According to the book Manufacturing Victims
, the therapy industry operates under the same market economy as any other business: if the customer doesn't come back, it means you have failed. Thus, the ideal therapy is one that makes the patient dependent on the therapist rather than ready to move on with their life.
As a trope, this comes to play in the form of therapists who encourage patients to get stuck in their problems, or even get worse, rather than to move on and improve their lives. The goal is to keep the patient coming for regular $75 to $150 per hour sessions.
In some cases, this malpractice includes a variant of Defiled Forever and/or false memories.
Please note that those who make a living Manufacturing Victims are not necessarily malicious: they keep telling themselves that their method is popular because it works, when the grim reality is that it's popular because it gets people hooked on it. Regardless, a large majority of training for therapeutic work attempts to instill the idea that this trope is bad, as making the person dependent on therapy just replaces the old problem with a new one. Unfortunately, there's generally no good way for an outsider to tell the difference between the actual use of this trope and the existence of a hopeless case that keeps coming back despite lack of improvement. Also note that many psychiatric conditions like schizophrenia, bipolar disorder and clinical depression are chronic conditions that would legitimately require years of drug therapy, counseling, and passive monitoring. That doesn't even get into the many and varied controversies over addiction treatment and therapy, including whether 12 Steps, non-12-step abstinence programs, or managed substitution/use are the gold standard or are enabling addiction itself. Mental health issues and dealing with them are highly individualized and personal matters.
Finally, there is the elephant in the room that for some disorders/conditions (especially in regard to PTSD, complicated grief, autism, and some forms of anxiety disorder and some personality disorders) that existing drug therapy, counseling, and passive monitoring and other therapeutic intervention are of limited use at best and useless at worst, and that accommodations (from sensory accommodations for autistic individuals to learning and avoiding triggers for PTSD or grief or anxiety) and time are the things that help the most in recovery.
For some individuals and at some times, intensive therapy and drug treatment might help immensely, but for others, the time spent in therapy and the side effects of maintenance medication aren't worth their limited or nonexistent benefits, and at least in three cases it can actually worsen disorders.note In these cases, Manufacturing Victims happens when therapists or mental health/rehab businesses promise unrealistic success rates and persuade the parents of autistic children or anxious people willing to please their therapists to continue maintenance medication when as needed or none would do, to continue therapies or counseling that really aren't needed (and that can be itself a trigger in the case of trauma like PTSD or grief, or even traumatize the patient such as with autism), or to consider inpatient rehab/therapy at a facility they are being paid for referrals to when outpatient is adequate.
This trope is about getting people hooked on therapy, including similar activities such as self-help support-groups. Compare and contrast Withholding the Cure (where the villain suppresses medication that cures a problem so they can sell medication that merely treats its symptoms, or because they want people to die from it), Poison and Cure Gambit (where the villain creates the problem in the first place), Chemically-Induced Insanity (where a character is given drugs to make them seem insane), and Gaslighting (where there is a deliberate attempt to weaken another's mental health by contradicting their perception of reality). See also Psycho Psychologist (a psychologist who is outright evil, although not all exploit their patients in the manner of this trope) and Tropaholics Anonymous (for support groups, which are sometimes accused of this trope).
Examples:
- Marvel Universe: Before she got her powers, Moonstone (usually of the Thunderbolts) was an extremely unethical psychiatrist. One of her female patients was afraid that her husband was cheating on her. When the patient started making progress with her issues, Moonstone telephoned the patient, disguised her voice to sound like a bimbo, and asked to speak to the patient's husband.
- Played for Laughs in this Dilbert strip.
- Averted in Dykes to Watch Out For: As Mo turns into a therapy junkie as a way of avoiding dealing with her life, her therapist actually throws her out.
- In The Brood, Mike, one of Dr. Raglan's patients, becomes addicted to his treatment when Raglan plays a surrogate of his father who gives Mike all the love that his real father didn't give him. He constantly looks for someone to "be my daddy" when Raglan throws every patient of the institute out when he's dealing with Nola's ultimate breakdown. He even says that no one can play his daddy like Dr. Raglan, giving it a very creepy and disturbing pseudo-incestuous vibe.
- Zig-zagged in Fight Club. The main character and his love interest join group therapy for conditions that they don't have, such as cancer, in order to feel a sense of connection and community. The question of whether the therapy helps people who actually need it is not addressed.
- The books by Kevin Trudeau paint the entire pharmaceutical industry this way. Do bear in mind that Trudeau is currently doing time in federal prison for criminal contempt stemming from failure to pay fines regarding his own dubious medical claims.
- In A Scanner Darkly, New-Path is manufacturing Substance D in order to get people hooked on it, which then gives them a convenient source of patients and slave labor.
- The Subtle Art of Not Giving a Fuck touches on this, calling out a number of self-help tactics as fleeting easy highs that make you briefly feel good rather than actual long-term fixes for your problems, and even equating some of them to drugs and alcohol, and goes on to highlight how many of them focus on what you lack and emphasize it.
