5 ms·

As I read the article, it occurred to me that one of the fundamental flaws of modern psychology (and its offshoots such as psychiatry and psychotherapy) is that

As I read the article, it occurred to me that one of the fundamental flaws of modern psychology (and its offshoots such as psychiatry and psychotherapy) is that they all tend toward a solipsistic, individualist treatment of the self. Other than specialized fields like group psychology, psychologists really try to ignore the collectivist aspect to societies; they try to treat one person at a time while ignoring our families, our communities. When they do make efforts at integrating these larger groups in treatment, it's an afterthought, and it's never quite consensual, because, after all, in this world, to treat someone (especially to drug someone) you require their direct consent, and even in couples therapy, there is usually one less-than-willing partner who just accedes to keep things together. Furthermore, it's always through an attitude of "here is one person who is ill and needs to heal, let's rally around him for his treatment." That is not how it works. People develop mental illnesses oftentimes from traumas and abuse and decades of shame. Therefore, the entire family, the whole community, needs to make efforts at healing if they are to stop this vicious circle. It is not merely one man's problem, it is not one man's responsibility, and it is not one man's shame. Speaking personally, the genesis of my mental issues is clearly not "chemical imbalance" but rather my relationship to the world. What I heard and saw on TV, my experiences with Mom, Dad, and Sister, my formative years in school and church--with, you guessed it, other people. I see a lot of pop-psychology YouTube clickbait that goes "Heal your relationships! Here's how!" and I don't doubt that people can take certain action with willing parties and heal certain relationships, but geez, guys, it took me 50 years to get to this point of isolation and alienation, and I alone will never heal relationships that have taken such a beating. It would take collective, cooperative will and action to do so. Treating one person at a time with these methods is like trying to catch the ocean and dye it green, one drop at a time. It just doesn't make sense. That's only one of many reasons why there are poor outcomes, especially for psychiatry, where they just toss you in a looney bin with lots of other messed-up people, and now that's your community and that's your reality, deal with it.

