Founder of the Open Therapy Institute Andrew Hartz and Rafael Mangual explore the growing influence of political bias in psychotherapy and what it means for both therapists and clients. Hartz makes the case for an approach to mental health care that respects personal beliefs while still promoting growth and well-being.

Audio Transcript

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Rafael Mangual: Hello and welcome to another episode of the City Journal Podcast. I am your host, Raphael Mangual, and I am so excited to be joined by Andrew Hartz, who is the founder of the Open Therapy Institute, a clinical psychologist. And the Open Therapy Institute is actually really cool because it publishes, as I understand it, the very first peer reviewed journal on Substack. And I believe it's called the Open Inquiry in Mental Health Journal. Is that right?

Andrew Hartz: Right? No, it's just Open Inquiry in Mental Health.

Rafael Mangual: Open Inquiry in Mental Health.

Andrew Hartz: Yes.

Rafael Mangual: Well, that's amazing. You're also the co-host of the Open Therapy Podcast with our colleague, Rob Henderson and Meghan Daum.

Andrew Hartz: That's right.

Rafael Mangual: Awesome. Well, thank you so much. Welcome to the show.

Andrew Hartz: Thanks for having me.

Rafael Mangual: I want to start with just asking you about the Open Therapy Institute, what it is and why you felt the need to found an organization like that.

Andrew Hartz: Yeah. So the mental health fields like academia and a lot of other professions skews pretty hard to the left. About 90 percent of therapists lean left. And the research and training is even more so I think it's like 17 psychology professors are liberal for every conservative. So it really shapes research and training a lot and practice. Over the period from 2014, 2015, going up to 2020, I think that political bias really reached a fever pitch as it did in a lot of professions. And I was just seeing really bad practices, patients being pathologized for their views. I even wrote in Wall Street Journal about some incidents of patients being turned away from therapy because their views on issues and they were labeled racist.

Rafael Mangual: Meaning like told hat they can't be treated or?

Andrew Hartz: It was a patient who said that they felt they didn't get a fellowship because of affirmative action that was labeled a racist and they were referred out in response to that. And honestly, if a therapist, if you really can't treat a patient because of their views, you should refer out. But it's a pretty big deal if a view that a majority of the country has is something that a whole clinic can't treat, that's a pretty big impairment. So I mean, I saw therapists talk about hating patients because they were white males. There were articles published that whiteness is an incurable parasitic condition. Whiteness is pathological narcissism. Obviously the toxic masculinity statement by the APA, just a kind of level of hostility and I think countertherapeutic values that were actually becoming normative at institutions like universities and professional organizations.

Rafael Mangual: It's strange because for as long as I can remember, one of the major themes in American psychological discourse was that we need to get rid of the stigma to encourage more people to come into therapy. There's whole populations that we're told are sort of too tied to either toxic masculinity or some other kind of block that stops them from getting help that they need, and that we should be doing more and more to open the doors of therapists to more people so that they can get help. And yet, from what you're telling me, it sounds like there's this whole subculture embedded in this profession that essentially closes itself off to a massive portion of the population by signaling its hostility toward them.

Andrew Hartz: I'd say it's more than a subculture. It might be a subset, but it's a subset that controls the most prestigious universities, most training programs, and the professional bodies. So it's a very influential subset and they kind of set the norms of discourse and the culture. But yeah, I'd say like if you look at articles about diversity, equity and inclusion or oppression or colonialism, there's a ton. And then if you look at for articles and psychology journals on topics like anti-conservative bias or anti-male bias, there's zero. Literally, we did database searches in top psychology journals, clinical psychology journals for like those precise words and it's zero articles. So it's more than a gap. It's a total blind spot and people aren't getting trained on these issues. Even something like, you wouldn't think this would be a problem, like faith issues. It's a very religious country. I think 3 percent of Americans are atheists, something like that. And yet most people like me and my clinical ... I got a PhD in clinical psychology. I didn't have a lecture on faith issues. A lot of therapists don't ask about it. If it comes up, they avoid it because they don't know how to talk about it.

Rafael Mangual: Despite it being sort of central to someone's identity?

