6 ms·

This is implying that therapy is nothing more than someone to talk to; if that’s your experience with therapy, then you should get another therapist.

• baobabKoodaa 2y ago
  Evidence points in this direction, though. Different methods of therapy appear to be equally effective despite having theoretical foundations which are conflicting with each other. The common aspect between different therapies seems to be "having someone to talk to", so I'm inclined to believe that really is what's behind the success.
  • pphysch 2y ago
    Having someone to talk to, who is somewhat emotionally intelligent, who doesn't have strong biases against you, and so on... If you are fortunate, you have people like that in your immediate circle, but increasingly few people do.
    • AmericanChopper 2y ago
      What part of the therapist training regimen tests for emotional intelligence? What test do they use to measure this?
      • pdabbadabba 2y ago
        They don't attempt to measure it, but they do teach approaches like "unconditional positive regard" and other techniques that allow a practitioner to demonstrate (or at least seem to demonstrate) a higher level of emotional intelligence. A big part of therapy is also rapport. Many people go through many therapist before finding one that works for them. In part, you can think of this as the market performing the assessment your'e referring to.
        • AmericanChopper 2y ago
          They don’t attempt to measure it because it not something that’s even properly defined with any rigour. Any person who seriously uses the phrase is going to have their own completely individual idea of what it means, and there’s no reason the think any therapist would have this nebulous quality, or even that their idea of what it means has any similarity to your idea of what it means.
          • pdabbadabba 2y ago
            I suppose I agree — "emotional intelligence" is probably not the word I would have used, writing on a blank slate. I think the idea is better captured in the concept of rapport, which is really just a function of clients' subjective experience working with a given therapist. A therapist can learn techniques to increase the chances of establishing a good rapport with a given client, but I'd be inclined to leave it at that.
      • detourdog 2y ago
        It is covered in the curriculum. They study emotional intelligence and with luck they are able to self-reflect using their education. Actual maladaptive personalities are the result of low emotional intelligence.
    • deleted 2y ago
      [deleted]
  • pas 2y ago
    > "having someone to talk to" it's a bit more complicated than that https://www.youtube.com/watch?v=Z37i8-FnAh8 https://www.youtube.com/watch?v=Z37i8-FnAh8 and on top of this the method of therapy is to find better copings, not just to vent.
    • baobabKoodaa 2y ago
      I'm not going to watch a 45 minute video in an effort to decipher what you are implying with this comment.
      • pas 2y ago
        I'm implying that data shows that efficacy of therapy depends on concrete factors (~5 of them discussed in the video). it's not "just someone to talk to".
        • baobabKoodaa 2y ago
          Thank you.
      • kridsdale1 2y ago
        You could dump the YouTube link in to Gemini Advanced and ask it for the point.
        • deleted 2y ago
          [deleted]
  • cbsmith 2y ago
    > Evidence points in this direction, though. > > Different methods of therapy appear to be equally effective despite having theoretical foundations which are conflicting with each other. The common aspect between different therapies seems to be "having someone to talk to", so I'm inclined to believe that really is what's behind the success. Just because talking is the common trait, doesn't mean that that's evidence that that is all it is. Paying someone to help you with the problem is also a common trait (and ironically, that is, no doubt, a contributory factor), but that isn't all that therapy is. Let's say that there are three ways to solve a problem, and depending on context that we're not terribly good at determining, one of those ways will work quite often, one will work some of the time, and the other will be a disaster... but there's an equal probability that each of those ways are equally likely to fall in to each of those categories. Statistically, one could claim that how you solve the problem is not behind the success. In a sense, that would be correct, because the real determinant of success would be being lucky with the solution you chose to employ. While one could imply though that really it's nothing more than being lucky at choosing the solution, in reality without all of what's involved in that choice, the problem will remain.
  • pdabbadabba 2y ago
    There may be a kernel of truth in this, but it depends on why you're seeing a therapist. For treatment of OCD, for example, or phobias, there are specific protocols that yield results, but they do not respond to just "having someone to talk to." Other kinds of conditions, like depression and anxiety, respond to a wider range of therapy styles. But those aren't the only conditions that people seek to treat through talk therapy. (And it's also an exaggeration to say that just having any conversation will help to treat anxiety and reopression. But it is probably true that treatment of these conditions is less technical and responds to a much wider range of styles.)
