4 ms·

Speaking from experience, seems to me the GP’s need to make people jump through hoops to earn their trust is a damned important part of _why_ they need those pr

by pdpi 8y ago

Speaking from experience, seems to me the GP’s need to make people jump through hoops to earn their trust is a damned important part of _why_ they need those professionals in the first place.

boomboomsubban 8y ago
At a certain point you need to consider their success rate against your own. Realizing that and accepting they may be able to help is an important step.
- pdpi 8y ago
  Right — but it’s a pretty damn big first step. I can think of a fair few people who were never capable of taking that step
  - jm__87 8y ago
    You can't help someone who doesn't want to help themselves.
    - GW150914 8y ago
      I mean, if someone is shot, you can still surgically intervene without them having to participate. It’s true in psych that you have to help yourself, but it’s also true that’s probsbly a valid critique of the art rather than science that is psych. Talk therapy has more in common with spiritual guidance or shamanism than medicine, except where the actual medicine enters the fray in the form of drugs and surgery. If you’re willing to help yourself, talking to someone is often helpful, but that’s been known for thousands of years. A real intervention doesn’t require someone to help themselves; an appendectomy doesn’t require patient participation and motivation.
      - jm__87 8y ago
        I mean, if someone is shot, you can still surgically intervene without them having to participate. Okay, this is clearly not what we were talking about. Sorry I was not more specific in my statement to generalize to all scenarios, ever. Edit: I think it is also a pretty fair assumption that if someone is shot or their appendix is about to burst, they would want help. The key difference here is that someone who is shot is not capable of helping themselves - with regards to many things people go to therapy for, the only way to fix your problems is going to be taking some actions yourself.
        GW150914 8y ago
        Consent is one thing “my appendix is killing me, help!” while actually doing the work yourself is another. Obviously any intervention requires consent to really work, but once you’ve consented to the appendectomy your role ends. You don’t have to actively engage in your own surgery past the act of wanting it. By contrast merely consenting to therapy isn’t enough, you have to do a lot of hard work as well. The fact that the hard work of everything from overcoming neuroses and anxieties to battling substance abuse is the patient doing the work suggests something about the nature of therapeutic intervention as “treatment” rather than advice-giving.
- jdietrich 8y ago
  For the most part, people see a psychotherapist because they've got problems that they feel unable to fix on their own. Awareness of resistance to the psychotherapeutic process is almost as old as psychotherapy - it's a central concept in Freudian psychoanalysis. "You have to be willing to help yourself" is perilously close to "psychotherapy only works on people who are capable of changing of their own volition", which calls into question the entire purpose of psychotherapy. If I could change my way of thinking through sheer force of will, why would I pay a professional $100 an hour to sit and listen while I do it? It evokes the classic defence of the quack - the spoon only bends if you truly believe in the power of the mind. If that problem is framed as "some patients are too sick to treat", then at least it shifts the burden of responsibility onto the therapist; it's not the patient's fault that the psychotherapist lacks the neccesary tools to facilitate change. Blaming the patient for having a bad attitude just makes the profession of psychotherapy look ineffectual.
  - jschwartzi 8y ago
    It's not really about being able to change yourself, it's about wanting to change so much that you're willing to put in the work. When I did it I had to unlearn a bunch of mental habits, but I also had to change my environment and seek things that were outside of what I knew. Therapy would have done nothing for me if I had let the therapist do all the work. I'm my case the work was to find a new way of living that is aligned with who I am and what I want for myself. When I went in I had some major anxiety problems, and by working with my therapist I was able to identify where those problems came from. I started taking steps to change how I lived so I wasn't as anxious anymore.
  - davidpatrick 8y ago
    While it does require your participation for success, you are paying the professional for the tools to help yourself. And sometimes others aren’t able to help themselves, and the professional’s job is to help them discover how to.
  - jm__87 8y ago
    Blaming the patient for having a bad attitude just makes the profession of psychotherapy look ineffectual. What sort of magic are you expecting from psychotherapy? You're paying someone to help you solve your problems. You're not paying someone to solve your problems for you.

