How strong is the evidence in favor of psychological treatment really?
I am not happy. I suffer from social anxiety. I procrastinate. And I have a host of another issues that are all linked, I am certain. I have actually sought out treatment with absolutely no effect. On the recommendation of my primary care physician I entered psychoanalytic counseling and was appalled by the theoretical basis and practical course of “treatment”. After several months without even the hint of a success I aborted the treatment and looked for help somewhere else.
I then read David Burns’ “Feeling Good”, browsing through, taking notes and doing the exercises for a couple of days. It did not help, of course in hindsight I wasn’t doing the treatment long enough to see any benefit. But the theoretical basis intrigued me. It just made so much more sense to be determined by one’s beliefs than a fear of having one’s balls chopped off, hating their parents and actively seeking out displeasure because that is what fits the narrative.
Based on the key phrase “CBT” I found “The now habit” and reading me actually helped to subdue my procrastination long enough to finish my bachelor’s degree in a highly technical subject with grades in the highest quintile. Then I slipped back into a phase of relative social isolation, procrastionation and so on.
We see these phenomena consistently in people. We also see them consistently in animals being held in captivity not suited to their species’ specific needs. I am less and less convinced that this block of anxiety, depression and procrastination is a disease but a reaction to an environment in the broadest sense inherently unsuitable to humans.
The proper and accepted procedure for me would be to try counseling again, this time with a cognitive behavioral approach. But I am unwilling to commit that much time for uncertain results, especially now that I want to travel or do a year abroad or just run away from it all. (Suicide is not an option) What lowers my odds of success even more is that I never feel understood by people put in place to understand in various venues. So how could such a treatment help?
I am open to bibliotherapy. I don’t think I am open to traditional or even medical therapy.
I have suffered from social anxiety continuously and depression off and on since childhood. I’ve sought treatment that included talk therapy and medication. Currently I am doing EMDR therapy which may or may not end up being helpful, but I don’t expect it to work miracles. Everyone in my immediate family has had similar issues throughout their lives. I feel your pain. Despite not being perfect and being in therapy, I feel like my life is going pretty well. Here is what has worked for me:
Acceptance: Not everyone can be or should be the life of the party. Being quiet or reserved or shy is a perfectly acceptable way to live your life. You can still work on becoming comfortable in more social situations but you are fine right now. There are plenty of people who will like you just as you are, even if you social skills are far from perfect. Harsh self-judgement can make anxiety worse and lead to procrastination and depression. What I try to do as best I can is to just do whatever I feel like in the moment, and just let the world correct me. I try not to develop too many theories about how the world will react to me since I know from experience that those theories will be biased and pessimistic.
Decide what you want from the world: I guess this is somewhat generic life advice, but it has really worked for me. I decided fairly early on what I wanted to get from the social world. I wanted 3 things.
marriage
children
a good career
Deciding those things, I plugged away at getting them. I was completely incompetent at talking to women but with some help from e-harmony I found one who I was able to be comfortable with and who liked me. We got married 6.5 years ago and we have a 2 year old daughter and another child on the way. Professionally, I found a career that involves a minimum of politicking and no customer interaction. And yet it is both intellectually satisfying and highly remunerative. Even though neither my home life nor my professional life are perfect, achieving my basic life goals has given me a deep feeling of confidence and satisfaction that I can use to counter feelings of anxiety and depression as they come.
Each step I took along the path towards my goals gave me more confidence to move forward, but that confidence wasn’t necessarily automatic. I have to periodically brag to myself about myself because otherwise I will naturally focus on my failures and weaknesses and start to feel like a loser. You should be very proud of your accomplishments in college. Most people could not do what you have done. Remind yourself of that. Feel good about yourself.
I am imagining that some issues of depression/social anxiety might be a lot easier resolved in an ancestral environment. Especially the social anxiety part.
It was mainly a thought that occured to me to write down as the rest of the story wrote itself. My problem is more social anxiety, which of course pertains to the social environment. Moving of course will not help this anxiety one bit, more probably even amplify it.
How strong is the evidence in favor of psychological treatment really?
