What I was expecting from the first paragraph was a discussion of whether therapy works. I think people should know that when it’s been studied, there’s little evidence that talk therapy works better than getting support from a friend, family member, or other trusted person. A person with a credential, some insight, and an empathetic manner is not clearly better to talk to than a person with some insight, an empathetic manner, and no credential. And it’s important to remember that therapy comes with significant costs in money and risk. Anyone who gets involved with the psychiatric system should be aware of the substantial risk of overmedication and medication side effects, as well as smaller but still real risks of involuntary medication and institutionalization.
To address some common objections:
1) But therapy worked for me!
Response: Maybe. But anytime a person invests substantial time and money into a given strategy, there is a risk that their assessment of the results of that strategy will be affected by confirmation bias, sunk cost bias, and cognitive dissonance.
Also the post hoc ergo propter hoc fallacy: I was depressed, then I went to therapy for six months, now I’m not depressed. Great, but most cases of depression resolve after six months, with or without treatment. How do you know what would have happened if you had tried some other strategy, or nothing at all, for six months?
2) But I don’t want to/can’t get a friend to listen to my problems for an hour+ a week, and a therapist will.
Response: Are you sure you need to talk about your problems for that long that often? Or is that just what the psychiatric establishment has taught us is standard?
Experiment for yourself, by all means, but my experience has been that a very brief conversation, coming at the right moment, can be incredibly therapeutic. Or an in-depth conversation every few months. Or support from a friend along with all the other self-help strategies that commonly work for mental/emotional problems.
3) If you tried therapy, you would see how great it is. Therefore, you must not have tried it, so I will dismiss your opinion.
Response: This is a dumb ad hominem, but it seems to come up every time I make this point, so I will address it. I’ve done a LOT of therapy, with a lot of different people, for a range of different problems, and it never worked. Put very little weight on this, of course, it’s very possible that it didn’t work for me but will work for you. I only bring up myself to foreclose the ad hominem.
Conclusion: if you’re considering therapy, be aware of the costs and benefits. And know that it’s not your only option, and it is one of the more costly options out there.
Let me start by saying that I definitely don’t recommend people go to therapy anymore unless I can also offer them guidance (like with this post) in what to expect or how to spot a good therapist or what kinds of modalities are effective. There are just too many bad therapists out there. But I think your comment may be too confident in the wrong direction.
>I think people should know that when it’s been studied, there’s little evidence that talk therapy works better than getting support from a friend, family member, or other trusted person.
Would love to read a source for this, if you could point me to which study you’re referring to. To me the most interesting studies on therapeutic effectiveness focus on a particular modality, like the one I linked to in the post, whereas “therapy” as a whole is such a mixed grab-bag of different philosophies and ideas that as a generic practice, I’m definitely willing to believe that most people’s experience with it has not been particularly effective. But that doesn’t mean an “informed shopper” with a good guide can’t beat the odds.
>But anytime a person invests substantial time and money into a given strategy, there is a risk that their assessment of the results of that strategy will be affected by confirmation bias, sunk cost bias, and cognitive dissonance.
Interestingly, my experience is the opposite; people are very quick to point out when therapy didn’t work for them, particularly if they feel like they wasted a lot of time and money at it. I don’t generally see a lot of people singing the praise of therapy unless they had an outstandingly good experience with it.
>Experiment for yourself, by all means, but my experience has been that a very brief conversation, coming at the right moment, can be incredibly therapeutic. Or an in-depth conversation every few months. Or support from a friend along with all the other self-help strategies that commonly work for mental/emotional problems.
Absolutely true, for the majority of situations people are troubled by. As I said in the post, I think therapy is best meant for when nothing else seems to work, including talking to friends and family.
>If you tried therapy, you would see how great it is. Therefore, you must not have tried it, so I will dismiss your opinion.
This is indeed a dumb argument, and I’m sorry that you’ve been told that. Like I said, I’ve often heard the opposite; people with bad experiences with therapy are more likely to speak out about their bad experiences, in general, and most get sympathy for expressing how therapy didn’t work for them. I can imagine people trying to suggest that THEIR experience with therapy was particularly good and so if you just tried the modality they experienced maybe you’d change your mind, but practitioner skill also makes a huge difference, and the relationship with the practitioner is always a wildcard, so people should generally be a lot less confident when recommending therapy to others.
