20 ms·

How you 'attach' to people may explain a lot about your inner life

388 points by fredley 6y ago

abellerose 6y ago
I really hate how people are pushing psychotherapy as the treatment for people suffering psychologically. I wish society would be humane and let people end their life by an injection. It’s allowed in a few countries but restricted elsewhere. It confirms to me that people are monsters that force their will on others by forcing them to continue suffering or commit suicide in a manner that can fail; where you’re ripe to be manipulated for the pro life agenda because of brain damage.
- s5300 6y ago
  >>It confirms to me that people are monsters that force their will on others by forcing them to continue suffering or commit suicide in a manner that can fail; where you’re ripe to be manipulated for the pro life agenda because of brain damage. Animals acting like animals? In other news... Water still has ability to wet.
- ElFitz 6y ago
  I would encourage you to read this: https://www.newyorker.com/magazine/2003/10/13/jumpers https://www.newyorker.com/magazine/2003/10/13/jumpers > “I instantly realized that everything in my life that I’d thought was unfixable was totally fixable—except for having just jumped.”
  - deleted 6y ago
    [deleted]
  - drops 6y ago
    Is it normal to find the quoted sentence quite humorous?
    - coldtea 6y ago
      It's intended to be humorous.
    - ElFitz 6y ago
      Yes! It seems intended. And I thought it would convey my point in a striking and oddly lighthearted way better than my words ever could.
  - s5300 6y ago
    Going off your quote - cool. Terminal illness and severe chronic illnesses are not "totally fixable" though. If somebody's problems are totally fixable... they're not the people needing to be saved by legal dignified euthanasia. I don't understand why this is so hard for some people to understand.
    - rocqua 6y ago
      There is a difference between advocating for legalized euthanasia and advocating for a total and utter right to end one's own life at any point for any reason. OP seemed to argue for the latter, and who you are replying to argued against the latter. Now you seem to say that they should not argue against the former, which they were not arguing against.
      - ElFitz 6y ago
        Exactly! Thank you kind and understanding stranger!
    - ben_w 6y ago
      I accept that many people have incurable illnesses which are either literally torturing them or slowly robbing them of everything they value. The reason I am (slightly) against euthanasia despite this, is because I expect easy availability — to be clear, a culture where it is not even controversial rather than merely available lawfully — to also be world where it is easy for people who don’t fit that category being pressured into talking that path. The reason I’m only slightly against is that I don’t feel confident in weighing the quantifiable decrease in suffering with the probability distribution of possible increases in needless death. That, plus I recognise my argument is “that looks like a slippery slope”, where the real problem may well be that human behaviour isn’t what my imagination is telling me it is.
      - thrwaway69 6y ago
        Euthanasia can be restricted. No need to make it illegal and places where it is legal have measures in place to stop this.
  - Johanx64 6y ago
    I kind of doubt that people who have been struggling with depression for 10-20 years will share the sentiment. No doubt they will experience some sort of hardwired survival instict which kicks in as they are about to go, but that's about it.
    - ElFitz 6y ago
      I have been struggling with depression for 10 years. Diagnosed and all. I was a wreck. A total wreck. Now, I still don't know if I'm out of it. I don't' know that I ever will be. It's terrifying. I see patterns I wish were long gone creeping back all the time. But I finally have lasting and enduring hope. And I've come to realize that all these times I wanted it all to end... I just wanted to stop suffering. At the time, death seemed to be the only way.
  - thrwaway69 6y ago
    The problem is he jumped. He didn't have access to health professionals who will assess him before he could die. He wouldn't have jumped if he knew he could die in a more peaceful and controlled manner without shame. An euthanasia facility would have given him a second chance if it was properly maintained. They don't let you kill as you pass the door. They will make you wait, have you try things to help you before you could sign off the paper to die. I don't see why it should be illegal. it's like being against addiction control centres.
    - ElFitz 6y ago
      Well then, considering https://news.ycombinator.com/item?id=23916076 https://news.ycombinator.com/item?id=23916076, it'd seem we are on the same page!
  - at_a_remove 6y ago
    I have often noticed that the "it gets better" crew, who dispense whatever little memes and then move on, have no skin in the game. The reality might be much different if there were some accounting at the end. "It appears that this person continued to suffer another twenty-three years and then died joylessly. As such, you must spend the next twenty-three years in a miserable and unpleasant box. Oh, and you have to also endure people telling you that it is only temporary. Ta." The unpleasant reality is that there are many situations which are untractable and the denial of their existence -- and the suffering inflicted -- largely serves to soothe those looking for a just world. We regularly call upon people to continue to be (and worse, be "up" about it) in circumstances where, were they occurring in some fuzzy animal, we would be moved to a grueling euthanasia with whatever rock came to hand.
    - ElFitz 6y ago
      Some situations are indeed intractable. That's why, for the physical ones, we have things like palliative care. I don't know what can be for psychological issues. However, had you read the article, you would have noticed this short snippet: > Dr. Seiden’s study, “Where Are They Now?,” published in 1978, followed up on five hundred and fifteen people who were prevented from attempting suicide at the bridge between 1937 and 1971. After, on average, more than twenty-six years, ninety-four per cent of the would-be suicides were either still alive or had died of natural causes. “The findings confirm previous observations that suicidal behavior is crisis-oriented and acute in nature,” Seiden concluded; if you can get a suicidal person through his crisis—Seiden put the high-risk period at ninety days—chances are extremely good that he won’t kill himself later. The question then becomes "What about those remaining 6%?" Well, I don't know. Did they go through another, different crisis? Where they appropriately helped and supported following their first attempt? And if nothing could actually be done for them, then we end up with the traditional trolley cart dilemma. 94% lives worth living saved vs 6% miserables lives.
      - at_a_remove 6y ago
        Oh, I have seen that clip so many, many times. It's just about the first thing trotted out. I need not read that paragraph yet one more time, life is too long. It ignores things like, "What number of those ninety-four just continued to be miserable?" They didn't kill themselves, but it doesn't mean that they were not still suffering. It might well mean that they were bludgeoned with the "just think of how devastating it will be for your family" bit until they submitted to a life of quiet desperation. It's not a measure of life being worth living at all.
- LandR 6y ago
  This gets tricky though, some psychological problems are temporary. They can be fixed with proper treatment. However people suffering from them aren't in the best place to make a decision like wether or not they should end their own life. In this case you want to protect these people and get them better. I think the problem is we've built a society though where it's so easy to end up sad and that needs fixed.
  - ElFitz 6y ago
    Totally. Also, wether it's psychological issues or terminal physical illness, most people don't know what else can be done. For example, palliative care, properly done, can be incredible.
    - thrwaway69 6y ago
      The thing is why does everyone seem to forget here that some people don't have money, resources, family, environment or location to get access to many things that could help. Poor people surely will get happy if they get money, right? Surely therapy without a single worry in life will help them, right? Do you tell others to think about how happy you could be in a few years when they are sad? No, you don't. Do you encourage systematically poor people to suck it up because things will get better? Same mentality is used to justify racial injustices and inequality. Things will get better in future so suck it up for the movement. These people are in pain and should be able to stop it if they see it not worth it. Obviously there can be some time period such as a year or two before you can access euthanasia. Otherwise, it's cruel to let people suffer for years in false hopes.
