11 ms·

The Psychotherapy Myth

99 points by mpweiher 3y ago

Seb-C 3y ago
Every time I see such an article that dismisses psychotherapy, I cringe a little bit. It is obvious that the author is ignorant of the topic (psychotherapy). It sounds like a hardware engineer dismissing software engineers and strongly affirming that all bugs can be solved with hardware solutions. Some problems are indeed due to psychic issues and not physiological ones. Yes, you can probably workaround symptoms with drugs, but that does not really solve the problem. If you have mental blocks and a shitty life that makes you depressed, and alleviate the depression with drugs, you still have mental blocks and a shitty life. I wish that both disciplines were not as independent from each other as it is today. Having experts at both subjects could probably do wonders to help people and make proper progress.
- bathMarm0t 3y ago
  Option 1: Confront your mental blocks and shitty life with depression. Option 2: Confront your mental blocks and shitty life with less depression (due to pharmacology). Option 3: Confront your mental blocks and shitty life with a guide and less depression (due to pharmacology and therapist). Option 4: Wait for the law of averages. https://youtu.be/3s_BqdZrUbE https://youtu.be/3s_BqdZrUbE I'm taking option 3 all day, every day.* (e.g. I agree with you. They should always be done in tandem / there is no silver bullet). *It's very important that your therapist shares your zeitgeist or directly counters it as a devils advocate. The drugs... not so much.
  - rngname22 3y ago
    Option 4: Convince yourself your life isn't shitty via self-gaslighting / culture. (Often achieved historically via religion. Listen to stories of Jesus' suffering at church once a week for your entire childhood and any suffering you go through despite your good behavior suddenly seems less bad when you compare it to the ultimate Good Person who was tortured and killed on a cross). Option 5: Convince yourself it's worth suffering through your shitty life because if you're a good moral person, you can keep your eye on the prize (eternal afterlife in paradise with all your dead relatives and loved ones in eternal abundance and joy), also historically achieved via religion. "According to their analysis, religion is positively associated with life satisfaction, happiness and morale in 175 of 224 studies (78%). Furthermore, religion is positively associated with self-rated health in 27 of 48 studies (56%), with lower rates of coronary heart disease in 12 of 19 studies (63%) and with fewer signs of psychoticism (“characterized by risk taking and lack of responsibility”) in 16 of 19 studies (84%)." https://www.pewresearch.org/religion/2019/01/31/religions-relationship-to-happiness-civic-engagement-and-health-around-the-world/#:~:text=According%20to%20their%20analysis%2C%20religion,of%20224%20studies%20(78%25) https://www.pewresearch.org/religion/2019/01/31/religions-re....
mnemotronic 3y ago
Obvious Scientology tripe, or the author thinks it's April 1st. Try taking a manic-depressive off lithium for a couple weeks, but only if they live with you.
wu2Fe7sp 3y ago
This ain't it; there's a debate to be had about the quality of evidence of the many different approaches to psychotherapy, but this person, this tone and this arguments are not it. You can watch people who know much more about the topic (which could be achieve by a more open-ended cursory search) here in the comments trying to elucidate points that are not even made by the OP, just out of the good faith of their hearts (and a desire to keep things on topic). But posting a self-fashioned race-realist certainly would repel most knowledgeable people with good faith.
aaron695 3y ago
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dartvox 3y ago
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DrNosferatu 3y ago
Very misguided and science denying. Psychotherapy is about the relationship. This point is of such importance, that in Germany (where psychotherapy is covered by the mandatory health insurance) patients are allowed to have a couple of test sessions with several different therapists and then choose to continue with the one they feel best. Also - as already pointed out - there’s a multitude of schools or types of psychotherapy (CBT, Psychodynamic, etc.) with statistically significant benefits. Of course, some are more suited for some cases than others. The OP treats psychotherapy as a monolith. One way to look at it, is, that many people weren’t raised with competent-enough parenting (or mentoring) to acquire the skills to cope with some issues on their own - i.e.: the “just deal with it”. And this is the role of the therapist: not to become a parent, but to play the prosthetic role of a very competent parent, or mentor. So that the patient can increase self-awareness, self-reflection, and emotionally grow into being able to better deal with the situation at hand. However, perhaps the biggest takeaway message here is that we need to educate Society - as we educate kids to learn to recycle - on how to choose a good therapist, what good therapy feels like, the importance of accredited and evidence-based methods (so people don’t rely on astrology and other quacks for - and therefore avoid properly dealing with - their emotional health needs), as well as, what should NOT happen in therapy sessions. PS: And also educate about what is black & white thinking ;)
- ecshafer 3y ago
  If psychotherapy is not a myth, what is the exact mechanism that therapy fixes an issue? If it were science that answer would be readily apparent. I can say exactly how photosynthesis works using chemical structures at every step of the process. But I can’t look up in a book how precisely psychotherapy fixes depression. Psychology has a dearth of actual repeatable testable experiments, which is why it’s not a science. If so many people lack parenting that gives them the skills to tough it out and deal with it, that psychotherapy is necessary, why were so many people able to function prior to psychotherapy? Psychotherapy is only 100 years old, hell it’s only been socially acceptable for like 20 years. But people functioned just fine.
  - testtestabcdef 3y ago
retrocryptid 3y ago
Sounds like SOMEONE is pissed off he got dismissed from his psych professorship. So first he sounds like a white nationalist, now he sounds like a scientologist.
trowaway6392610 3y ago
Seeing a shrink ruined my life. I used to be happy, productive, and socially engaged. Now I'm bouncing around medications, sleeping on the couch all day, and constantly ruminating about the past that I lost. Feelings are less important than the big picture of your life. Fuck mental health care for convincing me to prioritize my feelings in the moment over my long term happiness.
neilk 3y ago
I was not impressed, and this is before I knew who the authors were. I think it's worth examining, but only to see how right-wing cranks cosplay as scholars. 1) They keep using passive voice, like "Scholars say..." to introduce their critiques. One could be bad writing but multiple times is suspicious. WHICH SCHOLARS??? This is a sure sign of someone trying to obscure the motives and origin of their critique. The white nationalist author identifies himself as an independent scholar, which suggests strongly he really means far-right cranks like themselves. 2) The authors never clearly identify their target. Who are they attacking - popular representations of psychotherapy, or the validity of psychotherapy itself? They introduce the topic with culture war tropes, gesturing vaguely to what elites talk about at "cocktail parties" (what is this, the late 1960s?) and incredibly, the movie "Ordinary People" (1980!). Anyway, they assert that there is a myth in popular culture and then tear down the most simplistic version of the argument - that therapists are superhuman engineers of the soul. Strawmanning heavily here, and presenting a false dilemma - one can only be self-reliant or only depend on therapy. But so what. Popular culture gets a lot of things wrong. 3) In any case, by a somewhat crooked road, they proceed from there to some critiques of the effectiveness of psychotherapy, itself. And it's worth considering. All of social and medical science is undergoing a huge replication crisis. They rely heavily on meta-studies. Unfortunately, those studies show the opposite of what they are claiming. So by various techniques, they try to mathematically weaken the conclusions of those meta-studies, coming up with surprisingly precise numbers about how wrong the studies are. (This, by itself, is already a hallmark of the right-wing crank.) Is psychotherapy just great all the time? No. I've had my share of therapists that I'd consider pretty awful. But anecdotally I've found that the more academically qualified, the better the therapist is, and the closer they adhere to evidence-based therapies. If the Winegards' critique was true that the field is rotten, it should be the opposite. I can't help contrasting these author's arguments with a book I happen to be reading right now, The Body Keeps The Score, by Bessel van der Kolk. This is a best seller which may have done more than any other book to inject concepts like trauma into contemporary consciousness. I'm just in the first chapters, where van der Kolk works in a VA hospital where there are many divots in the wall, due to Vietnam veterans flipping out and punching it, often over trivial frustrations. These are conservative and military people, and they have tried hard to do what the Winegards prescribe - going to church, not dwelling on their past experiences - and they fail, because their trauma keeps reasserting itself. van der Kolk later sees some of the same signs