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Comment by phnofive | Hacker News Reader

Thanks for the summary, as it’s the only way I’d have heard this person’s view. 1) paints a broad and inaccurate view unless there is more specificity about what kind of medication is being discussed. 4) & 5) are well taken, though; where do professionals with confidentiality restrictions get help, each other?

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He didn't really discuss what kind of medication.

My interpretation is he feels medication is pushed too much and rarely solves the problem. He mentioned how people wanted to taper off and eventually stop taking prescription medication. He didn't like how he isn't allowed to help with that area.

Also he voiced how the cost difference for someone staying in the hospital as an impatient is very high compared to seeing him. Insurance will try to prevent patients from seeing him 3 days per week and only want once a week (even if 3 days is helpful). Insurance companies have every detail about a patient and demand it without respecting privacy.

Happy to see you clarified your take on point one. While summaries are helpful, it's playing the telephone game on interpretation. It's better to view the source material whenever possible.

A have a family member who is a marriage and family therapist (MFT). She and most of her peers themselves see therapists. This is partly because people who become (good) therapists have themselves had to struggle with issues in their lives and dealt with it by experiencing therapy.

It's also a way to be able to talk to someone else about their cases. The person they go to is themselves bound by confidentiality restrictions so they can talk about whatever they need to without worrying that patients' communications will be leaked.

Addressing your last point, at least in the UK, therapists usually/often have supervisors. I think it's a fairly peer-to-peer system, rather than hierarchical, once you get to a certain point of seniority.

In Australia it's a registration requirement for a psychologist to have another psychologist who supervises then in respect to the personal impact of caring for their patients.

the talk is from the US, where the american dream forces doctors into individual practice being the norm.

Therapists and psychologists in the U.S. are required to have supervisors in the latter stages of their training (2-5 years). Many of them continue to have a supervisor afterwards. Most therapists and psychologists are not doctors.

For people with so-called personality disorder (and that seems to be the group they're talking about: need for therapy; adverse childhood events) medication isn't recommended and treatment should be a long form talking therapy. "Meeting the Challenge, Making a Difference" has some useful information. https://www.crisiscareconcordat.org.uk/inspiration/meeting-t...

That's an important point because this group of people often find themselves medicated with a range of different drugs - valproate, quetiapine, lamotrigine, topiramate, carbamazepine, lithium, benzos, z drugs, SSRIs, etc etc, but there's little evidence that these meds provide any benefit for this group of people.

(I'm not anti-medication.)

I agree, that does seem to be what he is obliquely referencing.

I hope I don’t need to be on a stimulants forever, but at least the effect is quantifiable.

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