Therapy isn't fixing America's mental health crisis(time.com)
time.com
Therapy isn't fixing America's mental health crisis
https://time.com/6308096/therapy-mental-health-worse-us/
111 comments
> the "I hope you are in therapy" stated expectation went from 0 to every-other-profile almost overnight.
Wait, what? Could you expand on this? I don't use these apps, so I wouldn't see this trend myself. But I hear plenty of therapy-speak elsewhere, so I'd believe it.
Is the idea that they honestly want a potential romantic partner to be undergoing therapy? Is the theory that this will make the person a better partner? Or is there some horrible idea like it'll reduce the amount of "emotional labor" they have to perform in the relationship? What's the underlying worldview?
Wait, what? Could you expand on this? I don't use these apps, so I wouldn't see this trend myself. But I hear plenty of therapy-speak elsewhere, so I'd believe it.
Is the idea that they honestly want a potential romantic partner to be undergoing therapy? Is the theory that this will make the person a better partner? Or is there some horrible idea like it'll reduce the amount of "emotional labor" they have to perform in the relationship? What's the underlying worldview?
My most charitable read of that trend is the narrative that everybody is broken and traumatized and if they're not in therapy then they're in denial about their unaddressed issues, and a therapist is the only person who can truly fix you before you bring those issues into a relationship.
I'm quite confident that this isn't a thoroughly examined belief for most people espousing it, it's a meme that's supposed to show sophistication as a partner.
I'm quite confident that this isn't a thoroughly examined belief for most people espousing it, it's a meme that's supposed to show sophistication as a partner.
I was a psychology major in college. In one of my smaller seminars, we had a research psychiatrist come in as a special guest one week. He told us that all the evidence showed that the effectiveness of therapy has no correlation with the training (or lack thereof) of the practitioner. The only factor was the empathy score of the therapist.
I have seen a few therapists over the years, but that always stuck with me. I'd take good conversation with a trusted friend or family member over a therapist any day. It might even serve us better to do away with the credentialing process altogether and sort of lift the veil on actually what happens in therapy.
The one really great therapist I had didn't even "do therapy" but instead helped with all sorts of practical advice when I was navigating a complicated divorce.
I have seen a few therapists over the years, but that always stuck with me. I'd take good conversation with a trusted friend or family member over a therapist any day. It might even serve us better to do away with the credentialing process altogether and sort of lift the veil on actually what happens in therapy.
The one really great therapist I had didn't even "do therapy" but instead helped with all sorts of practical advice when I was navigating a complicated divorce.
I agree that empathetic, compassionate human connections are way more useful than therapy is GENERALLY. (Therapists that function in an occupational manner, such as doing exposure therapy, DBT, EDMR, etc is different and I do not want a trusted friend to do any of that to me!)
I however would push against doing away with the credentialing process. You can threaten an abusive/shitty therapist with losing their license. There are plenty of absolute quacks, especially religious-specific therapy, and being able to say "do not associate me with these dumbfucks" is important. [It's not uncommon for religious counseling to discourage reporting rape or child abuse!]
I however would push against doing away with the credentialing process. You can threaten an abusive/shitty therapist with losing their license. There are plenty of absolute quacks, especially religious-specific therapy, and being able to say "do not associate me with these dumbfucks" is important. [It's not uncommon for religious counseling to discourage reporting rape or child abuse!]
To me, the two have served a similar but non-overlapping function. There’s stuff I’ve find a lot easier to bring up in therapy, or bring up in therapy and then talk to friends about when I feel more comfortable.
Priests do not need to be credentialed in counselling. I wonder how this affects things?
If empathy scores correlate better with therapy effectiveness than training, does the existence of a mental health crisis suggest a general decrease in available empathetic interlocutors throughout society? Are people having fewer empathetic relationships or encounters in their daily life than in the past?
>If empathy scores correlate better with therapy effectiveness than training, does the existence of a mental health crisis suggest a general decrease in available empathetic interlocutors throughout society?
I think that's a great insight which tracks well to my anecdotal experience from the last 10 years.
Dating apps have turned potential partners into Pokemon on your phone to be collected. Doordash has stripped delivery drivers of all humanity and abstracted them away into mindless automata. Social media has gamified and commodified outrage and hatred on a global scale. At every corner you look today, the bonds of human society have been disolved and replaced with pay-gated third party API calls. And this mindset has extended like a cancer to all aspects of life. Even "therapy" itself conforms to this. What was once something relied upon friends and family has been outsourced to the "heres my money, now fix my problem" mentality.
Corporate greed has effectively atomized us in a way that 20th century totalitarian states could have only imagined. And once we've been atomized, it becomes trivial to sell basic human experiences back to us in a nice neat package. Empathy becomes just another service you can summon with your phone, so why bother practicing it?
I think that's a great insight which tracks well to my anecdotal experience from the last 10 years.
Dating apps have turned potential partners into Pokemon on your phone to be collected. Doordash has stripped delivery drivers of all humanity and abstracted them away into mindless automata. Social media has gamified and commodified outrage and hatred on a global scale. At every corner you look today, the bonds of human society have been disolved and replaced with pay-gated third party API calls. And this mindset has extended like a cancer to all aspects of life. Even "therapy" itself conforms to this. What was once something relied upon friends and family has been outsourced to the "heres my money, now fix my problem" mentality.
Corporate greed has effectively atomized us in a way that 20th century totalitarian states could have only imagined. And once we've been atomized, it becomes trivial to sell basic human experiences back to us in a nice neat package. Empathy becomes just another service you can summon with your phone, so why bother practicing it?
I hung and agreed on every word but specifically;
> Empathy becomes just another service you can summon with your phone, so why bother practicing it?
Yikes. So true.
> Empathy becomes just another service you can summon with your phone, so why bother practicing it?
Yikes. So true.
It might be. And as people get more and more lonely, the problem gets more serious, as statistically speaking the amount of empathetic interlocutors you meet decreases.
From my experience, the people who have therapists tend to either be far from family, not close with family, and/or from a dysfunctional family.
