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Comment by hamburga | Hacker News Reader

I was a psychology major in college. In one of my smaller seminars, we had a research psychiatrist come in as a special guest one week. He told us that all the evidence showed that the effectiveness of therapy has no correlation with the training (or lack thereof) of the practitioner. The only factor was the empathy score of the therapist.

I have seen a few therapists over the years, but that always stuck with me. I'd take good conversation with a trusted friend or family member over a therapist any day. It might even serve us better to do away with the credentialing process altogether and sort of lift the veil on actually what happens in therapy.

The one really great therapist I had didn't even "do therapy" but instead helped with all sorts of practical advice when I was navigating a complicated divorce.

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I agree that empathetic, compassionate human connections are way more useful than therapy is GENERALLY. (Therapists that function in an occupational manner, such as doing exposure therapy, DBT, EDMR, etc is different and I do not want a trusted friend to do any of that to me!)

I however would push against doing away with the credentialing process. You can threaten an abusive/shitty therapist with losing their license. There are plenty of absolute quacks, especially religious-specific therapy, and being able to say "do not associate me with these dumbfucks" is important. [It's not uncommon for religious counseling to discourage reporting rape or child abuse!]

To me, the two have served a similar but non-overlapping function. There’s stuff I’ve find a lot easier to bring up in therapy, or bring up in therapy and then talk to friends about when I feel more comfortable.

Priests do not need to be credentialed in counselling. I wonder how this affects things?

If empathy scores correlate better with therapy effectiveness than training, does the existence of a mental health crisis suggest a general decrease in available empathetic interlocutors throughout society? Are people having fewer empathetic relationships or encounters in their daily life than in the past?

>If empathy scores correlate better with therapy effectiveness than training, does the existence of a mental health crisis suggest a general decrease in available empathetic interlocutors throughout society?

I think that's a great insight which tracks well to my anecdotal experience from the last 10 years.

Dating apps have turned potential partners into Pokemon on your phone to be collected. Doordash has stripped delivery drivers of all humanity and abstracted them away into mindless automata. Social media has gamified and commodified outrage and hatred on a global scale. At every corner you look today, the bonds of human society have been disolved and replaced with pay-gated third party API calls. And this mindset has extended like a cancer to all aspects of life. Even "therapy" itself conforms to this. What was once something relied upon friends and family has been outsourced to the "heres my money, now fix my problem" mentality.

Corporate greed has effectively atomized us in a way that 20th century totalitarian states could have only imagined. And once we've been atomized, it becomes trivial to sell basic human experiences back to us in a nice neat package. Empathy becomes just another service you can summon with your phone, so why bother practicing it?

I hung and agreed on every word but specifically;

> Empathy becomes just another service you can summon with your phone, so why bother practicing it?

Yikes. So true.

It might be. And as people get more and more lonely, the problem gets more serious, as statistically speaking the amount of empathetic interlocutors you meet decreases.

From my experience, the people who have therapists tend to either be far from family, not close with family, and/or from a dysfunctional family.

In a statistical sense, the role of the family therapist was probably traditionally filled by women - but now those women have real jobs - and the family doesn't have a part-time therapist as available anymore (on average).

At least in my family - it is astounding the difference between my grandmother and her daughters.

Anecdata of one family. My Grandma was a legendarily empathetic. Maybe no one could fill her shoes?

But it seems like especially tough shoes to fill when you already have a full-time job...

I would have guessed church and related groups but if you want to make it gendered...

Why not both

US mental health crisis is 100% driven by systemic lack of empathy. Makes sense it’s not getting better.

Jpow and corporate are coming for worker gains.

Climate change is waved off as a subjective mental illness.

Religious and secular toxic positivity crackpots demand we all smile and express nothing but happy thoughts lest we hurt their fee-fees.

“Experts” like Haidt blame social media, not the world teens see via social media; ossified minds of leadership chant the same old catechisms screwing the kids futures up. What teen girl wouldn’t go bananas as her body starts buzzing with hormones driving her to procreate given the obvious uncertainties.

The demand to exist in a cognitive dissonant state is only getting worse.

I'd like to believe that a therapist, unlike a good friend, would know the difference between well-meaning advice and good advice. Because I can give the former, but I'm not sure about the latter. A therapist should know better, if only due to the number of times they saw the effects of suggesting A instead of B.

I'd say it's not even about giving advice, just listening can make wonders. As a side note, any advice from a therapist is a slippery slope and they tend to avoid it, rather make the patient discover what they need by themselves and not impose something externally just because they're their therapist. (With some notable exceptions, e.g. in CBT.)

A lot of what passes for therapy could probably be done cheaper by going to a confessional and telling a priest.

CBT seems to have some scientific research backing it but I’m skeptical.

As they the jokes go most psychologists study it, trying to understand their mental health issues and most studies are done on psychology students students.

Going to a priest may be cheaper, but when they say to "go to god" instead of to the police when reporting rape and abuse, it becomes quite costly.

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