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Therapy isn't fixing America's mental health crisis

34 points by Paul-Craft 3y ago

deleted 3y ago
[deleted]
Ancalagon 3y ago
I'm sure attending therapy will make me feel tons better until I come home to crushing debt, inflation, sky-high CoL, a culture of overwork, climate degradation, worthless jobs, a divided and failing middle-class, income disparity, lack of upward mobility, etc.
- hmmmcurious1 3y ago
  Yeah psychiatry is basically an effort to take all the collective sins society makes and drops them on your head, they say its your fault youre depressed. Similar to how religions made people feel guilty in the past so they can sell their religious message which is the only way out of this guilt.
  - jstarfish 3y ago
    Maybe in the 60s. Since then, it's always your parents' fault you're (whatever). The message for the last decade has been very much don't-feel-guilt-or-shame about anything, just blame those who came before you. Doesn't matter if your parents divorced, stayed together, were overattentive, were underattentive, were poor or were rich. It's their fault you're miserable. In reality, it's learned helplessness reinforced by social media and ongoing tech developments. Let me drive for you. Let me cook for you. Let me entertain you. Let me tell you what to believe. Let me write "your" speech for you and create "your" art for you. It's life in captivity. Animals in cages at the zoo are always miserable.
    - hmmmcurious1 3y ago
      The techniques and messages change but the underlying hypothesis remains. They say you are abnormal because you can see some things that are very simple like global warming. They condemn your human reaction to rebel against this and offer you a lobotomy to remain happy. It's not physical anymore but its still a lobotomy
      - jstarfish 3y ago
        > They say you are abnormal because you can see some things that are very simple like global warming. They condemn your human reaction to rebel against this and offer you a lobotomy to remain happy. This is the way things need to be though. You're not Elon Musk's rich uncle. If changing the fate of the entire world is your goal, you will die unaccomplished, frustrated and be miserable the entire time. It's beyond your control, even collectively, and obsessing about ambitions beyond your capabilities only leads to madness. Tend your own lot in life. Fix the things you can. "Climate is heating up" should not mean "design, launch and deploy a functional solar shield;" to you, it should mean "migrate somewhere cooler." Once you're capable of achieving small goals like saving your own ass, then you can afford to be more ambitious and worry about everyone else's.
        chowells 3y ago
        Yeah, this is also wrong. If all you do is this, then if you have human empathy you'll be utterly miserable. You'll care about all the shit happening to other people, and the fact that you have managed to minimize the damage to yourself doesn't really change anything. Your options are to either eliminate your own sense of empathy, or advocate for broad change. Stoicism's great flaw is that it tells you to do the former.
        jstarfish 3y ago
        > If all you do is this Sure, but that's not what I was advocating at all. I was very particular with my words in suggesting tending your own lot first, then helping others instead of the other way around. (People that only look out for themselves generally don't need to be told to do so!) It's the plane-oxygen-mask situation. You can't fix global warming for everyone without securing money and influence for yourself. So focus on securing those first. Empathy unchecked by logic is just hysteria.
    - olyjohn 3y ago
      That's not at all my experience with Therapy... Maybe you need to find a better therapist if all they are doing is teaching you to blame your parents for your problems and do nothing else.
  - mrguyorama 3y ago
    What are you, Scientologist? That's not how therapy works.
- willcipriano 3y ago
  Problem: People are leading unfulfilled lives and reporting they are depressed. My solution: Recenter your life around your family unit, do more physical activity, get off social media. Build a life worth living. The solution we went with: Take some pills so you can manage the horror of your disconnected life devoid of meaning and purpose. Problem: Energetic young boys are having trouble sitting in school for hours on end. My solution: Focus more on hands on activities, bring back woodshop and metalshop, include more breaks for physical activity during the day. The solution we went with: Get the boys so high on stimulants they can sit still like the girls. It's easier (and more profitable) to feed people pills than to build a society that people are happy in so that's what we do, but hey the line went up!
  - EatingWithForks 3y ago
    > The solution we went with: Get the boys so high on stimulants they can sit still like the girls. This is a bit inaccurate. ADHD is diagnosed more in boys than girls, but is way, way more debilitating than being energetic to the point where they may be incredibly dangerous in a woodshop or metalshop. It's not being able to keep track of each tool being used, or the order in which to use them. It's forgetting to turn machines off, and forgetting to unplug dangerous equipment. It's turning around to grab something and forgetting what you turned around for, and then forgetting the task you were doing before you realized you were missing a part. I would argue against treating ADHD like it's not a legitimate disability that requires accommodation. In the past, people with ADHD were just told they were stupid, lazy, or absentminded, when in reality they had a neurological disorder that had no diagnosis and no treatment at the time. That being said I overall agree with the fact that society doesn't allow for breathing room for people to be people and form human relationships that doesn't have a financial or economic angle. This is horrendous, and no amount of therapy or medication will resolve this fundamental, societal-level problem. But ADHD is real, acting like ADHD treatment is just societal feminization of men is a completely incorrect depiction of the disorder. We can simultaneously argue that the medical system is completely fucked and also acknowledge that sometimes you really do need a surgeon to repair broken legs!