I think the evidence shows that it works for some people, doesn’t work for other people, and the spectrum of outcomes stretches all the way from “miraculously fixed everything” to “made everything worse” :-/
Oh, and “some people” and “other people” refers not just to the person being treated, but to a patient/psychotherapist pair. It is fairly common for people to have no success with a chain of therapists until they find “the one” who clicks and can effectively help with whatever the problem is.
Sorry, but there is really no answer to the question as posed.
So continue burning through therapists in the hope of being understood. Is there any shred of evidence that I should try psychoanalytic treatment again? From my impression the effect of it is similar to homeopathic treatment.
Sorry, but there is really no answer to the question as posed.
How can I restate it to get a more answerable question?
So continue burning through therapists in the hope of being understood.
I don’t know. Note that this answer is different from “continue with what you were doing”. One of the points here is that any advice has to be highly personalized and generic recommendations are quite useless.
As an aside, are you looking for a therapist to understand you, or to effect some change in you?
How can I restate it to get a more answerable question?
I don’t think you can get a useful answer from strangers on the ’net.
We see these phenomena consistently in people. We also see them consistently in animals being held in captivity not suited to their species’ specific needs. I am less and less convinced that this block of anxiety, depression and procrastination is a disease but a reaction to an environment in the broadest sense inherently unsuitable to humans.
What does it mean for a dog to be procrastinating?
Procrastination usually involves human wanting to do things that are not natural.
I used to believe that procrastination was something very unique to me but today I believe that nearly everyone struggles with it to some extend. Even someone like Tim Ferriss who advises a dozen startups and writes a book at the same time still deals with it. People who are productive simply have found strategies to still be productive despite being imperfect humans.
I am open to bibliotherapy.
You already read Burns. How about doing 15 minutes per day of his exercises for the next year?
Browsing the net= being sedentary, saving energy, staying in a place you know is safe and has access to food and water. Running= Wasting a shit ton of energy and putting yourself into the world and at risk for no immediate gain.
Seems obvious to me which you would be more naturally inclined to do.
We see these phenomena consistently in people. We also see them consistently in animals being held in captivity not suited to their species’ specific needs. I am less and less convinced that this block of anxiety, depression and procrastination is a disease but a reaction to an environment in the broadest sense inherently unsuitable to humans.
I’ve heard the idea from Somatic Experiencing—unfortunately, I haven’t found anything that goes into detail about that particular angle, except that part of it seems to be about having a tribe—it’s not just about spending time out of doors.
I’ll be keeping an eye out for information on the subject, but meanwhile, you might want to look into Somatic Experiencing and Peter A. Levine.
This scratches on some things some popular people sometimes note: A feeling of being derooted, having no sense of belonging or meaning. Maybe this is a reason for the recent resurging of religious organizations. Of course if this vague shred of an idea has some truth to it one should be able to create or find a tribe substitute.
Consider neurofeedback administered by a professional. In the U.S. it will cost between $50/200 a session. You probably need at least 20 sessions for permanent results, but you might be able to feel some effects during the first session.
Protocol Guide for Neurofeedback Clinicians (very expensive but the best); The Neurofeedback Solution How to Treat Autism, ADHD, Anxiety, Brain Injury, Stroke, PTSD, and More; and Getting Started with Neurofeedback (Norton Professional Books).
Neurofeedback has many different targets. I have used it to become more relaxed and focused. Most of what I learned came from talking to neurofeedback professionals. I strongly suggest you not experiment on yourself, but rather do so under the care of a professional.
Now, go find a therapist who’s at least 45 years old, preferably 50-plus, is not burned out, and loves what they do. It doesn’t really matter what the therapeutic modality is. Don’t go to a thirty-something CBT-weenie.
Edit: A bunch of recent posts on my blog are about therapy. May or may not be useful:
some personal anecdotes /data points from someone in a similar situation (social anxiety,depression,procrastination to the point of dropping out of uni,going abroad): I was lucky with my CBT-psychotherapist,they helped me unravelling that big knot of connected issues. I am still suffering, but now equipped to deal with it. That said, I decided to travel for 8month (NZ),basically as frontal override for some of my issues. Be aware traveling with mental issues can terribly backfire; you are on your own without your usual escape strategies. Depending on your flavour of issues, strategies to get around that vary but expect and be resolved to have the same bad days like at home. Having heaps of money to get your own room/room service/fast food/return tickets helps; ensure a really solid safety net from home (someone to lend you money,do minor services for you,people to call at strange times, people to call you regularly). Do not expect the condition “abroad” to change you quickly- you’ll still find it harder to get to know people than others. Expect lots of
gras is greener-fallacy; I caught my brain giving the exactly same reasons for going home early that it gave month ago for going away.
