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by _k7dr 1348 days ago
For me it's more the nature of the therapeutic relationship that gives me pause. I already don't find social experiences rewarding in any sense. My explorations with several therapists in trying to change or manage this failed, from what I think was the flawed hypothesis that I could be made to care about something that I didn't want to care about. And in fact, the nature of social experiences extends to the socialization necessary when interacting with a therapist. I don't know if most therapists are capable of addressing that issue.

This in fact seems to be a common issue with those who are diagnosed with schizoid personality disorder - that they are unable to develop a strong enough relationship with a therapist to see results, possibly because of a lack of social or related interest.

I can only hope that I don't permanently lose interest in working for money as well, for in that case I could be materially damaged for life.

And depression for me comes back when I'm reminded by others that they think I am depressed and need help. It is what well-meaning people and medical professionals cannot resist bringing up now that the subject of depression is less taboo than in the past. And yet, for me it's every little implication by the outside world that I could be in more trouble than I think I am that causes me the most anguish. As a result, I would prefer not to bring up depression if it's not so blatantly obvious that it can't not be discussed. They even could be right in reading my state of mind, but that same issue could also explain why therapy hasn't been successful for me.

Also, when I think about psychotherapy, I tend to remember this passage from Thinking Fast and Slow, a book that dozens of HN users have recommended, that resonated with me in precisely the wrong way:

"You will from time to time meet a patient who shares a disturbing tale of multiple mistakes in his previous treatment. He has been seen by several clinicians, and all failed him. The patient can lucidly describe how his therapists misunderstood him, but he has quickly perceived that you are different. You share the same feeling, are convinced that you understand him, and will able to help. [...] Do not even think of taking on this patient! Throw him out of the office! He is most likely a psychopath and you will not be able to help him."

Many years later I learned that the teacher had warned us against psychopathic charm, and the leading authority in the study of psychopathy confirmed that the teacher’s advice was sound.

I know that I was already biased when I reached this passage, but it single-handedly turned me off of the idea of pop-psych. This was exactly what I had done to the past few therapists I had seen, and I wasn't trying to be disagreeable or charming or anything. I had simply stated what was my own reality: that I felt that my previous therapists didn't understand me. The fact that Kahneman's idea of a well-trained psychotherapist is someone who ought to kick me out of their office instilled a lot of self-doubt about trying therapy again that I don't think I'll be able to explore with another party for a long time. Or, at the very least, that I should do my own research instead of taking the words of popular authors at face value.

3 comments

the flawed hypothesis that I could be made to care about something that I didn't want to care about

Been there too, had to actively push back. I don't want to be more socialized, better accepted or something. I want to not experience negative emotions while in society. Therapists probably try to resolve this issue in the most default way. I managed to convince mine that it's not what I want, but we are still exploring.

I agree with a sibling commenter - what you feel is the starting point. You don't have to learn/need to care about that something. Your goal is to stop worrying involuntarily when it's nearby. (Sorry if this is obvious or doesn't apply, I'm sharing because some of this wasn't obvious to me for some time.) Also, I can't really say that I'm interested in relationship with a therapist. Barring professional respect, I don't care about him personally, what I do care about are our sessions, the structure of these issues and his professional stance. This is what allows me to open some private doors before him. Not that "buddies" feeling. I wouldn't otherwise trust a similar person that much.

> This was exactly what I had done to the past few therapists I had seen, and I wasn't trying to be disagreeable or charming or anything. I had simply stated what was my own reality: that I felt that my previous therapists didn't understand me.

I have not read that book, but that doesn't seem to be what Kahneman is talking about? He is talking about people who say "all these therapists have failed me, but YOU are different," like they are trying to charm the therapist. I think the red flag here is people who are turning the session into praise for the therapist, whereas the normal reaction when the session is going well would be to keep the focus on yourself so you can finally get some progress.

Also note that you can only say "all previous therapists misunderstood me except you" to one therapist. Anyone after that would effectively be the second. Granted, it's demoralizing, but it IS progress :)

I'll just say this. You've described situations where what people say (you seem depressed or whatever) cause you to feel something. When you feel things - particularly things you'd rather not feel - that is an entry point to progress. Go ahead and feel it. Reflect on why it's there. If other people make you uncomfortable, ask why you feel uncomfortable. Remember, it's not them.