Have we overestimated the effectiveness of psychotherapy?

Re:Have we overestimated the effectiveness of psychotherapy? by pdpi on Saturday July 14, 2018 @06:32AM (#17529734)

Speaking from experience, seems to me the GP’s need to make people jump through hoops to earn their trust is a damned important part of _why_ they need those professionals in the first place.

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Re:Have we overestimated the effectiveness of psychotherapy? by boomboomsubban on Saturday July 14, 2018 @07:50AM (#17529951)

At a certain point you need to consider their success rate against your own. Realizing that and accepting they may be able to help is an important step.

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Re:Have we overestimated the effectiveness of psychotherapy? by jdietrich on Saturday July 14, 2018 @10:13AM (#17530418)

For the most part, people see a psychotherapist because they've got problems that they feel unable to fix on their own. Awareness of resistance to the psychotherapeutic process is almost as old as psychotherapy - it's a central concept in Freudian psychoanalysis.

"You have to be willing to help yourself" is perilously close to "psychotherapy only works on people who are capable of changing of their own volition", which calls into question the entire purpose of psychotherapy. If I could change my way of thinking through sheer force of will, why would I pay a professional $100 an hour to sit and listen while I do it? It evokes the classic defence of the quack - the spoon only bends if you truly believe in the power of the mind.

If that problem is framed as "some patients are too sick to treat", then at least it shifts the burden of responsibility onto the therapist; it's not the patient's fault that the psychotherapist lacks the neccesary tools to facilitate change. Blaming the patient for having a bad attitude just makes the profession of psychotherapy look ineffectual.

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Re:Have we overestimated the effectiveness of psychotherapy? by jschwartzi on Saturday July 14, 2018 @11:08AM (#17530613)

It's not really about being able to change yourself, it's about wanting to change so much that you're willing to put in the work. When I did it I had to unlearn a bunch of mental habits, but I also had to change my environment and seek things that were outside of what I knew. Therapy would have done nothing for me if I had let the therapist do all the work. I'm my case the work was to find a new way of living that is aligned with who I am and what I want for myself.

When I went in I had some major anxiety problems, and by working with my therapist I was able to identify where those problems came from. I started taking steps to change how I lived so I wasn't as anxious anymore.

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Re:Have we overestimated the effectiveness of psychotherapy? by jm__87 on Saturday July 14, 2018 @03:04PM (#17531806)

Blaming the patient for having a bad attitude just makes the profession of psychotherapy look ineffectual.

What sort of magic are you expecting from psychotherapy? You're paying someone to help you solve your problems. You're not paying someone to solve your problems for you.

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Re:Have we overestimated the effectiveness of psychotherapy? by eeZah7Ux on Saturday July 14, 2018 @04:04PM (#17532077)

Modern advertising is based on psychology. It works surprisingly well even when people try to resist it.

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Re:Have we overestimated the effectiveness of psychotherapy? by jm__87 on Saturday July 14, 2018 @04:16PM (#17532139)

Advertisers nudge you to do something you sort of already want to do. The amount of effort required to buy things is minimal and buying things you want to buy is usually enjoyable.

On the other hand, going to therapy is forcing yourself to do something that is difficult, sometimes painful and requires a lot of effort and resources (both time and money). I don't see the relationship between voluntarily going to therapy and advertising inducing you to buy things.

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Re:Have we overestimated the effectiveness of psychotherapy? by davidpatrick on Saturday July 14, 2018 @11:14AM (#17530632)

While it does require your participation for success, you are paying the professional for the tools to help yourself. And sometimes others aren’t able to help themselves, and the professional’s job is to help them discover how to.

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Re:Have we overestimated the effectiveness of psychotherapy? by pdpi on Saturday July 14, 2018 @07:54AM (#17529962)

Right — but it’s a pretty damn big first step. I can think of a fair few people who were never capable of taking that step

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Re:Have we overestimated the effectiveness of psychotherapy? by jm__87 on Saturday July 14, 2018 @03:08PM (#17531825)

You can't help someone who doesn't want to help themselves.

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Re:Have we overestimated the effectiveness of psychotherapy? by GW150914 on Saturday July 14, 2018 @03:15PM (#17531866)

I mean, if someone is shot, you can still surgically intervene without them having to participate. It’s true in psych that you have to help yourself, but it’s also true that’s probsbly a valid critique of the art rather than science that is psych. Talk therapy has more in common with spiritual guidance or shamanism than medicine, except where the actual medicine enters the fray in the form of drugs and surgery. If you’re willing to help yourself, talking to someone is often helpful, but that’s been known for thousands of years.

A real intervention doesn’t require someone to help themselves; an appendectomy doesn’t require patient participation and motivation.

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Re:Have we overestimated the effectiveness of psychotherapy? by jm__87 on Saturday July 14, 2018 @03:17PM (#17531877)

I mean, if someone is shot, you can still surgically intervene without them having to participate.

Okay, this is clearly not what we were talking about. Sorry I was not more specific in my statement to generalize to all scenarios, ever.

Edit: I think it is also a pretty fair assumption that if someone is shot or their appendix is about to burst, they would want help. The key difference here is that someone who is shot is not capable of helping themselves - with regards to many things people go to therapy for, the only way to fix your problems is going to be taking some actions yourself.

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Re:Have we overestimated the effectiveness of psychotherapy? by GW150914 on Saturday July 14, 2018 @05:14PM (#17532425)

Consent is one thing “my appendix is killing me, help!” while actually doing the work yourself is another. Obviously any intervention requires consent to really work, but once you’ve consented to the appendectomy your role ends. You don’t have to actively engage in your own surgery past the act of wanting it. By contrast merely consenting to therapy isn’t enough, you have to do a lot of hard work as well. The fact that the hard work of everything from overcoming neuroses and anxieties to battling substance abuse is the patient doing the work suggests something about the nature of therapeutic intervention as “treatment” rather than advice-giving.

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