      - ElFitz 6y ago
        I don't know how things work where you are, but I tend to reason based on the context and environment I know. Over here, we have a universal social security. While imperfect, incredibly bureaucratic, and hard to navigate at times, it ensures everyone can get access to most if not all medical care, for free for those who are in extremely precarious financial situations. But that is a political and social choice that was made in this country decades ago, and it is true it is not the same in many other places. Now, I want to believe this isn't what you meant, but another way to read your response could be "It'll take too long and it's too hard, too expensive, to help poor people out of their pain. We should instead let them put themselves out of their misery"
- coldtea 6y ago
  >I wish society would be humane and let people end their life by an injection. What's "humane" about that? It's the easy cop out, and hiding the problem under the carpet. Unlike terminal disease or something "suffering psychologically" is not unsurmountable... Not to mention tons of people tried to suicide because they suffered, failed, and then found out they're OK after all, and lived their lives just fine afterwards... >It confirms to me that people are monsters that force their will on others by forcing them to continue suffering or commit suicide in a manner that can fail Or, you know, people are angels, and don't just give poison to the first idiot that decided to kill themselves just because they temporarily suffer and think in their bad judgement that it can't be fixed...
  - bragh 6y ago
    Let's keep it very simple here. What possible justification can you have to force another being with feelings to suffer? By the way, even the part of "something "suffering psychologically" is not unsurmountable" is quite often unjustifiable, such as when psychological suffering is caused by the environment and there is no way to escape the environment.
    - rocqua 6y ago
      The fact that sometimes suffering is very intense and temporary and that forcing someone to live through that can later lead to a fulfilling and happy life. A life where they are grateful they suffered through the temporary thing without ending it. That alone should be enough to acknowledge that sometimes, people who want to die should not kill themselves. Besides that, the fact that quite often, a person killing themselves will inflict a lot of suffering on their surroundings. If you argue we don't get to force someone to suffer, why does a suicidal person get to force others to suffer? Neither the position "No one should ever get to end their own life" nor the position "Everyone should be able to end their own life at any instant of their choosing always and immediately" seem tenable to me. With a decent solution lying somewhere in between these to positions.
      - s5300 6y ago
- deleted 6y ago
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rocqua 6y ago
This really resonated with me
throwaway28191 6y ago
I had three different therapies in my life so far. The first one was a bad experience, the other two helped me a lot. I like both therapists but never felt like we are close or connected in any way this article writes about. Always I knew I'm dealing with a professional. I saw other patients leave the room before my session started. We needed to look for an appointment because of vacations and stuff, it was always just a person doing his job. And I'm fine with that. I also think it is necessary to have a person who is not too close to you helping you some times. Family members and friends want you to have as little pain as possible and doing better as fast as possible which is natural but often not the right thing. "On this view, the good therapist becomes a temporary attachment figure, assuming the functions of a nurturing mother, repairing lost trust, restoring security, and instilling two of the key skills engendered by a normal childhood: the regulation of emotions and a healthy intimacy." The therapist can't repair lost trust or security, only you can. A good therapist will help you do that.
- LandR 6y ago
  A personal question, if I may. I think seeing a therapist would be good for me, I have issues I'm struggle to fix myself but how does the conversation even start ? What I mean is, I can go to a regular doctor for a regular problem and he will say "what is the issue?" and I can explain it pretty clearly even if I don't know the underlying cause. e.g. "My leg hurts here when I move it in such a way" But I can't imagine how this conversation starts with a therapist. If they asked me what is wrong, I genuinely don't know. I don't know where to point to the pain. Then I just see myself sitting there with someone awkwardly, them thinking I'm an idiot.
  - chrisco255 6y ago
    I've only had one therapist but she was extremely good. And she would ask a lot of questions. She'd get me to untangle a lot of my thought processes. She'd ask me about the past and have me dig into that and really ask tough to answer questions that forced me to think about why I thought the way I did. It took probably a good dozen or so sessions to get to the point where I was relatively healed and even then it took some time after, but by then I was able to regulate my anxiety on my own.
mlindner 6y ago
TL;DR having personal bonds helps you be a normal person. If you didn't have them in early life a therapist can act as someone forms bonds. In general though psychotherapy is a bunch of quack, as stated in the article the only thing that really matters is the patient and shrink working together.
- sjg007 6y ago
  The point is to get the tools to develop a secure attachment with yourself with the end goal of developing an integrated emotional response.
deleted 6y ago
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cloogshicer 6y ago
If this resonates with you, or you're thinking about therapy, I recommend reading 'The Drama of the Gifted Child', by Alice Miller. Don't be put off by the title, it's a great read regardless if you're think you're gifted or not. Gifted in this context means something closer to 'sensitive'. This, together with therapy, has significantly improved my life.
kqr 6y ago
This is a good and interesting read regardless, but I'll just point out that when studies are properly controlled for confounders, the "relationship with the early caregivers" matters much less than we want to think. Maybe not even at all. What shapes us are our interactions with our early peers. This makes sense from a hunter-gatherer point of view too; those are the people we will spend almost all our life with. I highly recommend reading The Nurture Assumption for more on this. The author effectively argues with evidence for why relationships with parents are nothing more than relationships with parents. It really opened my eyes both for things that went on in my upbringing, the upbringing of people I know, and taught me what is going to be important as I raise my son.
- hrktb 6y ago
  I think it comes down to how extreme the relation is. In the article there ia a large portion about abusive relationships and other cases warranting a therapist's intervention. In these situations, sure parents behavior will leave a strong and lasting impact on children. For more standard cases, parents will provide a supporting enough environment (even if not perfect) and will make their kid interact more with the world, be it school, activities etc., limiting the impact of their own direct behavior. To get back to your point, parent's thinking and behavior is fundamental IMO, but usually not just in a direct, person to person way. It would be more on the environment and social position they provide to their children.
  - kqr 6y ago
    All true. Very well put.
  - doboyy 6y ago
    I feel this is a more accurate assessment. The relationship between abuse/quality of parenting and anxiety/disfunction can't be thought of as linear. When parenting starts qualifying as abuse, there is a pretty steep increase. Otherwise, genetic temperament and environmental interactions have more influence.
- HumblyTossed 6y ago
AdamCraven 6y ago
