3 ms·

> There’s a thought that’s haunted me for years: we’re doing all this research in psychology, but are we learning anything? Advancements in PTSD, dissociation,

> There’s a thought that’s haunted me for years: we’re doing all this research in psychology, but are we learning anything? Advancements in PTSD, dissociation, treatment resistant depression and attachment disorders is astounding. We know a lot more about how people work. Psychology has always been a person centered field - humans are complex, and what it does is more akin to QA than coding. It’s individualized. It doesn’t love studies because the underlying mechanism or traumas can be different even for people who went through the same things. Unfortunately advancements are not evenly distributed. There is an army of CBT therapists who work in one method that works for some but not the majority. Finding a practitioner is a crapshoot even when looking for specialists. The DSM is functionally treated as a billing manual, and to be paid practitioners need to jump through a long series of hoops. The medical billing side can’t deal with the complexity. All these aside, there are people who are really truly healing in ways they wouldn’t without the field. There are ideas that propagate through human culture make human behavior more understandable.

acchow 2y ago
Given that “humans are complex” and “it’s individualized”, would advancements be greater and faster by just allowing clinicians and scientists to just talk things out instead of coming up with “studies” which pretend to be “science” with a low reproducibility rate (and non-publishing on null results)?
- taurath 2y ago
  You may be looking for qualitative data and reporting which is on the rise! The term "evidence based" is bandied about all the time because insurance companies don't want to cover treatments that aren't considered standard. The problem is everyone is different on some level, and we often don't have the resources to get to the root of any problems. So treatments that may work extremely effectively for some may be thrown out because they don't work effectively for everyone, and can be contraindicated. Somatic therapists especially have to deal with this. Effective treatments are often outside of the "evidence based" tests, which can be based entirely around showing symptom improvement. This creates a catch-22 where if you lessen the restrictions you get a lot of crackpot providers, where if you keep them tight you keep people from being able to access treatments that may work well for them. There's also competing models for mental problems and approaches - the psychiatric model is similar to a doctor giving treatment for an illness. They tend to have a belief in biological determinism, IE if a parent had an illness then its likely you will have one too. The Biopsychosocial model is a little bit more holistic around the experiences of people and their physical environment and upbringing. The Trauma model is one I personally ascribe more to which conceptualizes mental health problems as understandable reactions to traumatic events that are conditioned within us. There are a lot of people who get real relief from outside the mainstream providers, and there are a lot of people for whom the standard providers have not been able to help. I think that is part of why there's so much activity around finding better models right now.

acchow 2y ago

Given that “humans are complex” and “it’s individualized”, would advancements be greater and faster by just allowing clinicians and scientists to just talk things out instead of coming up with “studies” which pretend to be “science” with a low reproducibility rate (and non-publishing on null results)?

taurath 2y ago
You may be looking for qualitative data and reporting which is on the rise! The term "evidence based" is bandied about all the time because insurance companies don't want to cover treatments that aren't considered standard. The problem is everyone is different on some level, and we often don't have the resources to get to the root of any problems. So treatments that may work extremely effectively for some may be thrown out because they don't work effectively for everyone, and can be contraindicated. Somatic therapists especially have to deal with this. Effective treatments are often outside of the "evidence based" tests, which can be based entirely around showing symptom improvement. This creates a catch-22 where if you lessen the restrictions you get a lot of crackpot providers, where if you keep them tight you keep people from being able to access treatments that may work well for them. There's also competing models for mental problems and approaches - the psychiatric model is similar to a doctor giving treatment for an illness. They tend to have a belief in biological determinism, IE if a parent had an illness then its likely you will have one too. The Biopsychosocial model is a little bit more holistic around the experiences of people and their physical environment and upbringing. The Trauma model is one I personally ascribe more to which conceptualizes mental health problems as understandable reactions to traumatic events that are conditioned within us. There are a lot of people who get real relief from outside the mainstream providers, and there are a lot of people for whom the standard providers have not been able to help. I think that is part of why there's so much activity around finding better models right now.