Hacker News Reader

Comment by borroka | Hacker News Reader

I will go even further than that. Talk therapy is the scam of the 2000s. The trickle that brought what we call therapeutic language into everyday life, the constant references to the narcissism of a partner who, if we are honest, had the great fault of just not wanting us anymore, the masochistic lingering over traumas that are nothing more than everyday life, the safe spaces, the escape from responsibilities that should be ours but we have been taught to assign to society, has had disastrous effects on human relations and also on political discourse.

On top of that, I have rarely, if ever, found people participating in talk therapy getting better. If it were a pill, no honest doctor would prescribe it.

View on HN

Mostly agree with this. In my heart of hearts I truly believe many problems are best left to be abstractions and not "explored." When you explore your problems, you dwell on them and when you dwell on them, you're often not in a good place.

It is all anecdotal of course but like you, I notice that my friends and family that constantly go to therapy never seem to get better... and often times worse. I don't think its a case of correlation either, I think they've just made a mountain out of molehill.

Now, I do want to say there are _many_ people that absolutely need therapy. I think if you just can't function, you need professional help. That shouldn't be discouraged.

> my friends and family that constantly go to therapy never seem to get better

Isn’t this true for any medical treatment?

I would hope not.

I'm still "young" so every visit to a Dr, I've come out with a solution.

In any case, I've gone to therapy and it feels like you're making progress (and perhaps I was) but never fixed the problem.

Exactly. If you are cured you stop doing the treatment. If you are not cured but only somewhat better, you continue it.

Cognitive behavioral therapy, the most common type of “talk therapy” these days, shows effectiveness on par with medications in a broad range of studies with good methodology.

It is important to remember that anecdotes are not data.

What kind of medications are we talking about, for what "issue" (suicidal thoughts or "my parents are disappointed because I did not go to college and I am feeling worthless") and what is the effectiveness, especially long-term, of either medication or talk therapy?

I certainly present anecdotes, and I also live in this world and I notice and I observe and I evaluate. The comment I am responding to does even less.

The second scam is, of course, couples counseling. I have sporadically watched Showtime's “Couples Therapy,” and I know several people who have gone to a couples therapist. The cost of a 50-minute session with the therapist presented on the show seems to be $700. After watching parts of the program, I can give my prescription to all the couples featured, free of charge: You need to break up and find someone else. It may be a collection of anecdotes, but I have yet to see a couple “fall in love again” or “settle their differences” after expensive couples counseling sessions. It's time to move on.

Does that demonstrate that therapy is effective or that medications are ineffective?

Not the GP, but I'll comment about ADHD, since that is what I have relevantly read research about.

For ADHD, it appears that therapy < medication < therapy + medication.

When compared head-to-head, therapy is almost as useful as medication, but the issue with therapy is that once the patient stops attending, the benefits tend to diminish rapidly.

However, therapy tends to have less side-effects and less stigma. According to some research, medication efficacy also tends to diminish overtime as well.

For other conditions, I cannot tell you. I feel like it would be too large of a brush to try and paint with. I could see conditions like personality disorders not benefiting from medication as much as therapy. Conditions like schizophrenia might not truly benefit from either. For conditions like depression and anxiety, I think the medications are efficacious if not perhaps less so than therapy, but do not quote me on this one.

CBT worked well for me. Unfortunately though after the first few weeks, doing the exercises and thinking about my problems seemed to reel me back into the gravitational pull of my problems right as I felt I was escaping. As you point out, its an anecdote and a sample size of one... but is a factor in my opinion.

Reply on news.ycombinator.com