[Our_Benefactors]

> told me it take years to get to the

That’s the grift — healing sold as a subscription. The incentive for therapists to behave this way can’t be regulated away because the regulation itself acts as a cover for this behavior: credentials, ethics boards, continuing-ed checkboxes — all window dressing to sanctify creating a dependency in the patient. The system launders manipulation through professionalism and calls it care.

[jakelazaroff]

If you want to become fit, you need to exercise indefinitely or your muscles will atrophy. If you want to lose weight, you need to diet indefinitely or you'll regain it. The steps you take to lower your cholesterol? Indefinite. Blood pressure? Indefinite. Blood sugar? Indefinite.

It's no different with mental health. We are perpetual works in progress. Any changes take not only effort to accomplish, but effort to maintain. That's just how humans work.

[johnnienaked]

The strongest indicator of general mental unwellness is the pervasive religious belief that "you need to work on yourself."

I think most if not all need for drug use would pretty much disappear overnight if we lived in a society where just being human didn't result in excommunication.

[jakelazaroff]

In my early 20s I ordered takeout every night and mostly ate like crap, but my health and general wellbeing improved (along with my finances) when I started cooking at home and eating a more balanced diet.

Was there something "wrong" with me? No, but I definitely prefer this version of myself! And it takes sustained, ongoing effort — there are still nights when I'm tempted to just order takeout, but I push myself to cook something and end up glad I did so.

The same goes for physical fitness, career, hobbies, personal relationships, mental health… you can just sort of blindly stumble through life without any intentionality, but to me it seems like a good way to squander your precious years on this planet.

[weregiraffe]

>If you want to become fit, you need to exercise indefinitely or your muscles will atrophy.

You can feel and see the effects of exercise very soon after starting. It's cumulative and predictable. Therapy is nothing like that.

[fragmede]

It depends on the therapist and the patient. Therapists, like every other profession has practitioners that are really really good, some that are mediocre, and everything in between. Patients, too, come in all shapes and all sizes.

When therapy works, it works really really well, and relatively quickly too. From casual observation of friends and other people around me (ie, as a regular person; I'm not a health care professional.) I've seen people manage to make sustained healthy changes in just a handful of sessions. I've also seen people not improve, or take far longer.

If you've been going to therapy for more than a few months and haven't been improving, it's time to change something up. Therapy should be "something like that".

[kelseyfrog]

If therapy was like that, what would it look like?

[weregiraffe]

If I knew, I'd be a billionaire.

[kelseyfrog]

That's the grift - fitness packaged as subscription. They want you to have to keep exercising to maintain fitness.

[sfn42]

Sarcasm, right?

[justonceokay]

I’m not so sure. I think there really are a lot of people who benefit from some kind of talk therapy and that that therapy might actually take a long time to produce results.

You have your whole life to ingrain thoughts, behaviors, and emotional responses into your being. If you anre unlucky, you might be surrounded by other people who reinforce maladaptive ways of thinking and being, such that they seem 100% normal. Expecting those deeply carved neural pathways to change quickly through any intervention is ridiculous.

Think about how cult deprogramming is a specialized skill with a high failure rate. Except this cult only has a single member, your inner monologue. It can take a lot of time for a therapist to figure out what the cult is even about, and it all comes from you talking (and talking and talking…)

[projectazorian]

Correct. And even if you've identified whatever changes need to be made, that doesn't mean you're ready to quit therapy. Often the required changes are difficult and emotionally challenging!

BTW, I think a lot of the HN cynicism on this subject comes from how psychotherapy is practiced in California specifically. California has a separate licensing system from the rest of the country and doesn't allow eg. teletherapy from therapists in other states. As a result I found that therapists in CA were more expensive, more difficult to access, and significantly lower quality than I've experienced elsewhere. I've heard that regulatory reforms might be on the way though, hopefully that happens.

[dns_snek]

I think "a lot" is understating it, I would guess that this describes the vast majority of people. It can take years just to find the connection between surface level problems that you see and their root causes. Then once you find the connection it takes a long time time to accept it and even longer to actually heal from it (if ever).

From what I understand, it's generally a lot easier to heal from an acute traumatic event of some sort, no matter how serious it is (e.g. physical or sexual assault), that than it is to heal from sustained and repeated trauma caused by "well-meaning" people.

