I hesitate to comment on these threads, because no one wants to take the risk of saying anything adverse. "What if I say something bad about therapy? would this cause someone else not to see a therapist and end up dying?"
But I will say this. As people are becoming more lonely in a crowd, as they can't silence the noise in an empty home, as they can't find someone to listen to them even when they surrender, therapy will be the only outlet. You often see the cases in japan where people rent friends.
It's not that therapy is bad (it's pure luck if you find the right therapist), it's that there was a solution for the problems it is trying to solve. A community. And the friends that come with it.
Nearly all of the clinical benefits of psychotherapy are delivered in the first few sessions. Some studies suggest an inverse correlation between duration and effect size - people in long-term therapy may have worse outcomes than people who complete a short course of therapy.
Psychotherapy is an effective treatment for most common mental health problems, but if you're going to therapy for more than 12-18 weeks, you're doing something other than treating a mental illness. You're likely getting something out of it otherwise you'd stop going, but that thing isn't improving your mental health in any meaningful way and may be actively causing harm.
I'd strongly encourage people to try psychotherapy if they're experiencing psychological distress, but I'd also strongly advise them to go in with a clear sense of what they'd like to achieve. If a therapist isn't willing to work with you in the first couple of sessions to create a specific, measurable, achievable, relevant and time-bound plan for your therapy, you should be very wary. Therapists who advocate an open-ended approach that eschews goal-setting and objective outcomes in favour of a nebulous sense of "insight" or "growth" aren't delivering evidence-based care and aren't acting in the interests of their clients.
> If a therapist isn't willing to work with you in the first couple of sessions to create a specific, measurable, achievable, relevant and time-bound plan for your therapy, you should be very wary.
I have a friend who's been in therapy for over a decade, due to debilitating anxiety from childhood trauma.
Went many years to first before switching to second, same story. I asked "well have you gotten any tasks or tools to help you deal with it?" multiple times, always same answer: "No".
Third time lucky it seems. Now seeing a therapist which comes with concrete suggestions and tasks. Things have improved. It's not a trivial problem to solve, but at least there's change now.
edit: You may ask, why stay with the therapists that didn't help? Anxiety... didn't want to upset the therapists by suggesting it wasn't helping.
a friend of mine who is working as a therapist says she doesn't take any patients for more than half a year. if she can't help them in that time then she probably can't ever.
another reason to stay with a therapist is outside pressure. and sometimes talking to someone does help a little bit in that it has a noticeable effect without improving things to the point that help is no longer needed, but that potentially leads to a dependency which is not good either.
therapists have a responsibility to act in the best interests of clients who are not able to "manage" therapists well. this doesn't get discussed enough.
The linked study is interesting and useful and I'm surprised I wasn't aware of it. Thanks for posting.
Still, these sorts of things are difficult to interpret because severity of problems are also correlated with length of therapy and inversely correlated with outcome. So it's hard to interpret, even if you try to statistically control for it.
It's also something that would be difficult to randomly assign because different lengths of therapy might not be a good match for someone.
It's a bit like saying "length of rehab following traumatic accidents aren't correlated with as positive of outcomes". That might or might not be true but if it were it would be difficult to interpret because you could imagine rehab would take longer after serious accidents and also have more difficult outcomes.
There's other things to consider with length, like maybe the focus is shifting? Maybe someone continues to benefit from it?
Anyway, I agree it's important to try to remain focused in therapy and not use it in the wrong ways, but length is a difficult thing to make sense of sometimes.
We do have randomised trials to support the argument, but (like most treatments) there's a very obvious dose-response curve. If we take outcome measures after each therapy session, we can see that each additional therapy session has a diminishing marginal benefit.
There's a reasonable argument that the most severely affected patients might gain clinically meaningful benefits from very small incremental gains, but that's very difficult to falsify because the effect size is so small. Long-term psychotherapy undoubtedly fails any reasonable cost-benefit test, but even setting that aside, I'd suggest that anyone who isn't satisfied with the results of therapy after 12-18 sessions would be better off trying something else - either a different therapist, a different psychotherapeutic modality, or a biomedical treatment.
Anecdotally, the vast majority of people who I encounter who are in long-term psychotherapy aren't severely unwell; obviously that is in large part explained by the barriers to access faced by most severely unwell patients. Many of these people aren't "mentally ill" in any meaningful sense, exhibiting only subclinical symptoms of anxiety or depression even at the point of starting therapy. They don't have clear goals for therapy, or any real sense of when it would make sense for them to finish therapy. If they find therapy to be an enjoyable activity like doing yoga or having a massage then I have no qualms with that, but many of them ascribe benefits to long-term therapy that simply aren't supported by the evidence.
Good therapists don’t schedule constant weekly checkins for folks who don’t need it. I’ve had times when my therapist said check in after 4 months to see if things are fine.
Therapy works for people who need a lot of help to barely get to normal. It also helps a lot for people who would typically be classified as just fine, but they still want to become better people. I’m in that category. I hope none of us believe we are already the best we can ever be, there’s always room for improvement. If that’s the case, why wouldn’t you want to continue working with a professional to try and figure out how that can happen?
>If that’s the case, why wouldn’t you want to continue working with a professional to try and figure out how that can happen?
Because there's essentially no evidence to support it, the cost is very significant and there are very real risks of adverse events. Most developed countries (and America in particular) have a very serious problem of over-medicalisation, over-diagnosis and over-treatment, which greatly inflates healthcare costs for no real benefit.
More broadly, what do we mean by "better person"? If we define it in the Californian sense of hyper-optimised self-actualisation, then long-term psychotherapy for clinically healthy people might plausibly deliver on that goal. If we mean a better friend, a better neighbour, a better citizen, then I think you'd be far better off spending an hour and $200 a week doing something towards those aims.
I’m saying it helps me, you’re saying it cannot help me. I’m wondering who I should believe.
If anything there seems to be this visceral reaction by (mostly) men to the idea that they could use any help from outside to become better. Every guy seems to think they’re Ron Swanson with irony being the show was written by the so-called Californians and he gets help from friends anyway. You could argue “that’s friends not a therapist” well maybe I’ve found better advice coming from a professional than an amateur. I’m tired of taking advice and giving advice within my friend group when we ourselves can’t deal with the same advice ourselves.
There is an immense IMMENSE bias towards the idea that if something is vaguely a mental health intervention it must be helping. So much of mental health practice especially outside of pharmaceuticals is well well outside the realm of evidence based medicine.