in his civilian patients, and as a young intern assigned to monitor patients on the late shift, hears many confessions of abuse that are never repeated to the doctor in the morning. The Winegards attack the concept of psychotherapy as if it's quack medicine for trivial ills, the kind you can shrug off with a little grit. And their critique remains at a safe distance from the problem, through their own vague perceptions of pop culture and browsing the internet for meta-studies. If the Winegards could show some examples of people overcoming trauma by just manning up, praying or, suppressing things and getting on with it, then maybe I'd be interested. Or if they wanted to talk about the eroding of medicalized terms through popularization, like "trauma", I'd be at least partially on board. But they don't, and they won't. Like all right-wing cranks, they aren't concerned with what you might assume; that is, the health of patients. they're concerned with knocking down "elites". You know you're dealing with a right-wing crank when they characterize their enemy as an elite that is both contemptibly weak and inexplicably strong. They offer no explanation as to how their enemy's cultural power was achieved and maintained. It certainly couldn't have been because it kind of works or because the need is great. It's always because of the masses being hypnotized by messages in the media - like, you know, Ordinary People (1980). Beware this sort of thinking, because it leads to reactionary solutions.
iamthemonster 3y ago
I'm not saying rationalwiki is an authoritative source but you might find it a useful starting point to learn about the authors: https://rationalwiki.org/wiki/bo_winegard5vg5 https://rationalwiki.org/wiki/bo_winegard5vg5
- aaron695 3y ago
  > I'm not saying rationalwiki is an authoritative source Then don't fucking link it. I'm not saying Encyclopedia Dramatica is an authoritative source but you might find it a useful starting point to learn about Rational Wiki - https://encyclopediadramatica.online/RationalWiki https://encyclopediadramatica.online/RationalWiki
- sverona 3y ago
  My suspicions were aroused when I saw they interviewed J. Michael Bailey, who has been doing science backwards for decades now to paint me and the people who saved my life as a bunch of deluded perverts. The manifesto on "race realism" (!!!) is enough to convince me that the authors of this piece would shoot me dead if they ever got the chance. They can kindly fuck off back to the 1920s with that nonsense.
- chownie 3y ago
  Is that link correct? It appears to point to an empty page
  - NoZebra120vClip 3y ago
    https://rationalwiki.org/wiki/Bo_Winegard https://rationalwiki.org/wiki/Bo_Winegard
- mdp2021 3y ago
  While I have seen any kind of participation (hence quality and dubious patterns) in Wiki articles, this is what you find there: > W spends most of his time on Twitter talking about _ and the alleged evils of _. He commonly retweets _ and other so-called _. W identifies as a member of the _ which is basically an attempt by _ to re-brand themselves as political moderates.[ref] That is profiling work. (Not just "Ad hominem".) -- The clash with the name "rational-wiki" is too strong not to be noted. -- (Sniper, put some argument there: you are qualifying yourself. Not in a good light.)
NoZebra120vClip 3y ago
This is a weird article, and one of the weirdest features that leaps out at me is that they are treating "psychotherapy" as a monolithic thing to discuss and be studied. There are, of course, many forms of psychotherapy, such as CBT, EMDR, IFS, etc. etc. So I don't see how any one monolithic study of "psychotherapy" can evaluate its effectiveness, even if they are going to focus solely on depression, and indeed, this article only addresses depression. Furthermore, of course, depression does not occur in a vacuum, and in my case it was the tip of the iceberg, and future sessions would progressively refine and broaden the diagnostic landscape. Most of all, the positive experiences I have gained from psychotherapy are not simply talking to a professional guy and having him validate my feelings, but rather I've learned practical tools for coping and alleviating symptoms. You may work out of this year's depression, only to find yourself depressed again in five years. If you had taken drugs, then you come crawling back to the psychiatrist and the pharmacy again and you get back on drugs. If you had taken psychotherapy, then you may not need to return to the psychotherapist, if you have been equipped with the right tools, you could have them in a notebook still, and then you just do some checklists, you follow steps, and you've got your skills for coping back at your fingertips again. Granted, I don't believe that psychotherapy is the be-all-end-all of curing mental illness. In fact, psychotherapy was invented in competition to, or perhaps as a replacement for, auricular confessions to a Catholic (or Orthodox) priest. The Protestant Reformation had eviscerated Germany's ability to cope with the mind's inmost challenges, and the common people had lost their most trusted human confidants, the ones who ministered in the person of Christ. So Freud and his Freunde came up with a way to whisper secrets to a man, have them held in confidence, and maybe even get some advice in return. But essentially, it was just a secular façade to compensate for a sacrament which had been efficacious for thousands of years.
- worklaptopacct 3y ago
  I can assure you that a great majority of practicing Catholics do not treat confessions seriously. Coming from a traditionally Catholic society, we don't have any better coping techniques than "simply man up". I'm fascinated with Americans who discover Catholicism though. Suddenly the religious parts of Europe become what Japan is to anime enthusiasts - a mythical land of perfection.
postmodest 3y ago
[flagged]
bpm140 3y ago
I think like many people, the first couple of paragraphs inspired me to see what else was published on the site for more “context” about the author’s point of views. At this point, writing a good-faith rebuttal to the article seems unnecessary.
- EdwardDiego 3y ago
  Wow, did the same as you, and eep... > The demographic groups involved likely have an average intellectual quotient (IQ) under 85, an aspect that's seldom discussed openly in France. What is the cost of silence?
- phkahler 3y ago
  IMHO this article doesn't belong on HN.
  - tptacek 3y ago
    There's a button for that!
    - artemonster 3y ago
      why cant i downvote the post itself? is there a karma requirement for that?
      - tptacek 3y ago
        No, you can't downvote posts, and if you use flags as a form of downvoting you may find your flags quietly defanged. In this case, though, I think you'd be on pretty firm ground.
- calderknight 3y ago
  Consider reading this: https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html > Comments should get more thoughtful and substantive, not less, as a topic gets more divisive. > Please don't post shallow dismissals, especially of other people's work. A good critical comment teaches us something. > Please don't use Hacker News for political or ideological battle. That tramples curiosity. > Please don't pick the most provocative thing in an article or post to complain about in the thread. Find something interesting to respond to instead.
refulgentis 3y ago
Strawman, no one thinks that it is false: humans can be resilient and tough-minded; they can suffer the slings and arrows of life without expensive interventions from “experts".
- mactavish88 3y ago
  Agreed. My understanding from someone I consider to be a very good clinical psychologist is that the only time you may need some psychotherapeutic intervention is when you are genuinely stuck with a problem you can’t figure out yourself _and_ it’s significantly hampering your quality of life in some way you consider meaningful. And then, you only need help until you’re unstuck. Teach a man to fish, and all that…
  - Michelangelo11 3y ago
    Right, but you hear "everyone should be in therapy" from all corners; there's at least one dating app (Bumble, I think) that has an "In therapy" tag you can put on your profile; and BetterHelp advertises themselves with a commercial where girls at brunch talk about a guy one of them has been seeing, and they agree she should stop seeing him once they realize he's not in therapy, even though they know almost nothing else about him ( https://freddiedeboer.substack.com/p/im-not-trying-to-be-dramatic-but https://freddiedeboer.substack.com/p/im-not-trying-to-be-dra...). That isn't really a view of therapy as a specific intervention, but as an almost mandatory practice for adults, kind of like going to the gym. The view of the psychologist you mention is actually sadly rare. Obviously, I think the widely shared view of therapy is a total bastardization of any worth therapy might have had in the first place.
    - tptacek 3y ago
      This thread is literally the first time I've ever heard "everyone should be in therapy" from anybody.
      - pastacacioepepe 3y ago
H8crilA 3y ago
The more I learn about my depression the more I realize just how underdeveloped medicine is in this area. Everything that the author writes is true, some psychiatrists will even admit as much - i.e. that standard treatments such as psychotherapy or SSRIs or exercise work, but each of them just barely. We may be decades or even centuries away from reliably treating depression. Most depressions indeed go away on their own, and perhaps are even helpful - they can force a person to reconsider and rearrange their life. The heavier ones probably have to be treated with everything that the patient and their environment can muster, all at the same time. And since the patient usually can't do much, it's up to the environment (friends, family, health care, mental hospitals). Please keep that in mind and force your depressed friends to go for walks, or do anything else at all, repeatedly. All the +5% basics like physical activity or smalltalk really do add up. Though the depressed person will not be able to see it for a while.
