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Comment by tekla | Hacker News Reader

I tried therapy a few times, at the insistence of several friends. After 3 platforms, and 7 therapists, I've decided its a complete waste of time. I'm not 11 and require someone telling me things I can find in a dollar bin self-help book at $100 per 30m.

I'm mildly convinced that therapy is another big-pharma conspiracy to pay for services that are worthless.

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The thing I don't understand about therapy is that there's no amount of self-inflicted problems you can have that therapy couldn't tell you is someone else's fault.

Think of the worst person you can imagine in your persona life, who goes around causing problems for other people and then complaining that "everyone's an asshole." That person can go shop around for therapists until they find one who reaffirms all their beliefs that other people need to change for them. And I don't think it would be wild to assume therapists like that will receive the highest praise for their work, as opposed to the ones who tell you to fix something about yourself, which many people will take as a personal attack.

If someone can't fix their own problems so they're seeing a therapist, how can they be trusted to select a good therapist for themself? It seems like the whole concept of this system actively incentivizes bad therapy and externalizing blame.

Great comment!

I can empathize with this, however, I think it's worth pointing out that the value of therapy does not lie in the insights that are communicated. Even if they weren't in self-help books, you could in theory just go read the textbooks that therapists do.

The value I have found in it is in actually spending time talking about my emotions, with a reasonable human being, and receiving reasonable reactions. It's a chance to build "reps" in emotional intelligence that are otherwise scarcely available in regular life (mine, at least.)

It's like working out. Sure, you can lift buckets of sand in your garage and get strong. People still go to gyms and hire personal trainers.

> It's like working out. Sure, you can lift buckets of sand in your garage and get strong. People still go to gyms and hire personal trainers.

The personal trainer metaphor is one I used when trying to convince a friend (we're both Iraq veterans) to go to therapy.

Something to the effect of: "it's like personal training, they're there to respond and push you, but ultimately you're doing the work and making things happen. sometimes you need someone to push you hard, sometimes you need a soft touch, and sometimes you need someone to just check your form or get you to do different exercises."

Why would big pharma want you to spend money talking to someone instead of buying their drugs?

Who is going to prescribe the drugs?

A psychiatrist, not a therapist.

therapists dont prescribe drugs

But what was the mental disorder you suffered from that made you seek out therapy? If you didn't suffer from one then of course it was worthless. It's like taking iodine supplements when you aren't iodine deficient.

Or, as another apt metaphor, its like taking hydration tablets instead of water. Not that they don't help, but that you're using them wrong. In your example, it sounds like arrogance, hubris, and dogmatic conviction could be problematic if a person cannot recognize room for growth without first identifying a character flaw to grow out of.

The advantage of therapists is it can help and has fairly low risk of side effects unlike drugs or more extreme methods.

It’s stilly to think they can solve everyone’s problems. Sometimes people just need to sit in front of a bright light to fix a chemical imbalance etc.

I never understand the attitude of "it didn't work for me, so it is a scam". It feels very myopic.

There's plenty of studies coming to the same conclusion. Mostly, the conclusions are that therapy can improve a near-absolute lack of human contact but not much else. Famously, going to a sports club, even sometimes just once per 6 months, had more positive effects than 2 hours of therapy a week.

I’ll be an N=1 counter example.

My somatic therapist dramatically changed my life and helped me overcome some pretty deep wounds and traumas.

I’ve done a lot of things in recent years to get better, and working with her has been definitely near the top of the list in terms of effectiveness.

To be clear, this is a different modality (somatic and touch work), which for me was far more effective than the therapy I had tried prior.

These days I'm not so sure how this would be judged. Earlier, like >20 years ago it wouldn't have mattered: you were functional (~able to hold down a job and live reasonably for >2 months) before therapy and after. The problem is that there's plenty of non functional people that therapy doesn't seem to be able to help.

Glad you thought it helped you, though.

Can you give some examples of such studies?

It's not just pharma. It's a big revenue driver for the entire healthcare industry for the past decade. Billions have been spent trying to generate demand and create'awareness'. Everyone is in on it, including HR people at your companies trying to stay relevant, countless mental health related start-ups, insurance companies, and providers.

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