Andrew Hartz: There's kind of this sense of, well, there's faith-based counselors, but most religious patients see a secular therapist, maybe they're looking for somebody with a particular specialty or that's not what they're seeking, and they're likely to see a therapist who doesn't have training on those issues. In fact, there was a poll of psychologists where I think it was a majority felt that are upset that they didn't get more training on faith-based issues and spirituality. And so there's all different types of biases that have come in. I'd say the first step is they're not being researched and they're not being published in journals, but then they're not making their way into training. And then those biases just end up shaping how therapies practice.

Rafael Mangual: Yeah. No, and look, I see it in conservative circles where there is this very deep-seated belief that therapy as an institution is just hostile to anyone sort of to the right of Mao.

Rafael Mangual: There was a meme actually I just saw the other day, it was a therapist talking to a patient and it's text and the therapist asks, “Well, do you have firearms in your home?” And he says, “Ma'am, I have firearms in your office.” The joke is that it clearly didn't even occur to this person that there are people for whom this is a part of daily life. And it's actually something that I've spoken to other conservatives about where that's a major concern. It's like, well, if I go see a therapist and they're hostile to gun ownership, they may actually try and twist my words to get the government to ...

Andrew Hartz: Yeah. Or they don't understand guns and they're anxious about it and they get worried. So then they call a number and then you're on a list. There's a lot of anxiety that those situations are going to be mishandled. And of course that keeps gun owners from utilizing psychotherapy, precisely some of the people that arguably would most need it, people who are at risk of suicide and people at risk of violence who you really want them to be in therapy and to trust and feel understood by the profession. And that's another thing where I think we did the first continuing ed accredited training for psychotherapy with firearms owners and it's just like not out there.

Rafael Mangual: What’s that like? Tell me about that.

Andrew Hartz: There's different things you can do. I mean, one of the recommendations, just like a really beautiful recommendation is like obviously you want a locked gun safe where you're storing your firearms, and like keep images on it that ground you when you go our kids, religious symbols, have a check and a pause before you go in there to remember what you value if you're at risk. And there might be periods where you want a friend or somebody else to hold your firearms for a period of time and then you can get them back. But you should be working collaboratively with your therapist to manage risk when it comes up and not just have somebody who doesn't know anything about guns and is just panicked and pathologizing it and mishandling it, which I think happens.

Rafael Mangual: So talk to me a little bit about the goals of the Open Therapy Institute. Is it to mainly train psychologists who are working with patients on how to be more sensitive to these issues, how to be more open to patients who are on the right, who might be religious or gun owners, or is it also, is there a sort of broader, more political aspect to the project?

Andrew Hartz: No, I think the goal is just to get the best psychotherapy to people regardless of their viewpoint. A lot of people that reach out to us are conservative, but some are more central or they're centrist or they have mixed political views. We want to, I think the patients who would want a therapist who's skilled on these issues is the vast majority of patients who are religious, male, conservative, something, gun owners, something. It's the vast majority of patients. So we're hoping that if patients start utilizing our service, they start contacting us for therapists, we can start to attract therapists to join, become members, and grow the list of therapists who are skilled in this area and kind of use the demand for these services to increase the supply and get more pressure on therapists to be trained well in these areas.

Rafael Mangual: So it sounds like this broader perception that there is a left-wing bias in sort of psychological therapy as an institution is pretty accurate.

Andrew Hartz: I think they're not ... Yeah, and I think that they're not aware. Therapists are often not ... I'm sure if you did a survey of therapists, a hundred percent would say they have no bias on anything ever, but they're not aware of how ... Yeah, so have you noticed in your waiting room, all your magazines are left leaning or you have like a rainbow flag or a BLM flag. And what if somebody's like anxious that their kid wants to transition, they think that's not the right decision for them. They're reading this as this isn't a safe place for them to talk about their concerns. They're not going to be heard here. I know a friend of mine went to go see a therapist about a particular issue. They see a BLM flag in the window and they just left without having the first appointment. They often don't find somebody else. They give up. They give up on the profession. I do think conservatives might sometimes underestimate how valuable good therapy that's attuned to their values could be, especially during like 2014 to 2023 or something, so many people were self-censoring, so many people were canceled, isolated. If they had a resource where they could go talk to somebody confidentially to say, “How do I make connections? When and where might I want to speak up? How can I get support for some of the hostility I'm facing in the workplace or at school?” That would have been really invaluable to have. We didn't have it and people could find a therapist randomly and hope it worked, but to actually have those resources I think could be really useful and to have good data on these issues could support conservatives in a lot of ways and lead to better outcomes.