hvs 3y ago
I agree with a lot of what you say, but it's not a complete wash. I know if I go off my meds I go to a bad place pretty quickly. That's not society, that's something a bit off with pile of cells that I currently call "me." Humans and society are messy. There aren't easy answers and we are a culture dying for easy answers. Sometimes it really does help to have an impartial person sitting there just letting you bitch once a week. Sometimes it doesn't.
- kayodelycaon 3y ago
  Same here. I’m bipolar. Modern medicine and therapy has allowed me to have good quality of life instead of barely surviving with increasingly severe manic episodes. Somehow enough progress is made in the real world that psychology manages to meaningfully advance.
  - niemal_dev 3y ago
    The fact you embrace and accept metabolic damaging substances (all psychiatric substances are) and lack some very critical understanding in mitochondrial DNA damage and ATP production bottlenecks down on the cellular level is fascinating (which were the reason you had manic episodes to begin with if we were to make an educated guess). You are basically digesting and taking substances that further damage you and in the long-term are going to make you even worse. "Meaningful advice" like that is what keeps people enslaved to big-pharma and the largest human enslaved era the human history has ever witnessed.
    - jhardy54 3y ago
      Where did you get your medical degree?
      - kayodelycaon 3y ago
        I think they read this study and didn't read the details: https://www.frontiersin.org/articles/10.3389/fpsyt.2021.546801/full https://www.frontiersin.org/articles/10.3389/fpsyt.2021.5468... There's a lot of neat stuff in there but no real conclusions to draw from it beyond a potential avenue for further research. I'd like to see what comes out of it.
        TheNewsIsHere 3y ago
        You went the generous route. I was going to say “The Barney Stinson School of Taking Out Your Ass”. ;)
flatline 3y ago
I have had so many of the same thoughts! Therapy has benefitted me greatly over the years and I have definitely grown from the experience. It has also helped me sort out the aspects of my life that therapy can help me address, and those areas in which it offers very little. There is no substitute for a supportive, nurturing environment of peers, lovers, elders, children, activity partners, business partners, etc. - take what you will from that list in which you personally find sustenance. Therapy is designed in part to help navigate those relationships, but an hour a week of talking individually to a specialist is woefully inadequate to repair any of them. The best it can do is give you coping tools and rudimentary communication skills. Increasing we are isolated and one or more of those key relationships is missing or badly dysfunctional and any support system that was once there in which those relationships could be mended is now gone. Let’s not forget however that those support systems had (and still have) toxic attributes. They favored men, and put women and minorities in a subservient role. They tied you to family that may be abusive, or a dogmatic belief system. Kick that social structure out from under people, and what do you have left? An ever-changing and often overwhelming tapestry of less substantial and more poorly-defined relationships. Isolation as a replacement for conflict resolution. Therapy has not really caught up, nor is it even designed to address any of this.
- golemiprague 3y ago
  [dead]
marcus_holmes 3y ago
Good thoughts. I think the idea that a lot of our mental disorders are actually rational responses to a disordered community/society has a lot of merit. We are social creatures, we need to be considered in that context.
- SamPatt 3y ago
  My theory: Life is difficult enough that there are many psychological defenses in place - both at the individual and societal level - to keep us focused on our survival and not devote too many mental resources to considering underlying questions of motivation, purpose, or fairness. Some people are in particular circumstances, or perhaps have certain personalities, such that those defense mechanisms aren't as strong, and once they step off the pure survival path, they experience a recognition of cold reality which can't be understood from the those who've never strayed from the survival path. It's rational to reach many of the conclusions which mental ill people do. Not all, by any means. But I believe in some aspects of depressive realism, and I think many people who take their own lives are making a reasoned decision, as sad as that fact may be.
  - em-bee 3y ago
    i don't follow how someone whose defenses are being overwhelmed would be able to step of the survival path. on the contrary, they should be constantly in survival mode such that they are not able to develop other necessary mechanisms to be able to function in society, or the defense mechanisms they develop get in the way of that normal functioning. suicide can easily explained with wanting to end the pain or fear of even greater pain. a key mechanism to develop growing up is trust and learning how to relate to others. i don't think "normal" growing up should keep us focused on survival. or am i misreading you?
    - SamPatt 3y ago
      I'm using survival in a non-traditional way here. I'm not talking about "survival mode," I mean the normal development path you're describing, which is actually the one that best leads to survival.
0xcde4c3db 3y ago
One of the things that most shocked me when I started skimming psychology papers (trying to understand the state of evidence and validated theories for psychotherapy and other psychosocial treatments) is how much of it revolves around attributing dysfunction to a person's beliefs. It feels a bit like virtue ethics dressed up in a lab coat.
- whatshisface 3y ago
  In a very real sense the ghost of Freud haunts us.
- iaaan 3y ago
  I'd even take it a step further and say that modern psychiatry and psychotherapy are generally just another arm of the state, directing people towards acceptable behaviors decided by white men. Much of it ultimately revolves around being a good little worker bee, and if they can't convince you to do that, they'll drug you until you're pliable.
  - spicymapotofu 3y ago
    I find your comparison a little too blunt, too rough and lacking in complexity, but ultimately the comparison of politic and psychology is a valuable one in literature. For example, Deleuze and Guattari's Thousand Plateaus explores this relation through a poetic, philosophical lens. As analytic philosopher and radical psychiatrist, these two synthesize a response to Freudian [more specifically, Lacanian] mode of thought. I assure you that this topic is old ground, and that this pair's writings on it paved the way for a larger positivist response to the problems discussed in this thread.
  - P_I_Staker 3y ago
    It's basically a purity cult
verve_rat 3y ago
