Do We Need Therapy? Psychology and the Problem of Human Suffering: What Works and What Doesn't?
People have always experienced suffering in some form or another and there are no easy solutions. Some writers have spoken of distress as the 'dark night of the soul.' Life in our times involves many stresses, which include general and specific ones. A lot of people are being prescribed medications for their distress, but for lesser forms of difficulties, or even in conjunction with medication, people often choose therapy, but we can ask to what extent is it always helpful?
I am not a fully fledged therapist but have done some training in various therapy approaches and also, have some experience of being in therapy, as a mandatory requirement of training in certain forms of therapy. One big debate is the whole contrast between the psychodynamic approach to therapy is the cognitive behavioral therapy approach.
The psychodynamic approach stems from the approach of Sigmund Freud and draws upon the idea of the transference, which involves the relationship between the therapist and the client, especially what is projected onto the therapist. The whole tradition has also been developed by Melanie Klein, Donald Winnicott and others. It can take the form of individual or group therapy. It can be done sitting down or with the client lying down on the couch. It involves asking the person to think about the past, including childhood experiences.
The cognitive behavioral therapy was developed by Beck and Ellis and focuses upon the here and now, in contrast to the past. It involves looking at negative assumptions underlying beliefs. It can be used for a variety of issues including anxiety, depression and obsessive compulsive behaviour.The client is asked to do homework in between sessions. One idea which I have come across within this form of therapy is that of enabling the person to become their own therapist.
There are many other forms of therapy available, including person-centred counselling and therapy based on mindfulness. Some are more widely available. Also, there is more evidence based research to back up cognitive behavioral interventions than psychodynamic approaches. However, some forms of therapy outcomes are hard to measure in a definitive way.
I am asking about how therapy helps in response to the problem of human suffering and asking to what extent it may help? Can it even aid in the experience of nihilism?
I am not a fully fledged therapist but have done some training in various therapy approaches and also, have some experience of being in therapy, as a mandatory requirement of training in certain forms of therapy. One big debate is the whole contrast between the psychodynamic approach to therapy is the cognitive behavioral therapy approach.
The psychodynamic approach stems from the approach of Sigmund Freud and draws upon the idea of the transference, which involves the relationship between the therapist and the client, especially what is projected onto the therapist. The whole tradition has also been developed by Melanie Klein, Donald Winnicott and others. It can take the form of individual or group therapy. It can be done sitting down or with the client lying down on the couch. It involves asking the person to think about the past, including childhood experiences.
The cognitive behavioral therapy was developed by Beck and Ellis and focuses upon the here and now, in contrast to the past. It involves looking at negative assumptions underlying beliefs. It can be used for a variety of issues including anxiety, depression and obsessive compulsive behaviour.The client is asked to do homework in between sessions. One idea which I have come across within this form of therapy is that of enabling the person to become their own therapist.
There are many other forms of therapy available, including person-centred counselling and therapy based on mindfulness. Some are more widely available. Also, there is more evidence based research to back up cognitive behavioral interventions than psychodynamic approaches. However, some forms of therapy outcomes are hard to measure in a definitive way.
I am asking about how therapy helps in response to the problem of human suffering and asking to what extent it may help? Can it even aid in the experience of nihilism?
Comments (88)
Does therapy help to the people when they are suffering from depression, negative thoughts, etc...? Of course yes. But in the terms of how it could be improve the therapy itself is quite difficult. I do not have as much as experience as you in this field. But I guess it depends a lot of individual's motivation to change. I can't go to a therapist pretending they are like "wizards" and then they will change my life forever to be happy. This is the main reason why the psyque is so complex I think. Sometimes I don't even know why I feel stress or with lack of motivation so I can't imagine how I have to explain it what happens to my mind to a therapist.
Nevertheless, I think therapy is essential for mental health because it prevents you from taking drugs. I mean all kind of drugs (permitted by pharmaceutical companies like "Prozac" or forbidden by States like weed or heroine). This is exactly what I am wanting to go. Sometimes we all have problems related to mental issues or order that we don't know where to scape for. In this complex context I will always recommend go to a therapist just to being listened by instead of consuming pills and get "quick happiness"
But again I am not so experienced in the world of human suffering and I do not know why sometimes psychiatric recommends taking "prozac" to be "less" depressed.
Personally, I think that what works is very individual. I remember one art psychotherapy saying that the most important aspect of therapy is having the right therapist. Perhaps, part of this is finding someone to relate too, but I would also think that it has a lot to do with the attitude and knowledge of the therapist. I do believe that becoming a therapist is not a task or profession that should be entered into too lightly as it calls for such depth of understanding.
As far as medication goes, I am not against it if it is necessary. That is because emotional suffering does have such a profound influence upon biochemistry, especially Serotonin and other neurotransmitters. When people get to the point of being psychotic, I do believe, based on my experience of working in mental health care, that it would be detrimental to work with therapy until some antipsychotic medication was offered to address the psychosis at the biochemical level initially.
Having the right therapist is a gift. Also I am not here to criticise all the therapists because I would sound so ignorant. Being a professional in something so complex as human psyche could be sometime so difficult to find the “right” solution for each person. Nevertheless, I am agree with you said about knowledge. Yes I guess there actually exists some basic “parameters” which could help each individual and try to find a solution.
Quoting Jack Cummins
This one is so interesting and thank you for clarifying this concept. I guess I spoke in so general terms previously. True, sometimes it is very important the medication but clearly when someone really needs it (as you explain, people that could suffer of psychotic). But those are special cases.