But when you stop and really think about it, conventional life advice — all the positive and happy self-help stuff we hear all the time — is actually fixating on what you lack. It lasers in on what you perceive your personal shortcomings and failures to already be, and then emphasizes them for you. You learn about the best ways to make money because you feel you don't have enough money already. You stand in front of the mirror and repeat affirmations saying that you're beautiful because you feel as though you're not beautiful already. You follow dating and relationship advice because you feel that you're unlovable already. You try goofy visualization exercises about being more successful because you feel as though you aren't successful enough already. Ironically, this fixation on the positive — on what's better, what's superior — only serves to remind us over and over again of what we are not, of what we lack, of what we should have been but failed to be. After all, no truly happy person feels the need to stand in front of a mirror and recite that she's happy. She just is.
- Law & Order: Special Victims Unit has played this card a few times.
- There are a few episodes that deal with "repressed memory" therapists and the problems they cause, since "repressed memories" are usually false.
- The cast does it too, though. There are numerous incidents in which a "victim" doesn't think that they were victimized, and they're portrayed as being in denial — which is possible, although in some cases, it seems more like they legitimately weren't traumatized by whatever "should" have traumatized them (which does happen, or they have delayed reactions — people react to trauma differently, with some more resilient).
- Penn & Teller: Bullshit! have an episode on 12-steppers, in which they argue that the method is nothing more than brainwashing and religious indoctrination. It doesn't help at all against alcoholism, and at worst it gets people more hooked on the alcohol itself as well as getting hooked on the AA movement. Plus, atheists such as the duo or other nonreligious people resent having to recognize a "higher power" as part of their therapy (more recently secular alternatives have emerged, though in many places AA remains a monopoly).
- Criminal Minds:
- She isn't an official therapist, but the unsub in "Today I Do" wants to be. She likes the idea of helping women through their problems, but when they become capable of managing without her, she lashes out. It starts with trying to show how desperately they need her. When that doesn't work, she resorts to kidnapping and eventually murder.
- One episode features a therapy program in which the participants write out their violent desires. The man who founded the program cut ties with it when he realized that this was happening; most people running groups stopped at step one, allowing their patients to dwell on their issues and cement their violent fantasies, rather than proceeding with the program as he started it, getting to the root of their issues and developing individualized treatment from there. Nothing is said as to whether the program as originally designed was particularly helpful, and it comes up in the episode because a serial killer founds one of the groups specifically to get inspiration for his crimes, so it isn't exactly well-meaning therapy that backfired, either.
- Dr. Fontaine in L.A. Noire turns artists and shell-shocked Marine veterans into addicts and serial killers.
- BioShock:
- Dr. Steinman uses ADAM, a highly addictive genetic modifier, to perform his Magic Plastic Surgery. Combined with his Mad Artist tendencies (he's a plastic surgeon who worships Picasso), his patients tend to need more plastic surgery to undo the first round... and he's the only one in Rapture.
- In fact, the Splicers you fight in general fall under this trope; "splicer syndrome" is a result of overusing ADAM, which is especially easy to do if one installs the various Super Serum formulas. The initial splicers were people who went mad from their ADAM use, terrorizing the populace as a whole by becoming deformed and deranged bandits. So, more people began splicing up to gain the powers to protect themselves from the initial splicers... only to turn into more splicers. And on it went, with the Plasmid companies still insisting on selling Plasmids & Tonics as "the only protection against splicers!" until the whole city was either dead or spliced up into insanity.
- Sophia Lamb, the Big Bad of BioShock 2, is a classic Psycho Psychologist depiction of this trope, taking in the already unstable and miserable splicers and preying on their weaknesses to brainwash them into her collectivist cult.
- Grand Theft Auto V: Since Isiah Friedlander's clients are wealthy career criminals with a buttload of issues and willing to spend millions to get a shrink who won't rat on their past crimes, he intentionally keeps his clients at a medium-stress state to prevent them from solving their own issues so that they'll keep coming back. Unfortunately for him, he accidentally blabs about his new public TV show to a former bank robber/mass-murderer. It's up to you to decide if you want to murder him for the blab.
- South Park: In "Bloody Mary", Randy drinks too much and is forced into the AA movement. He quickly gets hooked on it, thus making his life miserable and making his alcohol problem worse since the program repeatedly emphasizes that he is sick and powerless to control his drinking and thus is able to avoid taking responsibility for it. It's implied that the other members of the support-group have equally dysfunctional relationships to the whole thing.
- Drawn Together (Season 3, episode 13) has Foxy going into therapy. The psychiatrist (another housemate, red flag number one) implants a false memory of childhood sexual abuse, and this false memory takes over, ruining her life, making her end up in jail, and making her murder a lot of innocent people — in that order.
- Family Guy: In the episode "Friends of Peter G.", both Peter and Brian are sentenced to 30 days of AA as a result of extreme public intoxication. When they complain to Lois about how pointless the meetings are she says that AA has helped a lot of people over the years. Brian retorts that all that has happened is that their members have simply traded their addiction to alcohol for being addicted to the idea of being AA members.
