4 ms·

Nope. Therapy produces results only when based on a sincere desire to make change.

munk-a 3y ago
If someone is caught in a vicious spiral not only does Therapy sound like a better option than prison but even just a one time bailout might allow them to self-correct... I still think it'd be a good idea to have the therapy in place though. At the end of the day - people make mistakes, helping people out of those mistakes results in recidivism less often than you'd suspect.
- ohyes 3y ago
  That’s one flavor of embezzler, there probably a sociopath flavor as well. Sending a sociopath to therapy generally doesn’t work.
  - munk-a 3y ago
    Yes - but it's very difficult to tell whether someone is a sociopath if they're good at it. I think it'd probably be safer to err on the side of therapy and let the therapist's recommendation or repeat offenses dictate whether jail time is justified.
    - lelanthran 3y ago
      > I think it'd probably be safer to err on the side of therapy and let the therapist's recommendation or repeat offenses dictate whether jail time is justified. Repeat offenses as a signal? Sure! Therapist's recommendation? I'm skeptical. Their primary data is whatever the subject self-reports, and their secondary data is their somewhat subjective opinion on whether the subject has improved. If the subject does not want to stop and they are smart enough to figure out how to embezzle or to get high enough to embezzle, there's very little chance that the therapist would see through them. It's like EQ tests - the subject can make the test results say whatever they want the test results to say.
- forgetfreeman 3y ago
  Lots of things sounds like a better option when you remove the constraints of actual human behavior (see also: economics). Unfortunately human behavior is what it is regardless of whether your strategy accounts for it or not. So again, for the cheap seats, therapy is a complete waste of time in 100% of instances where the individual in question isn't genuinely pursuing change.
  - PythagoRascal 3y ago
    Yes, and an individual's convictions remain static forever and cannot be influenced by others. You can't convince me otherwise. Your argument sounds tautological.
    - forgetfreeman 3y ago
      K. You probably shouldn't pursue a career as a therapist or have kids then unless you enjoy staggering around in a haze of cognitive dissonance.
- itronitron 3y ago
  I know of an employer at which one of the finance people had embezzled about 50K over the course of one or two years (from their employer). And at the same time they also embezzled 5K from the community sports league for which they did volunteer accounting/finance stuff. They ended up being arrested and convicted for stealing from the sports league, and they went to jail for a few months but they had some arrangement where they could leave every weekday morning to go to work and then return to jail in the evening. Their arrest and conviction was well known by and within their employer (from which they were known to have embezzled the 50K) since they needed to request leave to show up to court and also because the local papers covered it extensively due to it impacting the sports league. They were not fired, presumably because their employer did not want to run the risk of tarnishing its sterling reputation of properly managing its finances.
nine_k 3y ago
Don't at least some of them want to gain control of their impulses?
SkyBelow 3y ago
Given the number of possible things wrong with a human that leads to bad behavior, it seems like an extreme claim to suggest that desire to make a change is a necessary component in any successful therapy. Part of therapy can be building that desire. For example, therapy for issues stemming from learned helplessness are a counter example, as learned helplessness implies lacking a desire to make a change as they have already been conditioned to seeing it as impossible. The therapy involves building up that desire by having minor successes that end up breaking down the mental block which formed.
- lelanthran 3y ago
  None of what you said is quantitative and/or objective data.
  - jacobgkau 3y ago
    A "sincere desire to make change" isn't quantifiable in the first place.
    - lelanthran 3y ago
      > A "sincere desire to make change" isn't quantifiable in the first place. Well, that's my entire point: why use it as a metric or target? How do you tell if you achieved the objective when the target metric is unmeasurable? When the goal is (in GP's words) "building that desire to make a change", you can never tell anything about progress towards your goal: when you've achieved the goal, when you've not achieved that goal, when you're making progress, when you're making it worse - those things are all subjective. All we can do when treating sociopaths is to release them into the world again and judge their actions, not their self-reported feelings.
      - jacobgkau 3y ago
        > When the goal is (in GP's words) "building that desire to make a change", you can never tell anything about progress towards your goal: > All we can do when treating sociopaths is to release them into the world again and judge their actions, not their self-reported feelings. What's the purpose here, to treat the condition of being a sociopath, or just to enforce enough structure on them that they don't cause other people harm? My problem with what you said is that the entire idea of "sociopathy" is that a person lacks what the diagnoser considers to be "emotion" and is simply "pretending" to be a "normal" human by copying how they see other people behaving. That diagnosis isn't quantifiable in the first place; it's the diagnoser deciding they know what's happening in a patient's head by (guess what?) observing their words and actions. Farther up-thread, people were arguing sociopaths should go to prison and not receive therapy (particularly if they say they don't want therapy, but more generally if they've committed a crime). You're now taking that farther by saying even if they express a desire to make change, that shouldn't be taken into account when determining any treatment/punishment, because that's only an observation of words coming out of their mouth-- but that's the same route they were diagnosed via in the first place, so I find that hypocritical. If you're just saying criminals should be punished without regard for their mental health/conditions simply because their victims were victimized regardless, that's a valid utilitarian view. But realize (it at least sounds like) you're essentially arguing that therapy for mental conditions is generally impossible/pointless.
stavros 3y ago
Addiction is weird, though. A lot of the time, the addict doesn't actually want to be addicted.
- aidenn0 3y ago
  Conversely they will often only go to rehab at the threat of imprisonment or abandonment by friends and family. I'm sure there's an underlying logic to addiction, but it creates behaviors that are extremely contradictory.
  - stavros 3y ago
    I'm not an expert, but as far as I know, the logic is just a failure of long-term planning to dominate over short-term planning. "I know I shouldn't smoke, but this one cigarette will feel so good".
    - swores 3y ago
      That's definitely one way people get addicted, but I suspect not the most common. A huge proportion of drug addicts (and I suspect addicts of sex, gambling etc I'm just less familiar with those addictions) started taking their drugs because of how tough their life was. And even if you know that starting to take opiates or whatever drug of choice might not be a sensible plan long term, if you feel so bad that you'd rather kill yourself than live in your head sober, it's possible to actually want to keep using what you re addicted to because you don't believe that life without that drug can be any better. I don't know how common this is, but anecdotally I've known two people who used high dose prescription painkillers (obtained illegal) to give them enough positive feelings to be able to work on their mental health problems, both who would've been described as problematically addicted by most medical professionals, but who managed to use the opiates to work on their core mental health issues until such a time that they felt ready to not need opiates, at which point they found it relatively easy to stop. Because as horrible as it is to get the withdrawals, it's actually not very last longing and it can be considerably less painful than the pain of having such severe mental health issues that you were desperate to kill yourself before you started the drug use, not because you started the drug use. (Of course there's also people who get addicted because they think it will be fun, and end up suicidal because of it. And I also wouldn't recommend using opiates to work on your mental health, because despite my two anecdotes I believe the almost universal knowledge in medical circles is that it's much more likely to worsen your mental health than to improve it.