If a study shows therapy benefits a specific population it given for a specific period of time, it must benefit all people if you go monthly for ten years. The, what is for most people, massive cost of therapy itself in terms of money but also time is treated as if it has no potential for adverse impact.
I’ve been trying to hammer for most people the main cause of poor mental health in the developed world is not lack of access to therapy. It’s poverty.
The source that you linked points out that there is no experimental data to study this because experiments are designed with a fixed duration. This seems like a serious limitation.
Someone who stays in therapy longer might have a more complex issue that they seek to address, resulting in the negative association (that is, correlation) that you mention.
But I do agree that having a clear goal is a good idea.
Please be careful about treating the findings of any study as fundamental, universal truth. Science is messy and yesterday's accepted facts often becomes tomorrow's over simplifications. And when it comes to our understanding of treating mental illness, there are all kinds of exceptions to what we "know". None of this is black and white. This study talks about correlations. What it doesn't (and can't) have is counterfactual evidence to establish causation. Would the people who went longer have had as much success if they didn't go as long? We don't get to rewind and try.
My personal experience tells me that going MUCH longer than 12-18 sessions can yield life changing results. Before therapy, I was in a very bad place, having trouble understanding why I should go on living. At one point, I found myself curled up on the sidewalk in a big city, crying in the middle of the night, unsure I'd ever make it home. I needed help and luckily I found it. In my first session, I was very explicit that I didn't want to track any goals - my high pressure job (I led a group that was responsible for a billion dollars a year in annual revenue) already had too many of those for me to handle. I was 50+ sessions and six months in before I was able to observe any benefit from therapy - my therapist could see it much earlier, but I couldn't. Six months later some brutal life events, and my way of internalizing them, put me in a worse state than when I started. I then took months of medical leave from work at the advice of both my therapist and my family doctor.
After 150-200 sessions total, over the course of 2.5 years, I finally thought to myself "I feel healthy, do I need to keep going to therapy?" The very next session, before I presented that thought to my therapist, she said "You've made a ton of progress. I'm not sure it's worth your time and money to keep talking regularly. What do you think?" Today I'm 100% clear that life is worth living. And I have a much better understanding of how to recognize when my mind is processing things in an unhealthy way and what to do about it (sometimes an ad-hoc therapy session is part of the answer.
Is it possible that I could have changed treatments / practitioners and found success more quickly? Of course! But it's also possible that I could have tried switching, picked something even worse for me, and ended up taking longer or even taking my own life. If we knew the optimal path, we'd take it from the start. But we don't. Medical science around mental health isn't even close to offering that. I'd hate for others to give up on much needed treatment too soon because they aren't seeing success in 12-18 sessions. If they have the capacity to change course, maybe that's the right thing to do. If they don't, then staying the course could be exactly what they need.
I really disagree that therapy is trying to solve a lack of community. This may work for eg depression or social anxiety. But it’s much less clear if we’re talking about trauma recovery, psychosis management, etc. a community is very rarely well equipped enough to manage all manner of disordered eating, psychosis, compulsive disorders, etc. It’s important to recognize that it can be traumatizing for an undereducated person to be thrust into dealing with someone else’s mental illness crisis!
A community member trying to play therapist doesn’t usually go well. At the same time, being part of a community seems to be correlated with significantly better well-being for people with mental illness.
Therapy and community are completely independent. Therapy might help with managing the issues caused by a lack of community, but that’s only one way it can help. Even if you have a great community life therapy can be extremely useful.
The OP’s comment is the equivalent of saying “exercise is solving the problem of drinking too much soda”. It’s not wrong. Exercise can help alleviate some of the issues caused by drinking too much soda by helping reduce your possibly associated weight gain. But that doesn’t mean that if one weren’t drinking too much soda then exercise isn’t useful.
> A therapist trying to play therapist doesn't usually go well either.
I've been in therapy for 7-8 years with 2 therapists (well, 4 but one was a couples therapist and 1 only for a few months).
Therapy(as well as age, medication, stable life, high income, me doing a LOT of reading/active work) has (mostly) cured me of BPD.
But after 1-2 year of therapy with each therapist I feel I don't get much from therapy and the therapist just uses me for a steady income.
There's so much to say about therapists, ideally they would be great and some really are, but therapists also have their own issues, in my country I know A LOT of people who study psychology and want to become psychotherapists primarily to cure their own issues. I know about 10 people that became/are in the process of becoming therapists and I'd only use 1/10's services if I had to.
I'm not saying that to bash therapists, we are all people and have our own issues and therapists don't have to be zen masters in order to help someone and you can learn a lot from different people (provided you have healthy boundaries).
Anyway, as others have said, I feel that after some point therapists get comfortable into a paid-friend role and I'm not ok with that.
Therapists aren't supposed to use you for steady income. From a good therapist's perspective, if their clients continue to need therapy, they're failing.
This is certainly a pattern that can set in (and it did last time I saw a therapist). But I do believe a most therapists start out with a good-faith intent to fix people. There's a lack of therapists and a long line of patients waiting for help so it's not like they will be out of a job anyway.
The bigger problem is that there's very little scientific rigor in what they do. They don't have enough tools or skills to actually help me, because the science isn't there yet.
> the perversive incentives make them align to just do that.
I don't think any therapist actively avoided helping me, but rather at some point they too get comfortable and sort of slack it off like "So what have you been doing/how was your week" sort of thing.
There are mental illnesses that don't go away. You can manage them with medication and therapy, so why would you expect such patients to stop going to therapy.
> Therapy(as well as age, medication, stable life, high income, me doing a LOT of reading/active work) has (mostly) cured me of BPD.
What do you mean by BPD? If it's bipolar disorder, can you expand on this? Most of these factors (except income) apply to me, and I wouldn't say I'm mostly cured. I'm much better than I was a few years ago, but I still suffer greatly from it.
Maybe, but having a friend and a bad therapist may end in dumping therapist and looking for another one, having friend as therapist for serious issues may end up in having no friend and being lonely.
I think GP had a different kind of therapy client in mind, the one who's more looking to get to better know themselves or get help figuring out their life and their struggles, but far from having their mental issues prevent them from functioning in life. In these cases, community may really help, but it may also not — communities of close people are often very good at plastering over someone's biggest and most glaring issues by either validating them or just downright avoiding talking about it. I think the benefit of a hired professional in those cases is that they can look at things honestly without the burden of social dynamics and longstanding relationships.
