Maybe you don’t need to talk to someone
drsamanthaboardman.substack.com
drsamanthaboardman.substack.com
When I was younger I had an issue with anger management. Today I suspect I might be on the high functioning autism spectrum, but we didn't know back then what we do today. Obviously if I'm right about that, then it also explains why "talking to people" doesn't work for me. But I digress.
In my youth it was common for people to say to me "You need to vent before things blow up, get a punching bag or something." I used to buy into this idea that if you keep things bottled up eventually they will build and you will explode. That is, until someone pointed out that if your method of dealing with anger is to punch something, you are training yourself to respond to anger with violence. When I started to question the "venting" hypothesis I found healthier and more productive (for me) ways of dealing with meltdowns and ruminations.
I think this idea can apply to "speaking with someone" as well. Again, I'm not saying that if there is a crises people shouldn't seek help. Just that speaking to someone, as far as I can tell, ought to have a purpose other than "I just need to talk." What does that mean, to "need" to talk? What are you looking to get out of the conversation? Do you need advice because you don't know what to do? Do you feel alone and isolated and need evidence that you are not?
Anyway these are just my personal thoughts and ramblings ... always do what works best for you and if there's an emergency don't consider the random ramblings of some strange idiot on an Internet forum.
This advice is very questionable, it subtly assumes that you are causing your own problems. It sounds really obvious, but if you have an actual problem neither venting nor punching go any way towards making the situation better. Venting is only a legitimate strategy to me when it makes you feel really good. Otherwise it is more or less useless.
A better approach is identify the problem -> test if the identification was correct -> have a good faith go at some alternative theories anyway just in case cognitive biases are in play and you can shake them -> attempt to resolve the problem. Talking to someone in the 3rd step, if you trust their judgement, is valuable.
I had the exact same experience as you, and have zero faith in the institution of psychology, but also had a recent revelation that led me to appreciate the "talk about it" angle.
In cases of things like perceived injustice, sometimes you just need some validation. Using CSA as an example, something may feel very wrong, but all other signs (and even perhaps the people around you) suggest that everything is as it should be. It creates a crippling cognitive dissonance. Doesn't help that everyone and their dog knows what gaslighting is these days-- and are generous in dispensing it.
You can't punch your way out of that situation; it's unhelpful in every way. The people around you may be criminally complicit and actually colluding against you. You can't bottle it up either; it'll eat away at you and manifest in some nasty ways later. Short of faking your own death and moving to Thailand, the only way out of that fog is to solicit a second opinion from an outside, objective source so you can address it.
It's less about advice and more about closure. You feel like something is wrong, and you want to be told (a) you're crazy and here's a treatment plan, or (b) you were right all along and by-the-way-I-called-CPS.
(Of course, the kids are gaming this with therapists in telling only the favorable half of the story; you get out of therapy what you put into it. Bullshit in, bullshit out.)
(good) Therapists are emotional intelligence coaches, they are NOT "shoulders to cry on," quite the opposite in fact.
I worked with a therapist doing CBT for a while, and have recently been working with a career coach. Neither of them ever let me "ramble" or "just let it out" with anything. They stop me and force me to unpack and separate the emotions from the thoughts from the reactions, and logically think through what is happening and how I can react in a more healthy way.
my experience has been that it’s very “action” oriented, no BS or talking about the past. Feelings and emotions have to be grounded in reality, then you act.
My philosophy is you are what you eat: calm, healthy environments and emotional states breed themselves.
I think you nearly lead yourself to the answer here - it can and should have a goal of learning and self improvement.
Personally, what I thought was most helpful about therapy was getting a "second opinion" on the things that I think and the way I think about them. While I used to think of myself as a highly rational, evidence based, logical etc etc person, I discovered over time via a helpful outsider that in fact I was subject to biases and disordered thinking in the same way that most people are, all the while thinking that I was being perfectly reasonable. Especially when it came to things that I had bad experiences with in the past, that I was afraid of and / or was trying to avoid unpleasantness around.
I found that I could rationalize (meaning: reverse engineer seemingly reasonable reasons for) my worry about things that hadn't yet happened and were unlikely to happen, often involving complicated lines of reasoning which hid various fallacies. I figured out why I was worried about those things in the first place (which funnily enough wasn't clear to me at the time), and how experiences bias thought and perception of likelihood. All this involved eating a lot of humble pie, and resulted in a greater understanding of people around me and why they behave they way they do too.
The second most helpful thing was learning to cope. There's probably stuff that's out of your control (e.g. stuff that happened in the past that's still affecting you, or just plain old facts of life) that you can't change. It's not that therapy magically fixes your problems per se, but perhaps you're making it worse for yourself: e.g. shame, embarrassment, self-blame, over-worry. At the risk of sounding woo-woo, Buddhists talk about the "second arrow" which is the unnecessary suffering you inflict upon yourself on top of the suffering that you already have to live through - that rings true for me.
