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Show HN: Former tech journalist, now therapist--“What Is Therapy? FAQ”

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“What Is Therapy?”

Easily answered -- therapy is when you have to pay someone to be on your side.

It's not at all that. First of all, a good therapist will challenge their client to get out of their comfort zone and do things they would otherwise be uncomfortable doing. Second, you don't have to do anything as an adult, let alone pay someone.

What therapy is is a professional service. You go to a lawyer because you do not understand the law, and either have a problem now or wish to avoid problems later by changing your behavior. You go to a doctor because you do not understand your body, and either have a problem now or wish to avoid problems later by changing your behavior. You go to a therapist because you do not understand your unconscious, and either have a problem now or wish to avoid problems later by changing your behavior.

The main difference is that most people in developed nations today understand that they do not know know the law and do not understand the intricacies of their body. The idea that we don't understand our unconscious is a much newer development, and it's still very disquieting for most people. We'd like to believe that we are consciously aware of everything we do - but there's ample evidence that that's not the case, and people sabotage themselves without understanding that's what they're doing all the time.

@nostrademons, thank you for your perceptive and reasoned response. In my opinion, you don't have to bring the unconscious into your formulation. In fact, most of the therapists practicing today never utter the word "unconscious." To invoke the difficulty of understanding human behavior, one needs to go no "deeper" (for example) than the influence of events in early childhood (attachment theory), the imperfect thought processes of a human brain that has evolved over time (cognitive distortions), the fact that behaviors that are practiced over time become easier (neuroplasticity), or what we know about how traumatic experiences affect one's later life.

I would complete your "You go to a therapist..." sentence with "...because you're smart enough to understand that you don't know everything about your own complicated life, and you want to get the assistance of someone who is professionally trained in understanding human experience and helping people make and implement healthier choices in their lives." It's not voodoo--it's someone who knows the territory helping you get to your chosen destination faster.

And what does it mean to be professionally trained? Well, read my article for details. But I'll summarize: at minimum, a Masters degree in Counseling Psychology (3-4 years) and 3,000 hours of "supervised practice." In my case, that was 1,700 hours actually working as a therapist (seeing clients), maybe 1,500 hours of professional supervision while doing that work, over 100 hours of my own therapy, plus attending trainings, workshops, etc.

Who am I? I have an ancient Masters degree in computer science, I wrote for BYTE magazine (the first major computer magazine), I worked for Apple and a pre-IPO startup in Silicon Valley, and I program (badly) in Clojure. Because of my own therapy, I went from being a maladjusted, terminally shy young adult to being a therapist. I know that therapy can work wonders--if you're willing to do the work.

Thanks for listening.

What therapy is is a professional service.

If therapists were professionals, they would respond to their professional societies by abandoning discredited therapeutic methods. But they won't do this. Asperger Syndrome (AS) caused an epidemic of phony diagnoses, after which the professional societies responded by voting AS out of the new DSM, but therapists are ignoring them and continuing to diagnose and "treat" AS, more than a year after the handwriting appeared on the wall.

It's the same with Recovered Memory Therapy -- therapists are free to offer it to their clients, more than a decade after this phony therapy created what insiders call a "debacle" and a huge decline in public trust in therapy as a profession.

People who ignore their professional societies aren't professionals.

You go to a doctor because you do not understand your body, and either have a problem now or wish to avoid problems later by changing your behavior. You go to a therapist because you do not understand your unconscious, and either have a problem now or wish to avoid problems later by changing your behavior.

Your effort to compare therapy to sciences like modern medicine has been contradicted by the NIMH, which recently ruled that the DSM, therapy's "bible", may no longer be used as the basis for scientific research proposals, for the simple reason that it has no scientific content:

http://news.sciencemag.org/2013/05/nimh-wont-follow-psychiat...

Therapy is not a science, and it is not a profession. Therapy is to modern times what an aging aunt on a porch swing was to an earlier time -- a way to derive benefit from ordinary conversation. Notwithstanding the benefit people derive from therapy, all this talk about it being a scientific profession is nonsense, something now widely recognized.

@lutusp, I'm sorry for whatever experiences have led you to such a negative opinion of therapy; I'm sure you have very valid reasons to feel that way.

You're right, therapy is not a science, but it is doing its best to learn as much as possible about the human condition and to apply what it has learned to improve human lives.

In its defense, it's barely over 100 years old. Where was physics 100 years after its origins? Chemistry? Medicine? When therapy started, all Freud and Jung had to work with was observation of a person's visible and verbal behavior...and dreams. They did what they could with the tools that were available. Since then, we have roughly a century of observation, as well as research that has attempted to be as scientifically rigorous as it could be. And in the past 20 years or so, we've finally gained the first handful of technologies that have given us some basic data about what the brain is actually doing. We're still just beginning.

Here's what we're up against. The human brain is the most complex system in the universe, a crazy quilt of impulses that has accumulated from the blind forces of million years of evolution. Can you imagine how difficult it is to design an experiment that controls for unwanted factors? Now, add in the restrictions dictated by ethical concerns and the unimaginable range of human behavior. Is it any wonder that progress is so slow?

So, given how little we know, by what right do we presume to practice? You could ask the same of a physician from 200, or even 2,000, years ago. The answer would be the same: "Because people are suffering, and we have things we can do that have a good track record of reducing that suffering."

As a therapist, I am doing more than providing "benefit from ordinary conversation." See my reply to @nostrademons for details. It is well established, through numerous studies across the last 70 years, that measurable benefits are to be had from talking to a therapist who is non-judgemental, who communicates back to you an emotional understanding of your experience, and who is there to provide--as much as is humanly possible--unconditional support for you in your situation.

Changing human behavior is very, very difficult. But it can be done, and therapists of all sorts--psychiatrists, psychologists, social workers, marriage and family therapists, and other licensed counselors--have valuable skills to offer.

Thank you for listening.

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