    - gardenhedge 3y ago
- serjester 3y ago
  It's sad to see an entire generation of people adopting such a defeatist attitude, when objectively speaking we're living in some of the most prosperous times in all of history. Having grown up in post collapse USSR where every one of the issues you listed was 10X worse, it's genuinely disheartening to see so many people adopt an external locus of control and let it dictate their life.
  - EatingWithForks 3y ago
    If you grew up in post collapse USSR, you aren't of the age where you have to deal with the problems the parent post describes. It's important to recognize your lack of personal experience with it. I'm not saying that post collapse USSR wasn't a bad time. It was an absolutely horrible time and I am glad you're here. But it's important to recognize people have different challenges and live different lives than you. I'm likely much younger than you. My parents were able to afford to raise me in a house they owned, at my current age. I am not and nowhere near that buying power. My parents can look forward to a retirement fund. I cannot. My parents were able to work through the summer to pay for their graduate degrees. Graduate degrees are too expensive for me to attain, now. My parents could afford to take me to the emergency room when I had fevers as a child. I cannot afford a single emergency room visit for anything.
  - JohnClark1337 3y ago
    [dead]
- missedthecue 3y ago
  Do actually poor countries have higher rates of clinical and self-reported depression? Do Colombians or Tunisians suffer worse rates of mental illness than Americans? I am from a country where the median income is less than $10k, the gini coefficient is higher than the US, and where the six-day workweek is the norm. I literally don't know anyone on an SSRI. Sure, it's very possible someone is suffering in silence, but it's a far cry from when I studied in the United States and more than half of my classmates were medicated for mental disorders or went to therapists.
  - EA-3167 3y ago
    I suppose it would help to look at statistical signs of depression then, such as national suicide rate, rates of alcoholism and substance abuse, etc.
  - camdenlock 3y ago
    These are luxury diseases that you’ll only find in super-rich countries.
  - christkv 3y ago
    If you have to scramble to live it’s hard to have time to self analyze like we do in the west. I’m sure serious mental illness like schizophrenia or bipolar disorder is similar. Might also be covered up more by societies as it used to be in the west due to the family shame aspect that was very prevalent.
    - EA-3167 3y ago
      Even with similar standards of living, culture can play a HUGE role in how these things are talked about. Look at Japan for example, which has a shockingly high rate of people who just... walk out of their own lives forever. https://en.wikipedia.org/wiki/Jouhatsu https://en.wikipedia.org/wiki/Jouhatsu The discussion around depression and anxiety is also relatively new in Japan, but at the same time the evidence of those issues is not, look at NEETs and Hikikomori, a high suicide rate, and the aforementioned Jōhatsu! The thing is that in Japan there's a very strong tendency to keep that sort of thing in the family, keep it away from prying eyes. Your point about how shame works in different cultures is right on the mark IMO.
kbrannigan 3y ago
Pre religion: shaman, witch doctor, priest confessional, pastor guidance Post religion: therapist, self improvement , life coach, lifestyle guru.
- christkv 3y ago
  Priest and confessional is probably cheapest option still. The things those people have to hear probably matches most therapists.
  - omniglottal 3y ago
    Yeah, they may be great for empathy, but not so much for advice.
    - red-iron-pine 3y ago
      depends on what for. someone above mentioned studies that show the professionalism of the therapist doesn't really matter relative to empathy. like sometimes you just need to unload to someone who will listen and help you talk through issues.
tekla 3y ago
I tried therapy a few times, at the insistence of several friends. After 3 platforms, and 7 therapists, I've decided its a complete waste of time. I'm not 11 and require someone telling me things I can find in a dollar bin self-help book at $100 per 30m. I'm mildly convinced that therapy is another big-pharma conspiracy to pay for services that are worthless.
- pcurve 3y ago
  It's not just pharma. It's a big revenue driver for the entire healthcare industry for the past decade. Billions have been spent trying to generate demand and create'awareness'. Everyone is in on it, including HR people at your companies trying to stay relevant, countless mental health related start-ups, insurance companies, and providers.
- deleted 3y ago
  [deleted]
- jonas21 3y ago
  Why would big pharma want you to spend money talking to someone instead of buying their drugs?
  - websap 3y ago
    Who is going to prescribe the drugs?
    - Nasrudith 3y ago
      A psychiatrist, not a therapist.
    - HDThoreaun 3y ago
      therapists dont prescribe drugs
- hbn 3y ago