Rafael Mangual: So if that perception is accurate, I will always like to ask clinical psychologists in particular, are there common misperceptions that you wish people would sort of get out of their heads that maybe block them from accessing therapy that could be potentially helpful for them?

Andrew Hartz: Yes. There isn't one thing called therapy. There are lots of different modalities of psychotherapy.

Rafael Mangual: Yes.

Andrew Hartz: Some of them are like the more Freudian, open-ended. You talk about your childhood. Lay down on the couch or whatever. That's useful to some people.

Rafael Mangual: Sure.

Andrew Hartz: Another type is like more skills-based. You get some skills to deal with a specific issue in a more structured way. It's maybe focused on specific behaviors and everything in between. So there's dozens and dozens of different treatment modalities. And if one doesn't work, don't say therapy didn't work. It's like there's another thing. And a lot of it has to do with the individual skill of the therapist. You told me an example of like Shane Gillis.

Rafael Mangual: Yes. Yeah. So Shane Gillis, who's ... I enjoy standup comedy and he's one of my favorite comics at the moment. I think he was on Rogan or something like that and he was talking about his experience in therapy and he says, “I tried therapy.” And again, he's kind of using that overarching term as if what he experienced is what therapy always is, but he was like, “Yeah, the guy just basically spent three months trying to get me to hate my dad and so I stopped.”

Andrew Hartz: And it's such a clear articulation of a values issue that could come into therapy that therapists might not be aware of like how often do therapists undermine marriages and undermine family relationships to high cost to patients without even realizing it. And that is something that every therapist needs to be attuned to of like, look, there's going to be better outcomes if the marriage stays probably. I mean, maybe if it's abusive or there's all types of exceptions, but in general. And so you have to kind of keep that in mind. And I think like therapists can kind of maybe get a little bit of payoff when people vent about family members and then they bond to the therapist a little bit, but like that can sometimes come at a cost. So just to be mindful of the way that there's implicit values in how the therapy is being structured.

Andrew Hartz: And I think therapists are, that's an area that's under researched and underutilized in training.

Rafael Mangual: Yeah. You mentioned one area where I think there's been possibly tremendous harm done to the institution of psychotherapy, which is the trans issue. Yes. It has become a political hot button for good reason, right? I mean, the stakes are incredibly high and I think a lot of people have lost trust in the institution by virtue of the fact that they have seen so many credentialed professionals make this claim that seems more and more in tension with the best available evidence, which is this idea that you absolutely have to trans your kid the moment they start showing some kind of sign that they're not comfortable in their own body, lest you encourage or speed up the process of their suicide, which seems incredibly coercive.

Andrew Hartz: Unbelievable.

Rafael Mangual: And I remember reading not long ago, I can't remember exactly where it was published, I won't guess, but it was basically like an open letter that a mother had written to her daughter who had transitioned.

Rafael Mangual: And because she was in therapy, that therapist kind of encouraged her to cut her mom out of her life. And you could just ... I was in tears as I read this letter. I didn't know this woman. I didn't know, couldn't even picture her face. I did have no idea what she looked like, but just you could feel the pain of her essentially having lost a beloved daughter to this, I guess, sickness or condition, whatever you call it. And there was just an incredible amount of resentment toward the therapist that, and at least in this mother's word, sort of counseled her daughter out of her own family.

Andrew Hartz: Yeah. And I think I remember, I mean, it was interesting. So I had a really relevant personal story, which was one of the first patients I saw in my training had a kind of unusual identity where they identified as male and asexual during the day and female and hypersexual at night. And I thought there were elements of sex addiction. That was kind of the treatment that when they were female and at night would have multiple partners. And I remember for your first case, for your first couple cases as a therapist, that's a pretty challenging case. And I was like, “I need to talk to somebody who knows something about this.” And we didn't have anyone. And that was probably like 2014. And it was a couple years later, there's this consensus that was announced that I was finding out on the news, there's a consensus in the field. I’m in the field. I didn't have anything ... All of a sudden it was ... So it was kind of announced within the profession. And I would kind of talk to other psychologists, psychiatrists who were afraid to ask for, “Wait, what's the evidence for this? Where are the studies that are saying this?” And that was kind of like a big part of why Open Therapy Institute is needed is there's no professional body where people concerned about this issue could gather. Their big fear, ironically, of the therapist was, “If I say anything about this, it's going to kill my practice.” Meanwhile, you have an enormous pool of patients who want to see those exact therapists. So there was this disconnect where the patients want the therapist, the therapists want to do the work, but they can't sync up. And that's really, I think, the benefit of having an institution like Open Therapy Institute where everybody can be better off and speak up and be more honest and get better care if there's a central point where they can find each other.