Like any skill, you practice and learn through failure how to apply these things. I still worry occasionally, but I can now much more easily take a step back, evaluate, separate out what I can do and can't do about it, formulate a plan, ask for help, etc instead of turning into a nervous wreck who cannot do a thing. I now mostly worry the correct amount, which is the small amount that pushes me to do something productive about it :-)
I imagine this all sounds very abstruse if you don't have this problem and already worry the correct amount, but I'm writing this so that others in a similar situation and have an inkling that something's off (e.g. "why am I always so angry"), but haven't yet discovered what's going on can benefit. If anyone has questions about this, feel free to reply and we can chat privately.
Part of what shapes my experiences is that there are people in my life who have come to me to "talk about something" and when I offer them practical advise or an alternative perspective they either don't follow it or, worse, they get dismissive. As if solving the problem was not what they wanted, they just wanted to talk for the sake of talking.
Talking for the sake of talking is something that I have little patience for, as I can't relate to the "need", nor do I like listening to people talk in general (I might even go as far as to classify it as a form of misophonia since speaking voices actually bother me). For that reason, I don't really like talking much in general. The "return on investment" in terms of effort spent vs reward gained has just never worked out all that favourably.
But if we're talking about seeking out alternative perspectives, checking assumptions and beliefs and crafting action items then yes I've done that lots and would encourage everyone to seek that from time to time :)
I think when someone is seeking therapy, they should be prepared to have to try out a few different ones before finding the right one for them.
One thing that a therapist friend mentioned was that if you go see one, and they're just not working for you, to tell the therapist what it is that isn't fitting well. They very likely know a number of different therapists and may be able to point you to someone more suitable.
As an example: Cognitive Behavioral Therapy (CBT) vs. Eye Movement Desensitization and Reprocessing (EMDR) vs. Freudian Psychotherapy vs. Ketamine Therapy vs. [insert whatever modality you'd like]
Holding a system to this level of scrutiny is a choice.
This is absolutely true for some people, me included. I have learned to deal with these things in other ways but for the longest time I was stuck ruminating over stuff that happened decades ago and it always led to catastrophe.
The cynical / sceptical side of my brain often echos the quote "If you can't be part of the solution, there's good money to be made in prolonging the problem."
But the logical rational side thinks: hey, we pay for financial advice and legal advice, why not psychological advice?
So, you do you?
And for the same reason, you should probably lie to your doctor about any drug use, past or present. Which is a terrible policy to have, as you may be given treatments or prescriptions that interact negatively. But at least you can independently research those possible effects.
I keep seeing articles about a new suicide booth in Switzerland and the rate of euthanasia increasing in Canada... I understand people don't have a solution, but it feels like the experts aren't even trying. I think some good advice is to treat therapy like medicine and realize it might not solve the problem and there are real risks involved. I don't want to turn anyone away from therapy, but it isn't for me.
This is definitely the vibe I get from the mental health establishment. There's so much hot air about "awareness" and "stigma" and telling people "there is help", but that's essentially just marketing. That's not going to do much for someone who's seen a dozen therapists and tried as many medications to virtually no effect, or someone who found the "right treatment" and can hold down a job now but still feels like shit most of the time.
I was immediately presumed guilty and cursed at by nurses. Looked down upon by cops. Laughed at when I asked for a signed warrant or consent before acting.
Oh yeah, I wasn't there for a mental health hold. A cop claimed there were drugs up my ass. Literally.
They found nothing. Never got an apology. Just a bunch of judgemental assholes that assume if you're being evaluated for something it must be true. Even when discharged they marked "overdose" on my paperwork.... I was stone cold sober and was only there because some officer apparently thought I fit the profile of a drug smuggler. The medical workers didn't want to admit they were wrong so they just marked it as an overdose when absolutely nothing was found, including never performing a tox screen (it would have been negative). On the way out the doctor bragged about how he was monitoring closely to try and find a way to hold me longer, with the implied threat being he had hoped since whatever preconceived notion he had about me being a drug smuggler had no evidence that he could punish me instead by involuntarily committing me.
It's not a great situation to be in, and I absolutely would lie to a mental health professional to avoid going through it again.
Therapists aren’t just running around mandatory reporting people for talking about their problems. The things that you mention are triggered when someone is at risk either the patient presents a very clear hazard to themselves or others, or a therapist learns about abuse.
I’ve never heard of this happening lightly. The idea that a misinterpreted phrase is going to land you in legal trouble or involuntarily committed is simply wrong.
Source: am married to a therapist and know what actually would trigger mandatory reporting. They might need some tweaking, but they absolutely shouldn’t be repealed.
Therapists don't try to have people committed or make reports lightly. They're not going to try to take your guns away or have you committed because you use bad words or seem angry during a session. They're not going to report you or whatever for disclosing drug use, or an unusual (but consensual) fetish.
