Hacker News Reader

Comment by JonathanMerklin | Hacker News Reader

Honest question, really trying hard not to word it in a standoffish way: what do you get out of a therapist that can't be obtained from thought or general conversation outside of therapy?

I don't think a "brilliant rational mind" is a prerequisite for coming to the conclusion that you're spending money to lock someone in conversation with you - someone that would not associate with you otherwise. To me, the relationship is artificial and the lessons learned can be obtained for free. Therapy seems to be conversational prostitution, more or less.

But you and others affirm that therapy has a positive ROI, and some people recommend therapy with such vigor you'd think it was the only (or the best/most efficient) way to get that return. I just don't see it, and to date I haven't met a sufficiently elucidating explanation.

View on HN

A therapist is trained to spot things you miss.

It's like asking, "what does a junior engineer get out of being mentored by a senior engineer that they couldn't just figure out by coding or reading blogs?" A therapist brings things like context, breadth of knowledge, and honesty. I felt like the therapist wasn't incentivized to sugar coat things to spare my feelings, something close friends and family might do.

I am not sure about seeing one for 5 years, though. The point of a therapist is to make themselves unnecessary, in my opinion - they're supposed to give you the tools needed to do exactly what you're saying people should do - understand their behavior and change it.

I agree that seeing a therapist for 5 years may indicate they're not actually helping you progress.

I could offer a different data point, but since it's all subjective experience anyway, just make your own call. I've enjoyed long-term therapy because I found more things I wanted to work on. Ironically, it is my therapist who reviews things on a regular schedule and asks, "why are you coming to therapy now?"

(If your therapist isn't doing that, maybe that's a red flag that you are being taken advantage of?)

> I agree that seeing a therapist for 5 years may indicate they're not actually helping you progress.

It may also indicate you really need the therapy. That's the conundrum.

You need sometimes assess (reflect), possibly with your therapist, how they are aiding you effectively. In The Netherlands, there are waiting lists for psychiatrists (and a shortage), as well as waiting lists for specialized psychologists; hence they get paid either way. They'd rather have a client who benefits from their therapy.

If you think of a therapist as less "surgeon for the brain" who exists to fix issues and more like "personal trainer for the brain", then it makes more sense to have one long-term.

It's less about fixing things that are profoundly broken and more about incrementally trying to make the most of the brain you're given.

> I just don't see it

That's half of the point right there. You only know all the thoughts you will come up with. You go to a therapist because a good one will tell you things you never would have considered at all. Your mind has ruts so deeply worn you don't even know they are there. A therapist will nudge you out of them.

I've had a number of therapy sessions where my therapist said something about myself or my past that I literally had never considered in my entire life.

The other half is that good therapists have a lot of training in how the mind works and the tricks it plays on itself. They know to look for patterns where when you say X the problem is really Y, which is a connection you yourself have never made.

It's like asking "Why should I read this book? I'm not aware of anything in it that I don't already know." The point is that you don't know what you don't know that's in it. You can't accurately simulate a therapist in your head because your simulated one only knows the things you already know. An actual therapist will provide novel insight.

You are not a rational being. You are a bundle of emotions, patterns, habits, and semi-randomly locked-in sensitivities and responses.

Talking to a therapist does two things: it makes you interact with a human being, not an abstract concept or idea. This uses different areas of your brain, different cognitive and emotional pathways than does reading a book or simply "thinking about it"; and it allows you to receive the benefit of trained expertise in detecting what patterns, triggers, traps, and skills you have or need to have exposure to.

Calling it 'conversational prostitution' isn't really an accurate analogy; or rather, it shouldn't be if you're taking the therapy seriously, though a lazy therapist/patient couple could certainly devolve into something more like that. A prostitute provides a luxury service; a therapist is more like a business consultant, as you are both expected to put in work to understand the problems and work together towards solutions. So, sure, you could try to find the solutions yourself, but you don't know what you don't know, or even if you do generally know what your problems are, there's still an opportunity cost in building up the psychological domain expertise to fix them 'in house', when you could expedite the process by bringing in an expert.

A therapist can confront you as a human being in way that no book, friend, or family member ever can. There are often truths about being human that one has difficulty accepting on the basis of logic. A trained human being can find a way to make those truths acceptable.

The point of therapy is not to teach you, but to heal you.

The problem is we all carry around a lot of subterranean shame, fear and guilt, and your mind has a way of blinding you too it because those feelings are too intense to handle on a day-to-day basis. As a result, we all have blind spots and dysfunctional habits that we will defend at all costs. Haven't you met brilliant, highly rational people that keep acting stupid over and over again because they refuse to acknowledge their own problems?

We're all a little broken for emotional reasons, not rational reasons. Everyone knows they shouldn't smoke, and drink too much, and spend too much. But lots of people have problems with that, because it's not about a lack of knowledge.

A therapist, over time, gets you to open up, accepts you, and thus shines light on those dark places. When you accept them instead of reflexively rejecting them, you can actually see yourself with more clarity and thus behave more rationally.

So yes, you could learn whatever a therapist could teach you from reading books. But the benefit of a therapist is the relationship. You could also go through the same process with a good friend, but most people are bad at listening and being accepting, especially when you're sharing your deepest secrets. And sadly, most people don't seem to have the time. Haven't you ever tried to share something with a friend, but then they say something judgmental and you never show them that again? A therapist is trained not to do that.

Here is another helpful idea, hasn't been mentioned explicitly: a therapist has (or has had) many clients. For that reason alone, even if they had no more skill at coaching than your average friend, they have valuable insights.

You might think that you are very unique, but often that's not the case. Or, at least, your behavior can be decomposed into patterns, and a therapist can often forecast where that behavior leads (and, if they're skilled and/or lucky, where it's coming from).

There’s an interesting statistical observation that the kind of therapy seems to matter less than the relationship between therapist and patient. We are social animals a neutral experienced observer helping us identifying current problems and behaviors is much more impactful on an emotional level than a book. Narcissism is not an intellectual construct it is an emotional construct.

One example: we have our unconscious and sometimes we hide things from ourselves and strongly resist any attempt from ourselves or other people to expose that stuff.

Psychologists are experts in defusing such resistance and helping us work with that unconscious content, content that most people probably aren't very skilled in helping with.

Is not that a therapist will say or make you see or provide with a new angle to see things.

What a therapist does is to help you to ask and answer questions by yourself. Sometimes just the fact that putting things into words to a stranger is enlightening. A therapist might ask "why do you think you need to reason in terms of money, ROI and investment when talking about relationships?"

How I know this? I'm seeing a therapist too! I see her everyday. I've been married with a psychologist for 15 years now. I've been hearing these kind of questions forever!

> conversational prostitution

Do you grow your own food? If not, you are partaking in prostitutional farming.

Do you make the write the books you read? If not, you are paying for prostitutional authors.

"Conversational Prostitution"?

Are you saying if you were more attractive/deserving/whatever, people with therapeutic skills would go around sharing their insight with you for free?

I believe that's called a "friend". They might not necessarily be as good at it but they are doing it out of genuine concern for you

Reply on news.ycombinator.com