This is why I hate the focus on psychological resilience in the work place. It puts the onus on the individual to deal with stressful situations rather than asking what can be done to remove unnecessary stress in the first place.
- deleted 3y ago
  [deleted]
deleted 3y ago
[deleted]
seangrogg 3y ago
> As I read the article, it occurred to me that one of the fundamental flaws of modern psychology (and its offshoots such as psychiatry and psychotherapy) is that they all tend toward a solipsistic, individualist treatment of the self. This is by design. Psychology is intentionally about the individual and when it occasionally does look at groups it tends to do so through the lens of how a group produces value for the individual. Sociology is the study of collections of humans. It is intentionally about the group and when it occasionally looks at individuals it tends to do so through the lens of how an individual produces value for the group. This is not too dissimilar from the study of finance (generally micro, focused on individuals or companies) vs economics (generally macro, focused on the relationships between companies or countries).
- xyzzy123 3y ago
  Right, though I feel the OP's observation is that while sociology and psychology are both academic disciplines, there doesn't seem to be any equivalent to therapy, but applied at the community level. It feels like this is something that maybe good priests/churches used to do that accidentally got lost as society became more secular.
  - NoZebra120vClip 3y ago
    > It feels like this is something that maybe good priests/churches used to do that accidentally got lost as society became more secular. Certainly, and I could expound on this point at length, but suffice it to say that the elites of most long-lived world religions have had extensive experience, knowledge and wisdom in so-called "psychology" fields for millennia. In fact, as the State disestablishes religions, something must fill the vacuum, and in fact psych*y are used much in the same way as religion formerly was. Psych*y is in fact a compulsory and State-Established Religion for most of us in the West, particularly in these United States, because of the coercive nature of the clinic and hospital system, the court-ordered treatments, the subsidized "medicine" drugs and practitioners, and so forth. Most of us can tell you, even some atheists know, that psych*y is a shitty poor excuse for a religion, and no substitute for an actual faith practice, and the way the State foists it on us today is basically abuse.
hellotheretoday 3y ago
You’ve proposed sociology But seriously there are some therapeutic interventions that are closer to what you describe. I worked in them early in my career. They tend to be (or are exclusively?) aimed at pediatric populations with a high level of need. But we would work in the home 2-3x a week with the child, parents, siblings, etc. we would do community outings to evaluate and work in that context, do school observations and teacher collab, etc. do parent training, relational work between parent/sibling/child, connect parents to therapy if necessary, case management and other services like snap, etc. The child was the “identified patient” but we were working with the entire family unit As said it was generally unavailable unless you displayed exceptional need (eg your school was kicking you out because your behavior was so bad and your parents were putting you in respite care/considering residential treatment). It cost a lot. not nearly as much as residential but enough that no commercial insurance would pay for it. So if you got to that behavior level you had to go through the nightmare evaluation process of proving your child’s behavior was bad enough to qualify as functionally disabled to qualify for Medicaid entitlement because they’re the only ones that would pay. Even if you were under the income threshold for Medicaid and didn’t need the entitlement you still had to prove need for the service. So I guess this is a long way of saying that there are alternative modalities to deliver therapy. There’s actually a ton of them. But in practice you’ll likely never see them because no one wants to fund them outside of the most extreme circumstances and even then it’s often hard to get new approaches off the ground. New approaches start in academia and this kind of stuff for adults doesn’t get grant funding afaik. Why bother, it’ll never happen outside of the research because there is very little public money for adult mental health services in most, if not all, states. Children get way more and still barely get enough. So for adults you get the same old outpatient 45 or 60 minute psychotherapy, individual or group, where the only variance is the theoretical approach the clinician uses (which is increasingly “eclectic” aka “I don’t really do anything evidence based and just make it up as I go” but that’s a whole different issue). Or if your issues worsen you get inpatient for 3 days. If they worsen beyond that I hope you have continued access to insurance and social supports because then you’ll get a longer term residential placement. otherwise it’s often a shockingly quick road to homelessness or prison.
ergl 3y ago
Psychology and psychiatry are worlds apart and I think you're confusing one with the other. Psychiatry fits within what you described: individualized treatment, medication, etc. It's a branch of medicine after all, and it fits within the whole context of medical care as it is conceived currently (that is, brushing aside social context, community, etc) Psychology is all about context, that's kinda its motto. A good therapist always considers the family, socioeconomic backgrounds, all the things you say it ignores.
- NoZebra120vClip 3y ago
  > Psychology is all about context, that's kinda its motto. A good therapist always considers the family, socioeconomic backgrounds, all the things you say it ignores. Not what I said. I said they don't treat the family or the community. Psychology is typically an individualistic treatment of a single person (or a couple).
niemal_dev 3y ago
I think the best theory we have up to date for mental irregularities is metabolic dysfunction and damage at the cellular level through environmental stress, inheritance preconditions and super-processed foods. Psychology does and can have an impact but it's only a small fraction of the picture. Healing does not take community, you cannot find coherent and healthy community in a fully-antagonistic capitalistic society.
rabchi 3y ago
Critical psychology is an area within psychology that goes back to the late 1960s and that agrees with a lot of the criticism in OP and in your comment: https://en.wikipedia.org/wiki/Critical_psychology https://en.wikipedia.org/wiki/Critical_psychology If you are interested in learning more I have found these two books to be good introductions to the topic: - "Psychology, Subjectivity, and Society: An Introduction to German Critical Psychology" by Charles Tolman - "Psychology from the Standpoint of the Subject: Selected Writings of Klaus Holzkamp" edited by Ernst Schraube and Ute Osterkamp.

