In his book Bad Religion, Ross Douthat argues that as families have weakened and true friendships have waned, we have tried to fill the vacuum by relying on professional caregivers. Obviously, many of these professionals truly care about their clients, but this trend also indicates a deeper problem. Douthat writes:

As [the philosopher] Ronald Dworkin pointed out … the United States has witnessed a hundredfold increase in the number of professional caregivers since 1950. As of 2023, our society boasts 71,700 clinical psychologists, 728,000 clinical social workers, 388,200 mental health counselors, 71,200 marriage and family therapists, 34,200 life coaches—and hundreds of thousands of nonclinical social workers and substance abuse counselors as well. "Most of these professionals spend their days helping people cope with everyday life problems," Dworkin writes, "not true mental illness." This means that "under our very noses a revolution has occurred in the personal dimension of life, such that millions of Americans must now pay professionals to listen to their everyday life problems."

Douthat concludes: "The result is a nation where gurus and therapists have filled the roles once occupied by spouses and friends."