by pdpi 8y ago

Speaking from experience, seems to me the GP’s need to make people jump through hoops to earn their trust is a damned important part of _why_ they need those professionals in the first place.

boomboomsubban 8y ago

At a certain point you need to consider their success rate against your own. Realizing that and accepting they may be able to help is an important step.

pdpi 8y ago
Right — but it’s a pretty damn big first step. I can think of a fair few people who were never capable of taking that step
- jm__87 8y ago
  You can't help someone who doesn't want to help themselves.
  - GW150914 8y ago
    I mean, if someone is shot, you can still surgically intervene without them having to participate. It’s true in psych that you have to help yourself, but it’s also true that’s probsbly a valid critique of the art rather than science that is psych. Talk therapy has more in common with spiritual guidance or shamanism than medicine, except where the actual medicine enters the fray in the form of drugs and surgery. If you’re willing to help yourself, talking to someone is often helpful, but that’s been known for thousands of years. A real intervention doesn’t require someone to help themselves; an appendectomy doesn’t require patient participation and motivation.
    - jm__87 8y ago
      I mean, if someone is shot, you can still surgically intervene without them having to participate. Okay, this is clearly not what we were talking about. Sorry I was not more specific in my statement to generalize to all scenarios, ever. Edit: I think it is also a pretty fair assumption that if someone is shot or their appendix is about to burst, they would want help. The key difference here is that someone who is shot is not capable of helping themselves - with regards to many things people go to therapy for, the only way to fix your problems is going to be taking some actions yourself.
      - GW150914 8y ago
        Consent is one thing “my appendix is killing me, help!” while actually doing the work yourself is another. Obviously any intervention requires consent to really work, but once you’ve consented to the appendectomy your role ends. You don’t have to actively engage in your own surgery past the act of wanting it. By contrast merely consenting to therapy isn’t enough, you have to do a lot of hard work as well. The fact that the hard work of everything from overcoming neuroses and anxieties to battling substance abuse is the patient doing the work suggests something about the nature of therapeutic intervention as “treatment” rather than advice-giving.
jdietrich 8y ago
For the most part, people see a psychotherapist because they've got problems that they feel unable to fix on their own. Awareness of resistance to the psychotherapeutic process is almost as old as psychotherapy - it's a central concept in Freudian psychoanalysis. "You have to be willing to help yourself" is perilously close to "psychotherapy only works on people who are capable of changing of their own volition", which calls into question the entire purpose of psychotherapy. If I could change my way of thinking through sheer force of will, why would I pay a professional $100 an hour to sit and listen while I do it? It evokes the classic defence of the quack - the spoon only bends if you truly believe in the power of the mind. If that problem is framed as "some patients are too sick to treat", then at least it shifts the burden of responsibility onto the therapist; it's not the patient's fault that the psychotherapist lacks the neccesary tools to facilitate change. Blaming the patient for having a bad attitude just makes the profession of psychotherapy look ineffectual.
- jschwartzi 8y ago
  It's not really about being able to change yourself, it's about wanting to change so much that you're willing to put in the work. When I did it I had to unlearn a bunch of mental habits, but I also had to change my environment and seek things that were outside of what I knew. Therapy would have done nothing for me if I had let the therapist do all the work. I'm my case the work was to find a new way of living that is aligned with who I am and what I want for myself. When I went in I had some major anxiety problems, and by working with my therapist I was able to identify where those problems came from. I started taking steps to change how I lived so I wasn't as anxious anymore.
- davidpatrick 8y ago
  While it does require your participation for success, you are paying the professional for the tools to help yourself. And sometimes others aren’t able to help themselves, and the professional’s job is to help them discover how to.
- jm__87 8y ago
  Blaming the patient for having a bad attitude just makes the profession of psychotherapy look ineffectual. What sort of magic are you expecting from psychotherapy? You're paying someone to help you solve your problems. You're not paying someone to solve your problems for you.