Therapy Critical /=/ Anti-recovery

[Cloud Busting]

I'm so sick of this accusation.

I don't like the chaos. I don't want to live this way. I don't think I know all the answers. It's just that I don't think people know what truly causes mental illness, and that much of my problems were caused by societal problems that we should be working at fixing instead of throwing therapy at.

What is therapy supposed to do? How do meds work? We don't know why, we just "do." If therapy only works if you believe it will, doesn't that approve credence to the idea that it's merely a placebo?

I want to get better. I just don't think therapy works, and I don't understand why people think that means I'm against getting better. I think it's more likely there's just no help for the mentally ill and no one likes to admit it.

No one can explain how therapy even works, unlike other verifiable, objective health treatments. How am I supposed to trust the process if we don't even know why it works? Sounds like a waste of time and money to me.

 

[Holu]

Psych Grad Student here(well u kno me) but also as a fellow mentally ill and depressed person I think I can give a bit of a mixed set of answers to your questions.

It's just that I don't think people know what truly causes mental illness

Science does and it doesn't. The patterns are there for many disorders, but there is no obvious concrete cause we can point to. For instance, with a disorder like DID(dissociative identity disorder) the vast majority of people with it have experienced childhood trauma, so there is a clear casual link. Moreover, for some really rare cases of OCD, it can actually be a brain lesion, which can even be surgically removed to treat the OCD. But for the most part we have no idea what causes what exactly, since most disorders are simply too multifaceted. For example, MDD/PDD(Depression) have numerous genetic and environmental facets which cause the disorder, and that can range from body health, to brain inflammation, or gut inflammation, and so forth. Furthermore, it can also be a result of abuse, heartbreak, grief, and more. As of the current moment, the science is just not able to pinpoint an exact cause.

What is therapy supposed to do?

Several things, and it varies per what form of therapy and the general practices of the clinician. DBT, CBT, and ACT are some of the more common types of therapy, each serving differing functions for differing disorders. General psychotherapy(talk therapy) can also vary based on the beliefs of the practitioner. For instance a humanist inspired by Roger's is going to enjoy repeating back in questions what you say, whereas a behaviorist inspired by Skinner will focus more on your surrounding conditions and how they might influence you. Which is the best one? Well none of them, it's really to each their own. (This is cap biospychosocial model on top lmao).

How do meds work?

This is even more complex, because meds differ greatly from one another, but often can feel identical if they don't work for you. It also matters whether they are first line, second line, or third line medication, as each time you go up the meds progressively become stronger and higher risk. SSRIs will obviously differ from NDRIs, antipsychotics will differ from sedatives, but the whole thing becomes a jumble since sometimes you will receive multiple meds(assuming they interact safely with one another) especially if you have comorbid disorders. This really requires you to communicate with your doctor or psychiatrist and to do your own research regarding the specific medication you are taking.

No one can explain how therapy even works, unlike other verifiable, objective health treatments. How am I supposed to trust the process if we don't even know why it works? Sounds like a waste of time and money to me.

Can we explain it? Kinda. But therapy statistically does work(though I have problems with most of the reporting since I think it's heavily skewed if you don't account for baseline moods). Does that mean it will work for you if you have a more serious disorder or trauma, probably not, but for a broad population we can at least measure success by just interviewing people and monitoring how they improve on diagnostic tools. Unfortunately, therapy isn't a guarantee, and unlike fixing a bone, the brain is just too complex to answer this simply. As for whether it's a waste of time or money, that is entirely dependent on you. And that's not me saying "be more positive", it's just me pointing out that if you don't think therapy is going to work, then it's probably not going to do that much for you.

I want to get better. I just don't think therapy works, and I don't understand why people think that means I'm against getting better. I think it's more likely there's just no help for the mentally ill and no one likes to admit it.

I also personally don't think therapy works, but that's just because I'm a full blown nihilist who is uncooperative and resistant to treatment. I've been in therapy for most my life(since age 6) and it really hasn't done shit for me. Personally, I find that therapy and medication are often excuses that loved ones give for not knowing how to actually support us emotionally. It's easier to default responsibility to a professional, than it is to actually be the emotional support and connection someone needs.

Anyways hope this kinda helps. Or maybe it doesn't lol. The answer for everything is sadly "brain too complex we just aren't sure, even if we have ideas as to why".

Also if you ever want to talk more specifically about this you have my disc.

 

[woofwag]

I mean… we do have statistical evidence therapy works tho? I'm not super into the mental state rn to give you a bunch of stats, but you can look up rates of mental improvement after different therapy models like IOP, inpatient, IFS, EMDR, just plain psychotherapy, etc. It's not fair to discount something so broad and say "I just don't think therapy works" when there are literal millions of people having recovery success stories with the assistance of therapy. We do actually know quite a lot about the science of how therapy and meds work! I would recommend looking into it. I don't mean to sound cruel, but this is coming across as a rather un-researched opinion which doesn't consider a lot of the nuances of different therapy models, meds, and research into how these things affect us. I mean genuinely how much time have you sat down seriously and dedicatedly researching these things?

I will say that even on a personal level, therapy has made a HUGE difference in my life. While right now I am falling into an episode, I can still confidently say that therapy works (and trust me I have been through years of ineffective therapies, only recently did I discover a model/practitioner that has helped me). It does feel dismissive to outright say "I don't think therapy works" and "we don't know how it works." I'd highly encourage looking deeply into people's anecdotal evidence, as well as scientific studies into the practice of therapy and meds. There are SOOOOO many different types of therapy. Heck, there's even more non-traditional methods coming out all the time! Like ketamine therapy is super new, but more and more studies are coming out that show it can be life-changing for people struggling with different illnesses, both mental and physical.

