In 1982, American psychologist James Hillman issued a pointed challenge to his own profession.
In We’ve Had a Hundred Years of Psychotherapy and the World’s Getting Worse (co-authored with Michael Ventura), he argued that despite a century of psychological insight, the broader social fabric was not improving. His claim was a critique of the underlying assumptions shaping modern psychotherapy.
As the medical model began to take hold, Hillman questioned the legitimacy of individualized treatment that aimed to help clients cope with their symptoms without a examining whether those very symptoms were, in fact, sane responses to insane systems.
Hillman warned that psychology’s fixation on the individual would produce “exquisitely sensitive and self-aware individuals” who were cut off from community, history, and collective agency.
As societies become more polarised, Hillman’s views seem even more relevant today.
When suffering is framed primarily as a personal narrative—childhood wounds, attachment patterns, trauma histories—the social systems within which that suffering emerges disappear from view.
Whether we like it or not, each of us is born into the context of a family. Family systems are embedded in communities. Communities are shaped by economic systems, cultural narratives, and geopolitical forces. This means that toxic workplaces, housing insecurity, ecological instability, and political polarisation are not inconsequential peripheral influences. They are the structural social conditions we must function within.
There is no question that individual distress is real.
The bigger question is whether we can continue to treat personal issues as though they are separate from the social conditions—insecure job and housing markets, poverty, ecological crises, economic collapse, global conflict—that produce them.
More therapy. Better meds. But are we improving?
Since Hillman published his book, psychiatric diagnoses, prescriptions, and mental-health consultations have surged, yet wellbeing has not improved.
In Australia, nearly one in five people meets criteria for a mental disorder each year, with anxiety the most common. Roughly one in seven Australians takes antidepressants to get through the day—one of the highest prescription rates globally.
Today, more people have access to treatment, yet rates of anxiety, depression, loneliness, suicide, and mental-health-related emergencies continue to rise.
The promise that more access to care, better diagnoses, and more medication would yield a less distressed society has failed to live up to expectation. Instead we have an increasingly pathologised, medicated population trying to function individually within systemic, historical, and cultural failures.
The current statistics are staggering, so it begs the question: if nearly one in seven adults requires antidepressants and one in 10 female teenagers takes anti-anxiety medication simply to get through the day, we must ask whether the mental health system has become a mechanism for helping people endure deteriorating social conditions rather than transforming them.
Are we at a collective breaking point?
The myth of the pathologised self
Anchored in the medical model, therapy often treats childhood as the singular explanation for adult suffering. But when therapeutic interventions become endless excavations of the personal past, memory hardens into fact while perspective disappears.
But memory is not a neutral recording device. It is meaning-making. Memory is the story we tell ourselves about what happened. Over time, that story becomes our personal mythology.
When therapy treats memory as fixed evidence rather than a living narrative embedded in larger systemic contexts, wounds are labeled and revisited but rarely reimagined. Identity consolidates around “what happened to me,” rather than “how is what happened to me part of a larger story?”
Hillman argued that this cycle is sustained by a fictional ideal of the functional nuclear family, or what he called a “white therapist’s fantasy.” When impossible standards are upheld, dysfunction becomes inevitable and endlessly diagnosable. Pathology flourishes where unrealistic norms persist. His blunt observation still stings: “therapists need clients.” And where would Big Pharma be without consumers?
More than forty years later, the question remains: whom does therapy really serve?
When psychology fixates on the individual self, how we fail to focus on the broader forces at play—economic strain, ecological instability, political fragmentation, cultural dislocation. When the individual becomes the bearer of the collective pain, context disappears.
As Hillman warned, “If you’re continually looking back at childhood, you’re not looking around.” And when therapy turns us inward without returning us to the systems shaping us, we shrink. And if distress is continually individualised while the surrounding structures remain unexamined, the uncomfortable question becomes unavoidable:
If we are medicating ourselves to survive crumbling systems, who actually benefits?
That is precisely where a systemic lens offers a helpful therapeutic stance.
How systemic therapies help
Systemic and integral approaches begin from a different premise: what moves within us is not purely personal. It is relational, historical, and embedded in wider fields.
Systemic modalities such as Family Constellation Therapy (FCT) make the broader context visible. Rather than analysing an individual in isolation, FCT maps the systemic patterns surrounding a life—family structures, intergenerational patterns, cultural narratives, social forces. What once felt like an purely internal flaw is placed within a broader configuration.
When the inner image is externalised, the client shifts from immersion to observation. In that act of witnessing, memory starts to move allowing them to stand as an adult observer to dynamics that once overwhelmed them. In that shift, memory loosens. It is no longer relived from the child’s position, but re-situated within context. Perspective expands. As context comes into view, memory is reimagined from a higher perspective rather than re-experienced from the child’s helplessness.
This is not reinterpretation for comfort’s sake. It is developmental repositioning. And from that broader lens, personal agency returns.
Moving memory. Reclaiming agency.
Through a wider field of view, blame gives way to understanding. Shame loosens. What once felt like a personal flaw is recognised as part of a larger pattern. The question shifts from What is wrong with me? to What was happening around me that created my internalised response? and finally to the question that generates agency: Given that reality, who do I choose to be now?
This is the pivot Hillman called for. Perspective taking. The maturation beyond the childhood wound.
How can we stand in this world as fully functioning adults and hold our leaders accountable for systems that are crumbling around us if we are continuously excavating our childhood?
As Hillman warned, “If you’re continually looking back at childhood, you’re not looking around.” Therapy that anchors identity in trauma shrinks people to the size of their injuries. On the other hand, maturity expands personal responsibility and agency.
The purpose of therapy is to educate people into adulthood with the capacity to hold complexity, tolerate uncertainty, become accountable, and move from insight to participation, not to preserve the child’s viewpoint indefinitely.
A world in crisis does not need better-adjusted children. It needs adult citizens with perspective, integrity, and the courage to engage with the systems shaping their lives.
When we as a society shift from self‑absorption to soul‑making, from endless self-analysis to mature perspective-taking, we reclaim the dignity of personal agency. We step out of the waiting room of our own lives. When we connect with the collective as empowered adults, we have a greater chance of stepping into the work of remaking the social and global conditions that are breaking us.
So the reflection is simple:
Given everything that has shaped us—and everything that is shaping the world now—who do we choose to be within it? And how can we find our way to see beyond isolated, polarised viewpoints to mobilise personal and collective agency for the greater good?