In a statistical sense, the role of the family therapist was probably traditionally filled by women - but now those women have real jobs - and the family doesn't have a part-time therapist as available anymore (on average).
At least in my family - it is astounding the difference between my grandmother and her daughters.
Anecdata of one family. My Grandma was a legendarily empathetic. Maybe no one could fill her shoes?
But it seems like especially tough shoes to fill when you already have a full-time job...
In a statistical sense, the role of the family therapist was probably traditionally filled by women - but now those women have real jobs - and the family doesn't have a part-time therapist as available anymore (on average).
At least in my family - it is astounding the difference between my grandmother and her daughters.
Anecdata of one family. My Grandma was a legendarily empathetic. Maybe no one could fill her shoes?
But it seems like especially tough shoes to fill when you already have a full-time job...
I would have guessed church and related groups but if you want to make it gendered...
Why not both
US mental health crisis is 100% driven by systemic lack of empathy. Makes sense it’s not getting better.
Jpow and corporate are coming for worker gains.
Climate change is waved off as a subjective mental illness.
Religious and secular toxic positivity crackpots demand we all smile and express nothing but happy thoughts lest we hurt their fee-fees.
“Experts” like Haidt blame social media, not the world teens see via social media; ossified minds of leadership chant the same old catechisms screwing the kids futures up. What teen girl wouldn’t go bananas as her body starts buzzing with hormones driving her to procreate given the obvious uncertainties.
The demand to exist in a cognitive dissonant state is only getting worse.
Jpow and corporate are coming for worker gains.
Climate change is waved off as a subjective mental illness.
Religious and secular toxic positivity crackpots demand we all smile and express nothing but happy thoughts lest we hurt their fee-fees.
“Experts” like Haidt blame social media, not the world teens see via social media; ossified minds of leadership chant the same old catechisms screwing the kids futures up. What teen girl wouldn’t go bananas as her body starts buzzing with hormones driving her to procreate given the obvious uncertainties.
The demand to exist in a cognitive dissonant state is only getting worse.
I'd like to believe that a therapist, unlike a good friend, would know the difference between well-meaning advice and good advice. Because I can give the former, but I'm not sure about the latter. A therapist should know better, if only due to the number of times they saw the effects of suggesting A instead of B.
I'd say it's not even about giving advice, just listening can make wonders. As a side note, any advice from a therapist is a slippery slope and they tend to avoid it, rather make the patient discover what they need by themselves and not impose something externally just because they're their therapist. (With some notable exceptions, e.g. in CBT.)
A lot of what passes for therapy could probably be done cheaper by going to a confessional and telling a priest.
CBT seems to have some scientific research backing it but I’m skeptical.
As they the jokes go most psychologists study it, trying to understand their mental health issues and most studies are done on psychology students students.
CBT seems to have some scientific research backing it but I’m skeptical.
As they the jokes go most psychologists study it, trying to understand their mental health issues and most studies are done on psychology students students.
Going to a priest may be cheaper, but when they say to "go to god" instead of to the police when reporting rape and abuse, it becomes quite costly.
Pre religion: shaman, witch doctor, priest confessional, pastor guidance
Post religion: therapist, self improvement , life coach, lifestyle guru.
Post religion: therapist, self improvement , life coach, lifestyle guru.
Priest and confessional is probably cheapest option still. The things those people have to hear probably matches most therapists.
Yeah, they may be great for empathy, but not so much for advice.
depends on what for. someone above mentioned studies that show the professionalism of the therapist doesn't really matter relative to empathy.
like sometimes you just need to unload to someone who will listen and help you talk through issues.
like sometimes you just need to unload to someone who will listen and help you talk through issues.
I really jive with CBT methods. Unfortunately, health care allotments even for the otherwise securely insured is VERY limiting. After my initial three visits, I had to start ponying up. After a while whether it helps or not it becomes part of the same calculation most middle and lower class americans have to make when it comes to bills/utilities/food vs "niceties" ie our health.
I tried therapy a few times, at the insistence of several friends. After 3 platforms, and 7 therapists, I've decided its a complete waste of time. I'm not 11 and require someone telling me things I can find in a dollar bin self-help book at $100 per 30m.
I'm mildly convinced that therapy is another big-pharma conspiracy to pay for services that are worthless.
I'm mildly convinced that therapy is another big-pharma conspiracy to pay for services that are worthless.
The thing I don't understand about therapy is that there's no amount of self-inflicted problems you can have that therapy couldn't tell you is someone else's fault.
Think of the worst person you can imagine in your persona life, who goes around causing problems for other people and then complaining that "everyone's an asshole." That person can go shop around for therapists until they find one who reaffirms all their beliefs that other people need to change for them. And I don't think it would be wild to assume therapists like that will receive the highest praise for their work, as opposed to the ones who tell you to fix something about yourself, which many people will take as a personal attack.
If someone can't fix their own problems so they're seeing a therapist, how can they be trusted to select a good therapist for themself? It seems like the whole concept of this system actively incentivizes bad therapy and externalizing blame.
Think of the worst person you can imagine in your persona life, who goes around causing problems for other people and then complaining that "everyone's an asshole." That person can go shop around for therapists until they find one who reaffirms all their beliefs that other people need to change for them. And I don't think it would be wild to assume therapists like that will receive the highest praise for their work, as opposed to the ones who tell you to fix something about yourself, which many people will take as a personal attack.
If someone can't fix their own problems so they're seeing a therapist, how can they be trusted to select a good therapist for themself? It seems like the whole concept of this system actively incentivizes bad therapy and externalizing blame.
Great comment!
I can empathize with this, however, I think it's worth pointing out that the value of therapy does not lie in the insights that are communicated. Even if they weren't in self-help books, you could in theory just go read the textbooks that therapists do.
The value I have found in it is in actually spending time talking about my emotions, with a reasonable human being, and receiving reasonable reactions. It's a chance to build "reps" in emotional intelligence that are otherwise scarcely available in regular life (mine, at least.)
It's like working out. Sure, you can lift buckets of sand in your garage and get strong. People still go to gyms and hire personal trainers.