  The thing I don't understand about therapy is that there's no amount of self-inflicted problems you can have that therapy couldn't tell you is someone else's fault. Think of the worst person you can imagine in your persona life, who goes around causing problems for other people and then complaining that "everyone's an asshole." That person can go shop around for therapists until they find one who reaffirms all their beliefs that other people need to change for them. And I don't think it would be wild to assume therapists like that will receive the highest praise for their work, as opposed to the ones who tell you to fix something about yourself, which many people will take as a personal attack. If someone can't fix their own problems so they're seeing a therapist, how can they be trusted to select a good therapist for themself? It seems like the whole concept of this system actively incentivizes bad therapy and externalizing blame.
damnesian 3y ago
I really jive with CBT methods. Unfortunately, health care allotments even for the otherwise securely insured is VERY limiting. After my initial three visits, I had to start ponying up. After a while whether it helps or not it becomes part of the same calculation most middle and lower class americans have to make when it comes to bills/utilities/food vs "niceties" ie our health.
hamburga 3y ago
I was a psychology major in college. In one of my smaller seminars, we had a research psychiatrist come in as a special guest one week. He told us that all the evidence showed that the effectiveness of therapy has no correlation with the training (or lack thereof) of the practitioner. The only factor was the empathy score of the therapist. I have seen a few therapists over the years, but that always stuck with me. I'd take good conversation with a trusted friend or family member over a therapist any day. It might even serve us better to do away with the credentialing process altogether and sort of lift the veil on actually what happens in therapy. The one really great therapist I had didn't even "do therapy" but instead helped with all sorts of practical advice when I was navigating a complicated divorce.
- EatingWithForks 3y ago
  I agree that empathetic, compassionate human connections are way more useful than therapy is GENERALLY. (Therapists that function in an occupational manner, such as doing exposure therapy, DBT, EDMR, etc is different and I do not want a trusted friend to do any of that to me!) I however would push against doing away with the credentialing process. You can threaten an abusive/shitty therapist with losing their license. There are plenty of absolute quacks, especially religious-specific therapy, and being able to say "do not associate me with these dumbfucks" is important. [It's not uncommon for religious counseling to discourage reporting rape or child abuse!]
  - tnecniv 3y ago
    To me, the two have served a similar but non-overlapping function. There’s stuff I’ve find a lot easier to bring up in therapy, or bring up in therapy and then talk to friends about when I feel more comfortable.
  - chris_wot 3y ago
    Priests do not need to be credentialed in counselling. I wonder how this affects things?
- Telemakhos 3y ago
  If empathy scores correlate better with therapy effectiveness than training, does the existence of a mental health crisis suggest a general decrease in available empathetic interlocutors throughout society? Are people having fewer empathetic relationships or encounters in their daily life than in the past?
Yhippa 3y ago
I'm going to go out on a limb and posit that what we need to do to survive on a daily and short-term basis has far outpaced our ability to cope with it.
- nine_zeros 3y ago
  > I'm going to go out on a limb and posit that what we need to do to survive on a daily and short-term basis has far outpaced our ability to cope with it. Our ancestors never had to do so much to just survive. Humans are just not designed for this level of stimulation, keeping track of resumes, jobs, bills, credit scores, investments, children, retirement, mortgages, cars, a pushy manager, performance ratings and who know what else. Life has become miserable because too much is asked of an individual. It takes immense strength and mental clarity to get rid off all these burdens. The hardest to get rid of is poor quality of jobs.
  - wlpu 3y ago
    I don't really agree with your proposition, I think the base issue is more fundamental, simply put I think it comes down to the atomisation of the individual due to the structure of higher education and zeitgeist of fear of being accused or misinterpreted. While is it easier than ever to enter social spaces, I think people are struggling to build real meaningful relationships (romantic and platonic). There is the western "coming of age" ritual that involves going off to university by yourself for a few years and then a few years later going off to another place by yourself. Whether the fear of being misinterpreted is real, it is there for many people. People I know have changed a lot about what they say and the way they speak when people they don't know show up or enter a conversation, often saying things they don't believe in to give a good impression.
throw18376 3y ago
i've heard people speculate that there are just not enough people capable of being good therapists. it may be that it is too hard of a job, there's skill/talent that can't be taught, and only so many people can do it. maybe we can train more and more therapists but not more effective therapists. on the other hand accountability, social interaction in a safe context, providing an objective viewpoint, successfully teaching people "manualized" techniques like CBT -- these are all ways where a therapist could be helpful despite not being personally skilled at the art or craft of psychotherapy.
neonate 3y ago
https://archive.ph/cvOub https://archive.ph/cvOub
syndicatedjelly 3y ago
We’ve reached peak TaaS (Therapy as a Service). The industry went from outcome oriented to service oriented because people in tech saw an opportunity for some cash grabs
- red-iron-pine 3y ago
  don't blame tech for this, the healthcare industry in the US is ruthless and willing to chase any dime
AtlasBarfed 3y ago
