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    Now that we have your attention, journalists, will you ever address this? You've given these evil people interviews, and free press.

TAW122

TAW122

Emissary of the right to die.
Aug 30, 2018
6,671
Disclaimer and note: This is a rather complex and deep topic so in this megathread I aim to unpack and break down all the talking points, misconceptions, and many claims that pro-psychotherapy (aka pro-therapy) proponents have. Furthermore, while this megathread does have overlap with psychiatry, it isn't the main focus of this megathread, but will have some mentions of such as well, just not as in-depth as that's another topic for another megathread itself and I would rather not over-complicate this already length and complicated topic.

With that said, here are several major points (in large bolded font and underlined) along with some detailed points of this thread that I will be addressing:

Psychotherapy culture and the pervasiveness of such:

The concept of everyone needing psychotherapy and the overpromotion of such practices for even day to day challenges and problems. (The cultural attitude of pro-psychotherapy and such.)
In our present day, or even within the last few decades, it has become increasing common such that everyday people just parrot off and unsolicitedly recommend and bring up psychotherapy to someone when there is some contention, conflict, or disagreement. Not only is that an implication that the person is mentally defective (often inaccurate and offensive), but also rather patronizing and condescending (lecturing) towards the person who only primarily wishes to resolve whatever dispute, problem, or issue that is at hand. In other words, I believe that we as a society should step off of this culture of overpromoting therapy and the perception that it is a panacea to ALL of life's problems! It is NOT and worse yet, there are people who weaponize this tool in order to oppress the people that dissent or otherwise don't agree with them, which is a big problem itself (will be addressed later in this megathread).

The therapy circular loop (unfalsifiable claim) that pro-psychotherapy supporters love to use to discount, dismiss, or otherwise steer a conversation away from the main topic.
More oftenly than not, whenever the suggestion of seek psychotherapy is brought up in a conversation or dialogue, it is often used to suppress or otherwise shut down a person's argument without even addressing it and gives the recipient no opportunity to disprove it and that any claim against such a suggestion often deflects towards "trying another one" and the incorrect assumption that it always works when it doesn't. By then, a conversation has already been severely derailed that the original topic or matter at hand is already long lost.

Furthermore, this erroneous assumption is that the field of psychotherapy and related fields are infallible and unquestionable that it's always the person, patient, or recipient's fault for it not working is a very oppressive and dangerous presumption. This (at least in logical terms) is akin to circular logic and by default circular logic or reasoning is considered fallacious due to the fact that the premise proves the conclusion and conclusion proves the premise. Usually when the conversation becomes this part, there is no other avenue or direction to steer the conversation to as it's terminal and worse yet, it becomes an endless, ever-moving shifting goalpost.

The demonization and vilification of psychotherapy critics and those who question it.
In addition to the pervasive issue of therapy culture, proponents of psychotherapy often shun, silence, and/or otherwise censor and dehumanize critics or dissidents of such fields. When the critics try to come forward to expose the harms of psychotherapy and put it in check as well as bring to light the harms that it does is they are often persecuted. They are silenced into shame, vilified or demonized for even speaking out. This creates another layer of barrier that prevents real victims from seeking justice or even reparations from such harm. Even worse is that it puts psychotherapy and similar fields in an unfalsifiable position that cannot be challenged or even corrected while keeping their victims in the darkness suffering.

There is no better tool for oppressors and tyrants than one that is not only unfalsifiable (or very hard to disprove) and would effectively bypass logic and any other due process while automatically declaring a target unfit to even have due process. This is the problem with the field as it's being commonly used by people who don't agree with another's point of view and it's just a convenient way to dismiss, devalue, or otherwise deem them incapable so as to invalidate the oppositions' point of view. These things not only happen online in various platforms and the Internet in general, but also in real life when interacting with people.

It would be very difficult to affect and see change for such a field if the field itself is fraught with flaws and critics are unable to expose let alone push for meaningful change. As a result, the victims not only go unheard and are swept under the rug (out of society's mind, out of the oppressors' minds, etc.) and the rampant abuse continues to persist throughout time.