As someone who didn't have many healthy attachments growing up and has spent a lot of time with a wide variation of therapies. I agree with the article, many different therapies can fix people and I’ve found it better to have more than one type of therapy. I believe at the root of it is a mindset which centres around the cultivation of self-leadership. My multi-year long journey of what I learned and getting back to health - which most visibly manifested itself as CFS symptoms (Post exertional malaise) - can be summed up as: Trusting the therapist and understanding they are not perfect humans themselves. Accepting they are not going to fix me, they are a companion on the journey, I must fix myself with their help. Going on a journey through all major points in my past and re-experiencing what I'd been through. Whilst having the therapist with me to slowly help unfold the emotions and understand it from a different perspective (i.e. I did not cause the bad things that happened to me, it was not my fault). This helped me build a foundation, a place of support that didn't rely on other people, which gave me self-confidence to listen to the negative self-talk that I had blocked off for years, because it was too overwhelming to hear. When I started listening to this self-talk, I could then start to converse with it. e.g. "You aren't good enough", "Perhaps I'm not, but let's see what happens when I apply my focus to it", which started taking away its power and effect over me. Which led me to realising that my intellect and conscious part of my mind is probably only in control of 20%-30% of me. That I'm not a fully logically creature and that I needed to come to peace with my body's needs and messages from my less conscious mind and work together as an integrated whole, rather than trying to force my will based on pure 'rational' thought. Life has been considerably better since and my decades of depression and low energy have begun to abate. Whilst the points may seem simple, understanding like this rarely comes from knowing in the conscious mind. It is understanding that has to be understood at a deep level, which is why therapy can take a long time. My favourite way of describing this conscious acceptance but lack of sub-conscious understanding can be summed up as: “I know that, but try telling me that”.
- chadwittman 6y ago
  Your comment regarding your intellect and the conscious part of your mind only controlling about 20% - 30% of you is super interesting. I'd love to hear more specifically what made you come to that conclusion, as I've experienced a similar insight. Mine came from an overdose of marijuana ironically enough, but it gave me just enough perception of the feeling of two minds. I don't think I'll ever forget that experience.
carlsborg 6y ago
Summary: "... the deeper reason why no single psychotherapy seems to provide unique advantages over any other is that they ALL work because of shared elements. Chief among these is the therapeutic relationship, connected to positive outcomes by a wealth of evidence." "The emotional bond and the collaboration between client and therapist – called the alliance – have emerged as a strong predictor of improvement, even in therapies that don’t emphasize relational factors..." cites co-author of the book "Attachment in Therapeutic Practice" (2018). ".. what if, attachment theory asks, therapy gives you the chance to reach back and repair your earliest emotional bonds, correcting, as you do, the noxious mechanics of your mental afflictions?"
mwexler 6y ago
Like clockwork, every decade or so, someone says "Hey, we haven't looked at attachment theory in a while! We can get a few pubs and a book out of it.". A bunch of studies later, we see the repeat of all the previous findings: inconclusive, some interesting patterns, nothing super repeatable with strong effects. It's fine to revisit and revise past theory work. It's just surprising that after 70 years, this theory that should explain so much, after scrutiny, just... doesn't. Looking forward to the latest revisions to see how to apply attachment patterns to our modern world. I have popcorn in hand.
- jschwartzi 6y ago
  I would think it's very difficult to study human attachment using effect sizes. The sheer diversity of attachments a human makes and the rate at which each attachment changes means you're almost certainly seeing some confounding effects. You could bin attachment into styles and levels but it's more like a continuous function and you can never be certain that your bin sizes are adequate to describe the whole variability of the system.
- sjg007 6y ago
  Well if you want to make the argument that attachment theory is junk then you should provide some evidence.
  - mwexler 6y ago
    That's not really the way science works. The theory drives testable hypotheses. We look at data to feel some confidence that the hypotheses are correct. If we don't find that data, we can continue to believe in the theory, but with less and less confidence. If a theory cannot be supported, then I can make the claim that its not correct in its current form. I don't think it's junk, but more that it's causal impact may be less than the theory purports. And sure, we can have an alt theory that goes against Attachment theory, and generate hypos from that, and put them to the test. Answering a different question, but same problem: can't just say "won't work", need to generate specific testable hypotheses. I'm just pointing out that the theory is nice and should have more provable (and supported) predictions, but it keeps having limited support from research, fades from view, comes back around, history repeats. After a while, our confidence goes very low. But it's not zero, and the fact that it keeps showing up again provides new hope. The theory is attractive so I hope we find its proper alignment through this latest iteration. But it has a tough road to hoe.
donatj 6y ago
> Things get even more puzzling if you consider the sheer number of therapies on offer and the conflicting methods that they often employ. Some want you to feel more (eg, psychodynamic and emotion-focused approaches); others to feel less and think more They all share being heard, raw, and I believe that is key. I spent time talking with a consoler years ago to work through some personal issues, and I genuinely feel having someone there to listen in a way where I knew judgements on their part would never threaten our relationship was the true value. Being able to just tell someone how I felt about things, clearly and honestly, without the need to self censor or sugar coat - particularly in the way I would with a friend - helped more than anything else.
viburnum 6y ago
Probably a mistake to treat parenting styles as exogenous. Parents respond to their child’s temperaments too. It’s easy to be attached to an easy-going child. A kid that’s always crying is going to wear you out.
- caleb-allen 6y ago
  Perhaps a kid that is always crying is attempting and failing to communicate pain or discomfort. I've been told that I was a miserable newborn--I cried nonstop for months and months and my screams made everybody around me miserable too. My mother was told by family that I needed to cry it out, but 6 months on there was no difference. I was taken in to the hospital and was found to have had a hernia which required surgery. After surgery, I'm told, I was absolutely quiet and unproblematic. Through the rest of my childhood and teenage years I was the 'easy-going' kid of the family. Through therapy I have learned that my attachment style is avoidant, and I have no doubt that this early experience (among others) heavily influenced the way I process emotions and feelings. It isn't that I was a naturally 'easy-going' kid, or that I didn't have the troubles that my siblings had. I felt things, but my experiences taught me not to express them. I formed a tendency to over-intellectualize my experience and, in retrospect, heavily suppress negative emotions and even physical pain. My nature was not to seek out help when I felt immense pain, but to persist with self-reliance, at all costs. Like the commenter above, therapy has done wonders for me in learning to recognize my feelings and having the capability in processing them in a healthy way. I am not a parent and so I can't speak to the difficulty of a child's temperament; I have no doubt that one child's personality might be much more difficult to handle than another. A parent is clearly going to be affected to their children's temperament, but the parent is also responsible for teaching the child how to process those emotions, and is significantly more equipped in dealing with how the child affects them than the child is at dealing with how their parent affects them.
- woodandsteel 6y ago
  That's quite true. However, the article doesn't describe parents as such, it describes the actually style of parenting that took place, whatever were the reasons things went that way rather than another.
Nav_Panel 6y ago
> All of this suggests a tantalising alternative to both the medical professional’s and the layperson’s view of therapy: that what happens between client and therapist goes beyond mere talking, and goes deeper than clinical treatment. The relationship is both greater and more primal, and it compares with the developmental strides that play out between mother and baby, and that help to turn a diapered mess into a normal, healthy person. Oh man, pop culture is rediscovering the use of psychoanalysis, finally! Transference is so important! > I am referring to attachment. Oh. God dammit. Can't escape the vortex of "science", leading to the massive fragmentation of psychological frameworks, destroying the field's credibility.
- diffrinse 6y ago
  I'd argue pop culture started catching on when The Sopranos aired
  - Nav_Panel 6y ago
    Well, Freud was big back in the day, and then fell out of favor. And psychoanalytic theory still gets used in media and lit crit (and in writing the shows themselves), but... not in what it was built for, therapy.
    - greenshackle2 6y ago