It's my general suspicion that collective mental health is tracking with collective physical fitness, especially considering that exercise performs all antidepressant drugs by a fair amount As America keeps getting unhealthier and more obese, it isn't much of a stretch to say that mental health is following it
- francisofascii 3y ago
  Not just fitness, but friendships and communities.
useEffect 3y ago
deleuze intensifies
sdsd 3y ago
I think therapy works, but I think other things (like exercise, friendship, and having a good reason to expect good things in the future) usually are much more important, and it's hard for a therapist to help with any of those problems.
yosito 3y ago
One of the reasons is that the APA has guidelines that are hostile to a safe therapeutic environment. I've had much better luck working with non-American therapists that aren't subject to the APAs ideology.
- Qem 3y ago
  > the APA has guidelines that are hostile to a safe therapeutic environment. What guidelines are bad?
  - yosito 3y ago
    https://www.apa.org/about/policy/boys-men-practice-guidelines.pdf https://www.apa.org/about/policy/boys-men-practice-guideline...
8f2ab37a-ed6c 3y ago
It's been fascinating to watch the trend of therapy explode by orders of magnitude in popularity over the last 3 years. For anybody else keeping the finger on the pulse of trends through what people put on their online dating profiles, the "I hope you are in therapy" stated expectation went from 0 to every-other-profile almost overnight. It makes me question how much this is driven by the effectiveness of the therapeutic approach vs what is simply trendy and mimetic among bourgeois urban millennials.
- FooBarBizBazz 3y ago
  > the "I hope you are in therapy" stated expectation went from 0 to every-other-profile almost overnight. Wait, what? Could you expand on this? I don't use these apps, so I wouldn't see this trend myself. But I hear plenty of therapy-speak elsewhere, so I'd believe it. Is the idea that they honestly want a potential romantic partner to be undergoing therapy? Is the theory that this will make the person a better partner? Or is there some horrible idea like it'll reduce the amount of "emotional labor" they have to perform in the relationship? What's the underlying worldview?
  - 8f2ab37a-ed6c 3y ago
    My most charitable read of that trend is the narrative that everybody is broken and traumatized and if they're not in therapy then they're in denial about their unaddressed issues, and a therapist is the only person who can truly fix you before you bring those issues into a relationship. I'm quite confident that this isn't a thoroughly examined belief for most people espousing it, it's a meme that's supposed to show sophistication as a partner.
what-no-tests 3y ago
The (un)funny thing about CBT is that it is almost indistinguishable from the totalism and thought reform techniques deployed by the Communists in China, as described by Robert Jay Lifton in his work -- Thought Reform and the Psychology of Totalism: A Study of "Brainwashing" in China [0]. A read through Wilhelm Reich's earlier work [1] and a look at his fundamental dispute with Freud (i.e. - is depression and anxiety a problem in the individual, or in society, and if it's a problem with society then why adjust the individual instead?) will expose the status quo in psychology as simply a way to maintain exactly that. [0] https://en.wikipedia.org/wiki/Thought_Reform_and_the_Psychology_of_Totalism https://en.wikipedia.org/wiki/Thought_Reform_and_the_Psychol... [1] https://en.wikipedia.org/wiki/Character_Analysis https://en.wikipedia.org/wiki/Character_Analysis
websap 3y ago
People are trying to replace family, friends, relationships, hobbies, goals, and sense of purpose, with therapy. Use therapy to learn your blindspots and improve, not as a replacement for living a full life.
0xbadc0de5 3y ago
It seems like the more people rely on therapists, the worse the mental health crisis becomes. Couple that with the replication crisis and the opioid epidemic and I'm becoming increasingly skeptical of the entire profession. Given enough bad apples, one starts to suspect the entire tree is sick.
juancn 3y ago
The US psychology school tends to be very pavlovian in the way they apply therapy. It's prescriptive rather than empathic (do this vs helping you re-position your views of yourself). My guess is probably due to cost. Other schools of therapy take a long time, and healthcare in the US is extremely expensive, so I don't see those other techniques becoming popular.
notacoward 3y ago
I'm sure there's a real effect here, but it's hard to determine the magnitude of the effect when they fail to distinguish between diagnosis vs. actuality. How many people reporting excellent mental health really are OK? How many are just suppressing their problems, or aren't even the most affected by those problems (e.g. dark-triad folks who will never seek therapy on their own)? On the flip side, how many are catastrophizing, treating every-day things as problems requiring professional help and/or medication? How many then, and how many now? Without knowing those answers, we can't really tell how big the problem is. This has definitely been a problem with autism and ADHD diagnoses over the years. There's no reason to suppose it isn't also true e.g. with depression diagnoses.
bigfryo 3y ago
Definitely a healthcare crisis in America no doubt about it.. all you have to do is look at all these so called "Karen" videos on the internet.. . when I was a kid back in the 60s 70s 80s whatever even the 90s, there was nothing like this phenomenon... you never heard of a woman freaking out like this... starting fights in public... Etc... now men might have started fights, but it was almost unheard of for women to raise their voices and scream and yell... maybe inside the home but never in public... there's something going on in modern society that is driving people crazy really