hvs 3y ago

I agree with a lot of what you say, but it's not a complete wash. I know if I go off my meds I go to a bad place pretty quickly. That's not society, that's something a bit off with pile of cells that I currently call "me." Humans and society are messy. There aren't easy answers and we are a culture dying for easy answers. Sometimes it really does help to have an impartial person sitting there just letting you bitch once a week. Sometimes it doesn't.

kayodelycaon 3y ago
Same here. I’m bipolar. Modern medicine and therapy has allowed me to have good quality of life instead of barely surviving with increasingly severe manic episodes. Somehow enough progress is made in the real world that psychology manages to meaningfully advance.
- niemal_dev 3y ago
  The fact you embrace and accept metabolic damaging substances (all psychiatric substances are) and lack some very critical understanding in mitochondrial DNA damage and ATP production bottlenecks down on the cellular level is fascinating (which were the reason you had manic episodes to begin with if we were to make an educated guess). You are basically digesting and taking substances that further damage you and in the long-term are going to make you even worse. "Meaningful advice" like that is what keeps people enslaved to big-pharma and the largest human enslaved era the human history has ever witnessed.
  - jhardy54 3y ago
    Where did you get your medical degree?
    - kayodelycaon 3y ago
      I think they read this study and didn't read the details: https://www.frontiersin.org/articles/10.3389/fpsyt.2021.546801/full https://www.frontiersin.org/articles/10.3389/fpsyt.2021.5468... There's a lot of neat stuff in there but no real conclusions to draw from it beyond a potential avenue for further research. I'd like to see what comes out of it.
      - TheNewsIsHere 3y ago
        You went the generous route. I was going to say “The Barney Stinson School of Taking Out Your Ass”. ;)

flatline 3y ago

I have had so many of the same thoughts! Therapy has benefitted me greatly over the years and I have definitely grown from the experience. It has also helped me sort out the aspects of my life that therapy can help me address, and those areas in which it offers very little. There is no substitute for a supportive, nurturing environment of peers, lovers, elders, children, activity partners, business partners, etc. - take what you will from that list in which you personally find sustenance. Therapy is designed in part to help navigate those relationships, but an hour a week of talking individually to a specialist is woefully inadequate to repair any of them. The best it can do is give you coping tools and rudimentary communication skills. Increasing we are isolated and one or more of those key relationships is missing or badly dysfunctional and any support system that was once there in which those relationships could be mended is now gone. Let’s not forget however that those support systems had (and still have) toxic attributes. They favored men, and put women and minorities in a subservient role. They tied you to family that may be abusive, or a dogmatic belief system. Kick that social structure out from under people, and what do you have left? An ever-changing and often overwhelming tapestry of less substantial and more poorly-defined relationships. Isolation as a replacement for conflict resolution. Therapy has not really caught up, nor is it even designed to address any of this.

golemiprague 3y ago
[dead]

marcus_holmes 3y ago

Good thoughts. I think the idea that a lot of our mental disorders are actually rational responses to a disordered community/society has a lot of merit. We are social creatures, we need to be considered in that context.