That’s a large part of why I made this post; to help people get some benefit from therapeutic philosophies without having to necessarily go to a therapist themelves.
One part of your post jumped out at me as something that’s hard to reproduce without therapy:
> Experiment for yourself, by all means, but my experience has been that a very brief conversation, coming at the right moment, can be incredibly therapeutic. Or an in-depth conversation every few months. Or support from a friend along with all the other self-help strategies that commonly work for mental/emotional problems.
Getting help from a friend at the right moment can be very helpful. But sometimes your friends aren’t available at the exact right moment, just because of things in their own life or whatever. The nice thing about paying a professional is that you’re paying for reliability. If you can’t find someone to talk to when you really need it on a given week, at least your therapist will be around.
I agree with this and think people setting up peer counseling with a friend is high leverage. This means that one meeting/week is mainly focused on you and your problems, and one day a week the meeting is focused on them and their problems.
What I was expecting from the first paragraph was a discussion of whether therapy works. I think people should know that when it’s been studied, there’s little evidence that talk therapy works better than getting support from a friend, family member, or other trusted person.
Wikipedia defines the dodo bird verdict as “the claim that all empirically validated psychotherapies, regardless of their specific components, produce equivalent outcomes”, which is noticeably different than “talking to a friend produces equivalent outcomes to therapy”. They can both be true, but I don’t think they’re the same thing.
the claim that all empirically validated psychotherapies, regardless of their specific components, produce equivalent outcomes
I think when you aggregate the difference in effectiveness between different schools of therapies for different sorts of mental illnesses fades away. The reality is different schools of therapy are good for different types of illnesses, disorders or just unhappiness in general. I can see CBT being helpful in some cases. But I find the notion that someone, who has been abused for years during their developmental period, can be cured or even improved by few months of very structured and (simplistic) CBT therapy sessions is simply preposterous. For very simple truma I can definitely see CBT or similar manualized therapy being effective. For complex trauma, you will need years of comibnation of relational, interpersonal, humanisitc, existential, psychodynamic, somatic or neuro-science based therapy.
To sum up, it all depends on what kind of issues clients want to resolve. Specific types of therapies will be more effective for specific types of issues.
What I was expecting from the first paragraph was a discussion of whether therapy works. I think people should know that when it’s been studied, there’s little evidence that talk therapy works better than getting support from a friend, family member, or other trusted person. A person with a credential, some insight, and an empathetic manner is not clearly better to talk to than a person with some insight, an empathetic manner, and no credential. And it’s important to remember that therapy comes with significant costs in money and risk. Anyone who gets involved with the psychiatric system should be aware of the substantial risk of overmedication and medication side effects, as well as smaller but still real risks of involuntary medication and institutionalization.
To address some common objections:
1) But therapy worked for me!
Response: Maybe. But anytime a person invests substantial time and money into a given strategy, there is a risk that their assessment of the results of that strategy will be affected by confirmation bias, sunk cost bias, and cognitive dissonance.
Also the post hoc ergo propter hoc fallacy: I was depressed, then I went to therapy for six months, now I’m not depressed. Great, but most cases of depression resolve after six months, with or without treatment. How do you know what would have happened if you had tried some other strategy, or nothing at all, for six months?
2) But I don’t want to/can’t get a friend to listen to my problems for an hour+ a week, and a therapist will.
Response: Are you sure you need to talk about your problems for that long that often? Or is that just what the psychiatric establishment has taught us is standard?
Experiment for yourself, by all means, but my experience has been that a very brief conversation, coming at the right moment, can be incredibly therapeutic. Or an in-depth conversation every few months. Or support from a friend along with all the other self-help strategies that commonly work for mental/emotional problems.
3) If you tried therapy, you would see how great it is. Therefore, you must not have tried it, so I will dismiss your opinion.
Response: This is a dumb ad hominem, but it seems to come up every time I make this point, so I will address it. I’ve done a LOT of therapy, with a lot of different people, for a range of different problems, and it never worked. Put very little weight on this, of course, it’s very possible that it didn’t work for me but will work for you. I only bring up myself to foreclose the ad hominem.
Conclusion: if you’re considering therapy, be aware of the costs and benefits. And know that it’s not your only option, and it is one of the more costly options out there.
