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Comment by haswell | Hacker News Reader

While I don't believe "everyone should be in therapy" (nor have I encountered this attitude even as someone who believes in the value of therapy), the dating context is an interesting one with its own set of issues.

The reality for women on dating apps is pretty terrible, and therapy is a signal for "focused on self-improvement". In a dating pool filled with emotionally immature people, it can be useful to find other people who are similarly committed to self discovery/improvement.

And if you're dating in your mid 30s, a time when people are probably back in the dating pool because of a failed relationship, everyone is looking for evidence that a budding relationship isn't doomed to the same kinds of failure as the last one.

There aren't may ways to socially signal "I'm focused on (internal) self improvement and I'm serious about it".

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I actually don't think it sends a credible signal like that at all. I've been to several therapists, know people who've been in lots of therapy (unavoidable these days), and I don't think it leads to much if any self-improvement. It can produce plenty of insights, but insights almost never lead to change.

Anecdotally, I’ve also been to several therapists, and after a few that didn’t fit, found one who focuses on the issues I’m dealing with, and the experience has changed my life. I have friends who have experienced the same. I also have friends who are frustrated by it all. Good care can be tough to find. This doesn’t invalidate the field, or the benefit of seeking help. I’d tell people to treat this like they would other life impacting health providers. Take charge of the situation, and leave providers behind who are not helpful. I do think too many people approach therapy like it’s a prescription. “Take this much, get this result”. I started with this mindset, and adjusted when I realized that it doesn’t make sense.

All of that said, the main point was that talking about therapy in a dating context is more nuanced than “everyone should be in therapy”, and that some people look for this signal for understandable reasons.

How credible that signal actually is, is another question. If you’re looking for “I’m working on myself”, that doesn’t imply an expectation that someone has reached enlightenment. Just that they’re trying to be better.

A large number of people don’t seem to try at all, so I’d still argue that it’s a signal worth considering. But like most signals, it’s just a signal. It doesn’t guarantee anything.

> Good care can be tough to find. This doesn’t invalidate the field, or the benefit of seeking help. I’d tell people to treat this like they would other life impacting health providers. Take charge of the situation, and leave providers behind who are not helpful. I do think too many people approach therapy like it’s a prescription. “Take this much, get this result”.

The problem was not, as you imply, passivity on my part and an expectation that the therapist would deliver results with minimal involvement from me (I realize you didn't intend to belittle or dismiss me, but that's what the implication was).

The problem was that the therapists were just plain awful. They would ghost me, use therapy session time for unrelated things, were attracted to me and couldn't deal with it, etc. When they weren't doing any of these things, "therapy" consisted largely of them trotting out empty platitudes, or doing roleplaying scenarios that I dutifully played along with but mostly found simplistic and pointless. Occasions on which something valuable happened were few and far between, and were always torpedoed by unprofessional behavior from the therapist that killed the therapeutic relationship (see the examples from earlier).

Now, ironically, your own post strikes me as therapist-like behavior: you assumed what the cause of the problem was (passivity on my end), even though that did not happen at all, proceeded to give me advice on what to do ("Take charge of the situation, and leave providers behind who are not helpful" -- a startling insight indeed); advice that would apparently be simple to do, and would fix my problem. This is exactly how the therapists I've had the misfortune to work with operated: they would assume the client's issues are due to failing to see a simple solution (perhaps because of their "mistaken beliefs" or "bad mindset"), would point that out, and would expect the issues to be solved and, usually, a dose of reverence from the client. This, of course, bears essentially no resemblance to what it would take to help someone deal with a genuine, serious issue.

All in all; your post, so reeking of the typical therapy mindset with all its incuriousness and condescension, only strengthens my belief that therapy is essentially worthless (except possibly for mild and superficial issues, e.g. if things are fine in your life but you have occasional panic attacks, etc.).

And to bring it back to the original point: Based on the above, no, I don't think "in therapy" signals “I’m working on myself” in any meaningful sense. Plus, the stance that it does pretty much vindicates the view that everyone should be going to therapy, as it implies that therapy is a generally useful tool to help you become a better partner, and just about everyone wants to send the signal they're a good partner.

While I'd like to agree with your points about the potential downfalls of therapy, and the troublesome implications of these applied at scale to the perverse incentives of a pro-therapy society, I cannot. Your tone is far too adversarial here for the kind of productive conversation I'd like to see or be a part of. That user's response carried none of the malice you attribute to it, and I believe you should reconsider how you address conversations like this.

The response was enormously condescending, for reasons I went into at length, so I think the tone was justified. That the response was worded politely doesn't really matter.

> While I'd like to agree with your points about the potential downfalls of therapy, and the troublesome implications of these applied at scale to the perverse incentives of a pro-therapy society, I cannot.

Sorry, but I think being able to separate tone from substance is something pretty fundamental for having discussions you can learn from, so I wouldn't have much to tell you on this score even if I agreed about the tone being too adversarial.

Now I would respect something like "I agree with your points, but please lower the tone". But saying "I can't agree with your points because of your tone" -- come on.