Rafael Mangual: Yeah. Yeah. I mean, and look, I wonder how irrational it was for some of the therapists to be worried about the solvency of their practices if they raise questions. I mean, one of the cases that comes to mind here is Jordan Peterson, who's very famous clinical psychologist, former professor, who talked very openly about his license being jeopardized by the fact that he had made statements that just didn't align with the politics of the licensing body in Canada where he practiced. And I think a lot of people see and hear stories like that, and it's very motivating.

Andrew Hartz: Yeah. I mean, definitely people that are employed at certain hospitals, universities, and clinics, I think their job was threatened. I am actively looking for people who have stories of somebody going after their license for a politically motivated reason in the United States. Therapists are very worried about that happening, but we don't really have great cases. Now, it could be that the way it actually manifests most of the time is if a patient or group of patients have a problem with a therapist's politics, they find a tangential other issue or something that's not related at all and they file the complaints about that or the lawsuits about that. And the politics is clearly the motivation, but it's indirect. But in explicit targeting of a therapist license or lawsuit against a therapist for their politics, we're really interested in finding people who've had that experience because then we can respond to it.

Rafael Mangual: I want to talk a little bit about sort of where the Open Therapy Institute comes into play in terms of the process, right? I mean, you are dealing with people who have already gone through their training. What is your advice to academic psychology where people are first coming into the field and being introduced to these ideas and being trained and getting their credentials? I mean, it seems like that's a really important sort of choke point where we can make a difference if there was more room for a wider set of views.

Andrew Hartz: I would, just to kind of go back to, this is like another framing of the problem that's a little bit different.

Rafael Mangual: Yeah.

Andrew Hartz: Political issues tend to be the most emotionally dysregulating issues today. Interesting. So if you think what's going to get somebody's blood pressure up and get them emotionally dysregulated, it's going to be abortion, guns, Israel, race, immigration. It's going to be one of these things. If you want to get people dysregulated fast, drop one of those things. And so that's exactly why they're clinically important, because that's what's derailing relationships, that's what they're getting dysregulated about, that's where the cognitive distortions are, that's what can drive symptoms. At the same time, they're the most likely to be mishandled by the therapist because the therapists are dysregulated by them. So that's exactly the point of like, this is an incredibly fruitful place for therapeutic exploration if it's done right, but therapists are really nervous about engaging it in part because they're so dysregulated about it and they don't have tools for it.

Rafael Mangual: To what do you attribute that sort of higher likelihood of dysregulation stemming from political issues?

Andrew Hartz: I think that it’s a…

Rafael Mangual: I'm asking you because it seems backward to me, right? It seems like that's some of the lowest stakes stuff in your life compared to your relationships or your career track.

Andrew Hartz: Anything that's going to hit on an immutable characteristic. If you're attacked for your race or gender or your religious beliefs, or I guess religious beliefs aren't immutable, but one of those core demographic categories, that's going to feel really personal. And so I think the move of politics towards identity makes individuals feel a lot more attacked and divided.

Rafael Mangual: Is there a difference between left and right when it comes to…

Andrew Hartz: Emotion dysregulation?

Rafael Mangual: Well, emotion dysregulation related to politics.

Andrew Hartz: I don't know that it's been studied. I don't know of a single study on that. I would love to see that, but my sense is that institutions moved away from a process called dialectical thinking. It's basically the ability to talk about pros and cons and risks and benefits. So you want ... It's fine for there to be partisan organizations that make their argument for whatever their cause is. I think that's inevitable and needed in a democracy, but neutral civil society institutions, presumably like universities are supposed to be, should be having a discourse where they talk about pros and cons from a range of perspectives. As those institutions have kind of become more and more homogenous ideologically, it's like they only talk about the pros of one side and the cons of others. And that black and white thinking, that all-or-nothing framing of issue after issue after issue is very, very dysregulating to people.