Possible solution:
We as a society should not continue to enable and encourage therapy culture as to minimize the concern trolling that many busybodies have. Instead, I believe that society should view psychotherapy as a tool that is fallible and has limitations and flaws and should not by quick to suggest that to people without understanding the situation! What do I mean by this? I mean that if someone is struggling with whatever issue they have (unless it's explicitly emotional stuff that warrants seeing a psychotherapist -or- if they themselves voluntarily request for such services), they should be listened to and at least given the chance to speak their case. One should not immediately jump to conclusions or go to suggest psychotherapy at the first sign of conflict or even signs of difficult or struggle. It is a perversion of services to inappropriately recommend people to go see them and more oftenly than not, it is oftenly used as a way to invalidate others! There are many other solutions that should be explored first, especially pragmatic solutions for pragmatic, real life problems! I believe that modern society has become less about tolerating dissent and critical thinking and are quick to just jump on a misconceived panacea, in which is FAR from a panacea.

Furthermore, to reinforce my points, throughout human history while some form of psychotherapy or such existed for millennia, more often than not, people often thought about practical solutions to practical problems. Humanity has existed for hundreds of thousands of years (or more depending on what one's belief system is but I digress…), and surely they found ways to solve problems without parroting, patronizing, or otherwise dismissing others, and I believe humanity is capable to do such again, if they wish to. Sure, religion played a huge role in early ancient human history, but it doesn't necessarily have to be religion either!

What really happens in a psychotherapy (talk therapy) session:

What psychotherapy (talk therapy) is really about:
As someone who has been involved in the system and had sessions while growing up and even in my adult life (last time being about half a decade or so ago), I can describe the general structure of what really happens in these sessions. (Sure, while there are apologists and defenders who try to push their counter-narrative, that's NOT what this is about!) This segment is merely describing exactly what happens in those sessions and exposing it for what it really is.

An example sample session:
So what actually happens in a session is where the client (or patient) is talking to the psychotherapist and generally it starts off with some small talk like how are you (as an opening), then not long before they get into the session and start discussing the topics with the clients. More oftenly than not, the psychotherapist would be just rebounding and acting as a soundboard towards whatever the client says, like "how do you feel about xyz?" or very limited responses like "Mhm", "Hm", etc. Throughout the interaction, there is always a constant surveillance of what the client says that if triggered a red flag or something that could be actioned on (danger or risk), then the professional will assess and act accordingly. Rarely (almost never, if ever) does a psychotherapist give actual concrete advice or work towards 'solving' the clients' problems, but just merely talking about the clients' feelings and asking the client to do the work themselves (which defeats the purpose of going; if going is just to talk about how one feels about things and vent, then there are better ways to spend one's money or more productive and effective means to go about solving problems!).

In the event that a client says the wrong thing, the client would be assessed and questioned (usually a threat assessment) and is rather interrogative in nature. During such a time it becomes a psychotherapist vs the client and anything that a client says can and will be used against him/her. When it is determined that the client is a danger (a threat), then action would be taken against them (this is where the field has the potential to become carceral), which can range from having to sign a safety plan (an agreement to stay safe and no do anything dangerous and there is likely follow up), all the way towards hospitalization against a client's will (the worst outcome of the ordeal). Assuming there isn't a threat, then the session proceeds as usual.

During the session, there will be gas-lighting and parsing of what the client says. It is generally presumed that the client is broken and is defective and needs to be corrected. Almost at no time does the psychotherapist address the ongoing systemic issues or causes for the symptoms (or things society/they deemed to be issues), and it's always about fixing and getting the client to conform to their standards, their visions, and their interests.

After time is up (however long a session may be), then the conversation just wraps up and then the psychotherapist sends the client on their way and goes about preparing for the next client (rinse and repeat). If the client didn't get anything substantial or get any closer to resolving their issues, the blame is of course placed on the client themselves or at least the fact that the client never found a good 'fit'. It is (almost) never about how the system itself is nor about how society is.