      Last I checked it does about as well as all other types of therapies in studies. What does it say about the theories of mind underlying the different schools of therapy that they all work about equally well?
      - Nav_Panel 6y ago
        Ah, "Studies" whose language and inventories are already rooted in particular paradigmatic understandings of psychology. I would expect psychoanalysis to do worse, in the studies, than "regular" psychology! Damning that it doesn't!
  - 6y ago
obiefernandez 6y ago
Really long article but this is the crux: > The emotional bond and the collaboration between client and therapist – called the alliance – have emerged as a strong predictor of improvement, even in therapies that don’t emphasise relational factors. > Until recently, most studies of this alliance could show only that it correlates with better mental health in clients, but advances in research methods now find evidence for a causal link, suggesting that the therapy relationship might indeed be healing. Similarly, research into the traits of effective therapists has revealed that their greater experience with or a stricter adherence to a specific approach do not lead to improved outcomes whereas empathy, warmth, hopefulness and emotional expressiveness do.
- scottlocklin 6y ago
  >The emotional bond and the collaboration between client and therapist – called the alliance – have emerged as a strong predictor of improvement, even in therapies that don’t emphasise relational factors. Yeah, OK, I might buy that as much as I might buy any result associated with something as nebulous as psychotherapy. How do they characterize this, exactly? Having good feelings about a therapist you got better from ... you probably have better feelings about a podiatrist associated with fixing your foot pain than the one who didn't as well. That doesn't mean your feelings are causal of your foot getting better. In fact the podiatrist (or therapist) might not have done anything real either; sometimes you just get better.
  - woodandsteel 6y ago
    As the article makes clear, it is not just general good feelings, but the specific, back-and-forth interactions between the therapist and the patient.
    - scottlocklin 6y ago
      That's great: how are these specific interactions measured? Without that being something actually measurable in the corporeal world, it's just gibberish and assertions.
planck01 6y ago
"To complicate matters, numerous studies over the past few decades have reached what seems a counterintuitive conclusion: that all psychotherapies have roughly equal effects." The article gives a number of possible explanations for this, but not the obvious one: that the effect of psycho-therapy right now might not be more than a placebo effect. I wonder why this could not be the case.
- afterburner 6y ago
  Or just the simple salve of talking to someone (who is payed to listen to you intently). We are social creatures after all.
- fsiefken 6y ago
  I think it's because of the quality of the alliance, this is of course also what the article argues. According to my memory the studies have the same effect because of the therapist, not because of the placebo effect of the method. If it would be primarily a placebo effect you'd expect non-empathic therapist to do just as good. I think CBT therapy scored better on average, so in that case it's not only the therapist but also the method.
- trabant00 6y ago
  I can understand the relationship between the two is what makes the difference. But the framework and the tools must as well. Given the same level of trust, empathy, communication, etc, one form of therapy should give different results than other. They can't all be equal. Unless ofc none of them do anything. I can find no other possible explaination.
  - deleted 6y ago
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  - jschwartzi 6y ago
    The framework and the tools are mechanisms for establishing trust and for eliciting feelings and sensations. But it's the rapport with the therapist that seems to matter the most.
getpost 6y ago
(Restatement from a comment I posted previously[0] in a related thread.) My go-to reference is Attachment Disturbances in Adults: Treatment for Comprehensive Repair by Daniel P. Brown PhD & David S. Elliott PhD. [1] [0] https://news.ycombinator.com/item?id=21739622 https://news.ycombinator.com/item?id=21739622 [1] https://www.amazon.com/Attachment-Disturbances-Adults-Treatment-Comprehensive/dp/0393711528/ https://www.amazon.com/Attachment-Disturbances-Adults-Treatm...
Nasrudith 6y ago
I wonder if one alternate explanation for the "dodo theory" is like antidepressants in that the average level of effectiveness in aggregate is fairly low but each individual patient usually has several which work for them. I am not an expert admittedly.
snappieT 6y ago
It's so sad to hear about mom/mother/maternal so much in that article, and so little about the father's side of things. I want to believe that I can be an emotionally-nurturing influence on my kids, it feels like such a shame that there was zero mention that a male can fulfill this role - does the science say it's not possible at all? Otherwise a great article and some sections certainly did resonate.
- pizza234 6y ago
  I've been significantly "involved" in this area in the last few years, and as far I see it, it's pretty much the standard blend of gender roles and nature-vs-nurture. Most of the western societies are still based on the mother educator and father provider model. On top of this, I personally agree that mothers tend to have the qualities that makes it easier to deal with children (in a wide sense), which creates a positive feedback (or negative, depending on the POV). None of this is out of reach for fathers. My opinion is that with some effort and an equal amount of dedication, binding and influence on children are equal (although of course, different in nature). However, it's generally uphill. Keep in mind that once you start to notice the gender role, even more than hearing little about fathers, you'll see the negative stereotypes: check out how are the separated fathers are depicted in the cinema - it's something that "can't be unseen". Having said that, there's movement of course, primarily in/from the Scandinavian countries. Generally speaking, gender equality increases towards the north of Europe. American countries are, I suppose, a bit of a patchwork (definitely some countries are very "behind"). I'm not sure how much time, and if ever, genders will equalize, in particular in the literature/arts depiction. Ultimately, it's also a choice - fathers being providers is not implicitly negative, it's a cultural choice (in the context of a country). Laws, they definitely need to adapt, though!
- tropdrop 6y ago
  There was a halfhearted attempt to remind that this figure doesn't have to be the mother: "By contrast, children of unresponsive or insensitive caregivers form insecure attachment. They become anxious and easily distressed by the smallest sign of separation from their attachment figure... Finally, children with abusive caregivers become disorganised: they switch between avoidant and anxious coping, engage in odd behaviours and, like Cora, often self-harm." So this is an implicit acknowledgement that the gender of that early caregiver matters less than that they are nurturing. But I agree, the article is remiss in explicitly making mention that the gender of the early caregiver does not matter - especially given that the other half of the article is devoted to a male-female relationship (Cora and her therapist) which clearly contradicts the assumption that this needs to be a mother-child. Personally, I would have loved to see mention that even those with one stable caregiver can still develop issues when the other caregiver is not stable, or worse: that the other caregiver does not care. That often results in a person forming good relationships with their friends, but having a different (worse) standard of conduct towards their romantic partner - e.g. a child who sees their same-gendered parent [physically or verbally] abused, and once an adult, enters into an abusive relationship because that is what is normal to them in regards to the "other" gender.
cradra 6y ago
About age of 20 I suddenly became unable to pee in urinals. Can't pee in aircraft toilets either or anywhere I feel like I'm under scrutiny in some way. I've endured what felt to me like severe physical pain on long haul travel. I can't persuade my subconscious to let me pee even though I really want to. No idea why this happened to me, having previously had no problems whatsoever. The only thing that I can think of was getting a gay approach at about that age but I can't say that was the cause of it though I think it might have been.
- throwaway543645 6y ago
  I also have trouble with this. It helps if I pretend that I'm somewhere else, where I'd be comfortable doing my business. I think, "I'm at home, in my own bathroom. I was playing a video game and I paused it to take a quick leak."
  - cradra 6y ago
    Yes I've tried that but I can't seem to fool my subconscious it seems.
aszantu 6y ago
stuff makes sense now