The value I have found in it is in actually spending time talking about my emotions, with a reasonable human being, and receiving reasonable reactions. It's a chance to build "reps" in emotional intelligence that are otherwise scarcely available in regular life (mine, at least.)
It's like working out. Sure, you can lift buckets of sand in your garage and get strong. People still go to gyms and hire personal trainers.
> It's like working out. Sure, you can lift buckets of sand in your garage and get strong. People still go to gyms and hire personal trainers.
The personal trainer metaphor is one I used when trying to convince a friend (we're both Iraq veterans) to go to therapy.
Something to the effect of: "it's like personal training, they're there to respond and push you, but ultimately you're doing the work and making things happen. sometimes you need someone to push you hard, sometimes you need a soft touch, and sometimes you need someone to just check your form or get you to do different exercises."
The personal trainer metaphor is one I used when trying to convince a friend (we're both Iraq veterans) to go to therapy.
Something to the effect of: "it's like personal training, they're there to respond and push you, but ultimately you're doing the work and making things happen. sometimes you need someone to push you hard, sometimes you need a soft touch, and sometimes you need someone to just check your form or get you to do different exercises."
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Why would big pharma want you to spend money talking to someone instead of buying their drugs?
Who is going to prescribe the drugs?
A psychiatrist, not a therapist.
therapists dont prescribe drugs
But what was the mental disorder you suffered from that made you seek out therapy? If you didn't suffer from one then of course it was worthless. It's like taking iodine supplements when you aren't iodine deficient.
Or, as another apt metaphor, its like taking hydration tablets instead of water.
Not that they don't help, but that you're using them wrong.
In your example, it sounds like arrogance, hubris, and dogmatic conviction could be problematic if a person cannot recognize room for growth without first identifying a character flaw to grow out of.
The advantage of therapists is it can help and has fairly low risk of side effects unlike drugs or more extreme methods.
It’s stilly to think they can solve everyone’s problems. Sometimes people just need to sit in front of a bright light to fix a chemical imbalance etc.
It’s stilly to think they can solve everyone’s problems. Sometimes people just need to sit in front of a bright light to fix a chemical imbalance etc.
I never understand the attitude of "it didn't work for me, so it is a scam". It feels very myopic.
There's plenty of studies coming to the same conclusion. Mostly, the conclusions are that therapy can improve a near-absolute lack of human contact but not much else. Famously, going to a sports club, even sometimes just once per 6 months, had more positive effects than 2 hours of therapy a week.
I’ll be an N=1 counter example.
My somatic therapist dramatically changed my life and helped me overcome some pretty deep wounds and traumas.
I’ve done a lot of things in recent years to get better, and working with her has been definitely near the top of the list in terms of effectiveness.
To be clear, this is a different modality (somatic and touch work), which for me was far more effective than the therapy I had tried prior.
My somatic therapist dramatically changed my life and helped me overcome some pretty deep wounds and traumas.
I’ve done a lot of things in recent years to get better, and working with her has been definitely near the top of the list in terms of effectiveness.
To be clear, this is a different modality (somatic and touch work), which for me was far more effective than the therapy I had tried prior.
These days I'm not so sure how this would be judged. Earlier, like >20 years ago it wouldn't have mattered: you were functional (~able to hold down a job and live reasonably for >2 months) before therapy and after. The problem is that there's plenty of non functional people that therapy doesn't seem to be able to help.
Glad you thought it helped you, though.
Glad you thought it helped you, though.
Can you give some examples of such studies?
It's not just pharma. It's a big revenue driver for the entire healthcare industry for the past decade. Billions have been spent trying to generate demand and create'awareness'. Everyone is in on it, including HR people at your companies trying to stay relevant, countless mental health related start-ups, insurance companies, and providers.
i've heard people speculate that there are just not enough people capable of being good therapists. it may be that it is too hard of a job, there's skill/talent that can't be taught, and only so many people can do it. maybe we can train more and more therapists but not more effective therapists.
on the other hand accountability, social interaction in a safe context, providing an objective viewpoint, successfully teaching people "manualized" techniques like CBT -- these are all ways where a therapist could be helpful despite not being personally skilled at the art or craft of psychotherapy.
on the other hand accountability, social interaction in a safe context, providing an objective viewpoint, successfully teaching people "manualized" techniques like CBT -- these are all ways where a therapist could be helpful despite not being personally skilled at the art or craft of psychotherapy.
I'm going to go out on a limb and posit that what we need to do to survive on a daily and short-term basis has far outpaced our ability to cope with it.
> I'm going to go out on a limb and posit that what we need to do to survive on a daily and short-term basis has far outpaced our ability to cope with it.
Our ancestors never had to do so much to just survive. Humans are just not designed for this level of stimulation, keeping track of resumes, jobs, bills, credit scores, investments, children, retirement, mortgages, cars, a pushy manager, performance ratings and who know what else.
Life has become miserable because too much is asked of an individual. It takes immense strength and mental clarity to get rid off all these burdens. The hardest to get rid of is poor quality of jobs.
Our ancestors never had to do so much to just survive. Humans are just not designed for this level of stimulation, keeping track of resumes, jobs, bills, credit scores, investments, children, retirement, mortgages, cars, a pushy manager, performance ratings and who know what else.
Life has become miserable because too much is asked of an individual. It takes immense strength and mental clarity to get rid off all these burdens. The hardest to get rid of is poor quality of jobs.
I don't really agree with your proposition, I think the base issue is more fundamental, simply put I think it comes down to the atomisation of the individual due to the structure of higher education and zeitgeist of fear of being accused or misinterpreted.
While is it easier than ever to enter social spaces, I think people are struggling to build real meaningful relationships (romantic and platonic).
There is the western "coming of age" ritual that involves going off to university by yourself for a few years and then a few years later going off to another place by yourself.
Whether the fear of being misinterpreted is real, it is there for many people. People I know have changed a lot about what they say and the way they speak when people they don't know show up or enter a conversation, often saying things they don't believe in to give a good impression.
While is it easier than ever to enter social spaces, I think people are struggling to build real meaningful relationships (romantic and platonic).