Therefore, in such an example (which is a very general and standard session – there are different ones that vary, but the structure and format is more/less the same with some minute differences.), this shows what really goes on in an actual psychotherapy session. Most of the time, it also involves shaming, gaslighting, and/or making it that the client is the one who is broken and never really addressing the systemic issues that cause the symptoms to begin with.

Other misconceptions and incorrect myths, assumptions of psychotherapy:

The interchanging of terms, psychiatry and psychotherapy (or talk therapy).
It is common in conversations whenever people are referring to the field to interchangeably use them both, however, if one is being technical about them, they are distinct. Psychiatry refers to a branch of medicine that studies the diagnosis and treatments of mental illnesses as well as mental disorders. Psychotherapy (or also referred to as talk therapy) is about the treatment of behavioral and mental conditions through verbal communication and interaction with a 'professional'.

In both fields, regardless of whether one uses either term, they are both carceral in nature, meaning that by default, they already have a power imbalance and are seen as authority figures (think of them as basically like mind cops that have the power to order a detainment of someone who they 'believe' to be a danger to society or to oneself). Just because they are not actual law enforcement officers does not mean that they cannot impinge or have the authority to (temporarily) impinge on the civil liberties of their clients, patients!

Additionally, both fields overlap in such they both address mental illnesses and psychiatry is more focused on the medicinal and drug aspect, hence psychiatrists require medical knowledge and training for their field (they go to medical school), whereas psychotherapists and such would earn an advanced degree as well as be licensed to practice before they start seeing clients. They (psychotherapists) do NOT prescribe medications, but can refer a client to a psychiatrist and vice versa.

Even assuming cost is not a factor (devil's advocate), it is still fraught with (at best) uselessness depending on situation, and potentially harmful at worst!
Very often, people do bring up cost as a factor and that branches off into a discussion about accessibility, but even presuming that cost is not a factor, there are still many other ills with the field. In a world where the cost is not a factor (either the person is not paying it but is subsidized by another party or is offered for free), it isn't always the best nor appropriate solution for people's problems. Even at best, when people are offered such a service for free or at a low cost, it wouldn't necessarily help someone with their problems. Furthermore, it could even exacerbate existing problems, or worse, introduce new problems for said person.

(Consider an example of the flat tire: Logically and rationally speaking, someone with a flat tire isn't going to go towards a mechanic who isn't going to diagnose why their tire is flat and only decides to pump air into it without addressing the cause of the flat (a puncture, bad rim, bad valve stem, etc.. Instead, assuming such a mechanic not only suggests pumping more air or using a different air (instead of oxygen, they used nitrogen or some other gas), people would call that mechanic incompetent and dumb. However, in the case of psychotherapy and such fields, almost nobody ever critiques or calls out the bad practices!)

In other words, even if the cost isn't an issue for people (which it is), the actual kind of 'help' that is provided isn't really useful. Psychotherapy won't put food on the table, psychotherapy isn't going to magically make realistic problems that people face day to day go away! The list goes on… However, coping is not a solution alone to solve life's problems, it is merely just to distract oneself and endure the hardships of life. Of course, this is not referring to people whose intention is to simply 'cope'.

Conclusion:

Overall, this megathread primarily focuses on the flaws and exposes the harm done by psychotherapy, I would want to wrap up this thread by including some other perspective which I would find value. While this megathread primarily exposes all the harms of psychotherapy as well as criticisms of all the ills that happen with it. I do believe there are situations where it can be less harmful or potentially beneficial (if it is applied appropriately), and that will be in the next point.

A concession and middle ground:
Despite the criticisms of the field, yes, there are times where such a suggestion could be appropriate, but culturally and in mainstream, day to day life, it should NOT be the first suggestion nor the ONLY suggestion instead of actively working towards fixing problems, resolving conflicts, and seeking a better solution to whatever problem or issue is at hand. Note: Even with such a middle ground or concession, the most important part is when this "tool or help" is offered voluntarily and not coerced or pushed onto unwilling patients or clients without their consent. In fact, there are even some circles that believe that people who were offered the option of psychotherapy in a non-aggressive, non-compulsory, and non-paternalistic manner would have better outcomes and be more willing to partake in them without feeling forced to do so. They would also be more receptive towards feedback as they are doing so on their own terms. In addition to this, the useful application for such would be when someone is emotionally struggling and they just want to speak to someone to vent, or let off their worries without judgment or consequences, then it would be fair to suggest it to them gently.