In the latter case you probably don't even realize that it happened at first because it's an accumulation of a million paper cuts throughout your life. Then if you try to talk to the people involved (e.g. your parents) they'll probably dismiss you and say that you're being dramatic because each instance is utterly insignificant on its own.

You have to peel back so many layers of it until you finally understand what happened, how it affected you, and how to heal from it. And that's just on a cognitive level, on an emotional level which is the one that actually matters it's going to take even longer to internalize everything.

The best thing we could do as a society to solve like half of all of our problems (with everything from unemployment due to personality disorders, to drug use, to violent crime) is to start taking mental well-being seriously, to prevent as much harm as possible and to offer help (for free) at the earliest possible opportunity.

There should be mass public education campaigns about how seemingly subtle and inconsequential things can break people's minds if they're sustained and perpetuated over a long period of time and especially in childhood. And I don't mean those trendy "mental health matters" and "we accept your depression and anxiety <3" campaigns that have been going around for a while because 99.9% of that is completely inauthentic. Even out of the people who claim to care, the vast majority only care long as it's a mild case of it that doesn't actually visibly affect you too much - then the judgement starts.

[intended]

Yes the lack of a magic bullet is definitely the fault of science.

You can have bad experiences with therapy.

It will put patients off entirely from further therapy.

It sucks if this is you. It really does - because on the flip side, if therapy has worked for you, then you know how your life has improved.

[zeroq]

To be devils advocate it was an intersection point between psychotherapy being socially acceptable here in my part of EU and the start of covid where a lot of people reached a breaking point. From a business perspective it's a hunting season and it's not so different from IT where a lot of people game their way in. I was only shocked because I thought it was highly regulated system and on average you should get at least some help.

[zeroq]

And the problem is - after a few screw ups I've told myself - hey, maybe you don't know it all, maybe they have some secret formula you don't know about, just take it easy, lay back, don't be a smart ass, and let them take care of you. Be open minded.

I mean, I drove a Mustang in EU, shipped from US before Ford started selling them here. Local Ford didn't even had "mustang" in their system. I kept trolling them when they were offering free service for Ford drivers. My first 6 car mechanics were either a total scam or they were genuine but had absolutely no clue what they were doing.

What was I thinking? Maybe that the trade is regulated, and people with a title are more professional? Hell no.

[jakelazaroff]

You probably won't make any progress you if think of therapists like car mechanics, where you give them your broken car and they give you back a fixed one a few days later. Therapists can't just poke around in your brain to find the problems. They certainly can't fix them without your participation.

It's more like working with a physical trainer. You won't accomplish your fitness goals by just showing up. Rather, you need be engaged, learn how to actually use the tools they give you, strive to improve yourself and put in the effort to do so.

[zeroq]

Have you even read my post?

I met a gal who kept silent for five visits.

Five paid visits and I got no feedback at all. Silent treatment is what you call it.

And when I finally confronted her about that she told me that I'm making a scene, because normally people are seeing a change only after couple of years.

[jakelazaroff]

I'm not defending every therapist in the world, I'm responding to your car mechanic anecdote.

[throw83749499]

It kind of proves it is a scam. You tried it, it did not work. But for some reason you lived experience is invalid, and you should keep trying again and again!

I know a few people, who import and run vintage american cars in EU. They do all servicing themselves, buy spare parts from american ebay. They totaly think modern car industry is a scam. They would never allow some "professional" mechanic into their beloved car.

[projectazorian]

> It kind of proves it is a scam. You tried it, it did not work. But for some reason you lived experience is invalid, and you should keep trying again and again!

This is like saying dating is pointless because you dated a half dozen people and didn't end up marrying any of them. (That attitude is also increasingly common these days I've found, maybe because we've all been spoiled by the conveniences provided by the internet and modern consumer capitalism.)

[dns_snek]

> That’s the grift — healing sold as a subscription.

This therapist might've been, but often problems that require psychotherapy can't be done quickly, no matter how qualified they are and how expediently they're trying to help you. What they said wasn't wrong, but that description certainly makes it sound like they weren't trying to help at all which would've moved that healing timeline from "years" to "never".

Are you saying that psychological issues could be healed quickly if they just tried harder and didn't have the profit motive, or that they don't need to be healed at all?