34 points by Paul-Craft 3y ago

deleted 3y ago

[deleted]

I'm sure attending therapy will make me feel tons better until I come home to crushing debt, inflation, sky-high CoL, a culture of overwork, climate degradation, worthless jobs, a divided and failing middle-class, income disparity, lack of upward mobility, etc.

hmmmcurious1 3y ago
Yeah psychiatry is basically an effort to take all the collective sins society makes and drops them on your head, they say its your fault youre depressed. Similar to how religions made people feel guilty in the past so they can sell their religious message which is the only way out of this guilt.
- jstarfish 3y ago
  Maybe in the 60s. Since then, it's always your parents' fault you're (whatever). The message for the last decade has been very much don't-feel-guilt-or-shame about anything, just blame those who came before you. Doesn't matter if your parents divorced, stayed together, were overattentive, were underattentive, were poor or were rich. It's their fault you're miserable. In reality, it's learned helplessness reinforced by social media and ongoing tech developments. Let me drive for you. Let me cook for you. Let me entertain you. Let me tell you what to believe. Let me write "your" speech for you and create "your" art for you. It's life in captivity. Animals in cages at the zoo are always miserable.
  - hmmmcurious1 3y ago
    The techniques and messages change but the underlying hypothesis remains. They say you are abnormal because you can see some things that are very simple like global warming. They condemn your human reaction to rebel against this and offer you a lobotomy to remain happy. It's not physical anymore but its still a lobotomy
    - jstarfish 3y ago
      > They say you are abnormal because you can see some things that are very simple like global warming. They condemn your human reaction to rebel against this and offer you a lobotomy to remain happy. This is the way things need to be though. You're not Elon Musk's rich uncle. If changing the fate of the entire world is your goal, you will die unaccomplished, frustrated and be miserable the entire time. It's beyond your control, even collectively, and obsessing about ambitions beyond your capabilities only leads to madness. Tend your own lot in life. Fix the things you can. "Climate is heating up" should not mean "design, launch and deploy a functional solar shield;" to you, it should mean "migrate somewhere cooler." Once you're capable of achieving small goals like saving your own ass, then you can afford to be more ambitious and worry about everyone else's.
      - chowells 3y ago
        Yeah, this is also wrong. If all you do is this, then if you have human empathy you'll be utterly miserable. You'll care about all the shit happening to other people, and the fact that you have managed to minimize the damage to yourself doesn't really change anything. Your options are to either eliminate your own sense of empathy, or advocate for broad change. Stoicism's great flaw is that it tells you to do the former.
        jstarfish 3y ago
        > If all you do is this Sure, but that's not what I was advocating at all. I was very particular with my words in suggesting tending your own lot first, then helping others instead of the other way around. (People that only look out for themselves generally don't need to be told to do so!) It's the plane-oxygen-mask situation. You can't fix global warming for everyone without securing money and influence for yourself. So focus on securing those first. Empathy unchecked by logic is just hysteria.
  - olyjohn 3y ago
    That's not at all my experience with Therapy... Maybe you need to find a better therapist if all they are doing is teaching you to blame your parents for your problems and do nothing else.
- mrguyorama 3y ago
  What are you, Scientologist? That's not how therapy works.
willcipriano 3y ago
Problem: People are leading unfulfilled lives and reporting they are depressed. My solution: Recenter your life around your family unit, do more physical activity, get off social media. Build a life worth living. The solution we went with: Take some pills so you can manage the horror of your disconnected life devoid of meaning and purpose. Problem: Energetic young boys are having trouble sitting in school for hours on end. My solution: Focus more on hands on activities, bring back woodshop and metalshop, include more breaks for physical activity during the day. The solution we went with: Get the boys so high on stimulants they can sit still like the girls. It's easier (and more profitable) to feed people pills than to build a society that people are happy in so that's what we do, but hey the line went up!
- EatingWithForks 3y ago
  > The solution we went with: Get the boys so high on stimulants they can sit still like the girls. This is a bit inaccurate. ADHD is diagnosed more in boys than girls, but is way, way more debilitating than being energetic to the point where they may be incredibly dangerous in a woodshop or metalshop. It's not being able to keep track of each tool being used, or the order in which to use them. It's forgetting to turn machines off, and forgetting to unplug dangerous equipment. It's turning around to grab something and forgetting what you turned around for, and then forgetting the task you were doing before you realized you were missing a part. I would argue against treating ADHD like it's not a legitimate disability that requires accommodation. In the past, people with ADHD were just told they were stupid, lazy, or absentminded, when in reality they had a neurological disorder that had no diagnosis and no treatment at the time. That being said I overall agree with the fact that society doesn't allow for breathing room for people to be people and form human relationships that doesn't have a financial or economic angle. This is horrendous, and no amount of therapy or medication will resolve this fundamental, societal-level problem. But ADHD is real, acting like ADHD treatment is just societal feminization of men is a completely incorrect depiction of the disorder. We can simultaneously argue that the medical system is completely fucked and also acknowledge that sometimes you really do need a surgeon to repair broken legs!
  - gardenhedge 3y ago
serjester 3y ago
It's sad to see an entire generation of people adopting such a defeatist attitude, when objectively speaking we're living in some of the most prosperous times in all of history. Having grown up in post collapse USSR where every one of the issues you listed was 10X worse, it's genuinely disheartening to see so many people adopt an external locus of control and let it dictate their life.
- EatingWithForks 3y ago
  If you grew up in post collapse USSR, you aren't of the age where you have to deal with the problems the parent post describes. It's important to recognize your lack of personal experience with it. I'm not saying that post collapse USSR wasn't a bad time. It was an absolutely horrible time and I am glad you're here. But it's important to recognize people have different challenges and live different lives than you. I'm likely much younger than you. My parents were able to afford to raise me in a house they owned, at my current age. I am not and nowhere near that buying power. My parents can look forward to a retirement fund. I cannot. My parents were able to work through the summer to pay for their graduate degrees. Graduate degrees are too expensive for me to attain, now. My parents could afford to take me to the emergency room when I had fevers as a child. I cannot afford a single emergency room visit for anything.
- JohnClark1337 3y ago
  [dead]
missedthecue 3y ago
Do actually poor countries have higher rates of clinical and self-reported depression? Do Colombians or Tunisians suffer worse rates of mental illness than Americans? I am from a country where the median income is less than $10k, the gini coefficient is higher than the US, and where the six-day workweek is the norm. I literally don't know anyone on an SSRI. Sure, it's very possible someone is suffering in silence, but it's a far cry from when I studied in the United States and more than half of my classmates were medicated for mental disorders or went to therapists.
- EA-3167 3y ago
  I suppose it would help to look at statistical signs of depression then, such as national suicide rate, rates of alcoholism and substance abuse, etc.
- camdenlock 3y ago
  These are luxury diseases that you’ll only find in super-rich countries.
- christkv 3y ago
  If you have to scramble to live it’s hard to have time to self analyze like we do in the west. I’m sure serious mental illness like schizophrenia or bipolar disorder is similar. Might also be covered up more by societies as it used to be in the west due to the family shame aspect that was very prevalent.
  - EA-3167 3y ago
    Even with similar standards of living, culture can play a HUGE role in how these things are talked about. Look at Japan for example, which has a shockingly high rate of people who just... walk out of their own lives forever. https://en.wikipedia.org/wiki/Jouhatsu https://en.wikipedia.org/wiki/Jouhatsu The discussion around depression and anxiety is also relatively new in Japan, but at the same time the evidence of those issues is not, look at NEETs and Hikikomori, a high suicide rate, and the aforementioned Jōhatsu! The thing is that in Japan there's a very strong tendency to keep that sort of thing in the family, keep it away from prying eyes. Your point about how shame works in different cultures is right on the mark IMO.