There is the western "coming of age" ritual that involves going off to university by yourself for a few years and then a few years later going off to another place by yourself.
Whether the fear of being misinterpreted is real, it is there for many people. People I know have changed a lot about what they say and the way they speak when people they don't know show up or enter a conversation, often saying things they don't believe in to give a good impression.
People are trying to replace family, friends, relationships, hobbies, goals, and sense of purpose, with therapy. Use therapy to learn your blindspots and improve, not as a replacement for living a full life.
The US psychology school tends to be very pavlovian in the way they apply therapy. It's prescriptive rather than empathic (do this vs helping you re-position your views of yourself). My guess is probably due to cost.
Other schools of therapy take a long time, and healthcare in the US is extremely expensive, so I don't see those other techniques becoming popular.
Other schools of therapy take a long time, and healthcare in the US is extremely expensive, so I don't see those other techniques becoming popular.
I'm sure there's a real effect here, but it's hard to determine the magnitude of the effect when they fail to distinguish between diagnosis vs. actuality. How many people reporting excellent mental health really are OK? How many are just suppressing their problems, or aren't even the most affected by those problems (e.g. dark-triad folks who will never seek therapy on their own)? On the flip side, how many are catastrophizing, treating every-day things as problems requiring professional help and/or medication? How many then, and how many now? Without knowing those answers, we can't really tell how big the problem is.
This has definitely been a problem with autism and ADHD diagnoses over the years. There's no reason to suppose it isn't also true e.g. with depression diagnoses.
This has definitely been a problem with autism and ADHD diagnoses over the years. There's no reason to suppose it isn't also true e.g. with depression diagnoses.
It's my general suspicion that collective mental health is tracking with collective physical fitness, especially considering that exercise performs all antidepressant drugs by a fair amount
As America keeps getting unhealthier and more obese, it isn't much of a stretch to say that mental health is following it
As America keeps getting unhealthier and more obese, it isn't much of a stretch to say that mental health is following it
Not just fitness, but friendships and communities.
I think therapy works, but I think other things (like exercise, friendship, and having a good reason to expect good things in the future) usually are much more important, and it's hard for a therapist to help with any of those problems.
Definitely a healthcare crisis in America no doubt about it.. all you have to do is look at all these so called "Karen" videos on the internet.. . when I was a kid back in the 60s 70s 80s whatever even the 90s, there was nothing like this phenomenon... you never heard of a woman freaking out like this... starting fights in public... Etc... now men might have started fights, but it was almost unheard of for women to raise their voices and scream and yell... maybe inside the home but never in public... there's something going on in modern society that is driving people crazy really
One of the reasons is that the APA has guidelines that are hostile to a safe therapeutic environment. I've had much better luck working with non-American therapists that aren't subject to the APAs ideology.
> the APA has guidelines that are hostile to a safe therapeutic environment.
What guidelines are bad?
What guidelines are bad?
We’ve reached peak TaaS (Therapy as a Service). The industry went from outcome oriented to service oriented because people in tech saw an opportunity for some cash grabs
don't blame tech for this, the healthcare industry in the US is ruthless and willing to chase any dime
It seems like the more people rely on therapists, the worse the mental health crisis becomes. Couple that with the replication crisis and the opioid epidemic and I'm becoming increasingly skeptical of the entire profession. Given enough bad apples, one starts to suspect the entire tree is sick.
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deleuze intensifies
The (un)funny thing about CBT is that it is almost indistinguishable from the totalism and thought reform techniques deployed by the Communists in China, as described by Robert Jay Lifton in his work -- Thought Reform and the Psychology of Totalism: A Study of "Brainwashing" in China [0].
A read through Wilhelm Reich's earlier work [1] and a look at his fundamental dispute with Freud (i.e. - is depression and anxiety a problem in the individual, or in society, and if it's a problem with society then why adjust the individual instead?) will expose the status quo in psychology as simply a way to maintain exactly that.
[0] https://en.wikipedia.org/wiki/Thought_Reform_and_the_Psychol...
[1] https://en.wikipedia.org/wiki/Character_Analysis
A read through Wilhelm Reich's earlier work [1] and a look at his fundamental dispute with Freud (i.e. - is depression and anxiety a problem in the individual, or in society, and if it's a problem with society then why adjust the individual instead?) will expose the status quo in psychology as simply a way to maintain exactly that.
[0] https://en.wikipedia.org/wiki/Thought_Reform_and_the_Psychol...
[1] https://en.wikipedia.org/wiki/Character_Analysis
I'm sure attending therapy will make me feel tons better until I come home to crushing debt, inflation, sky-high CoL, a culture of overwork, climate degradation, worthless jobs, a divided and failing middle-class, income disparity, lack of upward mobility, etc.
It's sad to see an entire generation of people adopting such a defeatist attitude, when objectively speaking we're living in some of the most prosperous times in all of history.
Having grown up in post collapse USSR where every one of the issues you listed was 10X worse, it's genuinely disheartening to see so many people adopt an external locus of control and let it dictate their life.
Having grown up in post collapse USSR where every one of the issues you listed was 10X worse, it's genuinely disheartening to see so many people adopt an external locus of control and let it dictate their life.
If you grew up in post collapse USSR, you aren't of the age where you have to deal with the problems the parent post describes. It's important to recognize your lack of personal experience with it. I'm not saying that post collapse USSR wasn't a bad time. It was an absolutely horrible time and I am glad you're here.
But it's important to recognize people have different challenges and live different lives than you.
I'm likely much younger than you. My parents were able to afford to raise me in a house they owned, at my current age. I am not and nowhere near that buying power. My parents can look forward to a retirement fund. I cannot. My parents were able to work through the summer to pay for their graduate degrees. Graduate degrees are too expensive for me to attain, now. My parents could afford to take me to the emergency room when I had fevers as a child. I cannot afford a single emergency room visit for anything.
But it's important to recognize people have different challenges and live different lives than you.