Community doesn't cut it. Communities judge you, they gossip about you, and they contain people who rightly or wrongly feel a sense of rivalry with you, feeling ambiguous or even opposed to you thriving. Even among your friends, some will unwisely share information in ways that turn out to hurt you, despite their best intentions.
A therapist is more like a grandparent, in a way that most grandparents can't be any longer. Once upon a time, your grandparents understood the world you lived in, or at least understood how people in your world related to each other. They understood how survival and respect and love worked for you and the people you dealt with. Virtually none of my friends could say that about their grandparents now, or even their aunts and uncles. None of my aunts, uncles, or grandparents ever lived in a world resembling mine. Everything about my life, including my emotional concerns, is alien to them.
Now, instead of talking to a relative who can't relate to your life and your concerns, or talking to friends who can't be trusted with secrets or aren't comfortable discussing the topics that are upsetting you, you can pick a therapist who understands the place and social milieu you inhabit, is bound to confidentiality, and on top of that has professional training and experience.
Sounds like you'd be a good grandparent. Maybe consider being the one to build that community, family, of understanding and acceptance first above all else.
Or, to put it in softer terms, as people become more isolated, common mental ups and downs can become more serious problems requiring medical intervention.
It’s interesting to go back to TV shows and movies from even the 1980s and 1990s and see how much bigger people’s social networks were. Like people would have regularly scheduled bridge nights with neighbors and shit like that.
TV was not reality and really really should not be an argument about how people actually lived in the past.
Signed: someone who lived in the 1990 and is living now. Someone who watched shows back then and now. Let me tell you, they are not like a real life at all.
Using fiction and media as metaphor is a sign of how mediated our existences are and, with the cooperative reality show that is social media, will only become moreso.
"It’s interesting to go back to TV shows and movies from even the 1980s and 1990s and see how much bigger people’s social networks were. Like people would have regularly scheduled bridge nights with neighbors and shit like that."
To be fair, those are TV shows and movies...not real life.
I take your point. But remember that TV shows and movies are highlighted at contemporaneous audiences. Unless they’re trying to draw attention to something out of the ordinary, the depictions of day to day life are probably going to be close enough so that at least the audience of the time doesn’t view it as unusual.
This is not true? Neither Friends nor Big Bang Theory are drawing attention to their protagonists living in massively unusual or even impossible setup. And they are as popular as it gets.
I’m not overly familiar with Big Bang Theory, but about Friends it is practically a running joke that the characters are living way beyond what people of their background could afford in new york now or back then.
Now obviously it is explained in universe (it is a rent controlled flat of Monica’s grandma), and the explanation out of universe is clear too (easier to produce the show on a spacious set, and looks better too). But it would kinda mislead you if you take it to show how a chef and waiter realistically used to live in the 90s of NYC.
Go have regularly scheduled game nights. They seem to be one of the most popular forms of meetups. The same people go every week; it's a way you make friends. Bridge might be nearly extinct, but social gaming get-togethers sure aren't.
That’s like me telling millennials “go have kids!” The fact remains that both things are far less common than they used to be and that has societal implications.
They're more common, not less. Much more common. In the time period you're talking about, the only people you'd have had bridge nights with were neighbors and family friends. Today, in a city like Chicago, you could do 5 of them per week. Things were not better in this regard 30-40 years ago; they were worse.
My neighbors and I have regularly scheduled pizza nights with the pizza oven we all built together.
It is a regular occurrence on the neighbor text thread for someone to say they are getting a settlers of Catan or ticket to ride game going. I played euchre with my neighbors last week (though admittedly it isn’t regularly scheduled).
My son plays chess with his grandfather and cousins weekly via the internet and my parents have a weekly pinochle game the same way.
I’m a member of a disc golf league that plays weekly and there is a bowling league three nights a week near me. Some friends have a weekly d&d game.
I’m having trouble thinking how any of this is different than it used to be other than some of it is available to people who are far away from each other via the internet.
Chicago. And you can just start doing this. The disc golf league didn’t exist until some friends and I built it. The pizza oven came into existence when my neighbor said “hey, want to build a pizza oven?” And I said yes.
Of course you can just start doing this, but there are a lot of real, difficult problems in the world that'd be solved if people "just start solving them."
It's good to feed into people's agency but it's bad to rely upon it.
People in the past weren't more socially connected because they had more ironclad determination to be more socially connected.
The reality is that there are lot of external factors that mediate the formation and maintenance of communities like the one you have built: physical proximity, the built environment and what activities it supports, availability of less "fruitful"/social pastimes, etc.
People are struggling with this now because these external factors have changed dramatically over the last few decades. A few exceptions here and there (and there are plenty!) does not actually stand up against a well-documented epidemic of loneliness. There is simply no evidence for the implicit claim that this trend is due to people being born with less determination to be socially connected.
There is plenty of evidence that we have built our cities (and especially suburbs) to be socially atomizing, our culture has shifted toward extreme individualism (which, unsurprisingly, atomizes), our media is now hyper-personalized which atomizes our perception of the entire world, we have significantly degraded important social institutions (nothing has filled the vacuum of religion), we increasingly prevent our children from going outside and building their own social networks, we change jobs with increasing frequency, we physically move locations with increasing frequency, so on and so forth.
I’m curious on the studies that show loneliness has increased. How was that tracked?
I’m certainly not arguing that people were more determined to be social in the past and that lonely people should just bootstrap up a community, but people met their neighbors in the past the same way you meet them now, when someone moves in you introduce yourself and invite them over for an activity.
If someone wants to go to church there is certainly nothing stopping them, I’m not religious but my brother is a pastor in a very well attended church.
Interesting re the moving rate -- it does seem I'm wrong on that; my demographic is by far the highest moving rate so probably personal experience colored that.
Yeah I'm in my 30s and I've noticed the generation above me is less awkward and the generation below more awkward.
My personal pet theory is the explosion of homework and the reduction of opportunities for kids to play together is making people awkward which makes it harder to make new connections.
> There is plenty of evidence that we have built our cities (and especially suburbs) to be socially atomizing, our culture has shifted toward extreme individualism (which, unsurprisingly, atomizes), our media is now hyper-personalized
...and all these things happened because of profit motives.
No, it's not. It's easier to find that kind of community in an urban area, not harder. People want to form communities. The more people, the more potential energy for community formation.
To be fair, you're a multi-millionaire with the luxury to afford things and freedom to schedule things without stretching thin too much. The typical person in the urban land (at least in my social circle) has trouble finding affordable childcare, which means they just can't go out at that very first step.
