6 ms·

This is good advice. Sadly, many on HN are very pro "mental health professionals". I see the opposite advice proffered frequently. These "professionals" make th

by ctrlp 3y ago

This is good advice. Sadly, many on HN are very pro "mental health professionals". I see the opposite advice proffered frequently. These "professionals" make things worse by pathologizing normal life. Their availability to function as ersatz "friends" discourages people from making the real kind, imho.

vasco 3y ago
It's just inviting downvotes but I also agree with you. Therapy is a scam and no doctor can explain how or why anti-depressants work (also why they have people "try" many before finding the "right one for you"). But people are too cool for friends and family now and hearing hard truths so they pay someone to be told they matter and how to run their lives. I have seen different approaches to therapy being done to different friends and only one friend got better - this tells me it can work for some, but the odds are you're getting a grifter. In this case their therapist told them they didn't need anti-depressants (shocker) and after ~15 sessions said they were fine and didn't need help anymore. Everyone else is medicated and still going every month, presumably til they die.
- deleted 3y ago
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  - deleted 3y ago
    [deleted]
- axioms_End 3y ago
  1) Length of therapy is strongly correlated to school. CBT and it's forks are relatively short and ability-oriented, where psychodynamic is very long with hazy endpoint. And generally CBT should be pushed much more, as it's faster, more goal-oriented, and less prone to, let's say, therapist biases. 2) Although I get the idea that people need friends and family, it's easy to forget that people with severe issues do not look like they have them. And taking care of eating disorder/personality disorder/*PTSD/whatever else treated through therapy, not medication patient is a lot of work to which most people are not equipped, and which drains a lot, to the point of resentment (if they can't run away) or just ghosting. Also, it's not that people do not hear "harsh truths" - it's more about not being able to comprehend them, due to broken thought patterns.
  - vasco 3y ago
    There's a big spectrum and you have good points. I honestly believe that a small amount of people are better off being medicated, keyword being very small (<0.1%). Those that would be a danger to themselves or others in a real way. So I concede some ground. But I refuse to believe that a society with a significant % of people on anti-depressants is a way to live. Look at my country's statistics: https://www.statista.com/statistics/1020727/antidepressants-pharmaceutical-consumption-in-portugal/ https://www.statista.com/statistics/1020727/antidepressants-... Most of my friends on them are just bummed out about their life but not enough to change their situation. Perhaps CBT is the answer, my big issue is that the majority of therapists over-prescribes, and that makes me lose trust in the whole thing. It's like trying to see the good parts of cryptocurrencies, you need to ignore a lot of shit and in the end you wonder if its worth it.
    - sph 3y ago
      You ignorance on the matter shows. You are probably living in the US where pushing pills is the norm. Honestly, this entire anti-therapy subthread is a shitshow of misinformation. Let me shed some light: there are psychotherapists, that are not doctor, and can't prescribe anything. Then there's psychiatrists, which are medical doctors, and might approach your depression with the pill du jour. SSRIs just cure the symptom, not the actual bloody problem one has. You don't need a pill, nor a doctor unless it's an actual curable condition (bipolar, ADHD, etc.). You need someone to talk to.
      - ctrlp 3y ago
        Some of us are saying that paying a professional because you just "need someone to talk to" is a situation created, enabled, and perpetuated by this talk therapy culture. Some of us are pointing out the history of this profession and its incredible lack of scientific rigor and perverse incentives.
  - sph 3y ago
    I dislike immensely the idea of CBT and I reckon it's the reason therapy got such a bad rap. Talk therapy is immensely more free form. The goal-oriented approach works great in our modern productivity focused society, it's not a way to just learn to unleash what you actually want to be. Source: 3 years of talk therapy.
- chownie 3y ago
  > Therapy is a scam and no doctor can explain how or why anti-depressants work (also why they have people "try" many before finding the "right one for you"). We also don't know the mechanism behind how anaesthesia works, this doesn't mean anaesthetists are grifters. Mental health issues are not easily distinguished, "depression" is a cluster of conditions which probably have different treatment responses but all present alike. It's not unusual that some people will respond to SSRIs, others will need beta blockers and a third group will need talk therapy.
  - ctrlp 3y ago
    I don't remember seeing many studies about anesthesia doubling the risk of going unconscious like anti-depressants and suicide. Or many situations in which someone just doesn't respond to the anesthesia. That's the track record we're talking about here. Not sure it even rises to the status works sometimes.
newaccount74 3y ago
Have you ever been to a therapist? My family did a few group therapy sessions when my dad died, and it wasn't anything like you suggested. At no point did the therapist suggest there was anything wrong with us or suggest medication. She just listened and helped us deal with the new situation. Was it absolutely necessary to talk to a therapist? No it wasn't. Did it make the situation easier to deal with? Yes it did.
- ctrlp 3y ago
  Group therapy is basically like having a mediator in a room to facilitate conversation. It's not quite the same as individual therapy. I'm glad you got some value out of that interaction.
norwalkbear 3y ago
Therapy is a scam, see the replication crisis on hackernews's front page today. An enormous amount of studies don't replicate.