kbrannigan 3y ago

Pre religion: shaman, witch doctor, priest confessional, pastor guidance Post religion: therapist, self improvement , life coach, lifestyle guru.

christkv 3y ago
Priest and confessional is probably cheapest option still. The things those people have to hear probably matches most therapists.
- omniglottal 3y ago
  Yeah, they may be great for empathy, but not so much for advice.
  - red-iron-pine 3y ago
    depends on what for. someone above mentioned studies that show the professionalism of the therapist doesn't really matter relative to empathy. like sometimes you just need to unload to someone who will listen and help you talk through issues.

tekla 3y ago

I tried therapy a few times, at the insistence of several friends. After 3 platforms, and 7 therapists, I've decided its a complete waste of time. I'm not 11 and require someone telling me things I can find in a dollar bin self-help book at $100 per 30m. I'm mildly convinced that therapy is another big-pharma conspiracy to pay for services that are worthless.

pcurve 3y ago
It's not just pharma. It's a big revenue driver for the entire healthcare industry for the past decade. Billions have been spent trying to generate demand and create'awareness'. Everyone is in on it, including HR people at your companies trying to stay relevant, countless mental health related start-ups, insurance companies, and providers.
deleted 3y ago
[deleted]
jonas21 3y ago
Why would big pharma want you to spend money talking to someone instead of buying their drugs?
- websap 3y ago
  Who is going to prescribe the drugs?
  - Nasrudith 3y ago
    A psychiatrist, not a therapist.
  - HDThoreaun 3y ago
    therapists dont prescribe drugs
hbn 3y ago
The thing I don't understand about therapy is that there's no amount of self-inflicted problems you can have that therapy couldn't tell you is someone else's fault. Think of the worst person you can imagine in your persona life, who goes around causing problems for other people and then complaining that "everyone's an asshole." That person can go shop around for therapists until they find one who reaffirms all their beliefs that other people need to change for them. And I don't think it would be wild to assume therapists like that will receive the highest praise for their work, as opposed to the ones who tell you to fix something about yourself, which many people will take as a personal attack. If someone can't fix their own problems so they're seeing a therapist, how can they be trusted to select a good therapist for themself? It seems like the whole concept of this system actively incentivizes bad therapy and externalizing blame.