I'm not sure how to put this respectfully but I think you guys involved in this conversation here are all just extremely out of touch with real problems people have on a day-to-day basis.
I saw a therapist for several years and it was very valuable, so I'm not knocking therapy. Specifically I chose to see a psychiatrist who was well versed in talk therapy, not just drugs, because I think this stuff should be approached as evidence based, medical in nature, and administered by a doctor.
However, one takeaway for me was that when it comes to talk therapy, some of it is evidence-based, scientific, and backed by high quality studies, however most of what's out there is not. Cognitive behavioral therapy (CBT) has good evidence of efficacy and so do maybe a few other techniques - Googling "evidence based therapy" is a good way to start going down the rabbit hole. It's not that hard to learn how to do CBT, at first with a professional, and eventually on your own.
Once you progress past the evidence-based stuff, IMHO you're basically just talking to a (hopefully) wise friend who you trust, which is great and might work similar to placebo, but also $200/hr and has the potential to medicalize stuff that doesn't need to be medicalized, so your time and money may be better spent building connections with other people (support groups, plain ol' friends etc).
So my point here is I think as long as you understand its limitations therapy is great. If someone is unambiguously suicidal they should probably be put on drugs plus talk therapy and then weaned off the drugs as it becomes clear they are no longer a risk to themselves, since the alternative is they die.
I used to have the same opinion and found my model has shifted quite a bit. There are a surprising lack of high quality studies on a lot of this. However, there’s really good data on a couple points: Therapy is likely to create significant, lasting improvements compared to placebo, and the more significant factor is therapeutic relationship, not modality.
There’s a lot of evidence for CBT because it’s a modality that is relatively easy to study, and so it’s studied a lot. It’s very structured and designed to produce results quickly. This doesn’t mean it’s superior in general.
Chronic psychological disorders are strongly correlated with early attachment issues and adverse childhood experiences. There are many ways to address this, but I would view a successful long term therapy as reprogramming a nervous system rather than talking to a friend or building new habits. In my experience, even many therapists fail to understand this distinction. Like hiring any skilled professional, finding the right match can be a time consuming process.
> there was a solution for the problems it is trying to solve. A community. And the friends that come with it.
People who have strong community and friendships seek and benefit from therapy. Having community and friendship certainly can help navigate many of the myriad reasons that people might see a therapist for, but having them doesn’t necessarily solve those things. And the expectation that they would, or could, can be an acute burden and even sometimes a terminal strain on those relationships.
I won't say what I truly think about "therapy" as an industry, but this fact is always something that sticks out to me. Sure there are bad surgeons, but I wouldn't go into heart surgery expecting to have to try a few surgeons before they performed a double bypass successfully.
There are no objective standards in the industry. In an industry with even basic standards you shouldn't have to keep trying to find a therapist that "helps".
You've got a point, but depression often leads to isolation. One clear benefit to therapy is that – if the therapist is any good – you will get a relatively neutral, objective opinion reflected back at you. Friends, community and religious or other support systems rarely give sufficiently objective advice or a bird's eye view of the problem. It's not so much about renting a friend as it is to pay an outside professional who can hopefully give you more insight into why things are not going as well as you were hoping for. It is notoriously hard to analyse your own issues, even if you are knowledgeable about psychology or feel you have good self-knowledge.
I want to pay for neutral insight from somebody not vested in me personally.
"Life Coaching" is another service that's trying to fill this hole. It's completely unregulated, it attracts shysters, scam artists, and lots of unsavory MLM looking businesses.
Exactly this. A lot of the friends I grew up with have no interest in what I find interesting. And I don’t care much for their lifestyle of going to the same kind of club for a 100th time.
Sometimes I talk shit on here, sometimes I just talk to the AI bot. Otherwise no one wants to talk to me or cares so I am the target fool to rent a life coach or whatever just to be able to rant to another person.
The number of HR shills I use to work with are all becoming life or executive coaches. And the insane thing is ... they're getting work! You can book 45 mins for $200 so they can tell you to channel your empath or take a Myers Briggs test.
> It's not that therapy is bad (it's pure luck if you find the right therapist), it's that there was a solution for the problems it is trying to solve. A community. And the friends that come with it.
Pretty common problem people are trying to solve is "why do I always pick friends/partners that get me into trouble or abuse me" or "how do I stop repeating to others what my family done to me".
Otherwise said, for healthy person that does not need therapy, yep community solves loneliness. For people who do need it, if dont.
It’s hard to access talk therapy in Japan because drugs can be prescribed evenly to all people and the results can be measured soon after, where as therapy could take many months before there is any results and is more person specific. I’ve seen so many people I know who could have benefited greatly from a little bit of CBT but were completely unable to access it.
“Therapy” provides many modalities, and generally they are based on pathology, which I feel is very limiting when you look at the broad scope of psychological wellness. One niche which it can end up filling is that of the (paid) friend. If that is missing in your life, you now have an ill-fitting surrogate for genuine companionship. It’s really not the purpose of therapy, but it is often the reality.
While I think that close friendships are important, I feel like that still falls well short of community.
Lawyers aren’t trying to do something like “make you mentally well::make you feel better.” An attorney is hired to provide a legal service. The difference is an entire level of abstraction.
You make it sound like a therapist doesn't do any work, they just get paid to sit there and socialize. There's a huge amount of emotional labor for therapists, like building trust with people whose stories they can't naturally empathize with. A lot of people need someone to just unload on (which, incidentally, is part of trauma recovery). If you do that to your friends, time after time, you lose your friends pretty quickly. That's (among other reasons) why therapists deserve to be paid for their work.
You're right that a community and friends (really, social connections) are key to good long-term mental health. But a lot of people get into a place where they no longer have that, or the community and friends they have are detrimental to their mental health (consider: LGBT people in ultra-conservative religious communities). No therapist can replace a community and friends, but they can be that "I'm not going to give up on you" (because payment) level of "friend" (airquotes because payment) to help you find those social connections.
Having actually done the therapy thing, and summarily discontinued it; here's my observations.
1. There's no endpoint. There's always some "deeper seated something" that necessitates further sessions.
2. The goal seems to change to the current deep-seated-something.
3. Sometimes, you need drugs. Psychologists have to use techniques and talk, and psychiatrists administer drugs. However, the field has yet to combine both into effective treatment.
> it's that there was a solution for the problems it is trying to solve. A community. And the friends that come with it.