They won't even report you or try to have you committed if you talk about suicide unless you meet certain criteria around likely self-harm. Saying, "man, I just don't want to live anymore" isn't going to do it. Saying "I don't want to live anymore and I have a plan to end my life in the next 24 hours" might. Even then, they're going to try really hard to guide you to voluntary actions and not involuntary ones.
The mandatory reporting laws are in place for specific scenarios like imminent danger, self-harm, or child abuse.
So - if you've actually looked into this at all and think "hey, something I say in therapy is going to trigger mandatory reporting" - yeah, that's a huge, enormous, red flag.
As I said, I'm married to a therapist. I know pretty well what triggers these things, what the process is, etc. It is an enormous headache for a therapist to have to do any of this - and it's certainly not like they're getting paid extra for every patient they report. And it's not like they have a red button that sends the men in white coats running into the room.
In normal therapy it's a multi-step process of notifications and follow-ups where a patient would have ample opportunity to raise objections, etc. If law enforcement is involved, they're not going to just cuff somebody and ask questions later unless you confess to murder in a session or something. And, maybe it's just me, but I kind of think mandatory reporting laws that kick in if someone admits to murder or imminent plans to murder someone are a good thing, not a bad one.
If you're working with a therapist through a hospital or whatever, they'll have a risk management department that will be involved in these scenarios. They're not going to support mandatory reporting or involuntary committing unless they feel it's necessary. If anything, those institutions are probably going to be biased against these things because of costs.
Independent therapists are going to avoid this because it's a huge hassle for them, too. Plus it's usually going to risk their relationship with that patient and possibly put them at liability if the patient decides to sue or go after them with their certifying board. (There is also risk, of course, if they clearly have a mandatory reporting situation and don't take action.)
It's honestly quite an astonishing revelation that you've said being cautious about these possibilities in this way is a certain red flag. That's basically a "thought crime" where being cynical of the system makes you an even bigger concern than someone who says they have a plan to end their life in the next 24 hours which apparently only earns a "might" be a flagging. Thus I choose not to interact, to the extent I can, with said system.
Sort of. It's more complicated than providers necessarily jumping through the formal hoops every time; it can be a mix of informal coercion, asking leading questions to prompt the necessary "red flag" answers, and putting up practical barriers to the person leaving even if they're "voluntarily" admitted on paper. [1] [2] [3] [4]
[1] https://www.buzzfeednews.com/article/rosalindadams/intake
[2] https://www.buzzfeednews.com/article/rosalindadams/largest-u...
[3] https://www.seattletimes.com/seattle-news/times-watchdog/pub...
For half of my confinement, the health care providers had neither my consent nor a court order allowing care. Some of them chose to touch me against my will anyway. I presented a signed/sworn affidavit with the signatures of two doctors, another nurse, an HSI detective, and a federal judge showing they had acted before they had a court order or consent. The state board rejected the claim, stating medical care providers can provide care involuntarily even when the patient is alert/oriented/capable of informed denial of consent even when there is no order and in my case even when there was no evidence of altered mental state or mental disorder.
That is, the state board's claim is a health care provider can do what they damn well please under the banner of health care without consent, regardless of the (lack) of presence fo a court order or other legal basis otherwise. There's simply no punishment.
The interesting thing is, when they finally did get a warrant to act without consent, they refused to do anything further. By then, their legal department got involved and realized I was going to sue the ever living shit out of them when nothing was found. That is, in the end it was discovered for some health care providers they never gave a single shit about the rights of the patient; the only thing that talks is money.
Final note:
To others reading this who find themselves in a similar situation, learn from someone who learned the hard way. "I don't consent" or "patient rights" or "get a warrant" don't work, even though they should be said for posterity. Here's what does: "lawsuit", "HIPAA complaint", "I will file a grievance", "I will be informing the medical board" (yes many of these may not work, but the doctor may not want the hassle even when they do have an order authorizing care.) Your denial of care has to involve something that makes things extremely inconvenient for them, simple appeal to ethics and patient rights do not work. THIS IS NOT LEGAL ADVICE.
therapist
d o c t o r
l a w y e r
s t r i p p e rI just fundamentally disagree. You need to vent sometimes, you need to get it out of your head and into the world. You need someone to lend an ear here and there. You can’t talk about certain repressed emotions with certain people either.
The trend seems to show we are more “connected” but more lonely than ever. How many people who frequent HN for example have someone they talk to about their life’s problems frequently? How many of those people want to be the person that only hear you venting without feeling used?
Therapists serve a wonderful purpose. Little strings attached, you can vent to someone and get feedback. Don't like them? Find a new one just like you would a friend or family member who doesn’t want to listen.
