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Comment by ben_w | Hacker News Reader

I suspect* that every school of psychotherapy represents a different internal configuration that human brains are capable of being in.

Perhaps just as some but not all of us are aphantasic, some but not all of us may think in the IFS way, or Jungian, or Freudian.

* from my comfortable armchair, don't read too much into this

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Most schools of psychotherapy are equally effective, with the very notable exception of CBT for anxiety disorders. For most patients, the school of psychotherapy only matters insofar as they buy into it - nearly all of the therapeutic benefit is totally independent of the particular methodology or even the training and experience of the therapist. Even therapeutic approaches specifically designed to be pure placebo turn out to be just as effective as everything else. If IFS or Freudian psychoanalysis are metaphors for how we think, then they just aren't useful metaphors.

https://en.wikipedia.org/wiki/Dodo_bird_verdict

https://psychiatryonline.org/doi/10.1176/appi.psychotherapy....

This just isn't proven at all. And likely untrue. There is a reason the dodo bird effect is controversial.

1. Most therapies have not received the number of RCTs as CBT so it's not possible to make statements like the one you made.

2. There is wildly varying quality in therapists and the quality of the therapeutic relationship is widely accepted to be centrally important to treatment outcomes. It is thus much more likely that a good therapist with a shitty tool is better than a bad therapist with a good tool. Averaged out, this would explain the same effect.

You've inverted the burden of proof. If someone dreams up a new kind of therapy, it's their job to prove that it actually works; they can't just assert that it works based on anecdote. I'm flattering those relatively-untested therapies by assuming that they're all equally effective. In any case, the effect size over pill placebo is extremely small (again, with the honourable exception of CBT for anxiety disorders).

I can't tell from either of your comments whether you're saying CBT has proven itself or falls short of the others. Just that it's different.

I would tend to agree with you here, with a caveat.

All these theories are describing the same underlying phenomenon so there is a "blind men and the elephant" effect. They also substantially build on one another

The caveat is that what really sets these models apart is how they propose to navigate the mind. This is where I believe IFS stands out. But it would take a much longer comment to explain that. Maybe it's worth writing an article about.

I've come to the conclusion that psychodynamic therapy is harmful for neurotic depressives like myself. Dwelling in my neuroses enhances them.

I wish there was a triage psychiatrist I could see that would help me identify the most effective type of therapy for my situation and then help me find a therapist.

Well, some of these schools are also just plain bullshit.

I would hesitate to say bullshit. They are all models and very abstract relative to the complexity of the mind. But to extend the blind men and the elephant allegory, there is a practical difference between describing a leg and describing a trunk.

and some say elephants don’t exist because they can’t see one.

To strain the metaphor: there are many true stories about elephants, but not all stories about elephants are true.

yes, and much of the criticism as well: it's called being humans

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