Very wrong. I have some familiarity with therapy, and in a way, community is actually detrimental when it comes to mental disorders.
Depression is a typical example. When somebody suffers from therapy, friends (community) will give all sort of cheesy advice like "relax, go out, do sports". This is detrimental because it's frustrating, but especially, because it triviliazes a serious problem (people not going to therapy because of stigma, when they should, is a real problem).
No amount of community can address a problem like depression, and this should be crystal clear.
Mental disorders, like serious illnesses, require a knowledgeable and systematic approach in order to be addressed.
Surely, modern isolation is causing mental health problems in the population, but community may be the solution to those specific problems, not to disorders in general.
> friends (community) will give all sort of cheesy advice like "relax, go out, do sports"
I get your point here, it's hard to get going with these things when you're depressed, but physical exercise is one of the only things that uncontroversially helps prevent depression.
Maybe a better way to deliver that advice would be to ask someone to come for a walk with you, or invite them to join your sports team.
I have experienced clinical depression and physical activity was absolutely 100% a critical part of both recovery and maintaining mental health. Most (but not all) people that I know who have experienced clinical depression have had similar experiences.
It can sometimes be hard to distinguish between "introvert" / "social anxiety" and "surrounded by assholes". Same with other mental issues, I think. It's often a problem in the environment!
It is definitely a cultural (environmental) problem. I wouldn't judge as assholes the surrounding people; it's just there is no education (I wasn't any different, until I had to deal with some cases) about mental health issues.
Freud stated this in his future of an illusion. The (righfull in his opinion) decline of chritian church institutions would lead to higher untreated mental illness. Though he also predicted the regression of the subconscious into a more supressed state. Leading to a society unable to deal with it in any meaningful way.
When dealing with a difficult situation, people need a combination of faith, discretion, empathy, and consistency.
Therapy is ideal for those who need all 4. Note that confessions and visits to the local astrologer also provide all 4.
Communities are essential. They provide empathy and have faith in you. Discretion can be harder to find, and consistency can be even harder....especially with the ungrounded nature of modern society. To that degree, Therapists serve a distinct purpose for the community.
The long term therapist is replacing community, but even more often, it is replacing spiritual gurus as a consistent & general purpose life guide.
People are being really hard on you, but there is truth and probably painful experience in this statement.
1) Your friends may have begun to make and spend more money than you, and you cannot participate in their activities. Many people here will say “just find new friends” not realizing how different their ages, lives and skillsets may be from yours. You only have to say no a few times before you are left out. You might even feel bad every time you turn them down.
2) You may be overburdened with work to the point where your most meaningful social connections are at work. Especially if this is a startup, if you take the night off to go drinking you might not deliver on a critical contract which may cause your work friends, who may have in the interim become your only friends, as well as you, to no longer have a place of employment.
Whatever it is I’m sorry you are going through this.
Yes. For me personally, I found the framing that “building and maintaining friendships takes time, energy, and sacrifice, but is so totally worth it for our healthy wellbeing,” very helpful to inspire me to focus on the kinds of relationships I want and justify the investment to be a better friend.
GP’s comment is a wry (“hobby”) and pithy and provocative take that’s not wrong. IMO, friends are the nutritious meal that’s more expensive than friend substitutes. GP seems to have a different conclusion on cost/benefit. But nobody can deny there is a cost!
Eating healthy food is an expensive hobby in money and time. Do it because it is important.
Spending time with friends is only as expensive as you choose to make it. Most of the time, I’m riding the bike I already paid for to a public park or to a restaurant I would have eaten at anyway.
Human social connection is a pretty critical component of a psychologically healthy life.
You don't sound like a great friend either. Doesn't make you a bad person. We don't need to be surrounded by people all the time. Maybe you are introverted like me. Just one or two people in the background is enough. Any more and it starts being a net negative.
None of my friends charge me $200/hr. Maybe you have therapy and friends mixed up? Or are your friends perhaps ladies of the night? Not that there’s anything wrong with visiting ladies if the night. I often wonder if that might be cheaper than therapy. I just worry that if they’re charging you, they might not be the most genuine of friends.
I think it is that you need to pay money to be with friends - food, drinks or activities you do together. While some groups socialize for free sitting in parks and chatting, many people do not like that. They get bored. The situation can get pretty bad if you are outlier earning less money then friends.
Friends groups centered around activity cost money to participate - whether materials for crafting, sports equipment, entrance fees, whatever. Friends groups centered around partying cost money too.
A while back I caved and asked some people I know about finding a therapist. Though, I was still very half assed about the whole idea.
I ended up giving up, because when I was looking, every therapist I could find that looked like a good fit was “not taking new clients” and the ones that were available seemed to specialize in things that were just not me.
when you call a therapist and express that you are having trouble, if they are not taking new patients they will generally refer you to someone else, and they will check in advance that the referral does have an opening. It would be highly unusual to leave somebody adrift.
It's different in Germany where you have to call around for weeks or even months to find a licensed therapist. The alternative would be to pay for one out of pocket but i don't see paying 90+€/hour as a good foundation for lasting mental change
I have only experienced it for a few sessions last summer so my judgement may not be that accurate. I didn't mean to sound so "authoritative" in my last comment. Anyway, i felt like it was putting me under a lot of extra stress, even though fortunately i was relatively well off at the time - i couldn't imagine not feeling extremely stressed out paying 90€/$ for therapy when youre already struggling to make ends meet. Seeing a regular therapist that I don't pay for (except indirectly through my health insurance, as a student around 140€ currently although it keeps getting more expensive every year) really gives me peace of mind that I'll be able to continue seeing her for the next 40-50 sessions and slowly work on lasting change.
Becoming a licensed therapist is a long and strenuous process in Germany. As a client, it gives me some peace of mind, although before my current therapist I also had some "bad" ones in the past (ones i didnt match with). As a result of this, getting into therapy in Germany is a availability issue, not a financial one, usually. Clients have to write dozens of emails/phone calls to therapists, which can be a big struggle especially considering the population we're talking about.
The process definitely needs a huge overhaul. There are a lot of willing and able prospective therapists, who can't, for example because they didn't have the perfect high school grades requored to study psychology here (unless you go to Austria, which the Austrian students understandably are a bit unhappy about), or because they can't years of expensive, badly paid training required to become a licensed therapist.
20 year zen practitioner here. Don't expect meditation or buddhism to make your problems go away. If you have an acute mental problem like depression, bipolar syndrome or are suicidal get professional help first. Then go study buddhism. Some teachers will even ask you to sign a waiver acknowledging this.
