Ask HN: Is Therapy Helpful?

[whitepirate20]

My partner is asking me to seek a therapist as my stress and anxiety is sky high and I’ve been serverely depressed for about a year, to which it’s now making me physically ill.

I’m in a vicious cycle of working, but not feeling satisfied with my work, excessive studying, weird sleep schedules, bad thoughts. I’m to a point where I feel that I may need external help and not sure how it works. I’d love to hear experiences from people who may have gone through a similar experience.

[brundolf]

Absolutely, but, know that finding the right therapist is less like finding a doctor, and more like dating or finding a church. One isn't interchangeable for another; you may have to search around a bit.

A good therapist is someone who:

- Really listens to you, and doesn't dismiss your feelings and experiences or try to put them in a box.

- (Gently) pushes you to dig into things and really uncover real stuff that leads you to progress. Some therapists just offer vague encouragement that feels nice for a bit but doesn't really help long-term.

- You trust. At least for me, there were some deep existential/identity developments I had to make. And I had to be aligned enough with my therapist on the big questions that I trusted them to help me along in the right direction. They won't ever have all the answers for you (be wary of those who say they do!); ultimately those come from you. But they're going to be an integral part of the process, so you have to be compatible as a team.

It took me three tries to find a therapist that was really right for me. It could take more than that. But it's absolutely changed my life in ways that nothing else could have.

One other tip: different therapists have different styles. At least for me and the people I know, "cognitive-behavioral" therapy was pretty useless. It tends to treat symptoms rather than causes. I recommend "parts-work"/IFS, which gets at the root causes and encourages you to identify and heal dissonance between different parts of yourself so that you can be on your own side instead of being in inner conflict. That said- everyone's different, and I'm sure other styles work for some people out there.

Best of luck.

[jfengel]

Indeed, finding my therapist felt a LOT like dating. I went to the Psychology Today site, entered a few compatibility parameters, and then scanned through the list.

And I admit that the first pass was a lot on how they looked, whether they seemed like somebody I would trust. That was distressingly like dating, and I kinda worried that I was actually applying the same criteria.

I finally found somebody like 20 pages down. It wouldn't have occurred to me to use the keywords that would have led me to that person, but it felt correct. I talked with them and a few other top candidates, and picked the one who seemed right.

It has worked out very well. Incidentally, they're also doing parts/IFS type things.

[idontwantthis]

I want to add that I think even attempting to get help is helpful on its own.

You can at least find out what help looks like and get à better perspective on your problems.

[ncr100]

YES!

If you want to feel differently and are willing to spend effort on change, a therapist can hear you say that to them, and then help guide you through various steps to feel differently, and also be there to support you through the process of change.

"Anxiety is great until it's not." -probably someone

My experience with therapy helped me to recognize and choose not to doubt and undermine myself, resulting in overall improvement in happiness. So, Yes therapy has been helpful for me.

Also, it is ok to seek out "new" therapists who're still under supervision themselves.

[dnissley]

Yes, if you can find one that you connect with. IIRC there is research that shows the quality of your relationship with your therapist is the main determinator for therapy's effectiveness. My experience is that this is quite difficult to find, as there isn't a way to do therapist "speed dating".

[giantg2]

Most therapists, being aware of that research, at least give a 15 minute call to get a general idea of fit and stuff.

[dnissley]

Huh, I never thought to ask. Never been offered that though. I'll give this a shot and report back the next time HN discourses on therapy.

[giantg2]

The few places I talked to seem to actually require it (along with intake forms and questionnaires).

[TherapyThought]

Throwaway due to sensitive subject, but therapy can work very well, but has a lot of variables. Finding any therapist can be a huge challenge right now, with months of wait lists, and I had to go to 4 or 5 before I found the right fit, who ended up being transformative once I did find them.

Would definitely give it a try and understand that not only is therapy a process, but finding a therapist is a process. Also worth working on other areas - taking care of your health, sleep, vacation - in parallel.

[atoav]

Every person I ever met who was in therapy told me that it was the best decision they ever made. In some cases it can also be harsh especially in the first phases) as it can confront you with things you do not like to accept or even perceive about yourself.

In the end it is your decision, but given that your partner brought it up, you might consider doing it just for them. I have never been the receiving end of therapy, but I believe there is nearly nobody who could not profit from it in some way.

[b20000]

i tried talk therapy and it did not work. the main reason being that the therapist had no first hand experience starting a company or her own practice and no experience with career related issues. so it is important to choose the right one. there is a huge void / opportunity IMHO for ex founders or tech people in genral to become therapists and heal people in our industry going through stuff like this.

[digianarchist]

Honestly those aren't subjects I would raise with a therapist. It sounds like you need a career advisor or mentor with experience.

[giantg2]

That, or they do need a therapist but the first one wasn't good, or a good fit. The relationship with the therapist is one of the biggest factors in the success of therapy.

[b20000]

i disagree… these issues are intertwined. career advisors have no clue about mental health issues, anxiety, depression, PTSD and so on.

[roguecoder]

I had very good results with psychodynamic therapy, but it takes longer than cognitive-behavioral approaches.

Psychodynamic therapy is like refactoring your brain: you look at old patterns you haven’t thought about in years, consider if they are still serving you, and make small, incremental changes that increase your cohesion of self & improve the interfaces with the rest of the world.

CBT is like bug bashing: find a problem, fix that line of code. If that line is the only problem it is amazing. If there are external reasons for what you are feeling, or a bunch of code written under unrealistic deadlines with unexpected behavior all over the place, CBT isn’t designed to help.