I'm likely much younger than you. My parents were able to afford to raise me in a house they owned, at my current age. I am not and nowhere near that buying power. My parents can look forward to a retirement fund. I cannot. My parents were able to work through the summer to pay for their graduate degrees. Graduate degrees are too expensive for me to attain, now. My parents could afford to take me to the emergency room when I had fevers as a child. I cannot afford a single emergency room visit for anything.
Problem: People are leading unfulfilled lives and reporting they are depressed.
My solution: Recenter your life around your family unit, do more physical activity, get off social media. Build a life worth living.
The solution we went with: Take some pills so you can manage the horror of your disconnected life devoid of meaning and purpose.
Problem: Energetic young boys are having trouble sitting in school for hours on end.
My solution: Focus more on hands on activities, bring back woodshop and metalshop, include more breaks for physical activity during the day.
The solution we went with: Get the boys so high on stimulants they can sit still like the girls.
It's easier (and more profitable) to feed people pills than to build a society that people are happy in so that's what we do, but hey the line went up!
My solution: Recenter your life around your family unit, do more physical activity, get off social media. Build a life worth living.
The solution we went with: Take some pills so you can manage the horror of your disconnected life devoid of meaning and purpose.
Problem: Energetic young boys are having trouble sitting in school for hours on end.
My solution: Focus more on hands on activities, bring back woodshop and metalshop, include more breaks for physical activity during the day.
The solution we went with: Get the boys so high on stimulants they can sit still like the girls.
It's easier (and more profitable) to feed people pills than to build a society that people are happy in so that's what we do, but hey the line went up!
> The solution we went with: Get the boys so high on stimulants they can sit still like the girls.
This is a bit inaccurate. ADHD is diagnosed more in boys than girls, but is way, way more debilitating than being energetic to the point where they may be incredibly dangerous in a woodshop or metalshop. It's not being able to keep track of each tool being used, or the order in which to use them. It's forgetting to turn machines off, and forgetting to unplug dangerous equipment. It's turning around to grab something and forgetting what you turned around for, and then forgetting the task you were doing before you realized you were missing a part.
I would argue against treating ADHD like it's not a legitimate disability that requires accommodation. In the past, people with ADHD were just told they were stupid, lazy, or absentminded, when in reality they had a neurological disorder that had no diagnosis and no treatment at the time.
That being said I overall agree with the fact that society doesn't allow for breathing room for people to be people and form human relationships that doesn't have a financial or economic angle. This is horrendous, and no amount of therapy or medication will resolve this fundamental, societal-level problem. But ADHD is real, acting like ADHD treatment is just societal feminization of men is a completely incorrect depiction of the disorder. We can simultaneously argue that the medical system is completely fucked and also acknowledge that sometimes you really do need a surgeon to repair broken legs!
This is a bit inaccurate. ADHD is diagnosed more in boys than girls, but is way, way more debilitating than being energetic to the point where they may be incredibly dangerous in a woodshop or metalshop. It's not being able to keep track of each tool being used, or the order in which to use them. It's forgetting to turn machines off, and forgetting to unplug dangerous equipment. It's turning around to grab something and forgetting what you turned around for, and then forgetting the task you were doing before you realized you were missing a part.
I would argue against treating ADHD like it's not a legitimate disability that requires accommodation. In the past, people with ADHD were just told they were stupid, lazy, or absentminded, when in reality they had a neurological disorder that had no diagnosis and no treatment at the time.
That being said I overall agree with the fact that society doesn't allow for breathing room for people to be people and form human relationships that doesn't have a financial or economic angle. This is horrendous, and no amount of therapy or medication will resolve this fundamental, societal-level problem. But ADHD is real, acting like ADHD treatment is just societal feminization of men is a completely incorrect depiction of the disorder. We can simultaneously argue that the medical system is completely fucked and also acknowledge that sometimes you really do need a surgeon to repair broken legs!
Source on those actions being associated with ADHD? I'm not arguing they are not but they seem extreme.
I am describing the basic experience of having ADHD.
ADHD is described as having difficulty with:
* paying attention
* listening closely
* following instructions
* organizing tasks in the workplace
* keeping track of physical objects
These are all things you need to do in a metal and woodshop!
Have you never sat down and talked to someone with ADHD describe their basic experiences? I know people with ADHD who literally need all of their things hung up on display on a wall or else they lose them. There is an extremely popular guide for organizing with ADHD that recommends tearing cabinet doors off cabinets because it's impossible to remember where things are once put away.
Here's a popular podcaster talking about having ADHD and needing accommodations, and goes deeply into his experiences with having ADHD and struggling to, for example, go to work on time because there are too many tasks to keep track of to go to work: https://www.youtube.com/watch?v=ToBxaBauF4M
ADHD is described as having difficulty with:
* paying attention
* listening closely
* following instructions
* organizing tasks in the workplace
* keeping track of physical objects
These are all things you need to do in a metal and woodshop!
Have you never sat down and talked to someone with ADHD describe their basic experiences? I know people with ADHD who literally need all of their things hung up on display on a wall or else they lose them. There is an extremely popular guide for organizing with ADHD that recommends tearing cabinet doors off cabinets because it's impossible to remember where things are once put away.
Here's a popular podcaster talking about having ADHD and needing accommodations, and goes deeply into his experiences with having ADHD and struggling to, for example, go to work on time because there are too many tasks to keep track of to go to work: https://www.youtube.com/watch?v=ToBxaBauF4M
Yep, it’s essentially an executive function disorder at its core. ADD/ADHD has always been a misnomer.
However, there is broad disagreement among professionals about the definition of Executive Function.
Perhaps the most respected clinical researchers/professors on the subject Dr. Russel A Barkley, devotes a sizable chunk of his book to the many contradictory definitions that exist in scientific lit.
https://www.guilford.com/books/Executive-Functions/Russell-B...
I bring this up to let space for discussion back into the topic. We shouldn't pretend like we have a full definition of ADHD or Executive Function Disorder. There are some aspects that receive wide agreement, a lot of pet theory unproven hypothesis being pushed around, and even more folklore disguised through scientific jargon.