388 points by fredley 6y ago

I really hate how people are pushing psychotherapy as the treatment for people suffering psychologically. I wish society would be humane and let people end their life by an injection. It’s allowed in a few countries but restricted elsewhere. It confirms to me that people are monsters that force their will on others by forcing them to continue suffering or commit suicide in a manner that can fail; where you’re ripe to be manipulated for the pro life agenda because of brain damage.

s5300 6y ago
>>It confirms to me that people are monsters that force their will on others by forcing them to continue suffering or commit suicide in a manner that can fail; where you’re ripe to be manipulated for the pro life agenda because of brain damage. Animals acting like animals? In other news... Water still has ability to wet.
ElFitz 6y ago
I would encourage you to read this: https://www.newyorker.com/magazine/2003/10/13/jumpers https://www.newyorker.com/magazine/2003/10/13/jumpers > “I instantly realized that everything in my life that I’d thought was unfixable was totally fixable—except for having just jumped.”
- deleted 6y ago
  [deleted]
- drops 6y ago
  Is it normal to find the quoted sentence quite humorous?
  - coldtea 6y ago
    It's intended to be humorous.
  - ElFitz 6y ago
    Yes! It seems intended. And I thought it would convey my point in a striking and oddly lighthearted way better than my words ever could.
- s5300 6y ago
  Going off your quote - cool. Terminal illness and severe chronic illnesses are not "totally fixable" though. If somebody's problems are totally fixable... they're not the people needing to be saved by legal dignified euthanasia. I don't understand why this is so hard for some people to understand.
  - rocqua 6y ago
    There is a difference between advocating for legalized euthanasia and advocating for a total and utter right to end one's own life at any point for any reason. OP seemed to argue for the latter, and who you are replying to argued against the latter. Now you seem to say that they should not argue against the former, which they were not arguing against.
    - ElFitz 6y ago
      Exactly! Thank you kind and understanding stranger!
  - ben_w 6y ago
    I accept that many people have incurable illnesses which are either literally torturing them or slowly robbing them of everything they value. The reason I am (slightly) against euthanasia despite this, is because I expect easy availability — to be clear, a culture where it is not even controversial rather than merely available lawfully — to also be world where it is easy for people who don’t fit that category being pressured into talking that path. The reason I’m only slightly against is that I don’t feel confident in weighing the quantifiable decrease in suffering with the probability distribution of possible increases in needless death. That, plus I recognise my argument is “that looks like a slippery slope”, where the real problem may well be that human behaviour isn’t what my imagination is telling me it is.
    - thrwaway69 6y ago
      Euthanasia can be restricted. No need to make it illegal and places where it is legal have measures in place to stop this.
- Johanx64 6y ago
  I kind of doubt that people who have been struggling with depression for 10-20 years will share the sentiment. No doubt they will experience some sort of hardwired survival instict which kicks in as they are about to go, but that's about it.
  - ElFitz 6y ago
    I have been struggling with depression for 10 years. Diagnosed and all. I was a wreck. A total wreck. Now, I still don't know if I'm out of it. I don't' know that I ever will be. It's terrifying. I see patterns I wish were long gone creeping back all the time. But I finally have lasting and enduring hope. And I've come to realize that all these times I wanted it all to end... I just wanted to stop suffering. At the time, death seemed to be the only way.
- thrwaway69 6y ago
  The problem is he jumped. He didn't have access to health professionals who will assess him before he could die. He wouldn't have jumped if he knew he could die in a more peaceful and controlled manner without shame. An euthanasia facility would have given him a second chance if it was properly maintained. They don't let you kill as you pass the door. They will make you wait, have you try things to help you before you could sign off the paper to die. I don't see why it should be illegal. it's like being against addiction control centres.
  - ElFitz 6y ago
    Well then, considering https://news.ycombinator.com/item?id=23916076 https://news.ycombinator.com/item?id=23916076, it'd seem we are on the same page!
- at_a_remove 6y ago
  I have often noticed that the "it gets better" crew, who dispense whatever little memes and then move on, have no skin in the game. The reality might be much different if there were some accounting at the end. "It appears that this person continued to suffer another twenty-three years and then died joylessly. As such, you must spend the next twenty-three years in a miserable and unpleasant box. Oh, and you have to also endure people telling you that it is only temporary. Ta." The unpleasant reality is that there are many situations which are untractable and the denial of their existence -- and the suffering inflicted -- largely serves to soothe those looking for a just world. We regularly call upon people to continue to be (and worse, be "up" about it) in circumstances where, were they occurring in some fuzzy animal, we would be moved to a grueling euthanasia with whatever rock came to hand.
  - ElFitz 6y ago
    Some situations are indeed intractable. That's why, for the physical ones, we have things like palliative care. I don't know what can be for psychological issues. However, had you read the article, you would have noticed this short snippet: > Dr. Seiden’s study, “Where Are They Now?,” published in 1978, followed up on five hundred and fifteen people who were prevented from attempting suicide at the bridge between 1937 and 1971. After, on average, more than twenty-six years, ninety-four per cent of the would-be suicides were either still alive or had died of natural causes. “The findings confirm previous observations that suicidal behavior is crisis-oriented and acute in nature,” Seiden concluded; if you can get a suicidal person through his crisis—Seiden put the high-risk period at ninety days—chances are extremely good that he won’t kill himself later. The question then becomes "What about those remaining 6%?" Well, I don't know. Did they go through another, different crisis? Where they appropriately helped and supported following their first attempt? And if nothing could actually be done for them, then we end up with the traditional trolley cart dilemma. 94% lives worth living saved vs 6% miserables lives.
    - at_a_remove 6y ago
      Oh, I have seen that clip so many, many times. It's just about the first thing trotted out. I need not read that paragraph yet one more time, life is too long. It ignores things like, "What number of those ninety-four just continued to be miserable?" They didn't kill themselves, but it doesn't mean that they were not still suffering. It might well mean that they were bludgeoned with the "just think of how devastating it will be for your family" bit until they submitted to a life of quiet desperation. It's not a measure of life being worth living at all.
LandR 6y ago
This gets tricky though, some psychological problems are temporary. They can be fixed with proper treatment. However people suffering from them aren't in the best place to make a decision like wether or not they should end their own life. In this case you want to protect these people and get them better. I think the problem is we've built a society though where it's so easy to end up sad and that needs fixed.
- ElFitz 6y ago
  Totally. Also, wether it's psychological issues or terminal physical illness, most people don't know what else can be done. For example, palliative care, properly done, can be incredible.
  - thrwaway69 6y ago
    The thing is why does everyone seem to forget here that some people don't have money, resources, family, environment or location to get access to many things that could help. Poor people surely will get happy if they get money, right? Surely therapy without a single worry in life will help them, right? Do you tell others to think about how happy you could be in a few years when they are sad? No, you don't. Do you encourage systematically poor people to suck it up because things will get better? Same mentality is used to justify racial injustices and inequality. Things will get better in future so suck it up for the movement. These people are in pain and should be able to stop it if they see it not worth it. Obviously there can be some time period such as a year or two before you can access euthanasia. Otherwise, it's cruel to let people suffer for years in false hopes.
    - ElFitz 6y ago
      I don't know how things work where you are, but I tend to reason based on the context and environment I know. Over here, we have a universal social security. While imperfect, incredibly bureaucratic, and hard to navigate at times, it ensures everyone can get access to most if not all medical care, for free for those who are in extremely precarious financial situations. But that is a political and social choice that was made in this country decades ago, and it is true it is not the same in many other places. Now, I want to believe this isn't what you meant, but another way to read your response could be "It'll take too long and it's too hard, too expensive, to help poor people out of their pain. We should instead let them put themselves out of their misery"
coldtea 6y ago
>I wish society would be humane and let people end their life by an injection. What's "humane" about that? It's the easy cop out, and hiding the problem under the carpet. Unlike terminal disease or something "suffering psychologically" is not unsurmountable... Not to mention tons of people tried to suicide because they suffered, failed, and then found out they're OK after all, and lived their lives just fine afterwards... >It confirms to me that people are monsters that force their will on others by forcing them to continue suffering or commit suicide in a manner that can fail Or, you know, people are angels, and don't just give poison to the first idiot that decided to kill themselves just because they temporarily suffer and think in their bad judgement that it can't be fixed...
- bragh 6y ago
  Let's keep it very simple here. What possible justification can you have to force another being with feelings to suffer? By the way, even the part of "something "suffering psychologically" is not unsurmountable" is quite often unjustifiable, such as when psychological suffering is caused by the environment and there is no way to escape the environment.
  - rocqua 6y ago
    The fact that sometimes suffering is very intense and temporary and that forcing someone to live through that can later lead to a fulfilling and happy life. A life where they are grateful they suffered through the temporary thing without ending it. That alone should be enough to acknowledge that sometimes, people who want to die should not kill themselves. Besides that, the fact that quite often, a person killing themselves will inflict a lot of suffering on their surroundings. If you argue we don't get to force someone to suffer, why does a suicidal person get to force others to suffer? Neither the position "No one should ever get to end their own life" nor the position "Everyone should be able to end their own life at any instant of their choosing always and immediately" seem tenable to me. With a decent solution lying somewhere in between these to positions.
    - s5300 6y ago
deleted 6y ago
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rocqua 6y ago

