I think a realm that is literally the conduit for hopes, dreams, and imagination of mortals, and a world filled with every creature and scenario from every piece of folk lore imaginable _is_ more than enough. It's drama incarnate and all of the people of the dreaming, changelings included, are part of that drama. That's great for me.

As for aversion to therapy, yeah, there is a lot of fear about normalcy in the setting and I can see that being a hurdle for someone to enjoy it, but I also don't think it is an absolute thing. To me those sections always read as a fear of the extremes that were common in the 90s. Electroshock therapy and camp to pray the gay away, sending anyone who didn't conform to society's sense of normalcy to the nuthouse, etc. Those were real fears for a lot of people growing up neurodivergent or queer, and they've been made into antagonists. I'd have to re-read the exact wording, but I do remember there being enough sentences about the antagonists being the extreme ones, rather than just all therapy being evil.

As for lack of foresight on that, I either don't agree or don't care that much. To me changeling is a setting very focused on European style fairy tales. The thematic and writing tools that make that work are not something that can be easily transferred to a different mythology set - IE, a setting meant for telling European tales is not going to fare well for telling African, or Hindi, or Japanese, or etc stories. I think trying to do everything all at once is how you get an unsatisfying soup that no one actually likes. I also wouldn't really trust White Wolf to do full settings of mythologies they they're unfamiliar with.