(One such example would be where people are struggling emotionally and want to vent, perhaps they have emotions and they want someone to 'help' them process them and not necessarily a trusted person nor friend, then yes in such a case I could see it being appropriate for them to pay someone (by their own volition) to be heard).

Even after writing and putting a lot of effort into this megathread, there will always be people who object or otherwise try to defend and/or justify such things. I cannot convince all of them and that's fine, at least I've made my points and for those who do stick around to read it all, thank you for patience and understanding for such a complex topic. I also hope that it not only sheds light into the problems of such a practice as well as (potential) solutions that could be had to reform the field, or even something entirely different. If I managed to get some people to think, give food for thought, or at least encouraged them to be critical and skeptical of the field, then I've at least succeeded in some capacity. Anyways, I hope this has been helpful and informative for people who read, perhaps others will use this as reference or be able to relate to it and/or at least discuss the topic in more. I made it into a megathread just to keep things in one place and also partly because this is a complex topic that deserves dissecting and breaking it down into more manageable parts to understand.

On a small final note, there may be additional points that are not covered in this megathread as it would be even more exhaustive and tedious to do so, but all the major points have been fleshed out in detail and covered as thoroughly as possible. I will be updating (or even possibly making another version in the future if there are substantial changes in the topic or if some of these things are outdated).
 
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GuessWhosBack

GuessWhosBack

If you have doubts, reach out. Here to listen.
Jul 15, 2024
332
Thanks for the post. As someone who has been to therapy several times, I'd like to comb through it and address your points. You wrote a lot, so I'm not sure if I'm going to address everything at once. I'm going to be assuming you are referring to talk therapy in particular.

In our present day, or even within the last few decades, it has become increasing common such that everyday people just parrot off and unsolicitedly recommend and bring up psychotherapy to someone when there is some contention, conflict, or disagreement. Not only is that an implication that the person is mentally defective (often inaccurate and offensive), but also rather patronizing and condescending (lecturing) towards the person who only primarily wishes to resolve whatever dispute, problem, or issue that is at hand. In other words, I believe that we as a society should step off of this culture of overpromoting therapy and the perception that it is a panacea to ALL of life's problems!

There is no better tool for oppressors and tyrants than one that is not only unfalsifiable (or very hard to disprove) and would effectively bypass logic and any other due process while automatically declaring a target unfit to even have due process. This is the problem with the field as it's being commonly used by people who don't agree with another's point of view and it's just a convenient way to dismiss, devalue, or otherwise deem them incapable so as to invalidate the oppositions' point of view. These things not only happen online in various platforms and the Internet in general, but also in real life when interacting with people.

On the interwebs in particular, there is a high incentive to sell the best picture of yourself to the masses. A lot of people act nice and kind on social media to please their ego. Pretending to be the Good Samaritan has never been easier. Simply suggesting someone that they get therapy on your favourite social media will instantly flood you with positive reinforcement and earn you the Good Deed Of The Day. The truth is that almost none of the people that overpromote therapy as this panacea that will help everyone are actually doing anything in the real world to alleviate mental suffering, which is what we should be overpromoting to begin with.

I have never had therapy suggested to me in real life, I simply pursued it voluntarily to see what it could do for me. One of the main reasons, perhaps, is that I see no rational reason for opening up to real people face to face unless they're mental health professionals or other sufferers. The average joe is not very well versed when it comes to mental health topics, presumably due to the privilege of never having mental health problems to begin with.

There are cases where seeking therapy is a valid suggestion - if someone is having a mental health crisis that is perhaps temporary, therapy can help soothe the pain. If someone has maladapted in some way that is in their control and wants to change, therapy can be the right choice. In some cases, counselling can help couples fix their problems.