This really resonated with me

throwaway28191 6y ago

I had three different therapies in my life so far. The first one was a bad experience, the other two helped me a lot. I like both therapists but never felt like we are close or connected in any way this article writes about. Always I knew I'm dealing with a professional. I saw other patients leave the room before my session started. We needed to look for an appointment because of vacations and stuff, it was always just a person doing his job. And I'm fine with that. I also think it is necessary to have a person who is not too close to you helping you some times. Family members and friends want you to have as little pain as possible and doing better as fast as possible which is natural but often not the right thing. "On this view, the good therapist becomes a temporary attachment figure, assuming the functions of a nurturing mother, repairing lost trust, restoring security, and instilling two of the key skills engendered by a normal childhood: the regulation of emotions and a healthy intimacy." The therapist can't repair lost trust or security, only you can. A good therapist will help you do that.

LandR 6y ago
A personal question, if I may. I think seeing a therapist would be good for me, I have issues I'm struggle to fix myself but how does the conversation even start ? What I mean is, I can go to a regular doctor for a regular problem and he will say "what is the issue?" and I can explain it pretty clearly even if I don't know the underlying cause. e.g. "My leg hurts here when I move it in such a way" But I can't imagine how this conversation starts with a therapist. If they asked me what is wrong, I genuinely don't know. I don't know where to point to the pain. Then I just see myself sitting there with someone awkwardly, them thinking I'm an idiot.
- chrisco255 6y ago
  I've only had one therapist but she was extremely good. And she would ask a lot of questions. She'd get me to untangle a lot of my thought processes. She'd ask me about the past and have me dig into that and really ask tough to answer questions that forced me to think about why I thought the way I did. It took probably a good dozen or so sessions to get to the point where I was relatively healed and even then it took some time after, but by then I was able to regulate my anxiety on my own.

mlindner 6y ago

TL;DR having personal bonds helps you be a normal person. If you didn't have them in early life a therapist can act as someone forms bonds. In general though psychotherapy is a bunch of quack, as stated in the article the only thing that really matters is the patient and shrink working together.

sjg007 6y ago
The point is to get the tools to develop a secure attachment with yourself with the end goal of developing an integrated emotional response.

deleted 6y ago

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cloogshicer 6y ago

If this resonates with you, or you're thinking about therapy, I recommend reading 'The Drama of the Gifted Child', by Alice Miller. Don't be put off by the title, it's a great read regardless if you're think you're gifted or not. Gifted in this context means something closer to 'sensitive'. This, together with therapy, has significantly improved my life.

kqr 6y ago

This is a good and interesting read regardless, but I'll just point out that when studies are properly controlled for confounders, the "relationship with the early caregivers" matters much less than we want to think. Maybe not even at all. What shapes us are our interactions with our early peers. This makes sense from a hunter-gatherer point of view too; those are the people we will spend almost all our life with. I highly recommend reading The Nurture Assumption for more on this. The author effectively argues with evidence for why relationships with parents are nothing more than relationships with parents. It really opened my eyes both for things that went on in my upbringing, the upbringing of people I know, and taught me what is going to be important as I raise my son.

hrktb 6y ago
I think it comes down to how extreme the relation is. In the article there ia a large portion about abusive relationships and other cases warranting a therapist's intervention. In these situations, sure parents behavior will leave a strong and lasting impact on children. For more standard cases, parents will provide a supporting enough environment (even if not perfect) and will make their kid interact more with the world, be it school, activities etc., limiting the impact of their own direct behavior. To get back to your point, parent's thinking and behavior is fundamental IMO, but usually not just in a direct, person to person way. It would be more on the environment and social position they provide to their children.
- kqr 6y ago
  All true. Very well put.
- doboyy 6y ago
  I feel this is a more accurate assessment. The relationship between abuse/quality of parenting and anxiety/disfunction can't be thought of as linear. When parenting starts qualifying as abuse, there is a pretty steep increase. Otherwise, genetic temperament and environmental interactions have more influence.
HumblyTossed 6y ago