SamPatt 3y ago
My theory: Life is difficult enough that there are many psychological defenses in place - both at the individual and societal level - to keep us focused on our survival and not devote too many mental resources to considering underlying questions of motivation, purpose, or fairness. Some people are in particular circumstances, or perhaps have certain personalities, such that those defense mechanisms aren't as strong, and once they step off the pure survival path, they experience a recognition of cold reality which can't be understood from the those who've never strayed from the survival path. It's rational to reach many of the conclusions which mental ill people do. Not all, by any means. But I believe in some aspects of depressive realism, and I think many people who take their own lives are making a reasoned decision, as sad as that fact may be.
- em-bee 3y ago
  i don't follow how someone whose defenses are being overwhelmed would be able to step of the survival path. on the contrary, they should be constantly in survival mode such that they are not able to develop other necessary mechanisms to be able to function in society, or the defense mechanisms they develop get in the way of that normal functioning. suicide can easily explained with wanting to end the pain or fear of even greater pain. a key mechanism to develop growing up is trust and learning how to relate to others. i don't think "normal" growing up should keep us focused on survival. or am i misreading you?
  - SamPatt 3y ago
    I'm using survival in a non-traditional way here. I'm not talking about "survival mode," I mean the normal development path you're describing, which is actually the one that best leads to survival.

0xcde4c3db 3y ago

One of the things that most shocked me when I started skimming psychology papers (trying to understand the state of evidence and validated theories for psychotherapy and other psychosocial treatments) is how much of it revolves around attributing dysfunction to a person's beliefs. It feels a bit like virtue ethics dressed up in a lab coat.

whatshisface 3y ago
In a very real sense the ghost of Freud haunts us.
iaaan 3y ago
I'd even take it a step further and say that modern psychiatry and psychotherapy are generally just another arm of the state, directing people towards acceptable behaviors decided by white men. Much of it ultimately revolves around being a good little worker bee, and if they can't convince you to do that, they'll drug you until you're pliable.
- spicymapotofu 3y ago
  I find your comparison a little too blunt, too rough and lacking in complexity, but ultimately the comparison of politic and psychology is a valuable one in literature. For example, Deleuze and Guattari's Thousand Plateaus explores this relation through a poetic, philosophical lens. As analytic philosopher and radical psychiatrist, these two synthesize a response to Freudian [more specifically, Lacanian] mode of thought. I assure you that this topic is old ground, and that this pair's writings on it paved the way for a larger positivist response to the problems discussed in this thread.
- P_I_Staker 3y ago
  It's basically a purity cult

verve_rat 3y ago

This is why I hate the focus on psychological resilience in the work place. It puts the onus on the individual to deal with stressful situations rather than asking what can be done to remove unnecessary stress in the first place.

deleted 3y ago
[deleted]

deleted 3y ago

[deleted]

seangrogg 3y ago

> As I read the article, it occurred to me that one of the fundamental flaws of modern psychology (and its offshoots such as psychiatry and psychotherapy) is that they all tend toward a solipsistic, individualist treatment of the self. This is by design. Psychology is intentionally about the individual and when it occasionally does look at groups it tends to do so through the lens of how a group produces value for the individual. Sociology is the study of collections of humans. It is intentionally about the group and when it occasionally looks at individuals it tends to do so through the lens of how an individual produces value for the group. This is not too dissimilar from the study of finance (generally micro, focused on individuals or companies) vs economics (generally macro, focused on the relationships between companies or countries).

xyzzy123 3y ago
Right, though I feel the OP's observation is that while sociology and psychology are both academic disciplines, there doesn't seem to be any equivalent to therapy, but applied at the community level. It feels like this is something that maybe good priests/churches used to do that accidentally got lost as society became more secular.
- NoZebra120vClip 3y ago
  > It feels like this is something that maybe good priests/churches used to do that accidentally got lost as society became more secular. Certainly, and I could expound on this point at length, but suffice it to say that the elites of most long-lived world religions have had extensive experience, knowledge and wisdom in so-called "psychology" fields for millennia. In fact, as the State disestablishes religions, something must fill the vacuum, and in fact psych*y are used much in the same way as religion formerly was. Psych*y is in fact a compulsory and State-Established Religion for most of us in the West, particularly in these United States, because of the coercive nature of the clinic and hospital system, the court-ordered treatments, the subsidized "medicine" drugs and practitioners, and so forth. Most of us can tell you, even some atheists know, that psych*y is a shitty poor excuse for a religion, and no substitute for an actual faith practice, and the way the State foists it on us today is basically abuse.