Let me start by saying that I definitely don’t recommend people go to therapy anymore unless I can also offer them guidance (like with this post) in what to expect or how to spot a good therapist or what kinds of modalities are effective. There are just too many bad therapists out there. But I think your comment may be too confident in the wrong direction.
>I think people should know that when it’s been studied, there’s little evidence that talk therapy works better than getting support from a friend, family member, or other trusted person.
Would love to read a source for this, if you could point me to which study you’re referring to. To me the most interesting studies on therapeutic effectiveness focus on a particular modality, like the one I linked to in the post, whereas “therapy” as a whole is such a mixed grab-bag of different philosophies and ideas that as a generic practice, I’m definitely willing to believe that most people’s experience with it has not been particularly effective. But that doesn’t mean an “informed shopper” with a good guide can’t beat the odds.
>But anytime a person invests substantial time and money into a given strategy, there is a risk that their assessment of the results of that strategy will be affected by confirmation bias, sunk cost bias, and cognitive dissonance.
Interestingly, my experience is the opposite; people are very quick to point out when therapy didn’t work for them, particularly if they feel like they wasted a lot of time and money at it. I don’t generally see a lot of people singing the praise of therapy unless they had an outstandingly good experience with it.
>Experiment for yourself, by all means, but my experience has been that a very brief conversation, coming at the right moment, can be incredibly therapeutic. Or an in-depth conversation every few months. Or support from a friend along with all the other self-help strategies that commonly work for mental/emotional problems.
Absolutely true, for the majority of situations people are troubled by. As I said in the post, I think therapy is best meant for when nothing else seems to work, including talking to friends and family.
>If you tried therapy, you would see how great it is. Therefore, you must not have tried it, so I will dismiss your opinion.
This is indeed a dumb argument, and I’m sorry that you’ve been told that. Like I said, I’ve often heard the opposite; people with bad experiences with therapy are more likely to speak out about their bad experiences, in general, and most get sympathy for expressing how therapy didn’t work for them. I can imagine people trying to suggest that THEIR experience with therapy was particularly good and so if you just tried the modality they experienced maybe you’d change your mind, but practitioner skill also makes a huge difference, and the relationship with the practitioner is always a wildcard, so people should generally be a lot less confident when recommending therapy to others.
That’s a large part of why I made this post; to help people get some benefit from therapeutic philosophies without having to necessarily go to a therapist themelves.
One part of your post jumped out at me as something that’s hard to reproduce without therapy:
> Experiment for yourself, by all means, but my experience has been that a very brief conversation, coming at the right moment, can be incredibly therapeutic. Or an in-depth conversation every few months. Or support from a friend along with all the other self-help strategies that commonly work for mental/emotional problems.
Getting help from a friend at the right moment can be very helpful. But sometimes your friends aren’t available at the exact right moment, just because of things in their own life or whatever. The nice thing about paying a professional is that you’re paying for reliability. If you can’t find someone to talk to when you really need it on a given week, at least your therapist will be around.
I agree with this and think people setting up peer counseling with a friend is high leverage. This means that one meeting/week is mainly focused on you and your problems, and one day a week the meeting is focused on them and their problems.
Better known as the ‘dodo bird verdict’...
Wikipedia defines the dodo bird verdict as “the claim that all empirically validated psychotherapies, regardless of their specific components, produce equivalent outcomes”, which is noticeably different than “talking to a friend produces equivalent outcomes to therapy”. They can both be true, but I don’t think they’re the same thing.
Similar definitions from study.com, Scientific American, some journal
I think when you aggregate the difference in effectiveness between different schools of therapies for different sorts of mental illnesses fades away. The reality is different schools of therapy are good for different types of illnesses, disorders or just unhappiness in general. I can see CBT being helpful in some cases. But I find the notion that someone, who has been abused for years during their developmental period, can be cured or even improved by few months of very structured and (simplistic) CBT therapy sessions is simply preposterous. For very simple truma I can definitely see CBT or similar manualized therapy being effective. For complex trauma, you will need years of comibnation of relational, interpersonal, humanisitc, existential, psychodynamic, somatic or neuro-science based therapy.
To sum up, it all depends on what kind of issues clients want to resolve. Specific types of therapies will be more effective for specific types of issues.
I’m confused why this is a response to my comment, which was not an argument for or against the dodo bird verdict but about definitions.