"Therapy didn’t work for you. But church does," said Usha to JD Vance.

Quoted in JD's new memoir, "Communion" (commission earned).

Did he need therapy and what's the story of its not working on him?

My traumatic childhood had made me resentful and left me with awful conflict management skills. I would overreact or withdraw—fight or flight!—over minor transgressions.... Because of Usha, I attended a few therapy sessions at the Yale student health clinic. The therapist I spoke with was a good guy, but I found therapy too uncomfortable. I didn’t like to talk to my own girlfriend about how crazy my homelife was, so why would I talk to a stranger? But there was a deeper problem with therapy as I encountered it. It was divorced from any sense of responsibility or guilt. In one session, we explored an incident that I’ve since discussed publicly: Driving with my mother on a relatively rural road, she loses her temper. She accelerates the car, threatening to crash and kill both of us.... Experts tend to describe unresolved trauma as when a person experiences “disruptive physical and emotional reactions in the present as their body and mind continue to defend against” threats they faced in the past. The gist is that my fight-or-flight response, my temper, and my general resentment about my feelings of insecurity were consequences of trauma I had experienced and hadn’t properly “processed.” And of course, part of that processing was understanding how trauma across the generations was linked. The trauma I experienced at the hand of my mother was connected to the time my grandfather got drunk and beat her. And of course, my grandfather didn’t have it easy growing up in the deep poverty of Kentucky coal country. I resisted this for a couple of reasons. The first is that the framing turned me into a victim rather than an actor.... The therapist’s framing... removed the moral dimension from human conduct.... I was searching for a more satisfying accounting of wrongdoing and responsibility. Of temptation and willpower. Of virtue and guilt.... [M]ost of all I wanted to be a better person. I wanted to be worthy of this woman I was madly in love with. And I began to fear that the past was a prologue: that whatever happened to my mother, whatever destroyed marriages and friendships in my family, would eventually destroy what I had with Usha....