- Knee_Pain 3y ago
  You (rarely) can force a cure onto people, and in the case of mental problem it's basically impossible. If the science was clear in that depression would be heavily contained if the sufferer engaged in physical activity, good sleep, good diet, good general routine and zero stuff like social media or mindless entertainment, then how man people would actually follow through? We criticize psychs for their love of giving pills, but we are the first who are lazy and stupid and would never actually do what's best for us
  - williamtrask 3y ago
    We might not be able to force a cure, but I can think of a multi trillion dollar industry (or two) that’s undoubtedly pushing the opposite. Maybe we should start there.
- donatj 3y ago
  I had a pretty bad bout of depression about a decade ago. My girlfriend left me, followed shortly by one of my closest friends dying. I saw a therapist and went on antidepressants. I didn’t find either particularly effective or helpful. I don’t know if it’s even possible for other people but what I ended up doing out of desperation was just logic-ing my way out of it. I would sense it coming and start directly countering thoughts and waves of emotions with reasons what I was feeling was not true and things I was grateful for. It was literally like arguing with my own thoughts and telling them to shut up. It shortened the bouts by a ton, stopped me from spiraling and eventually they stopped all together. Maybe that will help someone else super analytical like myself? I genuinely don’t know. In more recent years, did not help my wife with her struggles at all.
haswell 3y ago
Every time I read a critique of psychotherapy like this, it's hard not to conclude that the authors have very little knowledge of what therapy actually entails, and how it's changed over the decades. As someone who has dealt with mental health issues stemming from complex trauma for most of my life, it's difficult to take this seriously. What the author describes is a laughable caricature of the field, and seems pretty far removed from the realities that many people face. I see therapy as a commitment to focusing on root causes, and retraining maladaptive patterns of thought. I see my relationship with my therapist as that of a teacher/student. Someone who can help me reframe things and see other perspectives until I can do the same thing for myself. Coming from an abusive environment that hammered certain attitudes into me from an early age, I've found incredible value from establishing a trust relationship with a person who can act as a conversational sparring partner and can point out the patterns of thought I can't see in myself. I didn't have other people in my life who I trust this deeply, probably because of the underlying reasons I'm seeing a therapist. I've found that some of the most helpful ways to improve my mental state have nothing to do with those sessions. Sleep, exercise, time in nature, social connection, artistic outlets, etc. are all critical. But those are the things that I didn't know how to actually do. I wanted to want these things, but couldn't navigate the mental blocks that kept me stuck where I was. And for whatever immediate physiological benefit these activities bring, they don't undo decades of conditioned thought that needs to change. Using sheer willpower to force myself to exercise only worked for a short time, and I couldn't establish lasting habits until I had unwound associated unhelpful patterns. To present these things as better than or as effective as therapy is to completely misunderstand the point. Therapy is also not some panacea, and most of the real work happens outside of session. > Patients can expect to pay somewhere between 60 to 250 dollars per hour for a therapy session. (A jog in the park, a church service, a long walk in the woods are all, of course, free.) In many cases, insurance covers part of this; however, therapy can still be expensive for the patient, and therapists—men and women who often espouse dubious, even risible theories—are handsomely remunerated. As a kid, I grew up going to church services. Services in which I heard "spiritual leaders" rail against the sinfulness of homosexuality (among many other things). Around age 12, I heard earnest conversations from elders in the church about such people deserving to be stoned to death according to scripture. This was rather confusing and terrifying to hear from people who were supposedly worthy of my attention at a time when I was coming to grips with the fact that I felt attraction to both men and women. To deride psychotherapy and casually offer "free church services" as an alternative in the same sentence is pretty humorous to a person who has had life changingly positive experience with therapy...therapy that arguably became necessary after years of indoctrination and instilled existential dread by those free church services. I'm not railing against all churches, and there are some great organizations. But it seems only fair to point this out in an article that calls therapy to task for those instances when it doesn't work. I, for one, am grateful for therapy. It saved my life (literally), and has been an incredibly positive force in my life.
deleted 3y ago
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zzzeek 3y ago
millions of people benefit from psychotherapy every day, but random substack with predictable ties to right-wing nativist bullshit says it's all bunk. Well that's that then!
- colechristensen 3y ago
  I know several people very well who have struggled immensely to get helpful therapy. I myself have tried going down that route several times and come away disgusted by how bad it was. At best… at best it was emotional intelligence and self care at a grade school level. Talking to the provider was like talking to a robot or someone reading a script in a call center. The providers consistently effected a tone not unlike how one patronizes an unruly toddler. It was impossible, literally impossible to get them to switch to speaking to you like a person. I have known several people who went into to psychology mostly to serve their own navel gazing. Have heard several explicitly say the opportunity of manipulation (yes using that word) excited them. I’ve studied the history and present level of knowledge, the quality of the science backing it, and come away more concerned the more I know. Folks generally need people to talk to about the difficulties of life. The medical profession on that topic is… not that great. You don’t have to be a political whackjob to have serious concerns.
  - pawelmurias 3y ago
    > I have known several people who went into to psychology mostly to serve their own navel gazing. Thats a lot better case then people studying psychology to become psychologists because they are trying to heal their own severe emotional and mental issues.
  - tptacek 3y ago
    I know several people who have struggled immensely with getting routine medical care, not for lack of financial resources but because of how opaque and impersonal clinical health care can be. I'm not happy about that. But I don't extrapolate from there to the uselessness of medicine. If I get an infection, I'm going to go to a doctor, and not attempt to tough it out the way the Winegards suggest people with mental health ailments do.
tern 3y ago
I don't need studies to validate the hundreds of incredible results I've seen within the population I have direct access to (and myself) Moreover, what's most onerous, if anything, about the psychotherapeutic mindset is the implicit "broken / fixed" distinction (usually framed as something like "health" or "well-adjustedness") Another framing with regard to experience would look at "development," "growth," "abundance," "depth," "truth" There is much to unfold and discover in this life, and psychotherapy is a sliver of a broader set of practices—which have been with humanity for the entirety of recorded history—for doing so deliberately What's most interesting about this article is the demonstration of a high form of a certain current in conservative culture: intolerance for (read: anger and fear at) the "sensitivity" of others. The internal script is something like "I can't handle that other people are sensitive and lash out at me for how I am." The projection is self-evident.
- vmladenov 3y ago
  > I don't need studies to validate the hundreds of incredible results I've seen within the population I have direct access to We certainly wouldn’t want data to get in the way of our confirmation bias.
- nradov 3y ago
  A more accurate representation of the conservative position is that they just don't want to be forced to pay for psychotherapy for others, especially since there is very limited evidence that it actually works better than other treatments for certain conditions. I haven't seen any principled conservatives object to other people paying out of pocket for their own psychotherapy, even if they consider it ineffective.
  - NoZebra120vClip 3y ago