I think you start from a misconception of what therapy is.
Also, there is not ONE therapy.
CBT, which is an insufficient band-aid invented to give us practical tricks to cope with the contradictions of a capitalistic society in order to get back to being productive and “functional”, may very well fit your description. In fact it gives you tricks and homeworks you would not need if you had a community or good and deep relationships.
Psychoanalysis on the other hand is something else completely.
It does not solve you, judge you, nor offer answer.
It’s a language method for you to rearrange your internal warehouse, not by removing or adding items, but rather by rearranging what’s in there for it to make more sense.
Its not good to speak in absolutes. Therapy, and more broadly psychology, is a somewhat new invention that reflects whatever the academics at the top want it to be at the moment. Its current focus is to validate the self. The centralization and top down approach to categorizing behavior and wellness, imo, is dangerous.
Really well put. I don't like the idea of going to a therapist because I tried one once, and did not have a good experience. Yes, I could probably keep trying therapists until one clicks, but instead I decided to read up on CBT on my own.
So I have been doing "behavioral experiments" which help me challenge my irrational negative thoughts by surfacing them and then taking action in the real world to "gather evidence" and prove to myself that those negative thoughts were irrational.
It really is amazing, but the only problem with this is that you have to keep doing it and failing at it for a long time. I have given up and gotten back on it so many times, but that's the key -- to keep at it despite everything, with no excuses, for a very very long time. Expect failure, and keep picking yourself back up, again and again.
I tried this for a long time and had some success, but I was never happy with my rate of progress and it's only when I found a decent therapist who did it with me that I was able to make major breakthroughs that have massively improved my life. Absolutely, people should look into this on their own and get the process started. I highly recommend eventually supplementing the process with a therapist.
I’ve found having a human being explain to me how I’m wrong in ways I’d struggle to know I’m wrong was indispensable.
I used CBT for a few years before finding someone and they very effectively poked holes in many ideas I had about myself and the world. Nothing profound, but useful enough to help me make progress I wouldn’t have otherwise.
Individuals can’t know everything. We need other people to help bring more perspective and correct biases. It’s hard to find someone, but worth the effort if you can afford it.
She's in an upswing stage of mental energy. Live long enough and find out that these up and down swings are constant throughout anybody's life. When people are up they look for reasons and form semi-religious devotion to a pattern they identify: therapy, running, meditation, lifting weights, drugs, yoga, forming a family, you name it.
Thing is though: this too shall pass. You will go down again even though you keep doing that wonderful thing that you thought changed your life. And maybe you will abandon it, stay a year or two down, then go up again and find another thing.
My point being: the causality is often perceived backwards. You start feeling better and then you start doing a thing (or more) you suddenly have time and energy for. And as you feel better and better you point to that thing as the cause even though it's just an effect.
> You start feeling better and then you start doing a thing (or more) you suddenly have time and energy for.
But then, why even bother calling the feeling "better" in the first place if the cause is really something unknowable? Why bother calling it "better" or "worse" if there isn't anything to be done about it and it's just another phase of mental energy like clouds in the sky? Is a clear day "better" than a stormy one?
If anyone is interested in reading a fiction book related to therapy, read “When Nitzsche Wept” by Irvin D.Yalom.
> The book combines fact and fiction to imagine a meeting between the philosopher Friedrich Nietzsche and the physician Josef Breuer. In the story, Breuer helps Nietzsche with his despair while Nietzsche offers philosophical insights that challenge Breuer’s own beliefs and practices. The book delves into existentialism, psychotherapy, and the therapeutic process in an engaging manner. It provides a fictional account of the possible origins of psychotherapy while exploring the deep emotional and intellectual challenges faced by both men.
I've spent a few years in therapy with an excellent therapist who was recommended by my then-gf who was a psychiatrist herself.
I would describe it as learning how to monitor, debug, and rewrite the code that rubs in my head. By default you assume that what you think/feel is somehow objective but a lot of it is shaped by past experience etc and then you bring outdated models into your current life and it is an anchor.
why does this take a few years to figure out, or even seeing a therapist? A couple of specific books and introspection makes all those things quite obvious. Even before the giant rise of therapy, most old business and/or self help books say the same thing.
Stretching the analogy from the original commenter, the code is “in production “. It is already running, it is the conscious part of you. Reading all the self help books in the world will only reinforce the things that the system already believes and reject uncomfortable things. As for introspection, often by the time people get therapy, the processor load is already high enough that there is little room for introspection. A therapist is a trained debugger, and can help you get out of your own head and see things more “objectively”.
Also knowing is different from doing. What’s stopping you learning karate or bjj from books or even videos? You already have the hardware for it. But you need to learn new patterns, and a coach can often get you there more effectively. Also having a sparring partner is a good way to break old patterns and build new ones. Now replace karate with mental models/peace of mind etc, except now your system is not performing optimally by this point.
I have personally taken this route using mindfulness but I have a friend who recently started seeing a therapist so I can help answer this question:
- Some people just want to get straight to the point. They don't want to have to research, they might not even enjoy reading. They would just rather see a domain expert.
- Some people struggle with being vulnerable. Even around friends or family.
- Some people are not comfortable with not knowing the answer to certain questions so they never ask themselves or when they put these questions to themselves they get back toxic answers from their own mind.
- Some people are very resistant to change but understand that it is necessary.
In my case the problems were not obvious. I was enjoying my life and was professionally and dating-wise successful. So the analogy would be a system that appears to be running fine.
My psychiatrist friend made me realize there could be more. So by the time I went to see the therapist I wasn't really sure that there is a problem. They helped me see that a bunch of areas in my life were suboptimal and I was getting in my own way.
So in my case it wasn't like hiring someone to debug problems I am seeing in my system. It was like hiring a systems architect and saying "this seems to be working fine but we probably don't know what we don't know about performance" or whatever.
I’m not sure if I should leave you with a recommendation to watch Good Will Hunting or suggest that therapy can be quite different from self-help books.
> I suggest that you find a therapist you deeply like and trust
Massively hard suggestion here for many. For a lot of reasons. Nice to read the article though.
Back when I was taking coaching clients, I got "can you be my therapist" requests all the time (answer: polite no), and it still makes me a bit sad to think about the stories I heard, compared to the amazing result in the article.
Some people...well, what seems like a LOT of people, are paired up with mental health pros who are a terrible match for them, and there's not much they can do about it.
