Cohen uses this example to illustrate why the suicide rate of American men increased from 1960 to 1990, suggesting that it was not only genes at work increasing the incidence of suicidality, because genes don’t change in a 30-year period, but something different in the environment. He reports changes affecting the quality of parenting, including family instability, divorce rates, levels of violence, and decrease of traditional standards. Although he makes the point repetitively that genes are critical, he grudgingly admits that some therapies influence genetic determinism. He is not specific as to which therapies. Little or no mention is made of psychotherapy, behavioral therapy, psychopharmacology, or any of the therapies available to the traditional psychiatrist.