If someone is caught in a vicious spiral not only does Therapy sound like a better option than prison but even just a one time bailout might allow them to self-correct... I still think it'd be a good idea to have the therapy in place though. At the end of the day - people make mistakes, helping people out of those mistakes results in recidivism less often than you'd suspect.

ohyes 3y ago
That’s one flavor of embezzler, there probably a sociopath flavor as well. Sending a sociopath to therapy generally doesn’t work.
- munk-a 3y ago
  Yes - but it's very difficult to tell whether someone is a sociopath if they're good at it. I think it'd probably be safer to err on the side of therapy and let the therapist's recommendation or repeat offenses dictate whether jail time is justified.
  - lelanthran 3y ago
    > I think it'd probably be safer to err on the side of therapy and let the therapist's recommendation or repeat offenses dictate whether jail time is justified. Repeat offenses as a signal? Sure! Therapist's recommendation? I'm skeptical. Their primary data is whatever the subject self-reports, and their secondary data is their somewhat subjective opinion on whether the subject has improved. If the subject does not want to stop and they are smart enough to figure out how to embezzle or to get high enough to embezzle, there's very little chance that the therapist would see through them. It's like EQ tests - the subject can make the test results say whatever they want the test results to say.
forgetfreeman 3y ago
Lots of things sounds like a better option when you remove the constraints of actual human behavior (see also: economics). Unfortunately human behavior is what it is regardless of whether your strategy accounts for it or not. So again, for the cheap seats, therapy is a complete waste of time in 100% of instances where the individual in question isn't genuinely pursuing change.
- PythagoRascal 3y ago
  Yes, and an individual's convictions remain static forever and cannot be influenced by others. You can't convince me otherwise. Your argument sounds tautological.
  - forgetfreeman 3y ago
    K. You probably shouldn't pursue a career as a therapist or have kids then unless you enjoy staggering around in a haze of cognitive dissonance.
itronitron 3y ago
I know of an employer at which one of the finance people had embezzled about 50K over the course of one or two years (from their employer). And at the same time they also embezzled 5K from the community sports league for which they did volunteer accounting/finance stuff. They ended up being arrested and convicted for stealing from the sports league, and they went to jail for a few months but they had some arrangement where they could leave every weekday morning to go to work and then return to jail in the evening. Their arrest and conviction was well known by and within their employer (from which they were known to have embezzled the 50K) since they needed to request leave to show up to court and also because the local papers covered it extensively due to it impacting the sports league. They were not fired, presumably because their employer did not want to run the risk of tarnishing its sterling reputation of properly managing its finances.

nine_k 3y ago

Don't at least some of them want to gain control of their impulses?