  • burnte 2y ago
    > Different methods of therapy appear to be equally effective despite having theoretical foundations which are conflicting with each other. The common aspect between different therapies seems to be "having someone to talk to", so I'm inclined to believe that really is what's behind the success. This isn't true. Different methods work better for different problems. I've been in behavior health for 7 years now. It's having someone with a lot of education to talk to, someone with education in social and psychological problems and healthy coping mechanisms.
  • lo_zamoyski 2y ago
    From what I understand, therapy success rates are quite low, with only cognitive behavior therapy showing notable progress. That isn't to say all the others are categorically useless, only that in the majority of cases, they seem to be ineffective or harmful.
• bnralt 2y ago
  It’s implying that this is the case for many people, not all. Which it is, in my experience. Particularly since the advice you gave: > then you should get another therapist Seems to be fairly ubiquitous. “Find a therapist you like”/“shop around”/etc. leads a lot of people to find people who will tell them what they want to hear. Sometimes what people want to hear is how to practice CBT - but in that case, such people are probably going to be using AI to work on CBT.
  • helboi4 2y ago
    Yeah I have found there is very little you get from therapy that you can't get from a mixture of journalling, learning CBT methods, having a routine (which includes regular exercise) and trying lots of different methods of making friends that you assess maturely for their reliability. Maybe meditation if you're into that. All of these things are free and require effort, personal effort and intention being what will actually improve your life anyway, whether you use therapy or not. This makes therapy seem like a scam for anything other than dealing with a very dire short period of isolation.
• naasking 2y ago
  I think the preying part of therapy is that there's just no defined stop condition. There's no such thing as "healthy" in mental health. You get chemo until you go into remission or you die. You take blood pressure meds until you have a better lifestyle and body composition and don't need them anymore, etc. There's no analogue for "you're healthy now, go away so I can help others", and so therapy goes on forever until the patient stops for whatever reason.
  • cbsmith 2y ago
    > I think the preying part of therapy is that there's just no defined stop condition. There's no defined stop point for physical development either... Top performing athletes still have trainers, and nobody sees that as a problem. If it's mental development though, it must have a stop point?
    • detourdog 2y ago
      The stop point is obvious to the individual and the therapist. I'm dealing with someone that prefers to stop rather than actually self-reflection. There is nothing stopping them from exiting therapy. The therapist may be aware that the person is still a basket case but if they are non-violent they are free to roam.
      • cbsmith 2y ago
        Exactly.
      • naasking 2y ago
        > The stop point is obvious to the individual and the therapist. It's not at all. There are plenty of stories of people who realized that therapy was just causing them to ruminate on their problems, and that the therapist was just milking them for years before they wised up and walked away. That's not what I call "obvious".
        • detourdog 2y ago
• fatbird 2y ago
  This is very true, and I would add to it that the dominant paradigm in most therapy these days (at least those forms coming from a Cognitive Behavioural Therapy background) have "graduation" as an explicit goal: the client feels like they've addressed what they want to address and no longer need the ongoing relationship. This is largely due to a crisis in the field in the late 70s/early 80s when several studies demonstrated that talk therapy had outcomes no different than no therapy. In both cases, some got better, some got worse, some didn't change. CBT was a direct result of that, prioritizing and tracking positive outcomes, and from CBT came a lot of different approaches, all similarly focussed on being demonstrably effective. Talk therapy isn't a cure-all, but it's definitely more results-oriented than it was 50 years ago.