Anyway, it's good to be able to think about the unconscious zone[0] and I do admit I generally like "awareness"-style wording better than "un/sub/conscious" wording, in general. It focuses way more on the solution than the problem. But in the problem zone, the "unaware" word is not nearly as cool as "unconscious" or "subconscious."
Which, I've seen quite a fascinating range of these issues and there are even some interesting ways of deriving a given group's likely unconscious zones, a.k.a. blind spots.
0. Note, this is a high-growth study/pursuit, which means you can exhaust yourself and raise your anxiety in no time at all. Part of your body/mind will instinctively believe it is dying, so to speak, and it will react accordingly, so please be careful.
IMHO this is such a huge sign that therapy has no scientific rigor. If there was a clinically proven methodology it wouldn't matter so much who performs it. But with the therapists I've seen they all just seem to be applying their own pet theories to what's wrong instead of drawing from anything like an actual education.
Of course this means you need to try a bunch of different therapists to see which one works. It's basically random chance whether they can offer something that resonates with you. You might as well ask a Tarot deck for help.
I've just been to two endocrinologists who gave me completely different diagnosis (they said different organs are the issue) Is this a sign endocrinology has no scientific rigor?
There is another explanation for the variation in therapy: different people respond well to different kinds of therapy. And it's really hard to tease this out by doing a randomized controlled trial, so this manifests in papers showing that most kinds of therapy work equally well (but potentially on different subsets of people)
I would attribute that to incompetent endocrinologists, but it's a fair point. It could just be a lot of bad therapists and not indicative of a problem with the science behind it.
And yeah, randomized controlled trials work poorly for this field. Which I guess is an important reason why the science hasn't gotten very far.
> IMHO this is such a huge sign that therapy has no scientific rigor. If there was a clinically proven methodology it wouldn't matter so much who performs it.
Doesn’t need to mean no scientific rigor, it could be that it isn’t regulated properly. It really matters who performs brain surgery, the outcome of me performing it and a trained and licensed professional are massively different. Even if I follow the clinically proven methodology as an untrained person.
Even as someone sincerely interested in psychology as serious science, I’m not really comfortable with the idea[0] of therapy—I assume mental health treatment is what’s usually meant by “therapy”?—especially if it implies that somebody can just “tell” me what my “subconscious” is “feeling” and expect me to take that at face value.
1) A prospect of looking for a person I can trust is quite daunting if it necessarily involves sharing sensitive things with those I wouldn’t trust once I get to know them. If you have the money and the confidence required to share very personal things with four different psychiatrists, it may work for you—it doesn’t seem likely to for me.
2) Knowing my own dislike for pseudo- or cargo cult science, I foresee how we would have to spend a lot of time diving into the “why” underlying every point, and I know from experience how it’s awkward (not to mention a waste of money and time) when you have done your own research and start noticing that a professional, in fact, (A) doesn’t know something and (B) unable to admit it and do more research (made worse if that person (C) charges by the hour).
Really, I can get on board with the idea of someone telling me that I’m in denial and me snapping out of it, but assuming I can’t acknowledge that when my friends say so why would I suddenly believe a person who knows me much less and, no offence, for all I know may well be making a living doing something not very far removed from fortune telling?
Long story short, it’s likely a Bad Idea(tm) to take these matters into your own hands[0], but I instead try to educate myself on the fundamentals by reading books. Among my recent findings on this topic is Iain McGilchrist’s The Master and His Emissary, if the above resonates with you may like it too (though I’ve only recently started it, not yet halfway through). Iain is, no surprise, a psychiatrist, but with a huge lean towards neuroscience, which is a good combination that to me makes for an interesting/palatable read. Being more or less the opposite of a self-help book, it builds on analysis of fairly hardcore well-sourced research and so far I feel enabled to make my own conclusions as to how it may (or may not, yet to be seen) apply to my psychological balance (slash lack thereof).
[0] Of course, this should go with a big red warning label that *I have not tried therapy* (yet?). Don’t listen to me, probably.
It might be a helpful framing to think of handling emotions and dealing with adversity as life skills, like cooking.
There isn't one single "correct" way to cook. Most people pick up some cooking skills naturally as they grow up - from family, from friends, through reading books or TV shows. But some people grow up with parents who are bad at cooking, in an environment where most people don't cook, and they will themselves be bad at cooking as adults. If they realize that later, "How come all my friends talk about cooking rice like it's no big deal", they might benefit from taking a cooking class, or sitting down and reading a basic cookbook. It could be a "food science" book that tells you the chemistry of Maillard reaction, but it doesn't have to be. The important thing is to try out different ways to cook than what you're used to, guided by someone who is good at cooking. That will be more effective that sitting down and trying to rediscover how to make an omelette from scratch.
Most people are getting by with their normal cooking skills, but everyone who could probably discover some ways to improve by watching a cooking show, or taking a cooking class. We could consider teaching more cooking in school to make sure everyone knows some minimum amount of cooking to get by in life.
Nice analogy, and there’s similarity between cooking and mental health care in how either can probably be explained quite formally at low levels, but the rabbit hole is so deep that to get any real-life utility in reasonable timeframe it seems like you just have to give up theory and follow some guidance or recipes.
Which I don’t mind, generally (discovering and applying meditation or other therapy techniques). What I mind about typical “therapy” as described here is that consulting someone, unlike with cooking, seems to require disclosing a lot about yourself to a person whom you probably don’t have enough information to determine the skill and depth of until after that disclosure has happened.
Plus, I suspect if you become sufficiently interested in how cooking works, you are not going to be satisfied by recipes or just-so advice. You’d be curious to know the why.
One alternative viewpoint for understanding why therapy is so effective for mental health issues, goes as follows:
Humans evolved in closely knit groups, where social relationships were extremely important. Good, close friendships were essential for survival. Humans evolved to innately feel better, when they feel that they have formed a close bond with another person.
Common Factors Theory posits that successful psychotherapy needs: alliance, empathy, genuineness, affirmation...
The school of the psychotherapist is not relevant(!), it's much more important that the patient and therapists are a "good match".
Having this viewpoint makes psychotherapy more understandable, and also explains why depressed people can't just read psychotherapy books and self-heal.
As a counter-example, one can read sources that provide logically coherent reasoning/research into how humans require human interaction and “self-heal” by exposing oneself to more of it.
Which, in fact, I have done and I do. (I am also somewhat fond of the “recursion” theory of self-awareness, in which modeling humans around us requires us to create a model of ourselves within their model, and which more or less requires other humans for human consciousness as it is generally understood to even occur.)