AdamCraven 6y ago

As someone who didn't have many healthy attachments growing up and has spent a lot of time with a wide variation of therapies. I agree with the article, many different therapies can fix people and I’ve found it better to have more than one type of therapy. I believe at the root of it is a mindset which centres around the cultivation of self-leadership. My multi-year long journey of what I learned and getting back to health - which most visibly manifested itself as CFS symptoms (Post exertional malaise) - can be summed up as: Trusting the therapist and understanding they are not perfect humans themselves. Accepting they are not going to fix me, they are a companion on the journey, I must fix myself with their help. Going on a journey through all major points in my past and re-experiencing what I'd been through. Whilst having the therapist with me to slowly help unfold the emotions and understand it from a different perspective (i.e. I did not cause the bad things that happened to me, it was not my fault). This helped me build a foundation, a place of support that didn't rely on other people, which gave me self-confidence to listen to the negative self-talk that I had blocked off for years, because it was too overwhelming to hear. When I started listening to this self-talk, I could then start to converse with it. e.g. "You aren't good enough", "Perhaps I'm not, but let's see what happens when I apply my focus to it", which started taking away its power and effect over me. Which led me to realising that my intellect and conscious part of my mind is probably only in control of 20%-30% of me. That I'm not a fully logically creature and that I needed to come to peace with my body's needs and messages from my less conscious mind and work together as an integrated whole, rather than trying to force my will based on pure 'rational' thought. Life has been considerably better since and my decades of depression and low energy have begun to abate. Whilst the points may seem simple, understanding like this rarely comes from knowing in the conscious mind. It is understanding that has to be understood at a deep level, which is why therapy can take a long time. My favourite way of describing this conscious acceptance but lack of sub-conscious understanding can be summed up as: “I know that, but try telling me that”.

chadwittman 6y ago
Your comment regarding your intellect and the conscious part of your mind only controlling about 20% - 30% of you is super interesting. I'd love to hear more specifically what made you come to that conclusion, as I've experienced a similar insight. Mine came from an overdose of marijuana ironically enough, but it gave me just enough perception of the feeling of two minds. I don't think I'll ever forget that experience.

carlsborg 6y ago

Summary: "... the deeper reason why no single psychotherapy seems to provide unique advantages over any other is that they ALL work because of shared elements. Chief among these is the therapeutic relationship, connected to positive outcomes by a wealth of evidence." "The emotional bond and the collaboration between client and therapist – called the alliance – have emerged as a strong predictor of improvement, even in therapies that don’t emphasize relational factors..." cites co-author of the book "Attachment in Therapeutic Practice" (2018). ".. what if, attachment theory asks, therapy gives you the chance to reach back and repair your earliest emotional bonds, correcting, as you do, the noxious mechanics of your mental afflictions?"

mwexler 6y ago

Like clockwork, every decade or so, someone says "Hey, we haven't looked at attachment theory in a while! We can get a few pubs and a book out of it.". A bunch of studies later, we see the repeat of all the previous findings: inconclusive, some interesting patterns, nothing super repeatable with strong effects. It's fine to revisit and revise past theory work. It's just surprising that after 70 years, this theory that should explain so much, after scrutiny, just... doesn't. Looking forward to the latest revisions to see how to apply attachment patterns to our modern world. I have popcorn in hand.

jschwartzi 6y ago
I would think it's very difficult to study human attachment using effect sizes. The sheer diversity of attachments a human makes and the rate at which each attachment changes means you're almost certainly seeing some confounding effects. You could bin attachment into styles and levels but it's more like a continuous function and you can never be certain that your bin sizes are adequate to describe the whole variability of the system.
sjg007 6y ago
Well if you want to make the argument that attachment theory is junk then you should provide some evidence.
- mwexler 6y ago
  That's not really the way science works. The theory drives testable hypotheses. We look at data to feel some confidence that the hypotheses are correct. If we don't find that data, we can continue to believe in the theory, but with less and less confidence. If a theory cannot be supported, then I can make the claim that its not correct in its current form. I don't think it's junk, but more that it's causal impact may be less than the theory purports. And sure, we can have an alt theory that goes against Attachment theory, and generate hypos from that, and put them to the test. Answering a different question, but same problem: can't just say "won't work", need to generate specific testable hypotheses. I'm just pointing out that the theory is nice and should have more provable (and supported) predictions, but it keeps having limited support from research, fades from view, comes back around, history repeats. After a while, our confidence goes very low. But it's not zero, and the fact that it keeps showing up again provides new hope. The theory is attractive so I hope we find its proper alignment through this latest iteration. But it has a tough road to hoe.

donatj 6y ago

> Things get even more puzzling if you consider the sheer number of therapies on offer and the conflicting methods that they often employ. Some want you to feel more (eg, psychodynamic and emotion-focused approaches); others to feel less and think more They all share being heard, raw, and I believe that is key. I spent time talking with a consoler years ago to work through some personal issues, and I genuinely feel having someone there to listen in a way where I knew judgements on their part would never threaten our relationship was the true value. Being able to just tell someone how I felt about things, clearly and honestly, without the need to self censor or sugar coat - particularly in the way I would with a friend - helped more than anything else.

viburnum 6y ago

Probably a mistake to treat parenting styles as exogenous. Parents respond to their child’s temperaments too. It’s easy to be attached to an easy-going child. A kid that’s always crying is going to wear you out.

caleb-allen 6y ago
Perhaps a kid that is always crying is attempting and failing to communicate pain or discomfort. I've been told that I was a miserable newborn--I cried nonstop for months and months and my screams made everybody around me miserable too. My mother was told by family that I needed to cry it out, but 6 months on there was no difference. I was taken in to the hospital and was found to have had a hernia which required surgery. After surgery, I'm told, I was absolutely quiet and unproblematic. Through the rest of my childhood and teenage years I was the 'easy-going' kid of the family. Through therapy I have learned that my attachment style is avoidant, and I have no doubt that this early experience (among others) heavily influenced the way I process emotions and feelings. It isn't that I was a naturally 'easy-going' kid, or that I didn't have the troubles that my siblings had. I felt things, but my experiences taught me not to express them. I formed a tendency to over-intellectualize my experience and, in retrospect, heavily suppress negative emotions and even physical pain. My nature was not to seek out help when I felt immense pain, but to persist with self-reliance, at all costs. Like the commenter above, therapy has done wonders for me in learning to recognize my feelings and having the capability in processing them in a healthy way. I am not a parent and so I can't speak to the difficulty of a child's temperament; I have no doubt that one child's personality might be much more difficult to handle than another. A parent is clearly going to be affected to their children's temperament, but the parent is also responsible for teaching the child how to process those emotions, and is significantly more equipped in dealing with how the child affects them than the child is at dealing with how their parent affects them.
woodandsteel 6y ago
That's quite true. However, the article doesn't describe parents as such, it describes the actually style of parenting that took place, whatever were the reasons things went that way rather than another.