It's a process called splitting. It's very well known in clinical circles. Every psychiatrist, psychologist is going to know this concept and it's really treatment, really central to a lot of treatments. And it's like when you are training and educating people and their media landscape is saturated with all-or-nothing framings of things, people are going to get super dysregulated. It's hard to maintain a practice of dialectical thinking. People have to work at it, but if the institutions aren't even trying and are sometimes fostering and cultivating all or nothing framing of issues, you're going to get super dysregulated people.

Rafael Mangual: Yeah. I'm trying to think of subpopulations who could maybe benefit from therapy for whom this is a particular problem. But before I actually get to that, one question I've always wanted to ask, and I do whenever I'm in the presence of a clinical psychologist, is the following, and I'm always interested in their takes, which is, therapy in my lifetime has always been talked about as an unalloyed good. Therapy is great for everyone, everyone should do it. The only reason that everyone doesn't do it is because they don't have access or the resources or whatever, but the world would just be a better place if a hundred percent of us were in therapy. And I've always wondered, it seems like I've never heard anyone answer clearly the question of like, is there a person for whom therapy might actually not just be unnecessary, but actually be bad?

Andrew Hartz: Yeah. It's a really interesting question. I mean, I do think that people who are seeking therapy should maybe trust themselves a little bit. If you're feeling like it's making you worse and it's not helping you, listen to that. If you feel like you've accomplished your goals, there is a little bit of therapists, patients need to know this, therapists wait for the patient to say when they're done.

Rafael Mangual: interesting.

Andrew Hartz: So patients are sometimes waiting for the therapist to say, “You've completed therapy.” Because I don't know as a therapist that there's not another issue here that's important. I will broach, is this something that you need to continue from time to time, but the person who's ultimately going to make that decision is the client. And so I think that's part of it. And then I think if you're seeing a therapist and it's not working, see somebody else. A bigger problem, I think one of the big problems is people hit a plateau and they stop growing and sometimes it's good to switch therapists.

Rafael Mangual: Yeah. But I guess what I'm thinking of is like, there are people in my life who, I don't even know if they would necessarily describe themselves as Stoics, but who sort of pride themselves in being able to push through difficult times on their own to push their emotions down when necessary. And maybe it's not healthy all the time, but there are some people who I know that believe this and they seem to be doing better than a lot of my friends who are in therapy and it just makes me wonder.

Andrew Hartz: I would totally listen to that. I mean, when somebody ... Therapy needs a goal. You have to have a goal. I really think that's important. It's shocking how many therapists don't establish a goal at the beginning. You have to do that. Why are you here? It can change over time, whatever, but if they're there and they're like, “Well, I'm here because I think I'm supposed to be in therapy because this isn't everybody.” I'm kind of like, “Well, what do you want to talk about?” If you're fine, that's great. So I think if there's not a goal ... I also think…

Rafael Mangual: I have a friend actually who started going to therapy and then realized all these problems that I was happier before I went to therapy and then I realized, oh, I'm actually, I'm depressed and I have this…

Andrew Hartz: Oh, interesting. Yeah. So I mean, I think if there's not a goal, you definitely don't need to go. And the goal could just be sometimes people that go are artists or writers or something and it's about creativity or something, but it should be something. And I do think there are certain times where, for example, there was some studies right after a really traumatic event, like maybe 9/11, like it was the people that immediately unpacked every detail of that event did worse than people who just lived their life for a little while and then if they had symptoms, they could go later. So I think there are, it's a very case by case thing. There definitely is ... If you're somebody, for example, like, okay, you're stoic, but every so often you lose it. That can do a lot of damage. You can lose your job, you can lose your marriage, you can have troubles with the law or things like that. That can be a very costly thing. So I get that if you start opening up what's there, it will be worse for a while. But the cost of not addressing an explosive anger issue are fairly high.

If there's no problem, there's no problem. So I think people can trust themselves a little bit about when they're ready to start, when they're ready to end, if it's not working. And then I think there is a lot of finding the right modality. There are certain types of people who want to come in, they do most of the talking, they kind of figure it out on their own with some guided questioning. That's what they're looking for. There are other people who really want some feedback or want concrete skills. And I think don't be afraid to ask for what you're looking for or end when you're ready to end.

