Comment by zeroq

Yeah actually I don’t need to be in agony or improve my outlook at all or even understand my motivations for my own actions to be happy. I needed real medical care. Therapists think pain can teach you to accept something, but true pain, it can’t teach you anything. It only makes you a worse person. There’s no possibility for the rationalization of true agony. Attempts to do so simply lead to worse, more dangerous mental problems.

The majority of people are tourists in the world of pain. They enter, make observations, then exit, assured that they had a harrowing experience. But for those of us who are residents in the city of pain, we know it stinks and it will grind us down until we become evil people. We are stuck there due to some kind of undeserved poverty which is not within our power to control. No amount of compromise or contemplation can escape you from a physical prison. It’s a cage that exists inside you rather than around you and it does nothing to shake the bars other than annoy the tourists who gawk as they pass by.

I know that’s pretty dark, but people simply will never acknowledge that life long happiness is somewhat dependent on luck. It would likely cause society to fail if the lucky people realized evil people were actually equally self aware but just fundamentally less lucky and under the influence of random inexplicable pain, that’s just a result of human biology. People just reject this idea even though it’s obviously true. Therapists simply don’t understand this simple fact because it’s not their job, they are there to guide the tourists.

> me telling you just isn't going to be internalized the same way

Sometimes, you need to be pointed in the right direction (or even told they exist). All the self-searching won't do any good if you're continually looking in the wrong places.

The therapist should at least be engaged in the session and actively listening - if they're just scrolling through their phone, find a different therapist.

But if you've been to 11 therapists and none worked, the problem is probably not all 11 of the therapists.

You have to be at least engaged in the session and actively introspecting too. If you're not curious about where your issues stem from and willing to try some (oftentimes difficult) approaches to dealing with them, the therapist isn't going to be either. They'll happily take your money and give you their time, but there isn't anything to work with to get better.

Some people just need a wall to talk to, to be fair.

That’s also a misrepresentation of what happened for many of us when we did therapy though. You have to want to change badly enough that you’re willing to try things. It’s not enough to have a vague sense that there’s something wrong. It has to be crystal clear to you that you need to change somehow.

There’s no silver bullet. Only a lot of flailing around and unmaking patterns that don’t work and sometimes patterns that did work.

>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.

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

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.

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.

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.

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.

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.

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.