You could do a lot of good therapy around your boundaries of disclosing vulnerable information with a stranger. A good therapist, and the right therapist for you, would support you in not disclosing more than you’re comfortable with.
The cargo cult science part was and is a big concern of mine as well. In practice it hasn’t been much of an issue. Yoga or music is another analogy for this — the theory isn’t nearly as important as the experience, and a lot of this eventually comes down to something more like practice and intuition rather than theoretical models.
I live in a country where there’s a lot of stigma about therapy, but I really loved my experience with it.
In my first session I discovered a huge sticking point of mine. I go and do something for self-care like gym or a massage, but the entire time I feel guilty because my wife’s home with kids.
It was obvious when I realised it, but it happened for years prior.
Niw my experience during these activities js so much better.
P.s. Whenever I see a headline with all lower case letters I immediately like it more. Lol
... Knowing that you're not alone can reduce stress (tension in your mind between what you think are the expectations for you versus what you actually would prefer) which has been distracting your thinking and creating discomfort.
Loving oneself, and improving / impacting your relationship with Yourself, can Open up a pathway to developing and using skills to connect with other people, helping them become more expressive.
Ultimately I find therapy helps provide additional mental freedom, allowing stronger self-assertion.
The article is exaggerating to make a point. It is usually, or almost always, true that people around you know more about what you should do in such situations than you do.
> people around you know more about what you should do in such situations than you do
Nobody knows the entire story of what you're going through better than you. People around you know bits and pieces. They do not have the time and energy to devote to your problems, they are making quick and dirty judgments. The often suggest something you've already tried. Or a solution they think solved a problem of theirs that superficially resembles yours. Or just what the current culture generally accepts.
And since we're talking psychology here I'm gonna go ahead and be keyboard Freud: saying that everybody knows better than you is just your low self esteem talking. I would have had a miserable life if I went with what people around me thought I should do.
therapists IMO is a paid "listening as a service". but many therapists won't have the necessary life similarity overlap to truly listen.
this is esp true for individuals who end up needing therapy b/c they think in ways that are not aligned with society.
so most therapists teach coping mechanisms to fit in more w/ society so that it becomes a source of support vs judgement. it's a nice and controlled "lobotomy" of the parts that "should" be excised.
vs the "integrate the shadow/subconscious" stance which believes that these parts cannot truly be excised and instead are suppressed instead of integrated.
This is a large part of why you should shop around for your therapist. I’m currently seeing a psychiatrist that also offers talk therapy, and we have similar backgrounds and life experiences, but he’s about 15 years ‘ahead’ of me.
I’ve made more actual progress and seen more genuine peace in seeing him for 6 months than I did in years of therapy prior. And as you said, a large part of it for me was “I can’t change this about myself, but I know it now and can consciously work around it and communicate my needs better to those around me” and that alone has been immensely positive for me.
There are undoubtably many cases where therapy is needed to help someone who is stuck, or so badly hurt or damaged they really need some one elses help to get past where they are at..
But, TBH, my experience is that in a fair few cases therapy is for people that just can't be honest with themselves.
Therapy is no more a monolith than medications in general are a monolith. Different therapies do very different things, just as different medications do different things. I don't even see where this article mentioned what kind of therapy is done: is it counselling? CBT? DBT? Behavioural therapy alone? Depth psychology? Psychoanalysis? MBSR? Without this information, it's as useless as saying "Prescription medication as a way of treating your bacterial infection"
Of course, many of the things they're saying here absolutely do not apply to all kinds of therapy.
I think this is going to be one of the important uses of AI -- therapy bots. Just having someone to seem like they're listening (ELIZA was kind of on to something -- but this is the chance to actually have meaningful interaction rather than just conversational tricks).
I hope it’s not. I think we need people to connect directly with one another, not move further away from doing so. If in our more intimate moments we’re interfacing with machines, I have the sense that we will be losing more than gaining something.
> But if you have a good therapist, they’ll find a way to slowly but firmly explain to you what your subconscious is telling you over weeks and months and years.
People are turning this into a religion and need to come clean about it. The language is almost identical, except they've replaced the word "God" with the word "subconscious". What's actually going on is eerily similar
To my ears "aligning" sounds New Age-y. Similarly, "subconscious" is an abused cultural meme. So I can see where the OP might be coming from. But in the context of the article the meaning seems to be improving self-awareness and self-reflection.
This makes us engineer types vulnerable to the irrational nature of people. We try to make sense out of irrational behavior and choose wrong partners or company due to it. We try to apply logic where logic is controversial. An OCD sufferer can clean their hands five times every time yet their teeth are rotten. We try to look and look to a person realizing their illogical ways and we suffer unimaginable amounts while waiting.
Can a therapist become your friend and go with your to visit your parents on Thanksgiving?
I lean more on the external world than the internal world on my quest to understand my own behavior. After all, I always eat before going shopping at the grocery store and is no coincidence that that I am surrounded by palm size candy less than 12 inches away from me at the cashier.
I like this notion of therapist as facilitator. It’s not really been the majority of my experience with mental health professionals. The prevailing attitude seems obsessed with pathology and normalcy.
It's wild how people don't acknowledge the subconscious mind or care to examine or experiment with how the conscious and subconscious mind interact. Even subconscious is a bad word for it. Outer conscious would be better.
I'd call the conscious the "outer" and the subconscious the "inner". It's hidden inside the black box. See also the structure of the brain (neocortex is on the outside, built on top of the other layers).
Why would you call the conscious the outer though if the conscious does not directly experience what we refer to as the external world? i.e it appears to be filtered through the subconscious.
My mental model is that the ego is a shield that separates the space of thought into subconscious and conscious parts, and it moves its boundaries to draw shadows (in the Jungian sense) around parts of the subconscious for the purpose of self-coherence and self-preservation.
Would it be fair to say that according to your mental model it casts a shadow on those parts but reflects light other parts?
As a side note I'm both amused and curious why my original comment currently has negative votes. I would think that there would be many people here that share that sentiment though I guess some people find it scary to question the nature of reality.
But I will say this. As people are becoming more lonely in a crowd, as they can't silence the noise in an empty home, as they can't find someone to listen to them even when they surrender, therapy will be the only outlet. You often see the cases in japan where people rent friends.
It's not that therapy is bad (it's pure luck if you find the right therapist), it's that there was a solution for the problems it is trying to solve. A community. And the friends that come with it.