Rafael Mangual: Right. Well, I'm thinking about the other side of that coin. And I write about policing and public safety here at the Manhattan Institute. That's my main area of focus. And one theme that I have seen over the years, even since before I started working on these issues, is that policing as an institution is underutilizing therapy. The suicide rate among police officers is significantly higher than many other professions. It's a profession like other first responders as well, where you are sort of semi-regularly exposed to really significant trauma. Even something that seems mild, right? Like you watch an episode of Cops, and you watch cops have to fight a guy into handcuffs. Fighting's not fun. It's very scary. Even if you have a gun and a partner to help you, you can get hurt, your life can be put at risk. I mean, I know officers who've had to take a life in the line of duty, some who've dealt with that very well, others not so well. Car accident scenes, seeing death, having to sit on dead bodies for hours at a time as a rookie officer because you knocked on a door for a wellness check and the person's been rotting for two hours and then you got to wait for the coroner to get there. And you think about all of these things that you'll see over the span of a 20-, 25-year career, and that's got to have an impact. And yet there's this sort of quiet but not so quiet idea that therapy is for the weak in that profession. And I think there's also a genuine fear that if you say too much, you put your own career at risk.

Andrew Hartz: Yes. Yeah. There's These kind of institutional dynamics that are really relevant too. I think worry about getting a diagnosis that impacts your career, other kinds of stresses, like just internal institutional dynamics on the force and then shift work, the hours can be really... There's all different types of stresses that can manifest. I think that, going back to your question about overutilizing, I think it matters what kind of therapy people are looking for. They should really make sure that they're trying to get something that fits with their values and personality. But I think we live in a time where social emotional skill is so central to almost every profession. I actually think with AI, those skills are going to be more important than ever as the human work is going to be more what we do. And so I think there's a way that therapy can be structured and framed about building social emotional skill that can be really empowering for people as opposed to what they feel where you go in and you are supposed to cry and complain and then just kind of keep doing that and you don't feel like you're... It's very disempowering and feminized and not constructive. And it's like actually like building social emotional skill can be super empowering and really help you succeed and have better relationships. And so I think there's a lot about the way it's been framed. Again, that's maybe a little bit more subtle, whereas the field has become more female-dominated, more left-leaning, it's just like irritating and rubbing people the wrong way because it's not attuned to what people are actually looking for.

Rafael Mangual: Yeah. I mean, that was something I wanted to ask you about, which is this perception that there's been a kind of feminization of psychotherapy, this idea that anything traditionally masculine is seen either as toxic or problematic or evidence of pathology. How widespread is that? And I mean, is there such thing as like a sort of male-coded therapy?

Andrew Hartz: Yeah. Yeah. I mean, I think so. I mean, I think again, it's like subtle and I think really unpacking these biases is going to take time. I think it's going to continue to evolve as we do more research on the topic. But yeah, I mean, even just kind of like the men need to get help expressing their feelings more. Sure. That's kind of the way that it's framed. I find that irritating. Right. As a therapist, it's like condescending. It's like, why? But when I think about helping men in a way that feels empowering to them, develop social, emotional skill and fluency where it's like, you can't be a CEO, you can't be an entrepreneur if you don't have good social, interpersonal, emotional skill. You're a police officer, you're constantly dealing with stress. Any job, it's like, this is so important to what you're doing. If you want to be better with women, your social emotional skill is going to be more like as important as physical attractiveness in terms of your ability to find a good partner. So all the things that men want and value, I think social emotional skills is going to be really important to them. Some of that does have to do with awareness of what you're feeling and why, and a fluency to address it when needed and ignore it when you don't. So I think there's ways of framing this that are actually going to sit better with men as opposed to this. It does feel kind of like an overly sensitive mom who's like, “You need to express your feelings more.” And it irritates me as a therapist to hear the way these issues are framed. But I think that there's like my sense is that there's like dozens and dozens of ways the field is just telegraphing this throughout the profession that they're not aware of. And it's just repelling people because it's...

Rafael Mangual: Is part of the problem a sort of lack of appreciation for the meaningful distinctions between men and women? There seems to be this idea that gender and sex are social constructs. And the reality is, I think everyone would agree is that men and women are actually very different in core ways. I was talking to my wife a few weeks ago about just kind of reminiscing about when we first became parents and talking about some of the differences in terms of how that stage hit us. When our first son was born, my wife became incredibly maternal and her strongest desire was like, “I want to be home more than anything else.” And me, it seemed like I unlocked this professional drive that I didn't even know was there. And it was like, “I now have to provide for this other human being for the next 20 years. I better turn it on.” And my productivity level went up, the amount of time I spent working went up and you were just two very different responses to the same stimulus that I think just stems from the fact that we are just completely different types of beings. Is there not enough appreciation for that in therapy? And if not, what do we do about it?