• solardev 2y ago
  I feel like this is easier said than done. There's not a great way (that I know of) to evaluate the quality/potential helpfulness of therapists... if only there were a Steam-like review system for them! There's ratemds.com, but not a lot of people use it, since there's not a central marketplace to find therapists to begin with (that I know of). I would love to be able to find good therapists locally and/or online. It just seems like such an expensive gamble every time. When I was younger, I went through many therapy sessions with multiple professionals of different kinds (psychologists, psychiatrists, MFT (marriage and family therapists, social workers, etc.). A couple of them were wonderful: thoughtful, caring, helpful, providing useful guidance with a compassionate ear. Another couple tried to be helpful but were still in training themselves (this was at a college) and couldn't really provide any useful guidance. One was going through a divorce of her own at the time and ended up crying in many of our sessions and having to abort them to deal with her own emotions – it was a tough time for her, and she's only human. I often tried to console her, but she wouldn't let me, so it made for a very awkward situation lol. One of them had one a single session with me, charged me for it, and then told me she couldn't help me and to go somewhere else. But the worst of them was an older guy who, despite the referrals and my history, thought I was faking mental illness. He dared me to attempt suicide, and when I eventually did (not because of him, but a separate romantic failure), he chuckled in my face and said, "Heh, you finally tried it, huh? Didn't think you would." This was an older psychiatrist in a small town – either the only one there, or one of very few – the kind of sleazy place that had a captive market and a whole bunch of pharma ads in the lobby, with young female pharma reps going in and out all day. What a racket =/ If I were wiser then, I would've reported him to the board and news media. So, anecdotally, my success rate with therapists was only 2/7. To be fair, I was a pretty fucked up teenager and young adult, but still... the point is that "just find a better therapist" is often a difficult process. Depending on your insurance and area, there may not even be any other therapists with a waiting list of less than a few months, and even if you can get in, there's no guarantee they are good at their jobs AND a good fit for your personality and issues. Think it's hard to find good devs? At least our line of work produces some measurable output (software/apps that run, or not, according to specs). How do you even measure the output of a therapist? Improvements to someone's life aren't going to happen overnight, and many never report back; the best successes may not bother to leave a review, the worst failures may end up dead before spreading the word. The rest probably just run out of sessions allowed by their insurance and try to move on with their lives, with unknown levels of positive or negative change.
• moralestapia 2y ago
  GP's not saying that, what GP is saying is "good luck trying to talk to your therapist if you stop paying $$$". I do think therapists are one of the professions that will be naturally displaced by LLMs. You're not paying them to be your friend (and they are usually very clear on that), so any sort of emotional connection is ruled out. If emotions are taken away, then it's just an input/output process, which is something LLMs excel at.
  • fatbird 2y ago
    I would argue the opposite: a good therapist isn't just offering back-and-forth conversation, they're bringing knowledge, experience and insight into the client after interacting with them. A good therapist understands when one approach isn't working and can shift to a different one; they're also self-reflective and very aware of how they're influencing the situation, and try to apply that intelligently. This all requires reflective and improvisational reasoning that LLMs famously can't do. Put another way, a good therapist is professionally trained and consciously monitoring whether or not they're misleading you. An LLM has no executive function acting as a check on its input/output cycle.
    • moralestapia 2y ago
      Absolutely everything you mentioned can be done by an LLM and arguably better.
      • fatbird 2y ago
        Not in the least. LLMs don't introspect. LLMs have no sense of self. There is no secondary process in an LLM monitoring the output and checking it against anything else. This is how they hallucinate: a complete lack of self-awareness. All they can do is sound convincing based on mostly coherent training data. How does an LLM look at a heptagon and confidently say it's an octagon? Because visually they're similar, octagons are relatively more common (and identified as such) while heptagons are rare. What it doesn't do is count the sides, something a child in kindergarten can do. If I were working in AI I would be focussing on exactly this problem: finding the "right sounding" answer solves a lot of cases well enough, but falls down embarrassingly when other cogitive processes are available that are guaranteed to produce correct results (when done correctly). Anyone asking chatgpt a math question should be able to get back a correctly calculated math answer, and the way to get that answer is not to massage the training data, it's to dispatch the prompt to a different subsystem that can parse the request and return a result that a calculator can provide. It's similar to using LLMs for law: they hallucinate cases and precedents that don't exist because they're not checking against nexis, they're just sounding good. The next problem in AI is the layer of executive functioning that taps the correct part of the AI based on the input.