Perhaps the most respected clinical researchers/professors on the subject Dr. Russel A Barkley, devotes a sizable chunk of his book to the many contradictory definitions that exist in scientific lit.
https://www.guilford.com/books/Executive-Functions/Russell-B...
I bring this up to let space for discussion back into the topic. We shouldn't pretend like we have a full definition of ADHD or Executive Function Disorder. There are some aspects that receive wide agreement, a lot of pet theory unproven hypothesis being pushed around, and even more folklore disguised through scientific jargon.
> Have you never sat down and talked to someone with ADHD describe their basic experiences?
My answer to this is the same as 99% of peoples answer: no.
My answer to this is the same as 99% of peoples answer: no.
Genuinely asking: Why are you asking for a source, and describing the depiction of a neurodevelopmental disorder as extreme, if you yourself seem to have very limited knowledge about the condition? What is your background of knowledge you are trying to use to measure something described as a disorder as extreme or not?
Genuinely responding: Because it sounds extreme? You painted a picture of someone who is incompetent ("not being able to keep track of each tool being used, or the order in which to use them") and a danger to themselves and those around them ("they may be incredibly dangerous in a woodshop or metalshop" and "forgetting to unplug dangerous equipment"). That seems extreme to me, hence why I said "they seem extreme".
I have been in the company of people with ADHD at various stages throughout my life and this depiction doesn't fully align with my personal observations. From what I've experienced, individuals with ADHD do face challenges, but they are not universally incompetent or dangerous. They may struggle in some areas but excel in others. My ask for a source was to understand if this portrayal was based on a study or evidence, or if it was a personal observation.
I have been in the company of people with ADHD at various stages throughout my life and this depiction doesn't fully align with my personal observations. From what I've experienced, individuals with ADHD do face challenges, but they are not universally incompetent or dangerous. They may struggle in some areas but excel in others. My ask for a source was to understand if this portrayal was based on a study or evidence, or if it was a personal observation.
I think you misunderstood my depiction as saying all ADHD people are universally incompetent or dangerous. I'm saying that forcing untreated, unaddressed, undiagnosed ADHD people in a metalshop and getting them to work with dangerous machinery instead of treatment is uniquely dangerous given how we know ADHD functions.
I also am shocked that you have apparently been in company of people with ADHD and you've never considered asking them how they experience their disorder. I mean, at minimum, it's important to ask how to accommodate them or if they'd like you to be considerate of anything in particular with respect to their disability. Can you explain how do you handle people who are in your circle and clearly have different positions than you do-- do you never ask them questions?
I also am shocked that you have apparently been in company of people with ADHD and you've never considered asking them how they experience their disorder. I mean, at minimum, it's important to ask how to accommodate them or if they'd like you to be considerate of anything in particular with respect to their disability. Can you explain how do you handle people who are in your circle and clearly have different positions than you do-- do you never ask them questions?
In your reply you said "I am describing the basic experience of having ADHD" so I don't think I have misunderstood you.
I can't continue this conversation as you are not commenting in good faith. You're "shocked" that I've never asked someone with ADHD to describe their condition? As I have already said, that puts me in the Most People camp.
People have different comfort levels with discussing their conditions and I have no reason to ask them. Just like I have never asked a wheelchair user any questions about them using a wheelchair.
I can't continue this conversation as you are not commenting in good faith. You're "shocked" that I've never asked someone with ADHD to describe their condition? As I have already said, that puts me in the Most People camp.
People have different comfort levels with discussing their conditions and I have no reason to ask them. Just like I have never asked a wheelchair user any questions about them using a wheelchair.
NGL I'm shocked you never asked a wheelchair user about their experiences using a wheelchair. I'm quite surprised because, like, I have plenty of disabled friends and honest conversations on how to accommodate them are quite normal in my circles, especially when covid first started and even now as some friends are more vulnerable to covid than others. How do you accommodate your disabled friends if you never talk to them about what accommodations they need?
edited to add: I'm genuinely asking and have continued to behave in good faith. I have no idea what makes you think I'm not. You seem to be repeatedly misunderstanding my position which is weird: I'm shocked you have 1) interacted with disabled people in your life; 2) apparently never ask about their experiences or accommodations! I don't think that's at all in a "most people" camp.
edited to add: I'm genuinely asking and have continued to behave in good faith. I have no idea what makes you think I'm not. You seem to be repeatedly misunderstanding my position which is weird: I'm shocked you have 1) interacted with disabled people in your life; 2) apparently never ask about their experiences or accommodations! I don't think that's at all in a "most people" camp.
Tbh that sounds like a lack of initiative on your part. Hearing out people's basic experiences is a good way to socially engage with people
Whatever you're doing now is not a good way to socially engage anyway.
eh, as someone with not-even-severe ADHD (it's fairly well-managed on a low dose of medication as long as I work out every day) those things seem normal to me---not good, and incredibly frustrating, but not uncommon.
I didn't take my meds yesterday because I'm not currently home so they're not in the same place they normally are and I forgot. I was going to go for a run, but by 8 am it was so hot I couldn't do it and just walked outside for a little while. I don't like taking my meds too late, and I wasn't working or really doing anything all day so I figured it was fine.
My partner did have to work yesterday, and she asked me to feed her mice. Their cage has four (maybe three? several) levels, each one with its own door. I opened the second door from the top to feed them, but they were on the top level so I ended up opening that door to feed them instead. I then happily went and fixed myself dinner.
I didn't notice I left the other door open until she came back an hour later. I'm just glad none of the mice escaped.
I didn't take my meds yesterday because I'm not currently home so they're not in the same place they normally are and I forgot. I was going to go for a run, but by 8 am it was so hot I couldn't do it and just walked outside for a little while. I don't like taking my meds too late, and I wasn't working or really doing anything all day so I figured it was fine.
My partner did have to work yesterday, and she asked me to feed her mice. Their cage has four (maybe three? several) levels, each one with its own door. I opened the second door from the top to feed them, but they were on the top level so I ended up opening that door to feed them instead. I then happily went and fixed myself dinner.
I didn't notice I left the other door open until she came back an hour later. I'm just glad none of the mice escaped.