Andrew Hartz: I mean, I might even go a little bit harsher with it in that I think that we, as a society beyond mental health, struggle with saying, what is the positive value that men bring to society? I think if you were kind of like going to talk about, well, men tend to have strengths in A, B, C or D, whatever you'd list, it will be attacked as sexist.

Rafael Mangual: Right.

Andrew Hartz: So even just saying like, on average, women tend to be better at these sorts of things and men tend to be better at these sorts of things, we kind of can't do that. And so that leads to, I think, just a broad devaluation of masculinity where whenever men are discussed, it's like they're less emotionally intelligent, they're weaker, they're more ignorant, they're failing, they're behind, they're more violent, they're more aggressive, they're worse parents, they're worse partners, the women do emotional labor, they're amazing. What would we do without them? We need to celebrate them. And it's like, there is just this kind of split where almost all the time we talk about men, it's in the negative. And I think we really can't even tolerate as a society saying like, men provide more leadership or more like innovation or risk taking or they provide a certain amount of strength and stability that is valuable in families.

My take on your average family is men do an enormous amount of emotional labor, but it's very different from female emotional labor. And it's like just being responsible for things like being prepared to deal with challenges, making sure that everybody has what they need, providing containment or rules or structure. There's different things that are hard to do. They're taxing and they're very valuable and very desired, but we as a society don't acknowledge that. And I think it leads to a devaluation of men and confusion, especially about young men about, “What do I do? What is my role here?” And the worst is like, if masculinity, if kids are taught that masculinity is a totally negatively coded thing, then they have to make a choice. Do I want to be bad and male or good and emasculated? And so, and you see this playing out where the people who want to be male are more and more linking that to psychopathic traits and the people who want to be good are emasculating themselves in a way that they might not want and women might not want, but we're kind of like, I think messed up about the ability to clearly articulate a positive value vision of masculinity because anytime we try to do it gets labeled sexist.

Rafael Mangual: Well, I think part of it too, you're exactly right, that it's on a societal level. I mean, I remember being in high school and talking in a class about women and female empowerment and the feminist movement and everyone seemed to just take for granted this idea, this claim that our society had elevated men to the detriment of women. And I was like, “I just don't see this.” I mean, every sitcom that you see the dad is this bumbling idiot, like Tim Allen in Home Improvement. He can't, even in his area of professional expertise, he can't help but mess up. Dads are always forgetting anniversaries and getting bad gifts and ...

Andrew Hartz: And the woman's amazing. Right. Yes. And I think there's a lot of female traits that we experience that are like high costs that are demanding. And there's a certain sense of like, I think this is maybe in the nitty gritty. You see this more in couples therapy. I think you'd see these biases manifest, but like if the woman, whenever she's overwhelmed, she cries and has the man take care of it, that's something that's work the man is doing, that's a weakness, he's being stronger, he's taking care of something, at least acknowledge that like the man is not going to be the partner who cries when he can't get what he wants and she takes care of it, probably more often than not. So like there are all of these dynamics that I think when they don't work, when they're not working in couples and families and marriages in society, I think men tend to respond by withdrawing, maybe cheating, becoming more infantilized. And we really struggle to kind of like ... I think we're stuck culturally on this issue and a big part of why these dynamics aren't getting articulated is because psychology's not doing it.

Rafael Mangual: No, I think that's exactly right. I also think not to bring his name up twice, but it was one of the reasons why Jordan Peterson really caught on so much. He was one of the only people that I have ever heard at scale give a very clear message about the positives of masculinity and giving people an identity to aspire to like, “Hey, take on some responsibility, be the person that your family can lean on in difficult moments and make yourself capable and dangerous.” And that I think largely explains why someone like that who was just kind of like toiling in anonymity for a while as a lowly professor in a Canadian university all of a sudden becomes this international phenomenon who's selling out arenas to give lectures on everything from how to interpret the Biblical story psychologically to the relationship dynamics and the importance of marriage. It is kind of fascinating to see because what it indicates is that there's a part of society that is starved for that message.