This seemingly new phenomenon that everyone with real problems needs talk therapy is a sign of a dysfunctional society, not a sign that therapy works for everything. Regarding the people that benefited from paying someone they don't know to listen to them 'professionally', one has to wonder whether they ever needed therapy in the first place instead of a good support group of friends and family that actually gave a damn.

More oftenly than not, whenever the suggestion of seek psychotherapy is brought up in a conversation or dialogue, it is often used to suppress or otherwise shut down a person's argument without even addressing it and gives the recipient no opportunity to disprove it and that any claim against such a suggestion often deflects towards "trying another one" and the incorrect assumption that it always works when it doesn't. By then, a conversation has already been severely derailed that the original topic or matter at hand is already long lost.

I have to disagree here. Sometimes the person suggesting therapy simply realizes that the problems the other is dealing with are "outside their expertise", so to say. People genuinely don't always know what to say, but they do understand that if they say the wrong things, they can make things much worse. I would assume that it is often coming from a place of good intentions. Rather than viewing it as a "deflection", I see it as "this is as far as I can go without risking screwing things further, please seek therapy". Of course, no one should take the suggestion to seek therapy as serious when the reason for that was something silly like a harmless disagreement.

Furthermore, this erroneous assumption is that the field of psychotherapy and related fields are infallible and unquestionable that it's always the person, patient, or recipient's fault for it not working is a very oppressive and dangerous presumption.

I would not say that this is the viewpoint of most psychologists. At least not the good ones. Or maybe I hope it isn't. A reasonable person should know that a shitty life cannot be fixed with talk therapy. External stressors won't be removed with talk therapy. What therapists can help with is coping and replacing maladaptive thought patterns with more productive ones. It's adamant you find a therapist that you see as a friend rather than an interviewer who will take away your atonomy as soon as you say the wrong words. What I do find shitty though, is that some therapists would rather put you on medication and forget about you than help you take the steps to actually fix your life. This is not a "success story" from the POV of the patient, but it is from the POV of the psychologist. Another life "saved". I suspect you are referring to CBT which imho is a very toxic form of therapy for certain cases.

Instead, I believe that society should view psychotherapy as a tool that is fallible and has limitations and flaws and should not by quick to suggest that to people without understanding the situation! What do I mean by this? I mean that if someone is struggling with whatever issue they have (unless it's explicitly emotional stuff that warrants seeing a psychotherapist -or- if they themselves voluntarily request for such services), they should be listened to and at least given the chance to speak their case

I agree. In my case, no one around had the capacity to understand me, and I knew that, so I immediately engaged with therapy instead.

Possible solution:
....
What really happens in a psychotherapy (talk therapy) session:
....

Perfectly agree.
 
TAW122

TAW122

Emissary of the right to die.
Aug 30, 2018
6,671
Thanks for the thorough reply and taking the time to read my megathread. Yes, this megathread is referring to talk therapy (aka psychotherapy) specifically since that is the most commonly suggested therapy when people spew that online or in person. What you said made sense about 'why' people do it and I agree with you. People are there just for their 'good karma, good deed points, virtue signaling' in order to get validation from others including their peers.

I'm glad that you went towards therapy by your own volition rather than having others recommend (or even pressure you) to do so, and that is a huge difference because it means you went there by choice, not by coercion or pressure. Indeed, I did mention later in the megathread that therapy does have it's uses in various situations. We're on the same page that the new phenomenon in society where everyone with real problems needs talk therapy is indeed a sign of a dysfunctional society (ironically, the a large amount of the real problems in society are caused by said dysfunctional society!). I agree with you that a good support system with friends and family that actually gave a damn, actually supported them through tough times will be much more beneficial to said individual(s). In fact, throughout human history, that seems to be the general consensus and the go to one's support systems and humans perhaps were more cooperative than in modern society, at least within one's own tribe, group, etc.

