Mental Mountains

Don't miss the review of all therapy books ever that's linked at the end of part I. For one thing, it's hilarious, and for another, the context it adds is pretty helpful.

For the HN-reading 22-year-old out there who is trying to climb out of that first unspeakably horrible episode of mental illness, and as part of that, trying to grok what psychiatry really is: at this point in history, models (theoretical or other) are great and can drive progress in psychiatry, but don't for one minute believe any hype like this, from the reviewed book's Amazon page:

"Ticic and Hulley equip readers to carry out focused, empathic therapy using the process found by researchers to induce memory reconsolidation, the recently discovered and only known process for actually unlocking emotional memory at the synaptic level."

Just, no. It's not even worth refuting. What happens at the synaptic level, and what happens at the emotional level, the experience of emotions? We are not meaningfully closer to bridging that gap than we ever have been. Despite great advances in brain science, that sort of talk still belongs in philosophy, not science or medicine.

This is not to say that UTeB or EIEIO or whatever model doesn't hold promise for those of us with lived experience of mental illness. The evidence base for talk therapy continues to evolve. Just ignore any kind of "unlocking secrets" talk. We aren't there yet. We aren't close. But on the web pages that sell books, we are always on the verge of...

Wait, does this imply that ruminating and getting blackout drunk could be an effective form of therapy?

>> The predictive model output the anxiety, using reasoning like “if you talk, people will hate you, and the prospect of being hated should make you anxious – therefore, anxiety”, but not any of the intermediate steps.

That really makes it sound like poor Richard was some kind of robot with an AI that used some kind of machine learning algorithm to build models etc.

It sounds a bit silly to be honest, like taking an analogy ("the human mind builds a model of the world"), mashing it up with some currently trendy terminology ("machine learning model") and then running with the result until it's stretched out to an absurd extent and you can't tell what the words mean anymore.

Very interesting read, well explained and somehow 'feels right'. I didn't think psychotherapy could work until it was explained to me this way.

In two words, cognitive dissonance