> The solution we went with: Get the boys so high on stimulants they can sit still like the girls.
love to be a woman with ADHD-PH and read this shit
love to be a woman with ADHD-PH and read this shit
Well, this is hackernews, one of the main nerd-to-incel-to-qanon pipelines. Misogynistic conspiracy theories fit right in.
bollocks. ain't no one talking about looksmaxxing or other incel-type terms. Too much money and education here, as a group mind you, as well.
> Problem: Energetic young boys are having trouble sitting in school for hours on end.
That's not the problem
> My solution: Focus more on hands on activities, bring back woodshop and metalshop, include more breaks for physical activity during the day.
Schools today seem to have more hands on activities and breaks for physical activities then they did when I was a kid in the 1980s; at least my kids' school certainly does.
While it helps some for ADHD (not its main purpose), it doesn't actually stop ADHD from being an issue for kids (not just boys) that have it. Individualized support helps more, and, where appropriate, medication helps even more.
> The solution we went with: Get the boys so high on stimulants they can sit still like the girls.
Getting high on stimulants doesn't make people more able to sit still.
Its true that some stimulants have a paradoxical effect that is the exact opposite of getting high in certain doses for people with ADHD, and this is leveraged therapeutically (not just boys), but, well, that's not the same thing.
ADHD isn’t the same as being energetic. Clinical depression isn't sadness.
That's not the problem
> My solution: Focus more on hands on activities, bring back woodshop and metalshop, include more breaks for physical activity during the day.
Schools today seem to have more hands on activities and breaks for physical activities then they did when I was a kid in the 1980s; at least my kids' school certainly does.
While it helps some for ADHD (not its main purpose), it doesn't actually stop ADHD from being an issue for kids (not just boys) that have it. Individualized support helps more, and, where appropriate, medication helps even more.
> The solution we went with: Get the boys so high on stimulants they can sit still like the girls.
Getting high on stimulants doesn't make people more able to sit still.
Its true that some stimulants have a paradoxical effect that is the exact opposite of getting high in certain doses for people with ADHD, and this is leveraged therapeutically (not just boys), but, well, that's not the same thing.
ADHD isn’t the same as being energetic. Clinical depression isn't sadness.
except taking adderall felt like getting high to me not its opposite.
Then you likely don’t have ADHD, or didn’t take them for longer than a week or so.
Stop stop stop right there with energetic young boys theory. https://youtu.be/gQ-rttdz_PI?si=E80n2xXeRrVf_qHy watch this
> Build a life worth living.
Easier said than done. You need money and a job fore that. A job which makes many people miserable.
Easier said than done. You need money and a job fore that. A job which makes many people miserable.
What was so much better about our parent's and grandparent's jobs?
I don't think you need all that much money to build a life worth living, at least in my experience.
I don't think you need all that much money to build a life worth living, at least in my experience.
They didn't have to work 120+ hours/week between them. Single-income households leave a lot more time for managing the family unit.
Grandpa lived through the Great Depression, and Great Grandpa would have had to work 7 days a week for 10 hours without any worker protections.
Then legislation got passed to make work not awful, and two World Wars happened that killed huge swathes of the prime working demographic -- 18-40 year old men -- and opened up the market for those who were left. That world doesn't exist anymore, and labor legislation is being peeled back.
Then legislation got passed to make work not awful, and two World Wars happened that killed huge swathes of the prime working demographic -- 18-40 year old men -- and opened up the market for those who were left. That world doesn't exist anymore, and labor legislation is being peeled back.
Yeah psychiatry is basically an effort to take all the collective sins society makes and drops them on your head, they say its your fault youre depressed.
Similar to how religions made people feel guilty in the past so they can sell their religious message which is the only way out of this guilt.
Maybe in the 60s. Since then, it's always your parents' fault you're (whatever).
The message for the last decade has been very much don't-feel-guilt-or-shame about anything, just blame those who came before you. Doesn't matter if your parents divorced, stayed together, were overattentive, were underattentive, were poor or were rich. It's their fault you're miserable.
In reality, it's learned helplessness reinforced by social media and ongoing tech developments. Let me drive for you. Let me cook for you. Let me entertain you. Let me tell you what to believe. Let me write "your" speech for you and create "your" art for you.
It's life in captivity. Animals in cages at the zoo are always miserable.
The message for the last decade has been very much don't-feel-guilt-or-shame about anything, just blame those who came before you. Doesn't matter if your parents divorced, stayed together, were overattentive, were underattentive, were poor or were rich. It's their fault you're miserable.
In reality, it's learned helplessness reinforced by social media and ongoing tech developments. Let me drive for you. Let me cook for you. Let me entertain you. Let me tell you what to believe. Let me write "your" speech for you and create "your" art for you.
It's life in captivity. Animals in cages at the zoo are always miserable.
The techniques and messages change but the underlying hypothesis remains.
They say you are abnormal because you can see some things that are very simple like global warming. They condemn your human reaction to rebel against this and offer you a lobotomy to remain happy. It's not physical anymore but its still a lobotomy
> They say you are abnormal because you can see some things that are very simple like global warming. They condemn your human reaction to rebel against this and offer you a lobotomy to remain happy.
This is the way things need to be though. You're not Elon Musk's rich uncle. If changing the fate of the entire world is your goal, you will die unaccomplished, frustrated and be miserable the entire time. It's beyond your control, even collectively, and obsessing about ambitions beyond your capabilities only leads to madness.
Tend your own lot in life. Fix the things you can. "Climate is heating up" should not mean "design, launch and deploy a functional solar shield;" to you, it should mean "migrate somewhere cooler." Once you're capable of achieving small goals like saving your own ass, then you can afford to be more ambitious and worry about everyone else's.
This is the way things need to be though. You're not Elon Musk's rich uncle. If changing the fate of the entire world is your goal, you will die unaccomplished, frustrated and be miserable the entire time. It's beyond your control, even collectively, and obsessing about ambitions beyond your capabilities only leads to madness.
