Comment by alexashka | Hacker News Reader

Comment by alexashka | Hacker News Reader

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In therapy, you are unconditionally accepted with positive regard, which facilitates viewing yourself more clearly without the need to lean on self-defeating coping mechanisms, like self-pity or shifting blame. As social creatures we instinctively perform a lot of mirroring of others' mental state, so simply by being accepted we are able to try on what it is like to accept ourselves.

This is the most succinct description of a positive human relationship I've ever read. It does lack a feedback mechanism for correcting destructive behaviour however.

A danger one can fall into with therapists, is that therapists have a self-interest in you coming back and/or giving a positive referral. If the therapist has that self interest in the back of their mind, they can avoid pushing you out of your comfort zone and/or enabling unhelpful patterns in order to get along.

Absence of pushback is something beautiful/rich people often experience - because others see them as a valuable asset, they optimize for maintaining the relationship, even if the person is being self destructive in the process. This is why drugs are such a problem among them - it is costly to tell them they have a problem and so beneficial to benefit from their weakness in your favor until the wheels come off.

"therapists have a self-interest in you coming back"

Just a single data point counter to this:

I had a therapist with whom I had a good relationship and who I'd seen for a long time who suggested that I find another therapist because we weren't making progress. I was reluctant to do so and we continued for a few more months when once again they suggested I find another therapist for the same reason, at which point I did leave and sought out another therapist (who was completely unrelated to this one, so there was no referral or kickback).

If the therapist was motivated purely by self-interest they could have easily not have pushed me away, twice, and continued to have me as a loyal client. Instead they asked me to go see another therapist, for my own good.

So, yeah, some therapists actually care. You have to find the right one, of course.

At least in SF any therapist worth their salt usually has a waiting list. Demand for services far outstrips supply. Even if they didn't care, they really have no vested interest in you coming back because there is a line of twenty people right behind you waiting to get in.

This is true of any profession.

LeBron has a waiting list of teams that'd love to have him. What about the bench players that make up >50% of the NBA? Does the demand for them far outstrip supply?

Chances are, you're not seeing the LeBron of therapy, you're far more likely to be seeing that bench player who is worried he's going to get cut.

> A danger one can fall into with therapists, is that therapists have a self-interest in you coming back and/or giving a positive referral. If the therapist has that self interest in the back of their mind, they can avoid pushing you out of your comfort zone and/or enabling unhelpful patterns in order to get along.

This is an example of a pattern I see everywhere now that I look for it. I think of it as the junk food metaphor. There are many products/people/experiences/ideas/relationships that make you feel good right now but later leave you feeling even worse than before. Every time I eat McDonald's, halfway through that double quarter-pounder with cheese I find myself thinking "This is so fucking amazing. Why don't I eat this everyday?" Ten minutes later, when my stomach feels like I took a punch to it, I remember the answer. McDonald's is good to me, but not good for me.

I think a lot of therapists are like that too. They are unconditionally kind and you get an hour to talk about nothing but yourself. You can walk out feeling amazing. But did you leave with any tools? Did you get any closer to solving the mental problems that hold you back? Often, the answer is no.

I'm lucky that the therapist I found strikes a very good balance of being short-term good and long-term good. When I'm really struggling and in a rough spot, he focuses the session on easing my pain right now. But when I come in and things are going OK, he says, "OK, now is a good time to try to work on some of those deeper problems." Then he'll ask a series of probing questions that turn over dark patches of my psyche I've been afraid to look under.

I leave those sessions with sweaty hands feeling like I got a root canal and a math test at the same time. Those sessions aren't good to me. But over the next couple of weeks, I start to feel like an abcess has been drained. Those sessions are good for me.

These days, a big part of life for me is finding the right balance between short-term and long-term benefits. I've erred too far in both directions and ended up miserable, but there does seem to be a sweet spot somewhere in the middle.

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