[themodelplumber]

(For context I'm a coach who long ago underwent various forms of therapy, and who now works with, is trained by, provides training to, and gets referrals from therapists. No specific vested interest / availability rn but I will share my experiences)

First, sorry to hear about your vicious cycle. Based on what you wrote it sure seems like you owe it to yourself to at least try therapy.

The process is designed to be gentle, so in general it's one of the easier activities to try in the sense of tolerating newcomers. For example if you are more comfortable discussing your "current status" and things you've tried, or might try, but not comfortable getting into your feelings, you can typically be forthright about that and expect a reasonably assuring response.

If you have specific concerns or fears regarding therapy, IMO it's a good idea to write them down and see if they pan out, or share them with your therapist as an objective way of showing that you are bringing your best circumspect self to therapy. They may also help by providing additional context.

In case it's also relevant, my professional area of interest, personality dynamics, involves the ways in which people work together well, or don't, and so I'd also note that it is often a good idea to try multiple therapists and see which pairing (you & them) is working out. People have personas / personalities into which they naturally self-organize, and if that persona is not one you enjoy being open with in a therapeutic setting, it may be time to move along.

Personally, I once had a therapist who was engaged with some clients (particularly those who enjoyed sports) yet he literally fell asleep on others. Another seemed disinterested and burnt out. These things can happen. But I also had another therapist who was fantastic for me--he told really funny jokes, recommended very useful books, and was really brilliant in lots of ways that were relevant to my situation.

Since you're coming from tech AFAIK, one thing I'll mention is that a lot of us tech people also make really good critics. We can sometimes shoot the messenger (therapist in this case) too easily, especially if we start earnestly researching what we think they are trying to do for us, and where they get all their ideas, and so on.

If this may apply to you, it's a good idea to focus on the things you are _trying for yourself_ and what the objective _results_ are. If you can measure those results (scoring your day, etc.) for example, all the better.

Anyway, just some thoughts, hang in there & good luck.

[giantg2]

"Ask HN: Is Therapy Helpful?"

I'd like to find out.

I can't convince my wife to go to couples therapy for communication and expectations. The kicker is that it was originally her idea...

[slater]

Yes. And definitely in your situation.

Caveat: Finding a good therapist that works for you and your situation.

[vector_rotcev]

TL;DR: yes.

Lots of other good information from others here, especially brundolf.

Other things to consider:

You can 'date around' at the beginning to speed up finding someone suitable - since getting to know a therapist takes a while and you might need to try two or three (or more) you should consider seeing several concurrently to begin with, Which might also make it easier for you to compare which suits you best.

Keep it to yourself - Not that you shouldn't share things with your partner or anyone who you want to, but if You're expecting to give reports on what's going on with your therapist to someone else afterwards, It's only ever going to be performative and never really about you if it's private - your own little opaque box of external-consequenceless space and time - then it can only be about you.

They are your consultant - framing matters and, given stereotypes and received perspectives, it can be quite easy to view it as some variation of submission to somebody else or punishment for failure because you're incapable - A better way to view it is that you've got this engine you that isn't working quite how you want it to and you've gone to a specialist consultant who you want to help you analyse and understand what's going on, the context is happening in, how it can be adjusted and then to help you actually adjust it - because it's you that's going to have to adjust it. They can't actually do anything or just tell you a magic secret perspective that will somehow fix it. You have to go and do things.

Look them up - and the different types of therapy they offer - there are lots, and humans have been helping each other figure out how to be OK for tens of thousands of years - all sorts exist, e.g. https://en.wikipedia.org/wiki/Cognitive_analytic_therapy

If you don't change, you won't change - one way or another, one thing or another, something has to change in order for your situation to change, maybe a lot of things. People variously describe this as 'difficult' or 'painful' or something similar. You'll learn things about yourself and the way you work that change decisions you make, will make, and would have changed decisions you made in the past if you knew at the time - this means you'll not only feel regret, but also feel resistance to change because of what that means you have to accept - the Sunk Cost Fallacy might not be 100% applicable in considerations like this, but it's a useful heuristic to keep in mind.

You will change - and that means not only for yourself, but also for others around you. Don't stay the same for them (expecting anyone else to not grow or change in order to satisfy you probably isn't in your idea of 'good') Accept that, and make peace with your not just your stress and anxiety lessening/going away being the only consequences.

Changing how you feel about progress, and how you drive yourself, and how you hold onto goals (or whatever you're studying and working for) will probably at some point feel like giving up on them or accepting that you're lesser or your goals won't be reached and you need to moderate them - however you alter your goals or how you feel about your goals, you should know that it's entirely possible to end up way more productive in terms of actual output afterwards.

Final note: it'll be a weird experience - enjoy observing it happening to you and the curiosity of it.

[michaelcao]

I think that transcendental meditation could help you as i suffered depression in the past when my dad passed away. You can find a transcendental meditation teacher at tm.org. It helps me a lot.

[linkdd]

The website and wikipedia article about transcendental meditation raises some huge red flags, looks a lot like a sect.

[michaelcao]

Ray Dalio practices Transcendental Meditation and believe that it has enhanced his open-mindedness, higher-level perspective, equanimity, and creativity. Ray Dalio is an American billionaire investor and hedge fund manager, who has served as co-chief investment officer of the world's largest hedge fund, Bridgewater Associates, since 1985.

[linkdd]

Billionaire or not, what someone believes is entirely up to him.

After further research, there is no scientific proof nor studies that would demonstrate the effectiveness of this method.

I would not underestimate the placebo effect, but a method where the name is a trademark, and can only be taught by people part of the organization seems too fishy.

If it is so effective, why is it not part of psychology curriculums?