    I can conceive of a whole gamut of therapies which I'd rather not be funding with my tax dollars or insurance premiums, but my list is distinct from yours, and it would seem fairly individualized. So it seems like the best solution is emerging: there are Christian Health Sharing ministries which impose requirements on the morals and faith practices of their members, and they also disallow sharing of costs for treatments which contradict or deny Christian doctrine, as delineated by the ministry's guidelines. So, people are free to associate with a health sharing plan that is not insurance, and promises to observe the tenets of shared beliefs (Christian or not). It works more like a mutual benefit society. In fact, there are a significant number of psychotherapists and other practitioners (natural medicine too) who do not accept any form of insurance. The health sharing ministries work with their patients to pay the bills.
croes 3y ago
> chief content of this myth is that people often cannot process or work through adverse events and traumas—abuses ... It's not people often, it's some people sometimes. Not everybody gets traumatized by the same things, not everybody needs help to process them. But some need help and for some psychotherapy helps.
reocha 3y ago
Background on the authors: https://rationalwiki.org/wiki/Bo_Winegard https://rationalwiki.org/wiki/Bo_Winegard https://rationalwiki.org/wiki/Ben_Winegard https://rationalwiki.org/wiki/Ben_Winegard
- ralfd 3y ago
  Rationalwiki is trash.
  - reocha 3y ago
    How so?
    - Viliam1234 3y ago
      I wouldn't call it "trash", but it comes with some political bias and personal vendettas. The reason for both is that the entire wiki probably has about dozen editors, some of them way more powerful than others. So you might think that "wiki = something edited by lots of people", but for many topics there was one person who decided whether something was okay or not and wrote the article accordingly, and everyone else only added details afterwards (or disagreed and was banned). From my perspective, the greatest problem is the local cultural norm that once you decide that someone is a bad guy, it is allowed (even encouraged) to exaggerate about them, and complaining about exaggerations can get you banned. Which means that when a mistake is made, it becomes very difficult to fix it, because of course after the exaggerations anything can look stupid.
    - tptacek 3y ago
      It is by reputation very online, very judgy, and very left, so its pronouncements are perceived as cliquish and insubstantial. That's probably the case; it's probably a mistake to just go click around that site and draw conclusions according to what it says. But it is also a useful link aggregator, so when it claims something, like "this person earnestly believes that the Earth isn't round and that there is not an atmosphere but instead an atmosflat", it's worth checking the links to make sure that isn't clearly the case. Oftentimes it is.
lucasiezzi 3y ago
I was about to start psychotherapy last month, I ask my family's friend therapist If he could recommend me where to go. So he interviewed me for about 30 mins and ask me about all my problems. A week later he send me the number of the therapist. I didnt write her yet, I think I dont need it as badly as before. Those 30 mins were key. I am highly introspective and logical, I only needed to orderly speak my problems.
- serpix 3y ago
  Go to therapy. It will be very effective due to you being introspective and logical. Your logical reasoning will be put to test by the therapist and what you thought was logical will be challenged constantly. This will illuminate your entire thinking. This is damn near impossible to do on your own. You would rather take a plane to travel a thousand miles than crawl there on your knees.
  - lucasiezzi 3y ago
    Thats a very interesting point. Maybe speaking my problems just "calmed" my anxiety temporarily and that why I thought I dont need therapy at the moment. But yes, I will have to go eventually.
RyanAdamas 3y ago
Therapy is to our modern life as Confession once was to the past.
- callalex 3y ago
  A key component of therapy is that it is judgment-free, unlike the harmful hatred that can be dealt by a pastor in Confession.
  - mvncleaninst 3y ago
    there is no judgement free context
_8j50 3y ago
First, I just don't get how after knowing about freud and his views anyone can trust freudian therapy. Second, I also don't get how people trust strangers with intimate details of their thought life. I suppose if being happy and functional is your goal, it makes sense to do whatever you can to improve your chances. Personally, I prefer to experience reality and find truth even if it isn't happy or beneficial. I never hear them give advice that makes people unhappy or ask people to sacrifice for others. Furthermore, fundamental views and values I hold are likely very different from any therapist, so they can't qualify to advice me (and many others). Based on what I know about human nature, it's pretty damn scary how much people trust therapists. Check out century of the self, a documentary I found on HN actually that documens how freudian psychology and modern marketing and capitalism aligned and worked together in the 20th century to create the world we are in today: https://youtube.com/watch?v=eJ3RzGoQC4s https://youtube.com/watch?v=eJ3RzGoQC4s
- tptacek 3y ago
  Is most therapy practiced today Freudian, in any sense more meaningful than that Freud helped inspire the whole field?
  - spicymapotofu 3y ago
    The user you're responding to has no understanding of psychoanalysis, Freudian or otherwise. There is a long standing tradition of judging the field from incredulity at Freud's simiplified conclusions, and you never hear the real critiques of the field from anyone who disputes the way that user does. Better critique comes from seasoned psychoanalysts, e.g. Deleuze and Guattari, and is unfortunately often inaccessible to the public.
    - _8j50 3y ago
      As the user he is responding to, your comment and pompous academic attitude is another cririque of mine. You know best and can't be bothered with specifics, because how dare anyone even question the field withour credentials.
  - 3y ago
garyrob 3y ago
There's a lot of dismissiveness here. What I don't see, so far, is even one comment actually engaging with the statistical analyses that are the heart of the article. (Maybe one's being written by someone else while I write this.) I assume most people here are very skeptical about homeopathy. And yet, there are plenty of statistical studies that "show" that it works. The interesting thing about them is that the more rigorously the studies are done in terms of conforming to best practices for minimizing the risks of confounding errors, the smaller the statistical affects are, until they get to near zero for the most rigorous ones. Which is exactly what you'd expect to see if the effects of homeopathy are actually nonexistent other than placebo. Which I believe them to be, since the "theory" behind homeopathy makes no sense at all to me. The article we're discussing here purports to show a similar thing: Studies that correct for more confounding factors show smaller effects. I can't judge how factually true analyses found in this article are; the writers may be making it all up. On the other hand, it could be a mistake to dismiss it out of hand just because its conclusions are not consistent with today's common wisdom. Also, we should note that anecdotal reports from individuals, here or elsewhere, about what good it has done them don't disprove the author's point. Psychotherapy can work for some people but still not have a great average effect size. Personally, I'd be very surprised if psychotherapy is actually worthless on average, although I think that the therapy I had in my late teens and 20's, for years, probably did me more harm than good, other than just having a group therapy group to talk to. Which WAS valuable. But most of the good came just from talking to other people who happened to be in the group, not from the therapist. (I had individual and group therapies during that period. I think the individual therapy was probably worth less than nothing; there were definitely harmful things that came out of it that I am very clear on decades later.) But my personal story is just another anecdote. It seems logical that if someone is trained in helping, and someone wants to be helped, then on average there would be positive results. But they may not be as much as is commonly thought to be the case in today's world.
- gerbilly 3y ago
  This reliance on an overwhelming amount of scholarship and citations is typical of conspiratorial writing, so it put's me off. I definitely won't be engaging with this evidence, basically: I don't want to be sealioned.
tonnydourado 3y ago
I'm all for evidence based medicine, but I don't think the authors could make me trust them less if they tried. Under all the studies cited and the scientific analysis there's this subtle, yet clear, gnarly conservative discourse that can be summed up as "Therapy? Be a man, would you?". And if that's not enough, there are all the ... I lost count how many, subtle logical jumps that seem reasonable for the sake of argument and brevity, but if you spend more than a second on it make you go "wait, that's right".
Simulacra 3y ago
I cannot disagree with the contents of this article enough. I can only go by my own personal experiences with psychotherapy, and observing family who have done the same, but the results speak for themselves. I was in a much worse place before psychotherapy, costing myself more in real dollars, time, and needless pain. Psychotherapy is a tool, it's not a panacea, but ultimately if it safely helps people feel and live better then why throw so much shade ?
hdjjhhvvhga 3y ago
[for depression] should be added in the title (I don't know about other psychological disorders, but this one is specifically discussed in the article.)
EPWN3D 3y ago
Yeesh this dude went to the Word Store on a $5 budget and put $300 on the in-store credit card.