by ctrlp 3y ago

vasco 3y ago

It's just inviting downvotes but I also agree with you. Therapy is a scam and no doctor can explain how or why anti-depressants work (also why they have people "try" many before finding the "right one for you"). But people are too cool for friends and family now and hearing hard truths so they pay someone to be told they matter and how to run their lives. I have seen different approaches to therapy being done to different friends and only one friend got better - this tells me it can work for some, but the odds are you're getting a grifter. In this case their therapist told them they didn't need anti-depressants (shocker) and after ~15 sessions said they were fine and didn't need help anymore. Everyone else is medicated and still going every month, presumably til they die.

deleted 3y ago
[deleted]
- deleted 3y ago
  [deleted]
axioms_End 3y ago
1) Length of therapy is strongly correlated to school. CBT and it's forks are relatively short and ability-oriented, where psychodynamic is very long with hazy endpoint. And generally CBT should be pushed much more, as it's faster, more goal-oriented, and less prone to, let's say, therapist biases. 2) Although I get the idea that people need friends and family, it's easy to forget that people with severe issues do not look like they have them. And taking care of eating disorder/personality disorder/*PTSD/whatever else treated through therapy, not medication patient is a lot of work to which most people are not equipped, and which drains a lot, to the point of resentment (if they can't run away) or just ghosting. Also, it's not that people do not hear "harsh truths" - it's more about not being able to comprehend them, due to broken thought patterns.
- vasco 3y ago
  There's a big spectrum and you have good points. I honestly believe that a small amount of people are better off being medicated, keyword being very small (<0.1%). Those that would be a danger to themselves or others in a real way. So I concede some ground. But I refuse to believe that a society with a significant % of people on anti-depressants is a way to live. Look at my country's statistics: https://www.statista.com/statistics/1020727/antidepressants-pharmaceutical-consumption-in-portugal/ https://www.statista.com/statistics/1020727/antidepressants-... Most of my friends on them are just bummed out about their life but not enough to change their situation. Perhaps CBT is the answer, my big issue is that the majority of therapists over-prescribes, and that makes me lose trust in the whole thing. It's like trying to see the good parts of cryptocurrencies, you need to ignore a lot of shit and in the end you wonder if its worth it.
  - sph 3y ago
    You ignorance on the matter shows. You are probably living in the US where pushing pills is the norm. Honestly, this entire anti-therapy subthread is a shitshow of misinformation. Let me shed some light: there are psychotherapists, that are not doctor, and can't prescribe anything. Then there's psychiatrists, which are medical doctors, and might approach your depression with the pill du jour. SSRIs just cure the symptom, not the actual bloody problem one has. You don't need a pill, nor a doctor unless it's an actual curable condition (bipolar, ADHD, etc.). You need someone to talk to.
    - ctrlp 3y ago
      Some of us are saying that paying a professional because you just "need someone to talk to" is a situation created, enabled, and perpetuated by this talk therapy culture. Some of us are pointing out the history of this profession and its incredible lack of scientific rigor and perverse incentives.
- sph 3y ago
  I dislike immensely the idea of CBT and I reckon it's the reason therapy got such a bad rap. Talk therapy is immensely more free form. The goal-oriented approach works great in our modern productivity focused society, it's not a way to just learn to unleash what you actually want to be. Source: 3 years of talk therapy.
chownie 3y ago
> Therapy is a scam and no doctor can explain how or why anti-depressants work (also why they have people "try" many before finding the "right one for you"). We also don't know the mechanism behind how anaesthesia works, this doesn't mean anaesthetists are grifters. Mental health issues are not easily distinguished, "depression" is a cluster of conditions which probably have different treatment responses but all present alike. It's not unusual that some people will respond to SSRIs, others will need beta blockers and a third group will need talk therapy.
- ctrlp 3y ago
  I don't remember seeing many studies about anesthesia doubling the risk of going unconscious like anti-depressants and suicide. Or many situations in which someone just doesn't respond to the anesthesia. That's the track record we're talking about here. Not sure it even rises to the status works sometimes.

newaccount74 3y ago

Have you ever been to a therapist? My family did a few group therapy sessions when my dad died, and it wasn't anything like you suggested. At no point did the therapist suggest there was anything wrong with us or suggest medication. She just listened and helped us deal with the new situation. Was it absolutely necessary to talk to a therapist? No it wasn't. Did it make the situation easier to deal with? Yes it did.

ctrlp 3y ago
Group therapy is basically like having a mediator in a room to facilitate conversation. It's not quite the same as individual therapy. I'm glad you got some value out of that interaction.

norwalkbear 3y ago

Therapy is a scam, see the replication crisis on hackernews's front page today. An enormous amount of studies don't replicate.