conflict is traumatic. Not every uncomfortable experience requires a trauma-informed response. At the same time: real trauma exists. People experience: sexual abuse, physical violence, war, serious accidents, disasters, assault, and life-threatening events And trauma can profoundly affect the brain, body, emotions, relationships, and behavior.

Loftus proposes the idea that: “Trauma should mean something clinically meaningful.” This distinction protects both populations: People who genuinely need trauma treatment and people who are unnecessarily taught to understand ordinary suffering through a trauma framework.

Chapter 10: Addiction

This chapter examines addiction through the tension between: desire and disease. Addiction has biological components. But addiction also involves: desire, habits, choices, reinforcement, environment, relationships, meaning, and behavior

A purely moralistic approach can be inadequate: “Just stop sinning.” But a purely medicalized approach can also become inadequate: “You have a disease, therefore you have no agency.”

Christian theology provides another category: enslavement. Paul's language about being enslaved to sin provides a richer framework than either simplistic moralism or simplistic medicalization.

The addict needs: compassion, accountability, treatment, community, behavioral change, spiritual formation, sometimes medication, sometimes structured recovery. Again, Loftus seeks the middle ground.

Conclusion: The “Good Enough Church”

The church does not need to become a therapy clinic. Nor should it become anti-therapy. The “good enough church” is one that knows what it is. The church worships God, preaches Christ, proclaims the gospel, administers the sacraments, teaches Scripture, cultivates Christian community, bears burdens, loves suffering people, prays, practices hospitality, encourages repentance and faith, and refers serious mental illness to competent professionals when appropriate. The church doesn't have to fix every psychological problem. It has to be faithful.

REVIEW

What I think Loftus gets right:

1. He correctly identifies the difference between therapy and therapy culture. The same thing happens with other good things. Food is good. Gluttony isn't. Sex is good. Pornography isn't. Money is useful. Greed isn't. Therapy can be good. Therapy culture can become detached from logic and be destructive.

   Don’t pathologize ordinary humanity. We should distinguish: sadness vs. depression; stress vs. disorder; conflict vs. abuse; disappointment vs. trauma; personality differences vs. pathology; sinful behavior vs. mental illness; suffering vs. disease. These categories can overlap, but they aren't identical.
   

2. He establishes the importance of responsibility. We have more capacity to act than we think. A psychological diagnosis should ideally become: “This helps me understand my difficulties.” not: “This tells me who I am.”
   

3. We can overstate the false dichotomy between therapy and discipleship. While it is helpful to clarify the difference between the church and therapy, we need to consider the overlaps as well. The church is not therapy, but Christian discipleship has emotional and psychological dimensions. We need to learn to hold that tension. 

   The church should neither become a therapy clinic nor become hostile towards mental health care. A healthy church should have an environment of counseling one another.

4. A clear warning not to therapize the Gospel. Watch for: Gospel reduced to: “Jesus wants you to feel better.” Sin reduced to: “Your negative thoughts.”  Sanctification reduced to: “Becoming emotionally healthy.” Community reduced to: “Finding your support system.” This is happening and it is dangerous.

5. For counselors and those engaging with therapy. Therapy shouldn't create lifelong patients. The goal isn't: “Keep coming forever so we can continually process your wounds.” Counseling should lead to: agency, resilience, responsibility, relationships, and meaningful action. Effective counseling should encourage people to face challenges, grow through suffering, tend relationships, and act towards what is good and true.

DISCUSSION QUESTIONS

1. What are clear lines of distinction between therapeutic care and Christian discipleship?

2. What are examples where psychological wellness and sanctification overlap?

3. How can the church address therapy culture? (eg,: a diagnosis can become an identity, suffering seen as pathology, discomfort seen as unsafe)

4. How has the church become therapeutic?

5. How can the church help people worship and grow in Christ in the context of the Gospel?