hellotheretoday 3y ago

You’ve proposed sociology But seriously there are some therapeutic interventions that are closer to what you describe. I worked in them early in my career. They tend to be (or are exclusively?) aimed at pediatric populations with a high level of need. But we would work in the home 2-3x a week with the child, parents, siblings, etc. we would do community outings to evaluate and work in that context, do school observations and teacher collab, etc. do parent training, relational work between parent/sibling/child, connect parents to therapy if necessary, case management and other services like snap, etc. The child was the “identified patient” but we were working with the entire family unit As said it was generally unavailable unless you displayed exceptional need (eg your school was kicking you out because your behavior was so bad and your parents were putting you in respite care/considering residential treatment). It cost a lot. not nearly as much as residential but enough that no commercial insurance would pay for it. So if you got to that behavior level you had to go through the nightmare evaluation process of proving your child’s behavior was bad enough to qualify as functionally disabled to qualify for Medicaid entitlement because they’re the only ones that would pay. Even if you were under the income threshold for Medicaid and didn’t need the entitlement you still had to prove need for the service. So I guess this is a long way of saying that there are alternative modalities to deliver therapy. There’s actually a ton of them. But in practice you’ll likely never see them because no one wants to fund them outside of the most extreme circumstances and even then it’s often hard to get new approaches off the ground. New approaches start in academia and this kind of stuff for adults doesn’t get grant funding afaik. Why bother, it’ll never happen outside of the research because there is very little public money for adult mental health services in most, if not all, states. Children get way more and still barely get enough. So for adults you get the same old outpatient 45 or 60 minute psychotherapy, individual or group, where the only variance is the theoretical approach the clinician uses (which is increasingly “eclectic” aka “I don’t really do anything evidence based and just make it up as I go” but that’s a whole different issue). Or if your issues worsen you get inpatient for 3 days. If they worsen beyond that I hope you have continued access to insurance and social supports because then you’ll get a longer term residential placement. otherwise it’s often a shockingly quick road to homelessness or prison.

ergl 3y ago

Psychology and psychiatry are worlds apart and I think you're confusing one with the other. Psychiatry fits within what you described: individualized treatment, medication, etc. It's a branch of medicine after all, and it fits within the whole context of medical care as it is conceived currently (that is, brushing aside social context, community, etc) Psychology is all about context, that's kinda its motto. A good therapist always considers the family, socioeconomic backgrounds, all the things you say it ignores.

NoZebra120vClip 3y ago
> Psychology is all about context, that's kinda its motto. A good therapist always considers the family, socioeconomic backgrounds, all the things you say it ignores. Not what I said. I said they don't treat the family or the community. Psychology is typically an individualistic treatment of a single person (or a couple).

niemal_dev 3y ago

I think the best theory we have up to date for mental irregularities is metabolic dysfunction and damage at the cellular level through environmental stress, inheritance preconditions and super-processed foods. Psychology does and can have an impact but it's only a small fraction of the picture. Healing does not take community, you cannot find coherent and healthy community in a fully-antagonistic capitalistic society.

rabchi 3y ago

Critical psychology is an area within psychology that goes back to the late 1960s and that agrees with a lot of the criticism in OP and in your comment: https://en.wikipedia.org/wiki/Critical_psychology https://en.wikipedia.org/wiki/Critical_psychology If you are interested in learning more I have found these two books to be good introductions to the topic: - "Psychology, Subjectivity, and Society: An Introduction to German Critical Psychology" by Charles Tolman - "Psychology from the Standpoint of the Subject: Selected Writings of Klaus Holzkamp" edited by Ernst Schraube and Ute Osterkamp.