If America valued communities like they did many decades ago, we wouldn’t need as much mental health support because we would already be getting it. But therapy is a tool to be used and many do not ever utilize it. To generalize like this article is trying to do is a shame. There’s plenty of therapists that help people see the bottlenecks in their lives to then fix and become happier and no longer need it.
I will 100% agree with the idea of stress to strength. Pavlov famously did experiments late in life on breaking dogs down with enough stress only to reverse the effects with enough stress.
> “[Pavlov] spent the rest of his long life giving stress-induced nervous breakdowns to dogs, after which he would try to reverse the breakdowns, all the while keeping careful experimental records.
> “He found (1) that he could classify dogs so as to predict how easily a particular dog would breakdown; (2) that the dogs hardest to break down were also the hardest to return to their pre-breakdown state; (3) that any dog could be broken down; and (4) that he couldn’t reverse a breakdown except by reimposing stress.”
Oh and the most common way to resolve said issues? A relatedness or connectedness to something.
It seems to me that the article's author is trying to do the opposite of generalize. They are in fact saying that generalizing is not good; specifically that assuming everyone needs therapy for everything might not be a good stance.
What about how many people see the “go to” thing as a sign of weakness? It’s just hard to make these blanket statements, that’s why I commented.
This comes off like you didn't read the article. The author instead seems to be speaking against a certain generalization that therapy is never a bad thing.
> To be clear, I am a fan of therapy, and as a practicing psychiatrist for almost 20 years, I have witnessed many patients improve in treatment. However, the therapy-is-the-answer model is problematic for several reasons.
The author is suggesting that therapy isn't always the answer to every problem. I think the author even agrees with you that therapy is often a good answer to many common problems.
Do parents need to spend more time with troubled kids? Do you as an individual just suck it up and move on to only have problems later in life? Generalizing in this way sounds like “not my problem”. In life you either teach people or put up with them. This article suggests people just become self-reliant. We all know that doesn’t just happen overnight.
Most professions that are noble ought to be putting themselves out of a job. Doctors, therapists, educators, etc. Not just passing the buck.
There are different approaches to therapy. The article points out some ways that talk therapy could actually make problems worse, not better. But a good therapist would recognize the kind of problem their patient is experiencing, get to know their patient, and opt for a treatment path or an approach to talk therapy that will not be detrimental.
And therapy goes way beyond "talking about your problems to a professional." Dialectical Behavioral Therapy, for instance, is a structured process that is often utilized specifically in cases where talk therapy would not be effective. [0]
Therapy isn't the answer to every problem, sure. It's not going to help me unclog the garbage disposal. But I think the generalization that most people would be better off with the support of a good therapist is a true one. And sure, that's just my own opinion - but it's my view that mental hygiene isn't that different from the other ways we maintain the health of our bodies, and most people don't seem to object to the generalized advice that everyone should see a dentist twice a year.
Some of the points this article raises, like the negative effects of rumination or the potential utility of stress, are already known to me because I learned about them from my therapist, advising me about them!
Choosing the right therapist can be a challenge though, especially if you don't know what a good therapeutic outcome should look/feel like. I think most of the advice in this article would be better applied to "how do I choose the right therapist" than "should I just completely rule out therapy."
[0]https://my.clevelandclinic.org/health/treatments/22838-diale...
> I think most of the advice in this article would be better applied to "how do I choose the right therapist" than "should I just completely rule out therapy."
FWIW, I read this advice as, "How do I choose the right therapy?" which is similar to what you're saying. I can see how someone reads this as the latter, however.
Doesn't sound like you disagree with the author. She's not saying therapy is always bad, just that it's not always good. This seems common sense. The question is, when is it better to get therapy than not to get therapy, what kind of therapy, with whom, and so on.
They are great arguments but just feels generalizing something many don’t even do to begin with.
We are finding links with depression and anxiety with the microbiome and I wouldn't be surprised to find anger control issues to also potentially be linked with the microbiome. But the microbiome links may just be correlation and its really something wrong in the human and the immune system is impact the biome. A lot of people find L Reuteri "yoghurts" help for example but you can not buy them you have to make it yourself. There is a multiple billion business in this if you can find just one microbiome adjusting drug that improves these conditions.
There's abstract situations here, but I'd rather have peers that really can see the basis I'm coming from, that have some ability to be on my side, as an alien apart from the world & wishing I saw more me & what I love so much reflected back in it.
* bashing out heavy metal on a cello (think Apocalyptica but without talent)
* lifting weights
* pounding a heavy punching bag
As a result, I view advice to get therapy as I do the suggestion that I "touch grass"; they're the sort of thing people say because they don't have the guts to tell me to go pound sand.
If therapy is less immediately effective for men, that may signal a greater need for it, not a lesser one. Learning to understand and experience one's emotions is both a skill therapy can develop and one that is needed for therapy (or journaling, etc.) to be maximally effective.