damnesian 3y ago

I really jive with CBT methods. Unfortunately, health care allotments even for the otherwise securely insured is VERY limiting. After my initial three visits, I had to start ponying up. After a while whether it helps or not it becomes part of the same calculation most middle and lower class americans have to make when it comes to bills/utilities/food vs "niceties" ie our health.

hamburga 3y ago

I was a psychology major in college. In one of my smaller seminars, we had a research psychiatrist come in as a special guest one week. He told us that all the evidence showed that the effectiveness of therapy has no correlation with the training (or lack thereof) of the practitioner. The only factor was the empathy score of the therapist. I have seen a few therapists over the years, but that always stuck with me. I'd take good conversation with a trusted friend or family member over a therapist any day. It might even serve us better to do away with the credentialing process altogether and sort of lift the veil on actually what happens in therapy. The one really great therapist I had didn't even "do therapy" but instead helped with all sorts of practical advice when I was navigating a complicated divorce.

EatingWithForks 3y ago
I agree that empathetic, compassionate human connections are way more useful than therapy is GENERALLY. (Therapists that function in an occupational manner, such as doing exposure therapy, DBT, EDMR, etc is different and I do not want a trusted friend to do any of that to me!) I however would push against doing away with the credentialing process. You can threaten an abusive/shitty therapist with losing their license. There are plenty of absolute quacks, especially religious-specific therapy, and being able to say "do not associate me with these dumbfucks" is important. [It's not uncommon for religious counseling to discourage reporting rape or child abuse!]
- tnecniv 3y ago
  To me, the two have served a similar but non-overlapping function. There’s stuff I’ve find a lot easier to bring up in therapy, or bring up in therapy and then talk to friends about when I feel more comfortable.
- chris_wot 3y ago
  Priests do not need to be credentialed in counselling. I wonder how this affects things?
Telemakhos 3y ago
If empathy scores correlate better with therapy effectiveness than training, does the existence of a mental health crisis suggest a general decrease in available empathetic interlocutors throughout society? Are people having fewer empathetic relationships or encounters in their daily life than in the past?

Yhippa 3y ago

I'm going to go out on a limb and posit that what we need to do to survive on a daily and short-term basis has far outpaced our ability to cope with it.

nine_zeros 3y ago
> I'm going to go out on a limb and posit that what we need to do to survive on a daily and short-term basis has far outpaced our ability to cope with it. Our ancestors never had to do so much to just survive. Humans are just not designed for this level of stimulation, keeping track of resumes, jobs, bills, credit scores, investments, children, retirement, mortgages, cars, a pushy manager, performance ratings and who know what else. Life has become miserable because too much is asked of an individual. It takes immense strength and mental clarity to get rid off all these burdens. The hardest to get rid of is poor quality of jobs.
- wlpu 3y ago
  I don't really agree with your proposition, I think the base issue is more fundamental, simply put I think it comes down to the atomisation of the individual due to the structure of higher education and zeitgeist of fear of being accused or misinterpreted. While is it easier than ever to enter social spaces, I think people are struggling to build real meaningful relationships (romantic and platonic). There is the western "coming of age" ritual that involves going off to university by yourself for a few years and then a few years later going off to another place by yourself. Whether the fear of being misinterpreted is real, it is there for many people. People I know have changed a lot about what they say and the way they speak when people they don't know show up or enter a conversation, often saying things they don't believe in to give a good impression.

throw18376 3y ago

i've heard people speculate that there are just not enough people capable of being good therapists. it may be that it is too hard of a job, there's skill/talent that can't be taught, and only so many people can do it. maybe we can train more and more therapists but not more effective therapists. on the other hand accountability, social interaction in a safe context, providing an objective viewpoint, successfully teaching people "manualized" techniques like CBT -- these are all ways where a therapist could be helpful despite not being personally skilled at the art or craft of psychotherapy.

neonate 3y ago

https://archive.ph/cvOub https://archive.ph/cvOub

syndicatedjelly 3y ago

We’ve reached peak TaaS (Therapy as a Service). The industry went from outcome oriented to service oriented because people in tech saw an opportunity for some cash grabs

red-iron-pine 3y ago
don't blame tech for this, the healthcare industry in the US is ruthless and willing to chase any dime

AtlasBarfed 3y ago

It's my general suspicion that collective mental health is tracking with collective physical fitness, especially considering that exercise performs all antidepressant drugs by a fair amount As America keeps getting unhealthier and more obese, it isn't much of a stretch to say that mental health is following it

francisofascii 3y ago
Not just fitness, but friendships and communities.

useEffect 3y ago

deleuze intensifies

sdsd 3y ago

I think therapy works, but I think other things (like exercise, friendship, and having a good reason to expect good things in the future) usually are much more important, and it's hard for a therapist to help with any of those problems.

yosito 3y ago

One of the reasons is that the APA has guidelines that are hostile to a safe therapeutic environment. I've had much better luck working with non-American therapists that aren't subject to the APAs ideology.