Andrew Hartz: And that like what psychology and mental health field, if it's doing its job well, what it can provide and how immensely valuable it can be. I think that is, he's a great example of like... And if you think about, I mean, I'll just keep promoting my Open Therapy Institute to have like a cohort of great scholars who are all doing that work. I think people might not fully appreciate until that work starts to come out more, but like how much of an impact that can have.

Rafael Mangual: Yeah. One of the things that I think has been interesting to me in my work from the psychology field. So again, I'm focusing more on these like public safety debates and several years ago I started really kind of reading a lot of the psychological research on antisocial behavior and criminal behavior, mostly because I had this intuitive sense that the best thing, the most important thing that our criminal justice system does is incapacitate unrepentant criminal offenders who just, they're not going to change their behavior. And I was sort of trying to figure out how to make this argument clearly and in a way that had research behind it. And there's a surprising amount of psychological literature on antisocial behavior and the cluster B personalities and their prevalence in criminal populations. ASPD, antisocial personality disorder has a prevalence rate in the general population of like two to four percent, but in certain prisons that have been surveyed, it's 40 to 70 percent of inmates that could be diagnosed or with a substance use disorder or borderline personality disorder. The prevalence of entitlement thinking in criminal populations is massive compared to the general population. And that insight was really cool to me because I thought it gave a much more powerful explanation for criminal behavior than say poverty or social inequality and a lot of the root causes that a lot of people on the left like to point to. But what kind of scares me about that is that the psychological literature doesn't seem to support the idea that there are readily deployable interventions that can sort of cure these conditions.

Andrew Hartz: Yeah. No, I think that's right. I would say, so my biggest concern, like a lot of, I think over the past decade, there was a lot of kind of like idealizing of criminal behavior. They wouldn't be committing these crimes if they didn't need to or something.

Rafael Mangual: AOC I think came out and said that it was just people stealing bread to feed their families like their Jean Valjean.

Andrew Hartz: But I think that that maybe shows something about maybe what's going wrong with empathy, that it's not ... As a therapist, if I think accurate empathy is predictive of outcome. It's an incredibly powerful thing to have accurate empathy, but accurate empathy means you have a read on somebody's psychological profile and what they're actually thinking and motivated by. This type of empathy is weird because it's so discordant with the reality. It's really a fantasy. There's this empathy with a fantasy figure who's committing this crime and there's really no connection or like not really connection to what it actually looks like. I think that happens across, wherever empathy, like weaponized empathy or overused empathy, it's almost always totally wrong. It's not accurate.

Rafael Mangual: Is it like a sort of a coping mechanism? I would think it's easier to deal with the idea of a world in which the people who do the worst things, there's an easy solution for that, right? We can just give them what they need versus coming to terms with a world in which like, hey, you just have to deal with the reality that some subset of the population's going to be really bad and do terrible things and there's nothing you can do about it.

Andrew Hartz: I knew somebody who was a writer, a political scientist, and he was writing about this issue specifically around conservatism. He's a conservative writer and he was saying that there's something depressive about conservatism because there's this acceptance on some level that there are problems that we can't solve. Now that might be a hallmark of maturity, but it's also a little bit depressive, whereas the idea of, no, there's no problem that can be solved, it can be unhinged or even manic in a way, but it's more palatable in some ways than like a…

Rafael Mangual: Meaning no problem that can't be solved.

Andrew Hartz: No problem that can't be solved. Yeah, there's this idea that we could live in a life without human suffering, live in a world without human suffering or something and to think like, no, maybe like suffering is really embedded in the human condition and a certain amount of chaos and unpredictability, even injustice is embedded in the human condition is a harsh truth that I think a lot of people and understandably don't want to believe.

Rafael Mangual: Yeah. I often tell people I think Hobbs was right and that's why I'm a conservative. Well, I hate to end on a depressing note, but unfortunately we are running up against time, but I wanted to just thank you so much for an incredible conversation. I thought that was fascinating, which we could have gone on more. So I hope you'll come back one day and keep talking to us.

Andrew Hartz: I'd love to.

Rafael Mangual: And I'm so excited to follow the work that you're doing at the Open Therapy Institute. I hope you all follow his work. Again, Andrew Hartz, clinical psychologist, founder of the Open Therapy Institute. Thank you so, so much for joining us.

Andrew Hartz: Thanks a lot.

Rafael Mangual: All right. And for those of you who have been watching, listening, please do not forget to like, comment, subscribe, do all the things, leave us a review, let us know what you think of the podcast and until next week, we will see you soon.