Nav_Panel 6y ago

> All of this suggests a tantalising alternative to both the medical professional’s and the layperson’s view of therapy: that what happens between client and therapist goes beyond mere talking, and goes deeper than clinical treatment. The relationship is both greater and more primal, and it compares with the developmental strides that play out between mother and baby, and that help to turn a diapered mess into a normal, healthy person. Oh man, pop culture is rediscovering the use of psychoanalysis, finally! Transference is so important! > I am referring to attachment. Oh. God dammit. Can't escape the vortex of "science", leading to the massive fragmentation of psychological frameworks, destroying the field's credibility.

diffrinse 6y ago
I'd argue pop culture started catching on when The Sopranos aired
- Nav_Panel 6y ago
  Well, Freud was big back in the day, and then fell out of favor. And psychoanalytic theory still gets used in media and lit crit (and in writing the shows themselves), but... not in what it was built for, therapy.
  - greenshackle2 6y ago
    Last I checked it does about as well as all other types of therapies in studies. What does it say about the theories of mind underlying the different schools of therapy that they all work about equally well?
    - Nav_Panel 6y ago
      Ah, "Studies" whose language and inventories are already rooted in particular paradigmatic understandings of psychology. I would expect psychoanalysis to do worse, in the studies, than "regular" psychology! Damning that it doesn't!
- 6y ago

obiefernandez 6y ago

Really long article but this is the crux: > The emotional bond and the collaboration between client and therapist – called the alliance – have emerged as a strong predictor of improvement, even in therapies that don’t emphasise relational factors. > Until recently, most studies of this alliance could show only that it correlates with better mental health in clients, but advances in research methods now find evidence for a causal link, suggesting that the therapy relationship might indeed be healing. Similarly, research into the traits of effective therapists has revealed that their greater experience with or a stricter adherence to a specific approach do not lead to improved outcomes whereas empathy, warmth, hopefulness and emotional expressiveness do.

scottlocklin 6y ago
>The emotional bond and the collaboration between client and therapist – called the alliance – have emerged as a strong predictor of improvement, even in therapies that don’t emphasise relational factors. Yeah, OK, I might buy that as much as I might buy any result associated with something as nebulous as psychotherapy. How do they characterize this, exactly? Having good feelings about a therapist you got better from ... you probably have better feelings about a podiatrist associated with fixing your foot pain than the one who didn't as well. That doesn't mean your feelings are causal of your foot getting better. In fact the podiatrist (or therapist) might not have done anything real either; sometimes you just get better.
- woodandsteel 6y ago
  As the article makes clear, it is not just general good feelings, but the specific, back-and-forth interactions between the therapist and the patient.
  - scottlocklin 6y ago
    That's great: how are these specific interactions measured? Without that being something actually measurable in the corporeal world, it's just gibberish and assertions.

planck01 6y ago

"To complicate matters, numerous studies over the past few decades have reached what seems a counterintuitive conclusion: that all psychotherapies have roughly equal effects." The article gives a number of possible explanations for this, but not the obvious one: that the effect of psycho-therapy right now might not be more than a placebo effect. I wonder why this could not be the case.

afterburner 6y ago
Or just the simple salve of talking to someone (who is payed to listen to you intently). We are social creatures after all.
fsiefken 6y ago
I think it's because of the quality of the alliance, this is of course also what the article argues. According to my memory the studies have the same effect because of the therapist, not because of the placebo effect of the method. If it would be primarily a placebo effect you'd expect non-empathic therapist to do just as good. I think CBT therapy scored better on average, so in that case it's not only the therapist but also the method.
trabant00 6y ago
I can understand the relationship between the two is what makes the difference. But the framework and the tools must as well. Given the same level of trust, empathy, communication, etc, one form of therapy should give different results than other. They can't all be equal. Unless ofc none of them do anything. I can find no other possible explaination.
- deleted 6y ago
  [deleted]
- jschwartzi 6y ago
  The framework and the tools are mechanisms for establishing trust and for eliciting feelings and sensations. But it's the rapport with the therapist that seems to matter the most.

getpost 6y ago

(Restatement from a comment I posted previously[0] in a related thread.) My go-to reference is Attachment Disturbances in Adults: Treatment for Comprehensive Repair by Daniel P. Brown PhD & David S. Elliott PhD. [1] [0] https://news.ycombinator.com/item?id=21739622 https://news.ycombinator.com/item?id=21739622 [1] https://www.amazon.com/Attachment-Disturbances-Adults-Treatment-Comprehensive/dp/0393711528/ https://www.amazon.com/Attachment-Disturbances-Adults-Treatm...

Nasrudith 6y ago

I wonder if one alternate explanation for the "dodo theory" is like antidepressants in that the average level of effectiveness in aggregate is fairly low but each individual patient usually has several which work for them. I am not an expert admittedly.

snappieT 6y ago

It's so sad to hear about mom/mother/maternal so much in that article, and so little about the father's side of things. I want to believe that I can be an emotionally-nurturing influence on my kids, it feels like such a shame that there was zero mention that a male can fulfill this role - does the science say it's not possible at all? Otherwise a great article and some sections certainly did resonate.

pizza234 6y ago
I've been significantly "involved" in this area in the last few years, and as far I see it, it's pretty much the standard blend of gender roles and nature-vs-nurture. Most of the western societies are still based on the mother educator and father provider model. On top of this, I personally agree that mothers tend to have the qualities that makes it easier to deal with children (in a wide sense), which creates a positive feedback (or negative, depending on the POV). None of this is out of reach for fathers. My opinion is that with some effort and an equal amount of dedication, binding and influence on children are equal (although of course, different in nature). However, it's generally uphill. Keep in mind that once you start to notice the gender role, even more than hearing little about fathers, you'll see the negative stereotypes: check out how are the separated fathers are depicted in the cinema - it's something that "can't be unseen". Having said that, there's movement of course, primarily in/from the Scandinavian countries. Generally speaking, gender equality increases towards the north of Europe. American countries are, I suppose, a bit of a patchwork (definitely some countries are very "behind"). I'm not sure how much time, and if ever, genders will equalize, in particular in the literature/arts depiction. Ultimately, it's also a choice - fathers being providers is not implicitly negative, it's a cultural choice (in the context of a country). Laws, they definitely need to adapt, though!
tropdrop 6y ago
There was a halfhearted attempt to remind that this figure doesn't have to be the mother: "By contrast, children of unresponsive or insensitive caregivers form insecure attachment. They become anxious and easily distressed by the smallest sign of separation from their attachment figure... Finally, children with abusive caregivers become disorganised: they switch between avoidant and anxious coping, engage in odd behaviours and, like Cora, often self-harm." So this is an implicit acknowledgement that the gender of that early caregiver matters less than that they are nurturing. But I agree, the article is remiss in explicitly making mention that the gender of the early caregiver does not matter - especially given that the other half of the article is devoted to a male-female relationship (Cora and her therapist) which clearly contradicts the assumption that this needs to be a mother-child. Personally, I would have loved to see mention that even those with one stable caregiver can still develop issues when the other caregiver is not stable, or worse: that the other caregiver does not care. That often results in a person forming good relationships with their friends, but having a different (worse) standard of conduct towards their romantic partner - e.g. a child who sees their same-gendered parent [physically or verbally] abused, and once an adult, enters into an abusive relationship because that is what is normal to them in regards to the "other" gender.

cradra 6y ago

About age of 20 I suddenly became unable to pee in urinals. Can't pee in aircraft toilets either or anywhere I feel like I'm under scrutiny in some way. I've endured what felt to me like severe physical pain on long haul travel. I can't persuade my subconscious to let me pee even though I really want to. No idea why this happened to me, having previously had no problems whatsoever. The only thing that I can think of was getting a gay approach at about that age but I can't say that was the cause of it though I think it might have been.

throwaway543645 6y ago
I also have trouble with this. It helps if I pretend that I'm somewhere else, where I'd be comfortable doing my business. I think, "I'm at home, in my own bathroom. I was playing a video game and I paused it to take a quick leak."
- cradra 6y ago
  Yes I've tried that but I can't seem to fool my subconscious it seems.

aszantu 6y ago

stuff makes sense now