99 points by mpweiher 3y ago

Every time I see such an article that dismisses psychotherapy, I cringe a little bit. It is obvious that the author is ignorant of the topic (psychotherapy). It sounds like a hardware engineer dismissing software engineers and strongly affirming that all bugs can be solved with hardware solutions. Some problems are indeed due to psychic issues and not physiological ones. Yes, you can probably workaround symptoms with drugs, but that does not really solve the problem. If you have mental blocks and a shitty life that makes you depressed, and alleviate the depression with drugs, you still have mental blocks and a shitty life. I wish that both disciplines were not as independent from each other as it is today. Having experts at both subjects could probably do wonders to help people and make proper progress.

bathMarm0t 3y ago
Option 1: Confront your mental blocks and shitty life with depression. Option 2: Confront your mental blocks and shitty life with less depression (due to pharmacology). Option 3: Confront your mental blocks and shitty life with a guide and less depression (due to pharmacology and therapist). Option 4: Wait for the law of averages. https://youtu.be/3s_BqdZrUbE https://youtu.be/3s_BqdZrUbE I'm taking option 3 all day, every day.* (e.g. I agree with you. They should always be done in tandem / there is no silver bullet). *It's very important that your therapist shares your zeitgeist or directly counters it as a devils advocate. The drugs... not so much.
- rngname22 3y ago
  Option 4: Convince yourself your life isn't shitty via self-gaslighting / culture. (Often achieved historically via religion. Listen to stories of Jesus' suffering at church once a week for your entire childhood and any suffering you go through despite your good behavior suddenly seems less bad when you compare it to the ultimate Good Person who was tortured and killed on a cross). Option 5: Convince yourself it's worth suffering through your shitty life because if you're a good moral person, you can keep your eye on the prize (eternal afterlife in paradise with all your dead relatives and loved ones in eternal abundance and joy), also historically achieved via religion. "According to their analysis, religion is positively associated with life satisfaction, happiness and morale in 175 of 224 studies (78%). Furthermore, religion is positively associated with self-rated health in 27 of 48 studies (56%), with lower rates of coronary heart disease in 12 of 19 studies (63%) and with fewer signs of psychoticism (“characterized by risk taking and lack of responsibility”) in 16 of 19 studies (84%)." https://www.pewresearch.org/religion/2019/01/31/religions-relationship-to-happiness-civic-engagement-and-health-around-the-world/#:~:text=According%20to%20their%20analysis%2C%20religion,of%20224%20studies%20(78%25) https://www.pewresearch.org/religion/2019/01/31/religions-re....

mnemotronic 3y ago

Obvious Scientology tripe, or the author thinks it's April 1st. Try taking a manic-depressive off lithium for a couple weeks, but only if they live with you.

wu2Fe7sp 3y ago

This ain't it; there's a debate to be had about the quality of evidence of the many different approaches to psychotherapy, but this person, this tone and this arguments are not it. You can watch people who know much more about the topic (which could be achieve by a more open-ended cursory search) here in the comments trying to elucidate points that are not even made by the OP, just out of the good faith of their hearts (and a desire to keep things on topic). But posting a self-fashioned race-realist certainly would repel most knowledgeable people with good faith.

aaron695 3y ago

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dartvox 3y ago

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DrNosferatu 3y ago

Very misguided and science denying. Psychotherapy is about the relationship. This point is of such importance, that in Germany (where psychotherapy is covered by the mandatory health insurance) patients are allowed to have a couple of test sessions with several different therapists and then choose to continue with the one they feel best. Also - as already pointed out - there’s a multitude of schools or types of psychotherapy (CBT, Psychodynamic, etc.) with statistically significant benefits. Of course, some are more suited for some cases than others. The OP treats psychotherapy as a monolith. One way to look at it, is, that many people weren’t raised with competent-enough parenting (or mentoring) to acquire the skills to cope with some issues on their own - i.e.: the “just deal with it”. And this is the role of the therapist: not to become a parent, but to play the prosthetic role of a very competent parent, or mentor. So that the patient can increase self-awareness, self-reflection, and emotionally grow into being able to better deal with the situation at hand. However, perhaps the biggest takeaway message here is that we need to educate Society - as we educate kids to learn to recycle - on how to choose a good therapist, what good therapy feels like, the importance of accredited and evidence-based methods (so people don’t rely on astrology and other quacks for - and therefore avoid properly dealing with - their emotional health needs), as well as, what should NOT happen in therapy sessions. PS: And also educate about what is black & white thinking ;)

ecshafer 3y ago
If psychotherapy is not a myth, what is the exact mechanism that therapy fixes an issue? If it were science that answer would be readily apparent. I can say exactly how photosynthesis works using chemical structures at every step of the process. But I can’t look up in a book how precisely psychotherapy fixes depression. Psychology has a dearth of actual repeatable testable experiments, which is why it’s not a science. If so many people lack parenting that gives them the skills to tough it out and deal with it, that psychotherapy is necessary, why were so many people able to function prior to psychotherapy? Psychotherapy is only 100 years old, hell it’s only been socially acceptable for like 20 years. But people functioned just fine.
- testtestabcdef 3y ago

retrocryptid 3y ago

Sounds like SOMEONE is pissed off he got dismissed from his psych professorship. So first he sounds like a white nationalist, now he sounds like a scientologist.

trowaway6392610 3y ago

Seeing a shrink ruined my life. I used to be happy, productive, and socially engaged. Now I'm bouncing around medications, sleeping on the couch all day, and constantly ruminating about the past that I lost. Feelings are less important than the big picture of your life. Fuck mental health care for convincing me to prioritize my feelings in the moment over my long term happiness.

neilk 3y ago

I was not impressed, and this is before I knew who the authors were. I think it's worth examining, but only to see how right-wing cranks cosplay as scholars. 1) They keep using passive voice, like "Scholars say..." to introduce their critiques. One could be bad writing but multiple times is suspicious. WHICH SCHOLARS??? This is a sure sign of someone trying to obscure the motives and origin of their critique. The white nationalist author identifies himself as an independent scholar, which suggests strongly he really means far-right cranks like themselves. 2) The authors never clearly identify their target. Who are they attacking - popular representations of psychotherapy, or the validity of psychotherapy itself? They introduce the topic with culture war tropes, gesturing vaguely to what elites talk about at "cocktail parties" (what is this, the late 1960s?) and incredibly, the movie "Ordinary People" (1980!). Anyway, they assert that there is a myth in popular culture and then tear down the most simplistic version of the argument - that therapists are superhuman engineers of the soul. Strawmanning heavily here, and presenting a false dilemma - one can only be self-reliant or only depend on therapy. But so what. Popular culture gets a lot of things wrong. 3) In any case, by a somewhat crooked road, they proceed from there to some critiques of the effectiveness of psychotherapy, itself. And it's worth considering. All of social and medical science is undergoing a huge replication crisis. They rely heavily on meta-studies. Unfortunately, those studies show the opposite of what they are claiming. So by various techniques, they try to mathematically weaken the conclusions of those meta-studies, coming up with surprisingly precise numbers about how wrong the studies are. (This, by itself, is already a hallmark of the right-wing crank.) Is psychotherapy just great all the time? No. I've had my share of therapists that I'd consider pretty awful. But anecdotally I've found that the more academically qualified, the better the therapist is, and the closer they adhere to evidence-based therapies. If the Winegards' critique was true that the field is rotten, it should be the opposite. I can't help contrasting these author's arguments with a book I happen to be reading right now, The Body Keeps The Score, by Bessel van der Kolk. This is a best seller which may have done more than any other book to inject concepts like trauma into contemporary consciousness. I'm just in the first chapters, where van der Kolk works in a VA hospital where there are many divots in the wall, due to Vietnam veterans flipping out and punching it, often over trivial frustrations. These are conservative and military people, and they have tried hard to do what the Winegards prescribe - going to church, not dwelling on their past experiences - and they fail, because their trauma keeps reasserting itself. van der Kolk later sees some of the same signs in his civilian patients, and as a young intern assigned to monitor patients on the late shift, hears many confessions of abuse that are never repeated to the doctor in the morning. The Winegards attack the concept of psychotherapy as if it's quack medicine for trivial ills, the kind you can shrug off with a little grit. And their critique remains at a safe distance from the problem, through their own vague perceptions of pop culture and browsing the internet for meta-studies. If the Winegards could show some examples of people overcoming trauma by just manning up, praying or, suppressing things and getting on with it, then maybe I'd be interested. Or if they wanted to talk about the eroding of medicalized terms through popularization, like "trauma", I'd be at least partially on board. But they don't, and they won't. Like all right-wing cranks, they aren't concerned with what you might assume; that is, the health of patients. they're concerned with knocking down "elites". You know you're dealing with a right-wing crank when they characterize their enemy as an elite that is both contemptibly weak and inexplicably strong. They offer no explanation as to how their enemy's cultural power was achieved and maintained. It certainly couldn't have been because it kind of works or because the need is great. It's always because of the masses being hypnotized by messages in the media - like, you know, Ordinary People (1980). Beware this sort of thinking, because it leads to reactionary solutions.