I can see why some people may suggest therapy and that it may come from a good place, but yes, those who say it due to simply disagreements, differences of opinions and views, or simply just to troll (basically 'concern trolling') are acting in bad faith and are disingenuous. Those are the people I'm mainly lambasting at. I do recall I mentioned there are places where therapy can be beneficial and such though.

I would not say that this is the viewpoint of most psychologists. At least not the good ones. Or maybe I hope it isn't. A reasonable person should know that a shitty life cannot be fixed with talk therapy. External stressors won't be removed with talk therapy. What therapists can help with is coping and replacing maladaptive thought patterns with more productive ones. It's adamant you find a therapist that you see as a friend rather than an interviewer who will take away your atonomy as soon as you say the wrong words. What I do find shitty though, is that some therapists would rather put you on medication and forget about you than help you take the steps to actually fix your life. This is not a "success story" from the POV of the patient, but it is from the POV of the psychologist. Another life "saved". I suspect you are referring to CBT which imho is a very toxic form of therapy for certain cases.

Yes, I do think there are rational and sensible psychologists, psychotherapists, and MHPs (Mental Health Professionals) in the field. I agree that a 'reasonable person' knows that a shitty life cannot be fixed simply by talking to a paid professional, as well as external stressors (they don't just magically vanish from paying someone to listen and act as a soundboard or give feedback!). Ideally, yes if one were to seek therapy, yes they should find someone who would respect the patient's viewpoints and treat them with dignity rather than just a number or automatically take away a patient's autonomy because "risk to others, oneself, etc." Yes, ideally a good MHP would be someone who respect's a patient's viewpoints and help the patient respectfully and get the patient to take steps to fix a patient's life issues. But alas, those are far and few, and this megathread isn't necessarily focused on that even though I do understand and recognize there are good MHPs out there for the people who WANT them and seek them voluntarily. Finally, yes CBT is definitely toxic in many things (and I'm not going to get into all the details as that would be another thread altogether).

As for the other points, yes I'm glad you agree with me especially the last few points you've mentioned. In the end, talk therapy itself is just another tool/method for solving specific problems in this world and is NOT a panacea for everything. Also, when people go seek therapy on their volition and genuinely (without being forced or coerced into it) they generally achieve a better outcome than those who are compelled to against their will.
 
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Alexei_Kirillov

Alexei_Kirillov

Missed my appointment with Death
Mar 9, 2024
737
Just curious, have you interacted with Thomas Szasz's work at all? I recently read The Myth of Mental Illness and would love to know your/other pro-choicers thoughts on it; it echoes a lot of these same sentiments. I think my biggest takeaway from the book was just how wrong it is to equate physical and mental illness.
 
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zengiraffe

Member
Feb 29, 2024
46
@Alexei_Kirillov I've listened to The Myth of Mental Illness on audiobook and I've also read Fatal Freedom: The Ethics and Politics of Suicide by Szasz and generally agree with both. Despite their somewhat aggressive titles the arguments and proposals Szasz lays out in his books are much more mild and measured. He's a big libertarian and pretty much just thinks the government should keep its nose out of people's business, including if those people are schizophrenics or suicidal.
 
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TAW122

TAW122

Emissary of the right to die.
Aug 30, 2018
6,671
Just curious, have you interacted with Thomas Szasz's work at all? I recently read The Myth of Mental Illness and would love to know your/other pro-choicers thoughts on it; it echoes a lot of these same sentiments. I think my biggest takeaway from the book was just how wrong it is to equate physical and mental illness.
I have heard of the psychiatrist and I actually respect a lot of his views because he was actually more moderate and isn't about pill pushing and label placing left and right towards patients. People like him are a rarity and I believe if psychiatry (and even psychotherapy itself) were to have a chance at reform and to do away with such abusive practices and policies, it would start from psychiatrists like him, being able to question the status quo, push for change in the field and such. Until then, psychotherapy, psychiatry, and similar fields as they are in present times are and will still be considered 'carceral and custodial' systems by default.
 