SkyBelow 3y ago

Given the number of possible things wrong with a human that leads to bad behavior, it seems like an extreme claim to suggest that desire to make a change is a necessary component in any successful therapy. Part of therapy can be building that desire. For example, therapy for issues stemming from learned helplessness are a counter example, as learned helplessness implies lacking a desire to make a change as they have already been conditioned to seeing it as impossible. The therapy involves building up that desire by having minor successes that end up breaking down the mental block which formed.

lelanthran 3y ago
None of what you said is quantitative and/or objective data.
- jacobgkau 3y ago
  A "sincere desire to make change" isn't quantifiable in the first place.
  - lelanthran 3y ago
    > A "sincere desire to make change" isn't quantifiable in the first place. Well, that's my entire point: why use it as a metric or target? How do you tell if you achieved the objective when the target metric is unmeasurable? When the goal is (in GP's words) "building that desire to make a change", you can never tell anything about progress towards your goal: when you've achieved the goal, when you've not achieved that goal, when you're making progress, when you're making it worse - those things are all subjective. All we can do when treating sociopaths is to release them into the world again and judge their actions, not their self-reported feelings.
    - jacobgkau 3y ago
      > When the goal is (in GP's words) "building that desire to make a change", you can never tell anything about progress towards your goal: > All we can do when treating sociopaths is to release them into the world again and judge their actions, not their self-reported feelings. What's the purpose here, to treat the condition of being a sociopath, or just to enforce enough structure on them that they don't cause other people harm? My problem with what you said is that the entire idea of "sociopathy" is that a person lacks what the diagnoser considers to be "emotion" and is simply "pretending" to be a "normal" human by copying how they see other people behaving. That diagnosis isn't quantifiable in the first place; it's the diagnoser deciding they know what's happening in a patient's head by (guess what?) observing their words and actions. Farther up-thread, people were arguing sociopaths should go to prison and not receive therapy (particularly if they say they don't want therapy, but more generally if they've committed a crime). You're now taking that farther by saying even if they express a desire to make change, that shouldn't be taken into account when determining any treatment/punishment, because that's only an observation of words coming out of their mouth-- but that's the same route they were diagnosed via in the first place, so I find that hypocritical. If you're just saying criminals should be punished without regard for their mental health/conditions simply because their victims were victimized regardless, that's a valid utilitarian view. But realize (it at least sounds like) you're essentially arguing that therapy for mental conditions is generally impossible/pointless.

stavros 3y ago

Addiction is weird, though. A lot of the time, the addict doesn't actually want to be addicted.

aidenn0 3y ago
Conversely they will often only go to rehab at the threat of imprisonment or abandonment by friends and family. I'm sure there's an underlying logic to addiction, but it creates behaviors that are extremely contradictory.
- stavros 3y ago
  I'm not an expert, but as far as I know, the logic is just a failure of long-term planning to dominate over short-term planning. "I know I shouldn't smoke, but this one cigarette will feel so good".
  - swores 3y ago
    That's definitely one way people get addicted, but I suspect not the most common. A huge proportion of drug addicts (and I suspect addicts of sex, gambling etc I'm just less familiar with those addictions) started taking their drugs because of how tough their life was. And even if you know that starting to take opiates or whatever drug of choice might not be a sensible plan long term, if you feel so bad that you'd rather kill yourself than live in your head sober, it's possible to actually want to keep using what you re addicted to because you don't believe that life without that drug can be any better. I don't know how common this is, but anecdotally I've known two people who used high dose prescription painkillers (obtained illegal) to give them enough positive feelings to be able to work on their mental health problems, both who would've been described as problematically addicted by most medical professionals, but who managed to use the opiates to work on their core mental health issues until such a time that they felt ready to not need opiates, at which point they found it relatively easy to stop. Because as horrible as it is to get the withdrawals, it's actually not very last longing and it can be considerably less painful than the pain of having such severe mental health issues that you were desperate to kill yourself before you started the drug use, not because you started the drug use. (Of course there's also people who get addicted because they think it will be fun, and end up suicidal because of it. And I also wouldn't recommend using opiates to work on your mental health, because despite my two anecdotes I believe the almost universal knowledge in medical circles is that it's much more likely to worsen your mental health than to improve it.