Are there a lot of models that don't work for people, and a lot of under-researched claims about the effectiveness of different therapies/meds? Absolutely! The practice of psychiatry itself is growing every day, and in comparison to other scientific fields, is actually relatively new. There are always going to be new models, new research, new things happening in the psychiatric world. But I do feel like this post is a bit too critical and dismissive of a practice so broad. I'd recommend trying to open up to the world of therapy more. You can absolutely still be critical of it (I am too), but this post feels quite defensive based on your wording and overall attitude about how the research on therapy is conducted.

 

[bpd.mess]

Psych Grad Student here(well u kno me) but also as a fellow mentally ill and depressed person I think I can give a bit of a mixed set of answers to your questions.


Science does and it doesn't. The patterns are there for many disorders, but there is no obvious concrete cause we can point to. For instance, with a disorder like DID(dissociative identity disorder) the vast majority of people with it have experienced childhood trauma, so there is a clear casual link. Moreover, for some really rare cases of OCD, it can actually be a brain lesion, which can even be surgically removed to treat the OCD. But for the most part we have no idea what causes what exactly, since most disorders are simply too multifaceted. For example, MDD/PDD(Depression) have numerous genetic and environmental facets which cause the disorder, and that can range from body health, to brain inflammation, or gut inflammation, and so forth. Furthermore, it can also be a result of abuse, heartbreak, grief, and more. As of the current moment, the science is just not able to pinpoint an exact cause.

Several things, and it varies per what form of therapy and the general practices of the clinician. DBT, CBT, and ACT are some of the more common types of therapy, each serving differing functions for differing disorders. General psychotherapy(talk therapy) can also vary based on the beliefs of the practitioner. For instance a humanist inspired by Roger's is going to enjoy repeating back in questions what you say, whereas a behaviorist inspired by Skinner will focus more on your surrounding conditions and how they might influence you. Which is the best one? Well none of them, it's really to each their own. (This is cap biospychosocial model on top lmao).

This is even more complex, because meds differ greatly from one another, but often can feel identical if they don't work for you. It also matters whether they are first line, second line, or third line medication, as each time you go up the meds progressively become stronger and higher risk. SSRIs will obviously differ from NDRIs, antipsychotics will differ from sedatives, but the whole thing becomes a jumble since sometimes you will receive multiple meds(assuming they interact safely with one another) especially if you have comorbid disorders. This really requires you to communicate with your doctor or psychiatrist and to do your own research regarding the specific medication you are taking.


Can we explain it? Kinda. But therapy statistically does work(though I have problems with most of the reporting since I think it's heavily skewed if you don't account for baseline moods). Does that mean it will work for you if you have a more serious disorder or trauma, probably not, but for a broad population we can at least measure success by just interviewing people and monitoring how they improve on diagnostic tools. Unfortunately, therapy isn't a guarantee, and unlike fixing a bone, the brain is just too complex to answer this simply. As for whether it's a waste of time or money, that is entirely dependent on you. And that's not me saying "be more positive", it's just me pointing out that if you don't think therapy is going to work, then it's probably not going to do that much for you.

I also personally don't think therapy works, but that's just because I'm a full blown nihilist who is uncooperative and resistant to treatment. I've been in therapy for most my life(since age 6) and it really hasn't done shit for me. Personally, I find that therapy and medication are often excuses that loved ones give for not knowing how to actually support us emotionally. It's easier to default responsibility to a professional, than it is to actually be the emotional support and connection someone needs.

Anyways hope this kinda helps. Or maybe it doesn't lol. The answer for everything is sadly "brain too complex we just aren't sure, even if we have ideas as to why".

Also if you ever want to talk more specifically about this you have my disc.

I'm still an undergraduate, but I thought you explained this really well and in a super informative way.

 

[vitbar]

I totally agree that a lot of mental illness is tied to societal problems that need fixing. This truth sadly doesn't help much on an individual level. Even if society was fixed it wouldn't heal existing trauma. Fixing the ills of society is more than a life's work, and meanwhile there is suffering.

Why a medication or therapy works is interesting, but not essential. A ton of medicines were used before the mechanics were understood. Some only recently too like some anesthetics.

I have mixed feelings about therapy. It has helped me, but I recognise the shortcomings. Some forms do work very well. Exposure therapy for phobias and even OCD is one example. I remain sceptical of a lot of the core ideas of the therapies I've had, but still found useful ideas as well.

 

[Holu]

I'm still an undergraduate, but I thought you explained this really well and in a super informative way.

Yayyyy. More psych people. We need more severely mentally ill and traumatized clinicians who can actually relate to what their patients are going through. This place also lowkey needs some people defending the science, even if the practitioners have failed many people here, the science is still valid.

Good luck in your studies!

 

[bpd.mess]

Yayyyy. More psych people. We need more severely mentally ill and traumatized clinicians who can actually relate to what their patients are going through. This place also lowkey needs some people defending the science, even if the practitioners have failed many people here, the science is still valid.

Good luck in your studies!

Naw, thank you so much! It's always been hilariously ironic to me that I'm studying psychology while being mentally ill myself. Obviously, there are lots of theories and research out there, and I feel like much of it is pretty valid, but yeah, I think the way some practitioners deliver it can be really bad. I feel hopeless at times, but I'm planning to take a unique approach once I start seeing clients.