iamthemonster 3y ago

I'm not saying rationalwiki is an authoritative source but you might find it a useful starting point to learn about the authors: https://rationalwiki.org/wiki/bo_winegard5vg5 https://rationalwiki.org/wiki/bo_winegard5vg5

aaron695 3y ago
> I'm not saying rationalwiki is an authoritative source Then don't fucking link it. I'm not saying Encyclopedia Dramatica is an authoritative source but you might find it a useful starting point to learn about Rational Wiki - https://encyclopediadramatica.online/RationalWiki https://encyclopediadramatica.online/RationalWiki
sverona 3y ago
My suspicions were aroused when I saw they interviewed J. Michael Bailey, who has been doing science backwards for decades now to paint me and the people who saved my life as a bunch of deluded perverts. The manifesto on "race realism" (!!!) is enough to convince me that the authors of this piece would shoot me dead if they ever got the chance. They can kindly fuck off back to the 1920s with that nonsense.
chownie 3y ago
Is that link correct? It appears to point to an empty page
- NoZebra120vClip 3y ago
  https://rationalwiki.org/wiki/Bo_Winegard https://rationalwiki.org/wiki/Bo_Winegard
mdp2021 3y ago
While I have seen any kind of participation (hence quality and dubious patterns) in Wiki articles, this is what you find there: > W spends most of his time on Twitter talking about _ and the alleged evils of _. He commonly retweets _ and other so-called _. W identifies as a member of the _ which is basically an attempt by _ to re-brand themselves as political moderates.[ref] That is profiling work. (Not just "Ad hominem".) -- The clash with the name "rational-wiki" is too strong not to be noted. -- (Sniper, put some argument there: you are qualifying yourself. Not in a good light.)

NoZebra120vClip 3y ago

This is a weird article, and one of the weirdest features that leaps out at me is that they are treating "psychotherapy" as a monolithic thing to discuss and be studied. There are, of course, many forms of psychotherapy, such as CBT, EMDR, IFS, etc. etc. So I don't see how any one monolithic study of "psychotherapy" can evaluate its effectiveness, even if they are going to focus solely on depression, and indeed, this article only addresses depression. Furthermore, of course, depression does not occur in a vacuum, and in my case it was the tip of the iceberg, and future sessions would progressively refine and broaden the diagnostic landscape. Most of all, the positive experiences I have gained from psychotherapy are not simply talking to a professional guy and having him validate my feelings, but rather I've learned practical tools for coping and alleviating symptoms. You may work out of this year's depression, only to find yourself depressed again in five years. If you had taken drugs, then you come crawling back to the psychiatrist and the pharmacy again and you get back on drugs. If you had taken psychotherapy, then you may not need to return to the psychotherapist, if you have been equipped with the right tools, you could have them in a notebook still, and then you just do some checklists, you follow steps, and you've got your skills for coping back at your fingertips again. Granted, I don't believe that psychotherapy is the be-all-end-all of curing mental illness. In fact, psychotherapy was invented in competition to, or perhaps as a replacement for, auricular confessions to a Catholic (or Orthodox) priest. The Protestant Reformation had eviscerated Germany's ability to cope with the mind's inmost challenges, and the common people had lost their most trusted human confidants, the ones who ministered in the person of Christ. So Freud and his Freunde came up with a way to whisper secrets to a man, have them held in confidence, and maybe even get some advice in return. But essentially, it was just a secular façade to compensate for a sacrament which had been efficacious for thousands of years.

worklaptopacct 3y ago
I can assure you that a great majority of practicing Catholics do not treat confessions seriously. Coming from a traditionally Catholic society, we don't have any better coping techniques than "simply man up". I'm fascinated with Americans who discover Catholicism though. Suddenly the religious parts of Europe become what Japan is to anime enthusiasts - a mythical land of perfection.

postmodest 3y ago

[flagged]

bpm140 3y ago

I think like many people, the first couple of paragraphs inspired me to see what else was published on the site for more “context” about the author’s point of views. At this point, writing a good-faith rebuttal to the article seems unnecessary.

EdwardDiego 3y ago
Wow, did the same as you, and eep... > The demographic groups involved likely have an average intellectual quotient (IQ) under 85, an aspect that's seldom discussed openly in France. What is the cost of silence?
phkahler 3y ago
IMHO this article doesn't belong on HN.
- tptacek 3y ago
  There's a button for that!
  - artemonster 3y ago
    why cant i downvote the post itself? is there a karma requirement for that?
    - tptacek 3y ago
      No, you can't downvote posts, and if you use flags as a form of downvoting you may find your flags quietly defanged. In this case, though, I think you'd be on pretty firm ground.
calderknight 3y ago
Consider reading this: https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html > Comments should get more thoughtful and substantive, not less, as a topic gets more divisive. > Please don't post shallow dismissals, especially of other people's work. A good critical comment teaches us something. > Please don't use Hacker News for political or ideological battle. That tramples curiosity. > Please don't pick the most provocative thing in an article or post to complain about in the thread. Find something interesting to respond to instead.

refulgentis 3y ago

Strawman, no one thinks that it is false: humans can be resilient and tough-minded; they can suffer the slings and arrows of life without expensive interventions from “experts".

mactavish88 3y ago
Agreed. My understanding from someone I consider to be a very good clinical psychologist is that the only time you may need some psychotherapeutic intervention is when you are genuinely stuck with a problem you can’t figure out yourself _and_ it’s significantly hampering your quality of life in some way you consider meaningful. And then, you only need help until you’re unstuck. Teach a man to fish, and all that…
- Michelangelo11 3y ago
  Right, but you hear "everyone should be in therapy" from all corners; there's at least one dating app (Bumble, I think) that has an "In therapy" tag you can put on your profile; and BetterHelp advertises themselves with a commercial where girls at brunch talk about a guy one of them has been seeing, and they agree she should stop seeing him once they realize he's not in therapy, even though they know almost nothing else about him ( https://freddiedeboer.substack.com/p/im-not-trying-to-be-dramatic-but https://freddiedeboer.substack.com/p/im-not-trying-to-be-dra...). That isn't really a view of therapy as a specific intervention, but as an almost mandatory practice for adults, kind of like going to the gym. The view of the psychologist you mention is actually sadly rare. Obviously, I think the widely shared view of therapy is a total bastardization of any worth therapy might have had in the first place.
  - tptacek 3y ago
    This thread is literally the first time I've ever heard "everyone should be in therapy" from anybody.
    - pastacacioepepe 3y ago

H8crilA 3y ago

The more I learn about my depression the more I realize just how underdeveloped medicine is in this area. Everything that the author writes is true, some psychiatrists will even admit as much - i.e. that standard treatments such as psychotherapy or SSRIs or exercise work, but each of them just barely. We may be decades or even centuries away from reliably treating depression. Most depressions indeed go away on their own, and perhaps are even helpful - they can force a person to reconsider and rearrange their life. The heavier ones probably have to be treated with everything that the patient and their environment can muster, all at the same time. And since the patient usually can't do much, it's up to the environment (friends, family, health care, mental hospitals). Please keep that in mind and force your depressed friends to go for walks, or do anything else at all, repeatedly. All the +5% basics like physical activity or smalltalk really do add up. Though the depressed person will not be able to see it for a while.