That said,was going away a good decision? Yes. Was it the optimal decision? I am not sure.
Who are you, what are your physical and social environments like, and do you do the obvious things like lifting weights (or at least similar if you’re female) and eating “right”?
The only reason to pay someone for non-specific therapy is if you don’t have any friends, and even then you can’t be truly honest without risking being institutionalized.
The only reason to pay someone for non-specific therapy is if you don’t have any friends, and even then you can’t be truly honest without risking being institutionalized.
Disagree. Frequent discussion of one’s anxieties can be a heavy burden on a friendship, and it’s vulnerable to cascading failures. If I have four friends and spread my worries evenly between them, and one finds this exhausting and decides to spend less time with me, then I have three friends I can talk to, each of whom will suddenly find me even more stressful to be around.
If you have a shitty relationship with your family, then that sucks. If you’re male, suck it up and be a man. If you’re female and not ugly, you have an unlimited number of guys to dump your feelings into. If you’re female, ugly, and have a shitty relationship with your family, then you probably have simiar friends and already share your feelings a lot with each other without fear of rejection so you’re good.
Unless you’re just gaming the system for pills (which is fine, if you know what you’re doing), then professional therapy for non-specific stuff is pointless.
It’s not useful to discuss whether or not anxiety, depression, or procrastination is a “disease.” It either is or isn’t a useful way to adapt to the current environment, and if it’s not useful you want to change either your reaction or your environment.
But the theoretical basis intrigued me. It just made so much more sense to be determined by one’s beliefs than a fear of having one’s balls chopped off, hating their parents and actively seeking out displeasure because that is what fits the narrative.
If by psychological treatment, you mean the Freudian kind, that’s mostly BS.
How strong is the evidence in favor of psychological treatment really?
I am not happy. I suffer from social anxiety. I procrastinate. And I have a host of another issues that are all linked, I am certain. I have actually sought out treatment with absolutely no effect. On the recommendation of my primary care physician I entered psychoanalytic counseling and was appalled by the theoretical basis and practical course of “treatment”. After several months without even the hint of a success I aborted the treatment and looked for help somewhere else.
I then read David Burns’ “Feeling Good”, browsing through, taking notes and doing the exercises for a couple of days. It did not help, of course in hindsight I wasn’t doing the treatment long enough to see any benefit. But the theoretical basis intrigued me. It just made so much more sense to be determined by one’s beliefs than a fear of having one’s balls chopped off, hating their parents and actively seeking out displeasure because that is what fits the narrative.
Based on the key phrase “CBT” I found “The now habit” and reading me actually helped to subdue my procrastination long enough to finish my bachelor’s degree in a highly technical subject with grades in the highest quintile. Then I slipped back into a phase of relative social isolation, procrastionation and so on.
We see these phenomena consistently in people. We also see them consistently in animals being held in captivity not suited to their species’ specific needs. I am less and less convinced that this block of anxiety, depression and procrastination is a disease but a reaction to an environment in the broadest sense inherently unsuitable to humans.
The proper and accepted procedure for me would be to try counseling again, this time with a cognitive behavioral approach. But I am unwilling to commit that much time for uncertain results, especially now that I want to travel or do a year abroad or just run away from it all. (Suicide is not an option) What lowers my odds of success even more is that I never feel understood by people put in place to understand in various venues. So how could such a treatment help?
I am open to bibliotherapy. I don’t think I am open to traditional or even medical therapy.
