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Comment by slowroll | Hacker News Reader

It sounds like the idea of “the universe has no plan for you” really didn’t help considering you needed therapy

Looks like you're getting downvoted maybe because of the mean spirit of your comment, but your idea is probably held by many, to which I say:

Therapy can be such a powerful force for self-discovery and mental well-being. To think that believing a given philosophical statement can have the same effect as deep inner work is to completely write off the power of therapy. I would highly recommend it for anyone who has grown up in less-than-ideal social systems (pretty much all of us) and who wants to improve their life.

I think that ship has sailed. Even the word "therapy" has lost all meaning, just like "mental health" and we are all just conditioned to believe that the only way to achieve anything is through group think and therapy.

If you're fucked up, try drugs, (preferably the _legal_ kind, but certain herbs work really well) before you try therapy. Therapy is expensive for a reason; it's 50% a scam.

Your implication that anything expensive is closer to a scam is of course nonsense. An MRI is very expensive, but it is not a scam. An oncologist is expensive, they are not a scam. Therapy is expensive and it is not a scam (because it works for most people, most of the time).

I’ve found that therapy is a bit like minecraft in that the people knocking it have almost certainly never tried it.

you might be right. But AFAIK, Therapy is a mostly USA thing. Most cultures don't do it. You'd probably say they don't because they are not yet enlightened. I think they'd probably have a different pov

>Therapy is a mostly USA thing. Most cultures don't do it.

First off, that's a bold statement that I need something to back it up, unless it's just your opinion.

For the sake of argument, let's say it is true, though. Is the more likely reason that there are different societal pressures, expectations, and outlets inherent in different cultures, causing different mental health outcomes and needs?

> First off, that's a bold statement

Why? It's just a simple statement of (alleged) fact. Like, say, "Shaker furniture isn't really a thing in Australia"; that can be true or false, but WTF is particularly "bold" about it?

> that I need something to back it up,

Why? That assumes everyone having regular therapy is the default and not having it is the weird exception. What's to say it isn't the other way around, so you are the one who needs to back up their statement?

But OK, let me disabuse you of your misconception: The only place I've ever heard of people undergoing years-long regular psychotherapy are pop-cultural references, film and TV... American film and TV. I get my films and TV perhaps mostly from Scandinavia, Germany and Britain, but as I'm sure you know America exerts a huge pop culture pressure in Europe. But in none of that is "I can't on Thursday afternoon, that's when I see my shrink" a cliché like it is in American stuff. (Not to forget, as late as the 1990s that whole trope was used self-ironically in at least one but I think several films by Woody Allen, making fun of his own neuroticism -- because back then it still wasn't the norm in America either.)

Needless to say, I've never come across the phenomenon in real life either, in any of the Northern European countries I more-or-less regularly frequent. You'd think if it was even remotely normal here I'd have come across a remark like "X couldn't join us today because of their regular therapy session" at least once in the last four decades, but I haven't.

> unless it's just your opinion.

It's a claim of fact, provable or disprovable; it literally can't be an "opinion". And, as per the above, all evidence I've ever seen strongly points towards the statement being true.

> For the sake of argument, let's say it is true, though.

Nah, not "for the sake of argument". Let's say it's true because it is.

> Is the more likely reason that there are different societal pressures, expectations, and outlets inherent in different cultures, causing different mental health outcomes and needs?

Yeah, sure. Mainly, AFAICT, because seeing your shrink once or twice a week like you see your barber every few weeks isn't a fashion accessory necessary for your status in the rest of the world like it seems to be for the American (upper?) middle class. Which IMO seems to indicate that the societal pressures, expectations, and outlets inherent in most other cultures are healthier than those of the American one. HTH!

If therapy is mostly a USA thing why does ICD exist as a completely separate diagnostics structure vs DSM? Why are there huge studies and money towards culture specific mental illnesses and phenomenon that doesn’t exist in the USA entirely?

Colloquially "therapy" tends to refer to just talk-therapy. It's useful to the extent that talking out your issues with someone is useful, but at $100/h.

There are forms of therapy as interventions that are generally shown to be effective according to research (e.g. CBT and variants), and I think we'd be rid of a lot of confusion by better distinguishing one therapy from another.

You are describing a paid friend. That is indeed vapid and baseless. Therapy is something you seek for meaningful long-term change in an area of your life that you see as an impediment to living. All health care is (or should be) focused on that question: What do you see as a problem. If your therapist just wants to sit down to listen to you vent for an hour and asks for $100 for it, find a new therapist. Preferably one that went to school.

I am describing what it indeed often becomes, but even clients who describe it as such may still care to pay for the privilege. Ethics aside there's no rigorous standardized approach for general psychotherapy. A therapist can draw from any direction.

If seeing a therapist is to be maintained indefinitely, then it's not triggering meaningful long-term change. You can't chalk up a problem of this scale to a matter of education.

> You can't chalk up a problem of this scale to a matter of education.

Why can't I do that? It seems to me that if different countries have much better generalised psychotherapy results, I can absolutely ascribe that difference to education.

Therapy is what happens in a third place (https://en.m.wikipedia.org/wiki/Third_place)

So few moderns have a third place now, that they pay people to take that role.

Are you implying that if someone believes the universe has a plan for them, then they won't need therapy?

I think they were implying that if they are horrified that the universe doesn't have a plan for them that therapy could help relieve them of that pain.

Taking therapy does not mean that the person failed to realize his dreams. Successful and unsuccessful people both might feel the need to therapy at some point in their life.

Show me someone who doesn't need therapy and I'll show you someone who is delusional about the stability of their mental and emotional state.

https://www.google.com/search?q=therapy+harmful

It's this kind of attitude that turns a lot of us off the field. When I hear an absolutist statement focused on ingroup versus outgroup I feel an immediate revulsion for the memeplex producing it. To be optimistically curious towards something that other people find brings them mental and emotional stability I need to see some acknowledgement that they have not tried and are therefore not qualified to dismiss every alternative.

I don't believe any reputable psychiatrist would claim that everyone needs therapy.

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