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astr4

astr4

memento mori
Mar 27, 2019
259
i'm reading up on this thomas szasz guy. seems he killed himself which is interesting. makes me respect him and his ideas more, i guess because i trust he was able to empathize with us.

i agree with a lot of what he has to say. i think i've left comments before along this line of thought, but mental illness is a social construct. we label people as mentally ill when they don't want to conform to our idea of what proper human behaviour is, when half the time it is the product of easily understandable trauma. easier to slap a label and medicate, though.
 
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Alexei_Kirillov

Alexei_Kirillov

Missed my appointment with Death
Mar 9, 2024
737
I have heard of the psychiatrist and I actually respect a lot of his views because he was actually more moderate and isn't about pill pushing and label placing left and right towards patients. People like him are a rarity and I believe if psychiatry (and even psychotherapy itself) were to have a chance at reform and to do away with such abusive practices and policies, it would start from psychiatrists like him, being able to question the status quo, push for change in the field and such. Until then, psychotherapy, psychiatry, and similar fields as they are in present times are and will still be considered 'carceral and custodial' systems by default.
Agreed; so much good would be accomplished by psychiatrists simply accurately representing their role in the world, instead of pushing the idea that they're just like regular doctors but for the brain.

i'm reading up on this thomas szasz guy. seems he killed himself which is interesting. makes me respect him and his ideas more, i guess because i trust he was able to empathize with us.

i agree with a lot of what he has to say. i think i've left comments before along this line of thought, but mental illness is a social construct. we label people as mentally ill when they don't want to conform to our idea of what proper human behaviour is, when half the time it is the product of easily understandable trauma. easier to slap a label and medicate, though.
Yeah, I've said it before on SaSu, but I truly do feel that what's defined as "normal human behaviour" has been shrinking over the years. It's really sad to see because of how badly it limits people. If you just naturally have a personality that's less inclined towards smooth social interactions, you can dedicate effort to working on that issue and building up the skill of social interaction; if you are "neurodivergent," on the other hand, there's something fundamentally different about your brain so there's no point in even trying.
 
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Voyage

Voyage

Songe à la douceur
Aug 11, 2024
22
As someone who suggests therapy to people, my dilemma is that there's a very limited number of things you can do that is therapeutic without therapy.

1. Therapists are under-trained. Many people with genuine distress have very negative experiences and those who go there for "self-improvement" report feeling great and I hate seeing that.

2. Some therapies suck ass, particularly CBT. They are "evidence-based" in the sense that some dubious studies say they work. Newer studies report less efficacy. See Jonathan Shedler's paper on it:
PDF

3. The therapy setting and the very identity of "therapist" offers numerous tools that are useful for therapy.

3a. There's this important concept called "transference". It's the unconscious act of projecting past experiences and emotions onto a person, in this case the therapist. The therapist, as a figure of authority, is a canvas for projections of the patient's feelings, expectations, insecurities about their parents. This is worked through in psychodynamic therapy (and definitely not CBT) to bring insight and change. My identity here as a stranger on the internet doesn't allow for this, at least not without extensive conversations and work.

3b. A therapist can set boundaries easily. Both sides of therapy understand that the therapist is doing it for work and it's much easier to have mutual respect of boundaries. This is particularly important for therapy with BPD individuals.

3c. It's hard to open up to anyone. A therapist is supposed to make it easy, though as you've experienced, some mfs be tryna lock you up.

4. Relationships are the single most important thing for therapeutic change. Some therapy books indeed call some relationships therapeutic. For a variety of reasons, an individual can have no real friends, find it hard to maintain relationships, is avoidant of all social situations, etc. In seeking therapy, you enter into a relationship with the therapist.

4a. To add to 4., Buffalo '66 is a dramatic Hollywood version of a therapeutic relationship, but yes, this I think is the single best thing that can happen to someone under great distress. There ain't no therapist in that movie.


To add to your point regarding therapy culture, there's a studying where students are forced to take part in DBT to see how it works as a "universal intervention". Students reported feeling worse afterwards.
https://www.sciencedirect.com/science/article/pii/S0005796723001560?via=ihub
 

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