Tend your own lot in life. Fix the things you can. "Climate is heating up" should not mean "design, launch and deploy a functional solar shield;" to you, it should mean "migrate somewhere cooler." Once you're capable of achieving small goals like saving your own ass, then you can afford to be more ambitious and worry about everyone else's.
Yeah, this is also wrong. If all you do is this, then if you have human empathy you'll be utterly miserable. You'll care about all the shit happening to other people, and the fact that you have managed to minimize the damage to yourself doesn't really change anything. Your options are to either eliminate your own sense of empathy, or advocate for broad change. Stoicism's great flaw is that it tells you to do the former.
> If all you do is this
Sure, but that's not what I was advocating at all. I was very particular with my words in suggesting tending your own lot first, then helping others instead of the other way around. (People that only look out for themselves generally don't need to be told to do so!)
It's the plane-oxygen-mask situation. You can't fix global warming for everyone without securing money and influence for yourself. So focus on securing those first. Empathy unchecked by logic is just hysteria.
Sure, but that's not what I was advocating at all. I was very particular with my words in suggesting tending your own lot first, then helping others instead of the other way around. (People that only look out for themselves generally don't need to be told to do so!)
It's the plane-oxygen-mask situation. You can't fix global warming for everyone without securing money and influence for yourself. So focus on securing those first. Empathy unchecked by logic is just hysteria.
That's not at all my experience with Therapy... Maybe you need to find a better therapist if all they are doing is teaching you to blame your parents for your problems and do nothing else.
What are you, Scientologist? That's not how therapy works.
Do actually poor countries have higher rates of clinical and self-reported depression? Do Colombians or Tunisians suffer worse rates of mental illness than Americans?
I am from a country where the median income is less than $10k, the gini coefficient is higher than the US, and where the six-day workweek is the norm. I literally don't know anyone on an SSRI. Sure, it's very possible someone is suffering in silence, but it's a far cry from when I studied in the United States and more than half of my classmates were medicated for mental disorders or went to therapists.
I am from a country where the median income is less than $10k, the gini coefficient is higher than the US, and where the six-day workweek is the norm. I literally don't know anyone on an SSRI. Sure, it's very possible someone is suffering in silence, but it's a far cry from when I studied in the United States and more than half of my classmates were medicated for mental disorders or went to therapists.
I suppose it would help to look at statistical signs of depression then, such as national suicide rate, rates of alcoholism and substance abuse, etc.
I see a lot of good replies here but no one posted a bit of material analysis.
Psychiatry is only really significant in wealthy societies. It requires a lot of resources- Look at the psychiatrist themselves: Need a medical education, and then need to choose a field that helps people with more subtle diseases. Most poor countries don't have an abundance of doctors, and the doctors they have focus on illnesses that are going to physically hurt people.
Then look at the patients. They need to have enough money to pay the psychologist, and then they need to have enough time to schedule the appointments, stick with them, and afford the pills.
Looking at the basic resources and constraints of a society, it'd be very surprising if poor countries had as many diagnoses of psychiatric conditions as wealthy countries.
And please note: I'm not making a value judgement on psychiatry here! Only saying that it requires a certain level of prosperity to become an element of society.
Psychiatry is only really significant in wealthy societies. It requires a lot of resources- Look at the psychiatrist themselves: Need a medical education, and then need to choose a field that helps people with more subtle diseases. Most poor countries don't have an abundance of doctors, and the doctors they have focus on illnesses that are going to physically hurt people.
Then look at the patients. They need to have enough money to pay the psychologist, and then they need to have enough time to schedule the appointments, stick with them, and afford the pills.
Looking at the basic resources and constraints of a society, it'd be very surprising if poor countries had as many diagnoses of psychiatric conditions as wealthy countries.
And please note: I'm not making a value judgement on psychiatry here! Only saying that it requires a certain level of prosperity to become an element of society.
Look at the suicide rates.
World Health Organisation does a bunch of work on safer pesticides because it's so commonly used as a method in lower income countries.
https://www.who.int/news/item/17-12-2020-new-study-highlight...
(Reducing access to means and methods is part of a package of measures that can be used to reduce deaths by suicide, and suicidality. It's important to remember that it's not the only thing being done).
World Health Organisation does a bunch of work on safer pesticides because it's so commonly used as a method in lower income countries.
https://www.who.int/news/item/17-12-2020-new-study-highlight...
(Reducing access to means and methods is part of a package of measures that can be used to reduce deaths by suicide, and suicidality. It's important to remember that it's not the only thing being done).
If you have to scramble to live it’s hard to have time to self analyze like we do in the west. I’m sure serious mental illness like schizophrenia or bipolar disorder is similar. Might also be covered up more by societies as it used to be in the west due to the family shame aspect that was very prevalent.
Even with similar standards of living, culture can play a HUGE role in how these things are talked about. Look at Japan for example, which has a shockingly high rate of people who just... walk out of their own lives forever. https://en.wikipedia.org/wiki/Jouhatsu
The discussion around depression and anxiety is also relatively new in Japan, but at the same time the evidence of those issues is not, look at NEETs and Hikikomori, a high suicide rate, and the aforementioned Jōhatsu! The thing is that in Japan there's a very strong tendency to keep that sort of thing in the family, keep it away from prying eyes. Your point about how shame works in different cultures is right on the mark IMO.
The discussion around depression and anxiety is also relatively new in Japan, but at the same time the evidence of those issues is not, look at NEETs and Hikikomori, a high suicide rate, and the aforementioned Jōhatsu! The thing is that in Japan there's a very strong tendency to keep that sort of thing in the family, keep it away from prying eyes. Your point about how shame works in different cultures is right on the mark IMO.
I have a Spanish uncle who did this in the 70s. Just walked out and disappeared. Eventually declared dead by his wife and my grand parents. Fate unknown but theory is he left for South America.
These are luxury diseases that you’ll only find in super-rich countries.
For anybody else keeping the finger on the pulse of trends through what people put on their online dating profiles, the "I hope you are in therapy" stated expectation went from 0 to every-other-profile almost overnight.
It makes me question how much this is driven by the effectiveness of the therapeutic approach vs what is simply trendy and mimetic among bourgeois urban millennials.