Qem 3y ago
> the APA has guidelines that are hostile to a safe therapeutic environment. What guidelines are bad?
- yosito 3y ago
  https://www.apa.org/about/policy/boys-men-practice-guidelines.pdf https://www.apa.org/about/policy/boys-men-practice-guideline...

8f2ab37a-ed6c 3y ago

It's been fascinating to watch the trend of therapy explode by orders of magnitude in popularity over the last 3 years. For anybody else keeping the finger on the pulse of trends through what people put on their online dating profiles, the "I hope you are in therapy" stated expectation went from 0 to every-other-profile almost overnight. It makes me question how much this is driven by the effectiveness of the therapeutic approach vs what is simply trendy and mimetic among bourgeois urban millennials.

FooBarBizBazz 3y ago
> the "I hope you are in therapy" stated expectation went from 0 to every-other-profile almost overnight. Wait, what? Could you expand on this? I don't use these apps, so I wouldn't see this trend myself. But I hear plenty of therapy-speak elsewhere, so I'd believe it. Is the idea that they honestly want a potential romantic partner to be undergoing therapy? Is the theory that this will make the person a better partner? Or is there some horrible idea like it'll reduce the amount of "emotional labor" they have to perform in the relationship? What's the underlying worldview?
- 8f2ab37a-ed6c 3y ago
  My most charitable read of that trend is the narrative that everybody is broken and traumatized and if they're not in therapy then they're in denial about their unaddressed issues, and a therapist is the only person who can truly fix you before you bring those issues into a relationship. I'm quite confident that this isn't a thoroughly examined belief for most people espousing it, it's a meme that's supposed to show sophistication as a partner.

what-no-tests 3y ago

The (un)funny thing about CBT is that it is almost indistinguishable from the totalism and thought reform techniques deployed by the Communists in China, as described by Robert Jay Lifton in his work -- Thought Reform and the Psychology of Totalism: A Study of "Brainwashing" in China [0]. A read through Wilhelm Reich's earlier work [1] and a look at his fundamental dispute with Freud (i.e. - is depression and anxiety a problem in the individual, or in society, and if it's a problem with society then why adjust the individual instead?) will expose the status quo in psychology as simply a way to maintain exactly that. [0] https://en.wikipedia.org/wiki/Thought_Reform_and_the_Psychology_of_Totalism https://en.wikipedia.org/wiki/Thought_Reform_and_the_Psychol... [1] https://en.wikipedia.org/wiki/Character_Analysis https://en.wikipedia.org/wiki/Character_Analysis

websap 3y ago

People are trying to replace family, friends, relationships, hobbies, goals, and sense of purpose, with therapy. Use therapy to learn your blindspots and improve, not as a replacement for living a full life.

0xbadc0de5 3y ago

It seems like the more people rely on therapists, the worse the mental health crisis becomes. Couple that with the replication crisis and the opioid epidemic and I'm becoming increasingly skeptical of the entire profession. Given enough bad apples, one starts to suspect the entire tree is sick.

juancn 3y ago

The US psychology school tends to be very pavlovian in the way they apply therapy. It's prescriptive rather than empathic (do this vs helping you re-position your views of yourself). My guess is probably due to cost. Other schools of therapy take a long time, and healthcare in the US is extremely expensive, so I don't see those other techniques becoming popular.

notacoward 3y ago

I'm sure there's a real effect here, but it's hard to determine the magnitude of the effect when they fail to distinguish between diagnosis vs. actuality. How many people reporting excellent mental health really are OK? How many are just suppressing their problems, or aren't even the most affected by those problems (e.g. dark-triad folks who will never seek therapy on their own)? On the flip side, how many are catastrophizing, treating every-day things as problems requiring professional help and/or medication? How many then, and how many now? Without knowing those answers, we can't really tell how big the problem is. This has definitely been a problem with autism and ADHD diagnoses over the years. There's no reason to suppose it isn't also true e.g. with depression diagnoses.

bigfryo 3y ago

Definitely a healthcare crisis in America no doubt about it.. all you have to do is look at all these so called "Karen" videos on the internet.. . when I was a kid back in the 60s 70s 80s whatever even the 90s, there was nothing like this phenomenon... you never heard of a woman freaking out like this... starting fights in public... Etc... now men might have started fights, but it was almost unheard of for women to raise their voices and scream and yell... maybe inside the home but never in public... there's something going on in modern society that is driving people crazy really