Knee_Pain 3y ago
You (rarely) can force a cure onto people, and in the case of mental problem it's basically impossible. If the science was clear in that depression would be heavily contained if the sufferer engaged in physical activity, good sleep, good diet, good general routine and zero stuff like social media or mindless entertainment, then how man people would actually follow through? We criticize psychs for their love of giving pills, but we are the first who are lazy and stupid and would never actually do what's best for us
- williamtrask 3y ago
  We might not be able to force a cure, but I can think of a multi trillion dollar industry (or two) that’s undoubtedly pushing the opposite. Maybe we should start there.
donatj 3y ago
I had a pretty bad bout of depression about a decade ago. My girlfriend left me, followed shortly by one of my closest friends dying. I saw a therapist and went on antidepressants. I didn’t find either particularly effective or helpful. I don’t know if it’s even possible for other people but what I ended up doing out of desperation was just logic-ing my way out of it. I would sense it coming and start directly countering thoughts and waves of emotions with reasons what I was feeling was not true and things I was grateful for. It was literally like arguing with my own thoughts and telling them to shut up. It shortened the bouts by a ton, stopped me from spiraling and eventually they stopped all together. Maybe that will help someone else super analytical like myself? I genuinely don’t know. In more recent years, did not help my wife with her struggles at all.

haswell 3y ago

Every time I read a critique of psychotherapy like this, it's hard not to conclude that the authors have very little knowledge of what therapy actually entails, and how it's changed over the decades. As someone who has dealt with mental health issues stemming from complex trauma for most of my life, it's difficult to take this seriously. What the author describes is a laughable caricature of the field, and seems pretty far removed from the realities that many people face. I see therapy as a commitment to focusing on root causes, and retraining maladaptive patterns of thought. I see my relationship with my therapist as that of a teacher/student. Someone who can help me reframe things and see other perspectives until I can do the same thing for myself. Coming from an abusive environment that hammered certain attitudes into me from an early age, I've found incredible value from establishing a trust relationship with a person who can act as a conversational sparring partner and can point out the patterns of thought I can't see in myself. I didn't have other people in my life who I trust this deeply, probably because of the underlying reasons I'm seeing a therapist. I've found that some of the most helpful ways to improve my mental state have nothing to do with those sessions. Sleep, exercise, time in nature, social connection, artistic outlets, etc. are all critical. But those are the things that I didn't know how to actually do. I wanted to want these things, but couldn't navigate the mental blocks that kept me stuck where I was. And for whatever immediate physiological benefit these activities bring, they don't undo decades of conditioned thought that needs to change. Using sheer willpower to force myself to exercise only worked for a short time, and I couldn't establish lasting habits until I had unwound associated unhelpful patterns. To present these things as better than or as effective as therapy is to completely misunderstand the point. Therapy is also not some panacea, and most of the real work happens outside of session. > Patients can expect to pay somewhere between 60 to 250 dollars per hour for a therapy session. (A jog in the park, a church service, a long walk in the woods are all, of course, free.) In many cases, insurance covers part of this; however, therapy can still be expensive for the patient, and therapists—men and women who often espouse dubious, even risible theories—are handsomely remunerated. As a kid, I grew up going to church services. Services in which I heard "spiritual leaders" rail against the sinfulness of homosexuality (among many other things). Around age 12, I heard earnest conversations from elders in the church about such people deserving to be stoned to death according to scripture. This was rather confusing and terrifying to hear from people who were supposedly worthy of my attention at a time when I was coming to grips with the fact that I felt attraction to both men and women. To deride psychotherapy and casually offer "free church services" as an alternative in the same sentence is pretty humorous to a person who has had life changingly positive experience with therapy...therapy that arguably became necessary after years of indoctrination and instilled existential dread by those free church services. I'm not railing against all churches, and there are some great organizations. But it seems only fair to point this out in an article that calls therapy to task for those instances when it doesn't work. I, for one, am grateful for therapy. It saved my life (literally), and has been an incredibly positive force in my life.

deleted 3y ago

[deleted]

zzzeek 3y ago

millions of people benefit from psychotherapy every day, but random substack with predictable ties to right-wing nativist bullshit says it's all bunk. Well that's that then!

colechristensen 3y ago
I know several people very well who have struggled immensely to get helpful therapy. I myself have tried going down that route several times and come away disgusted by how bad it was. At best… at best it was emotional intelligence and self care at a grade school level. Talking to the provider was like talking to a robot or someone reading a script in a call center. The providers consistently effected a tone not unlike how one patronizes an unruly toddler. It was impossible, literally impossible to get them to switch to speaking to you like a person. I have known several people who went into to psychology mostly to serve their own navel gazing. Have heard several explicitly say the opportunity of manipulation (yes using that word) excited them. I’ve studied the history and present level of knowledge, the quality of the science backing it, and come away more concerned the more I know. Folks generally need people to talk to about the difficulties of life. The medical profession on that topic is… not that great. You don’t have to be a political whackjob to have serious concerns.
- pawelmurias 3y ago
  > I have known several people who went into to psychology mostly to serve their own navel gazing. Thats a lot better case then people studying psychology to become psychologists because they are trying to heal their own severe emotional and mental issues.
- tptacek 3y ago
  I know several people who have struggled immensely with getting routine medical care, not for lack of financial resources but because of how opaque and impersonal clinical health care can be. I'm not happy about that. But I don't extrapolate from there to the uselessness of medicine. If I get an infection, I'm going to go to a doctor, and not attempt to tough it out the way the Winegards suggest people with mental health ailments do.

tern 3y ago

I don't need studies to validate the hundreds of incredible results I've seen within the population I have direct access to (and myself) Moreover, what's most onerous, if anything, about the psychotherapeutic mindset is the implicit "broken / fixed" distinction (usually framed as something like "health" or "well-adjustedness") Another framing with regard to experience would look at "development," "growth," "abundance," "depth," "truth" There is much to unfold and discover in this life, and psychotherapy is a sliver of a broader set of practices—which have been with humanity for the entirety of recorded history—for doing so deliberately What's most interesting about this article is the demonstration of a high form of a certain current in conservative culture: intolerance for (read: anger and fear at) the "sensitivity" of others. The internal script is something like "I can't handle that other people are sensitive and lash out at me for how I am." The projection is self-evident.

vmladenov 3y ago
> I don't need studies to validate the hundreds of incredible results I've seen within the population I have direct access to We certainly wouldn’t want data to get in the way of our confirmation bias.
nradov 3y ago
A more accurate representation of the conservative position is that they just don't want to be forced to pay for psychotherapy for others, especially since there is very limited evidence that it actually works better than other treatments for certain conditions. I haven't seen any principled conservatives object to other people paying out of pocket for their own psychotherapy, even if they consider it ineffective.
- NoZebra120vClip 3y ago
  I can conceive of a whole gamut of therapies which I'd rather not be funding with my tax dollars or insurance premiums, but my list is distinct from yours, and it would seem fairly individualized. So it seems like the best solution is emerging: there are Christian Health Sharing ministries which impose requirements on the morals and faith practices of their members, and they also disallow sharing of costs for treatments which contradict or deny Christian doctrine, as delineated by the ministry's guidelines. So, people are free to associate with a health sharing plan that is not insurance, and promises to observe the tenets of shared beliefs (Christian or not). It works more like a mutual benefit society. In fact, there are a significant number of psychotherapists and other practitioners (natural medicine too) who do not accept any form of insurance. The health sharing ministries work with their patients to pay the bills.