> The problem was not, as you imply, passivity on my part

I don't know you or the specifics of your situation, and I genuinely try not to make assumptions about other people. My comments were based on my personal experiences and conversations I've had with people in my personal life about therapy, and nothing was implied. The thought that passivity is what led to your own experiences never entered my mind.

To that end, I'm not responding to the other paragraphs that were focused on this misunderstanding. You experienced what you experienced. I experienced what I experienced. These things stand on their own, and the existence of one doesn't invalidate the other, nor was raising my experience meant as an indictment of yours.

> The problem was that the therapists were just plain awful. They would ghost me, use therapy session time for unrelated things, were attracted to me and couldn't deal with it

This all sounds absolutely awful, and incredibly unprofessional. I'm sorry this has been your experience, and the not-so-helpful experiences I had were more about the therapist's lack of trauma experience, and some other issues of treatment style that didn't work for me.

If I had therapists like the people you're describing...yeah, I can understand why you'd feel jaded about this.

And I guess that was the point of my anecdote - there are some good therapists out there. People should know about this. But it's just as important to be aware of the failures in the field. I saw my comment as building on what you were saying, i.e. that there can be situations that don't work, so be aware of that and adjust accordingly.

> only strengthens my belief that therapy is essentially worthless (except possibly for mild and superficial issues, e.g. if things are fine in your life but you have occasional panic attacks, etc.).

In my case, Complex PTSD from physical and sexual abuse as a kid (with a cornucopia of unhelpful extreme religious belief systems on the side). I experienced a period of suicidal ideation after years of nightmarish sleep issues. At some point it dawned on me that the only way through this was to confront my own mind. Drugs don't undo memories. Walking in nature doesn't come with education about how to stop ruminating on said abuse, or what to do when it makes an appearance every night in my sleep, etc. I'm sleeping really well recently.

If the issue is especially big, it's especially reasonable to need/get help.

And when I think about the state of mind I was in when I started seeking help, I can't imagine how my life would have gone if I had encountered the kinds of issues you describe. I'm grateful I was fortunate enough to find good care, and take seriously the fact that some people are not so fortunate.

Thank you for understanding the issue, sincerely. I've unfortunately seen lots of people defend therapy blindly, insist that any failure was due to either not finding the right therapist or "not doing the work", and take it for granted that you always have to go to therapy to recover from anything remotely significant.

The way I look at going to therapy right now is like having an oasis possibly hidden behind a minefield -- the oasis may or may not be there, but either way, you have to go through the minefield and the wrong move will blow your leg off, or worse. In those circumstances, trying to get to where the oasis -might- be is not worth it.

I'm genuinely glad you got effective help for what you were dealing with. It sounds truly awful, and nobody should ever have to bear a burden like that.

If you're ever interested in talking more about this off HN, you can contact me through the email in my profile. And also, if you're interested in reading more about therapy going badly wrong and clients' experiences of that, I can recommend the r/therapyabuse subreddit. I find that pretty much every post there speaks to me.

> It can produce plenty of insights, but insights almost never lead to change.

Insights by themselves can't won't lead to change, but they can be a starting point.

Look at it this way, say I am overweight and want to get in shape. The insight that I need to eat less and exercise by itself of course won't make me immediately fit.

But that insight combined with work and support might.

Also therapy, to me isn't about self improvement, it's about feeling better in one's skin. Often it not that the presenting problem even goes away, but that the way you relate to it changes.

> Look at it this way, say I am overweight and want to get in shape. The insight that I need to eat less and exercise by itself of course won't make me immediately fit.

> But that insight combined with work and support might.

Putting aside the fact that your example isn't actually an insight (diet and exercise as a way to lose weight is also something you hear suggested from every corner, although with more justification), the "insights" produced in therapy are supposed to lead to change largely on their own. That is, it's assumed the client already has all the resources needed but, poor dear, he's held back by flawed beliefs, which therapy is supposed to undo. Needless to say, this has little resemblance to reality.

> Also therapy, to me isn't about self improvement, it's about feeling better in one's skin. Often it not that the presenting problem even goes away, but that the way you relate to it changes.

Putting aside the fact that this kind of contradicts the first part of your post, where you argue for how therapy can in fact help solve your problems, sorry, this is pure cope. Changing the way you relate to a problem, in that sense, or reframing, is talking yourself into believing something bad isn't actually that bad. Auto-gaslighting with a therapist's assistance, really. I prefer to solve my problems instead of trying to trick myself into thinking they're not what they are.

Ha thanks, I love a good argument.

>Putting aside the fact that your example isn't actually an insight

So put it aside then, and think of your own better analogy. It changes nothing from the point I was making.

> the "insights" produced in therapy are supposed to lead to change largely on their own.

No one has believed this in a long time.

> I prefer to solve my problems instead of trying to trick myself into thinking they're not what they are.

So do I but sometimes things break, permanently.

I can't bring dead people back to life, if I'm injured or disabled by an accident I can't 'fix' that, but I can find a way to change how I relate to that unfix-able problem. This goes beyond re-framing, of course.

As to childhood experiences and trauma, they are real and often elicit means of coping which later become ingrained habits which can cause dysfunction later on.

Therapy can help you recognise these (insight!) and then start you on the long slow path of unlearning them so they don't cause you problems anymore.

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