I have suffered from social anxiety continuously and depression off and on since childhood. I’ve sought treatment that included talk therapy and medication. Currently I am doing EMDR therapy which may or may not end up being helpful, but I don’t expect it to work miracles. Everyone in my immediate family has had similar issues throughout their lives. I feel your pain. Despite not being perfect and being in therapy, I feel like my life is going pretty well. Here is what has worked for me:
Acceptance: Not everyone can be or should be the life of the party. Being quiet or reserved or shy is a perfectly acceptable way to live your life. You can still work on becoming comfortable in more social situations but you are fine right now. There are plenty of people who will like you just as you are, even if you social skills are far from perfect. Harsh self-judgement can make anxiety worse and lead to procrastination and depression. What I try to do as best I can is to just do whatever I feel like in the moment, and just let the world correct me. I try not to develop too many theories about how the world will react to me since I know from experience that those theories will be biased and pessimistic.
Decide what you want from the world: I guess this is somewhat generic life advice, but it has really worked for me. I decided fairly early on what I wanted to get from the social world. I wanted 3 things.
marriage
children
a good career
Deciding those things, I plugged away at getting them. I was completely incompetent at talking to women but with some help from e-harmony I found one who I was able to be comfortable with and who liked me. We got married 6.5 years ago and we have a 2 year old daughter and another child on the way. Professionally, I found a career that involves a minimum of politicking and no customer interaction. And yet it is both intellectually satisfying and highly remunerative. Even though neither my home life nor my professional life are perfect, achieving my basic life goals has given me a deep feeling of confidence and satisfaction that I can use to counter feelings of anxiety and depression as they come.
Each step I took along the path towards my goals gave me more confidence to move forward, but that confidence wasn’t necessarily automatic. I have to periodically brag to myself about myself because otherwise I will naturally focus on my failures and weaknesses and start to feel like a loser. You should be very proud of your accomplishments in college. Most people could not do what you have done. Remind yourself of that. Feel good about yourself.
So, can you say more about what aspect of your environment is bugging you? Captivity?? Do you want to try living somewhere more “outdoors”?
I am imagining that some issues of depression/social anxiety might be a lot easier resolved in an ancestral environment. Especially the social anxiety part.
It was mainly a thought that occured to me to write down as the rest of the story wrote itself. My problem is more social anxiety, which of course pertains to the social environment. Moving of course will not help this anxiety one bit, more probably even amplify it.
I think the evidence shows that it works for some people, doesn’t work for other people, and the spectrum of outcomes stretches all the way from “miraculously fixed everything” to “made everything worse” :-/
Oh, and “some people” and “other people” refers not just to the person being treated, but to a patient/psychotherapist pair. It is fairly common for people to have no success with a chain of therapists until they find “the one” who clicks and can effectively help with whatever the problem is.
Sorry, but there is really no answer to the question as posed.
So continue burning through therapists in the hope of being understood. Is there any shred of evidence that I should try psychoanalytic treatment again? From my impression the effect of it is similar to homeopathic treatment.
How can I restate it to get a more answerable question?
I don’t know. Note that this answer is different from “continue with what you were doing”. One of the points here is that any advice has to be highly personalized and generic recommendations are quite useless.
As an aside, are you looking for a therapist to understand you, or to effect some change in you?
I don’t think you can get a useful answer from strangers on the ’net.
What does it mean for a dog to be procrastinating?
Procrastination usually involves human wanting to do things that are not natural.
I used to believe that procrastination was something very unique to me but today I believe that nearly everyone struggles with it to some extend. Even someone like Tim Ferriss who advises a dozen startups and writes a book at the same time still deals with it. People who are productive simply have found strategies to still be productive despite being imperfect humans.
You already read Burns. How about doing 15 minutes per day of his exercises for the next year?
Indeed I can try again. Though social cues are quite powerful in maintaining the routine.
Having options is nice. Also more varied experiences tend to stick better, like reading two different explanations of the same phenomenon.
Not at all. Procrastination is letting near and immediate incentives overcome far and remote ones.
People procrastinate by browsing the ’net instead of going running—which one is more “natural”?
Going running for the sake of doing exercise isn’t natural.
Browsing the net= being sedentary, saving energy, staying in a place you know is safe and has access to food and water. Running= Wasting a shit ton of energy and putting yourself into the world and at risk for no immediate gain.
Seems obvious to me which you would be more naturally inclined to do.
I’ve heard the idea from Somatic Experiencing—unfortunately, I haven’t found anything that goes into detail about that particular angle, except that part of it seems to be about having a tribe—it’s not just about spending time out of doors.
