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Comment by ffuxlpff | Hacker News Reader

It is still debated if therapies even work. The evidence is moving to the direction that they don't.

Okay, I'll bite. What evidence is there that therapy, in general, doesn't work?

I remember in my psychology textbook and it said in terms of measured results therapy was better than nothing at all but no better than just chatting to friends. These things are hard to measure of course.

That's a hopeless generalization. People have many different problems and there are many different modalities of psychotherapy that try to address them.

Treating less severe forms of anxiety with CBT is going to be a lot more successful than treating deeply rooted personality disorders using any modality. Some problems are more suitable for CBT, and others are more suitable for EMDR, etc.

Just chatting to friends isn't enough unless you're just dealing with relatively mild, garden variety loneliness, depression, anxiety, or something similar.

It's not the past anymore, we don't need to debate, we can watch and listen to actual recordings of therapy sessions and the patients going from feeling variously bad to better. Here's Dr David Burns channel with a 4hr video of a session with a woman who is obsessively anxious about her college-age daughter's safety: https://www.youtube.com/watch?v=on2N5DsKHRk

Here's a 2.5 hour session (split into several videos) with a doctor who has a bad relationship with his son and felt like a failure for it:

https://www.youtube.com/watch?v=42JDnrD106w

https://www.youtube.com/watch?v=S5H2YGljhqQ

https://www.youtube.com/watch?v=bZ9_0j_fmeg

https://www.youtube.com/watch?v=eiCrdGVa8Q0

https://www.youtube.com/watch?v=cARvhlTckaM

Here's a couple of hour session with Marilyn who was diagnosed with lung cancer and spiraling with depression, anxiety, shame, loneliness, hopelessness, demoralization, and anger, despite her successful career:

https://www.youtube.com/watch?v=S7sQ_zDGsY8

https://www.youtube.com/watch?v=tyuFN4mbGZQ (there's probably more parts to find through YouTube somehow)

And a session with Lee with loneliness and marriage relationship problems:

https://www.youtube.com/watch?v=imEMM3r6XL8 (probably more parts as well)

It's like saying "it is still debated if debugging even works" as if all languages, all debuggers, all programmers, all systems, are the same and if you can find lots of people who can't debug then "debugging doesn't work". But no, you only need a few examples of "therapy working" to believe that it works, and see the whole session to see that it isn't just luck or just the relief of talking, but is a skill and a technique and a debugging of the mind.

I agree with you that outright claims of "therapy doesn't work" should be backed by evidence.

But a patient feeling better at the end of a single therapy session doesn't prove that therapy works either...

- Does the patient feel better between sessions too? Will they keep feeling better after the therapy ends? Aka are they "cured"?

- Would the patient feel equally good if they confided in a non-licensed therapist?

- Do the techniques (CBT, DBT, ACT, IFS, etc) actually provide tangible benefits versus just listening and providing advice?

This.

The links you provided need a control group to be considered proof. The key is how it compares to when counseling was provided by just a friend, not an expert.

You don't think we'd all know it if "talking to a friend" for a couple of hours cured years of anxiety, depression, anger, sadness, hoplessness, anxiety, etc. ? Would we even have therapists/therapy if that were the case?

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