croes 3y ago

> chief content of this myth is that people often cannot process or work through adverse events and traumas—abuses ... It's not people often, it's some people sometimes. Not everybody gets traumatized by the same things, not everybody needs help to process them. But some need help and for some psychotherapy helps.

reocha 3y ago

Background on the authors: https://rationalwiki.org/wiki/Bo_Winegard https://rationalwiki.org/wiki/Bo_Winegard https://rationalwiki.org/wiki/Ben_Winegard https://rationalwiki.org/wiki/Ben_Winegard

ralfd 3y ago
Rationalwiki is trash.
- reocha 3y ago
  How so?
  - Viliam1234 3y ago
    I wouldn't call it "trash", but it comes with some political bias and personal vendettas. The reason for both is that the entire wiki probably has about dozen editors, some of them way more powerful than others. So you might think that "wiki = something edited by lots of people", but for many topics there was one person who decided whether something was okay or not and wrote the article accordingly, and everyone else only added details afterwards (or disagreed and was banned). From my perspective, the greatest problem is the local cultural norm that once you decide that someone is a bad guy, it is allowed (even encouraged) to exaggerate about them, and complaining about exaggerations can get you banned. Which means that when a mistake is made, it becomes very difficult to fix it, because of course after the exaggerations anything can look stupid.
  - tptacek 3y ago
    It is by reputation very online, very judgy, and very left, so its pronouncements are perceived as cliquish and insubstantial. That's probably the case; it's probably a mistake to just go click around that site and draw conclusions according to what it says. But it is also a useful link aggregator, so when it claims something, like "this person earnestly believes that the Earth isn't round and that there is not an atmosphere but instead an atmosflat", it's worth checking the links to make sure that isn't clearly the case. Oftentimes it is.

lucasiezzi 3y ago

I was about to start psychotherapy last month, I ask my family's friend therapist If he could recommend me where to go. So he interviewed me for about 30 mins and ask me about all my problems. A week later he send me the number of the therapist. I didnt write her yet, I think I dont need it as badly as before. Those 30 mins were key. I am highly introspective and logical, I only needed to orderly speak my problems.

serpix 3y ago
Go to therapy. It will be very effective due to you being introspective and logical. Your logical reasoning will be put to test by the therapist and what you thought was logical will be challenged constantly. This will illuminate your entire thinking. This is damn near impossible to do on your own. You would rather take a plane to travel a thousand miles than crawl there on your knees.
- lucasiezzi 3y ago
  Thats a very interesting point. Maybe speaking my problems just "calmed" my anxiety temporarily and that why I thought I dont need therapy at the moment. But yes, I will have to go eventually.

RyanAdamas 3y ago

Therapy is to our modern life as Confession once was to the past.

callalex 3y ago
A key component of therapy is that it is judgment-free, unlike the harmful hatred that can be dealt by a pastor in Confession.
- mvncleaninst 3y ago
  there is no judgement free context

_8j50 3y ago

First, I just don't get how after knowing about freud and his views anyone can trust freudian therapy. Second, I also don't get how people trust strangers with intimate details of their thought life. I suppose if being happy and functional is your goal, it makes sense to do whatever you can to improve your chances. Personally, I prefer to experience reality and find truth even if it isn't happy or beneficial. I never hear them give advice that makes people unhappy or ask people to sacrifice for others. Furthermore, fundamental views and values I hold are likely very different from any therapist, so they can't qualify to advice me (and many others). Based on what I know about human nature, it's pretty damn scary how much people trust therapists. Check out century of the self, a documentary I found on HN actually that documens how freudian psychology and modern marketing and capitalism aligned and worked together in the 20th century to create the world we are in today: https://youtube.com/watch?v=eJ3RzGoQC4s https://youtube.com/watch?v=eJ3RzGoQC4s

tptacek 3y ago
Is most therapy practiced today Freudian, in any sense more meaningful than that Freud helped inspire the whole field?
- spicymapotofu 3y ago
  The user you're responding to has no understanding of psychoanalysis, Freudian or otherwise. There is a long standing tradition of judging the field from incredulity at Freud's simiplified conclusions, and you never hear the real critiques of the field from anyone who disputes the way that user does. Better critique comes from seasoned psychoanalysts, e.g. Deleuze and Guattari, and is unfortunately often inaccessible to the public.
  - _8j50 3y ago
    As the user he is responding to, your comment and pompous academic attitude is another cririque of mine. You know best and can't be bothered with specifics, because how dare anyone even question the field withour credentials.
- 3y ago

garyrob 3y ago

There's a lot of dismissiveness here. What I don't see, so far, is even one comment actually engaging with the statistical analyses that are the heart of the article. (Maybe one's being written by someone else while I write this.) I assume most people here are very skeptical about homeopathy. And yet, there are plenty of statistical studies that "show" that it works. The interesting thing about them is that the more rigorously the studies are done in terms of conforming to best practices for minimizing the risks of confounding errors, the smaller the statistical affects are, until they get to near zero for the most rigorous ones. Which is exactly what you'd expect to see if the effects of homeopathy are actually nonexistent other than placebo. Which I believe them to be, since the "theory" behind homeopathy makes no sense at all to me. The article we're discussing here purports to show a similar thing: Studies that correct for more confounding factors show smaller effects. I can't judge how factually true analyses found in this article are; the writers may be making it all up. On the other hand, it could be a mistake to dismiss it out of hand just because its conclusions are not consistent with today's common wisdom. Also, we should note that anecdotal reports from individuals, here or elsewhere, about what good it has done them don't disprove the author's point. Psychotherapy can work for some people but still not have a great average effect size. Personally, I'd be very surprised if psychotherapy is actually worthless on average, although I think that the therapy I had in my late teens and 20's, for years, probably did me more harm than good, other than just having a group therapy group to talk to. Which WAS valuable. But most of the good came just from talking to other people who happened to be in the group, not from the therapist. (I had individual and group therapies during that period. I think the individual therapy was probably worth less than nothing; there were definitely harmful things that came out of it that I am very clear on decades later.) But my personal story is just another anecdote. It seems logical that if someone is trained in helping, and someone wants to be helped, then on average there would be positive results. But they may not be as much as is commonly thought to be the case in today's world.

gerbilly 3y ago
This reliance on an overwhelming amount of scholarship and citations is typical of conspiratorial writing, so it put's me off. I definitely won't be engaging with this evidence, basically: I don't want to be sealioned.

tonnydourado 3y ago

I'm all for evidence based medicine, but I don't think the authors could make me trust them less if they tried. Under all the studies cited and the scientific analysis there's this subtle, yet clear, gnarly conservative discourse that can be summed up as "Therapy? Be a man, would you?". And if that's not enough, there are all the ... I lost count how many, subtle logical jumps that seem reasonable for the sake of argument and brevity, but if you spend more than a second on it make you go "wait, that's right".

Simulacra 3y ago

I cannot disagree with the contents of this article enough. I can only go by my own personal experiences with psychotherapy, and observing family who have done the same, but the results speak for themselves. I was in a much worse place before psychotherapy, costing myself more in real dollars, time, and needless pain. Psychotherapy is a tool, it's not a panacea, but ultimately if it safely helps people feel and live better then why throw so much shade ?

hdjjhhvvhga 3y ago

[for depression] should be added in the title (I don't know about other psychological disorders, but this one is specifically discussed in the article.)

EPWN3D 3y ago

Yeesh this dude went to the Word Store on a $5 budget and put $300 on the in-store credit card.