I’ll be keeping an eye out for information on the subject, but meanwhile, you might want to look into Somatic Experiencing and Peter A. Levine.
This scratches on some things some popular people sometimes note: A feeling of being derooted, having no sense of belonging or meaning. Maybe this is a reason for the recent resurging of religious organizations. Of course if this vague shred of an idea has some truth to it one should be able to create or find a tribe substitute.
I will look into it, thank you.
Consider neurofeedback administered by a professional. In the U.S. it will cost between $50/200 a session. You probably need at least 20 sessions for permanent results, but you might be able to feel some effects during the first session.
Source of information about effectiveness and duration?
None online. I have read several books on the topic and undergo it myself.
If you don’t mind, what were the books, and what changes have you noticed in yourself?
Protocol Guide for Neurofeedback Clinicians (very expensive but the best); The Neurofeedback Solution How to Treat Autism, ADHD, Anxiety, Brain Injury, Stroke, PTSD, and More; and Getting Started with Neurofeedback (Norton Professional Books).
Neurofeedback has many different targets. I have used it to become more relaxed and focused. Most of what I learned came from talking to neurofeedback professionals. I strongly suggest you not experiment on yourself, but rather do so under the care of a professional.
Existent. But psychological treatment is in it’s infancy. I am not a licensed mental health professional, but watch this:
https://www.youtube.com/watch?v=_V_rI2N6Fco
Now, go find a therapist who’s at least 45 years old, preferably 50-plus, is not burned out, and loves what they do. It doesn’t really matter what the therapeutic modality is. Don’t go to a thirty-something CBT-weenie.
Edit: A bunch of recent posts on my blog are about therapy. May or may not be useful:
http://meditationstuff.wordpress.com/
some personal anecdotes /data points from someone in a similar situation (social anxiety,depression,procrastination to the point of dropping out of uni,going abroad): I was lucky with my CBT-psychotherapist,they helped me unravelling that big knot of connected issues. I am still suffering, but now equipped to deal with it. That said, I decided to travel for 8month (NZ),basically as frontal override for some of my issues. Be aware traveling with mental issues can terribly backfire; you are on your own without your usual escape strategies. Depending on your flavour of issues, strategies to get around that vary but expect and be resolved to have the same bad days like at home. Having heaps of money to get your own room/room service/fast food/return tickets helps; ensure a really solid safety net from home (someone to lend you money,do minor services for you,people to call at strange times, people to call you regularly). Do not expect the condition “abroad” to change you quickly- you’ll still find it harder to get to know people than others. Expect lots of gras is greener-fallacy; I caught my brain giving the exactly same reasons for going home early that it gave month ago for going away. That said,was going away a good decision? Yes. Was it the optimal decision? I am not sure.
Making friends is hard with social anxiety but I think it’s your best bet.
Who are you, what are your physical and social environments like, and do you do the obvious things like lifting weights (or at least similar if you’re female) and eating “right”?
The only reason to pay someone for non-specific therapy is if you don’t have any friends, and even then you can’t be truly honest without risking being institutionalized.
Disagree. Frequent discussion of one’s anxieties can be a heavy burden on a friendship, and it’s vulnerable to cascading failures. If I have four friends and spread my worries evenly between them, and one finds this exhausting and decides to spend less time with me, then I have three friends I can talk to, each of whom will suddenly find me even more stressful to be around.
Friends include family.
If you have a shitty relationship with your family, then that sucks. If you’re male, suck it up and be a man. If you’re female and not ugly, you have an unlimited number of guys to dump your feelings into. If you’re female, ugly, and have a shitty relationship with your family, then you probably have simiar friends and already share your feelings a lot with each other without fear of rejection so you’re good.
Unless you’re just gaming the system for pills (which is fine, if you know what you’re doing), then professional therapy for non-specific stuff is pointless.
It’s not useful to discuss whether or not anxiety, depression, or procrastination is a “disease.” It either is or isn’t a useful way to adapt to the current environment, and if it’s not useful you want to change either your reaction or your environment.
If by psychological treatment, you mean the Freudian kind, that’s mostly BS.