In the other hand, I still maintain the danger of taking so much pills if you can avoid it. I mean, I wish taking this medication would be the las thing to do if it’s necessary.
I would just wish to add, by commenting upon your remark about drugs and alcohol. I am not someone who is opposed to some kind of drug experimentation. Most of us are curious to find ways of relaxation. One of the biggest problems connected to using weed is the way in which it is recognised now by many as being a trigger of psychosis. There is the whole field of dual diagnosis of psychosis and substance misuse.
As far as alcohol is concerned, I would say that many people find it helpful in relaxation and for social interaction. However, I have read that there is a rising problem of alcohol misuse in the pandemic and we may not know the full extent at present. Pubs are shut down but when I am in supermarkets I see people piling it into their trolleys. The people drinking alone, with no one to talk to me may be a whole group needing therapy at some point in the future.
I think that I was adding my comment while you were replying. The one thing I would say in response to your last post, is the whole issue of side effects of psychiatric medication. The newer antidepressants are better, but so many medications have effects of weight gain and potential for triggering diabetes.
Nevertheless, untreated mental illness can have a terrible impact, including suicide risk. It would just be so much better if people's difficulties could be addressed at a stage earlier, with a view to people talking about stresses, which when unprocessed, can so easily translate into serious mental illness.
Probably sometimes mental illness is untreated because it is still a taboo issue in some societies that do not respect the big problem actually means. Since the day we make as ordinary go to the therapist probably the context would change and then we could prevent many risk of mental illnesses as suicide.
I wish one day we start having more exercise of empathy with others and not making bad jokes because they are sad or living a bad moment.
I remember when I was university I was depressed. Nobody understood me and even made fun of me so I felt so lost that I was in the risk to take drugs (LSD). Hopefully I met the right therapist and I didn’t do so and I starting seeing the life with a different point of view. This is why I always recommend go to a therapist when the context starts going wrong.
Quoting Jack Cummins
Of course this situation will lead many people go to a therapist in the future. Covid-19 and its pandemic taught us how difficult is live in loneliness. All of those who were frequently visiting pubs didn’t know how to pass the shut down properly so they decided drink alone.
I don’t know how much affect drinking alone but I guess it could be so interesting to see in the future how this people interact in society when everything would be again in “normality”. Will they still drinking in house alone or in the pub socially? This point that you commented is so interesting.
You are right to say that there is an incredible amount of stigma surrounding mental illness. I do believe that this prevents many for seeking support.
Also, alcohol represents such a whole area for questioning. So much of social life is embedded in a culture of alcohol. People grow up and are socialised to begin to go to the pub, almost as soon as they outgrow the pub. Alcohol is the legal narcotic. I also tried weed and acid, but the whole process of getting these was a horrible drama in itself, going to strangers and being sold substances which were fake.
But I do believe that so many people are struggling at present, with mental health issues. One of the latest trends is therapy online but I am not convinced that this will be enough for many who are struggling. Also, mental health cannot be separated from real problems in the physical world, including poverty and homelessness. Obviously, the real practical problems need to be addressed but I think some therapy is needed, because people need to be able to talk about their experiences.
Quoting Jack Cummins
It can be a life saver, and it can be quite useless and even damaging. More power to to your non-directiveness or whatever you bring to the couch.
But every therapist should ask themselves very seriously and regularly whether they are helping people to tolerate the intolerable, rather than regain full agency in their lives. It should be the last rather than the first resort to an explanation of suffering that the cause is in the mind. Many people live in oppressive, stressful maddening situations, and they need practical help before anything else.
Likewise, the therapeutic effect of an appropriate environment and community should be part of any treatment program. My own favourite therapist is a tree, specialising in end of life and bereavement counselling.
You are right to say that therapy 'can be a lifesaver, and it can be useless or damaging.' I think that is probably the whole basis for my raising the topic for philosophy debate in the first place.
Actually, when I did undertake psychoanalytic therapy, at times it made me feel much worse about my life. I heard some therapy tutors say that sometimes things have to get worse before they get better. However, I did wonder how far this has to go.
Also, the whole need for therapy is based within cultural contexts. Perhaps, people have no one to turn to in the community and that is why they end up seeking therapy.
Therapy is no different to any other human activity. You can get good and bad practitioners and models. Generally people need to shop around to find a therapy mode or a therapist they find beneficial. The relationship with the therapist or therapeutic alliance is more important than the mode of therapy. This has been found in most of the research. Practical solutions focused interventions appear to be most beneficial. Merely talking is not likely to be enough.
I am not fond of the term - 'an experience of nihilism'. This is a red herring. If a person is experiencing anhedonia and truly believes that nothing matters this is rarely an expression of philosophy, Camus style. It is usually chronic depression and warrants treatment.
Interesting fact about this: I am from Spain and alcohol is legal due to a lot of taxes it produces to the State. It also happens to the tobacco. So I guess my governors think it is worthy having theses substances because despite they are drugs are kind “soft”. Nevertheless my country is not the only one who manages alcohol and tobacco as taxes I guess...
Quoting Jack Cummins
Agree with this point. It will not enough online therapy. Also as you said it depends a lot the social context of the patient: additions, poverty, bankruptcy, etc...
But as you explained I do not get about getting related to “community”. Do you mean socialising and having friends, etc...?
It slightly bothered my that you put the emphasis on suffering, and reducing suffering. The phrase "comfortably numb" comes to mind. Will you choose a deep love and a painful loss, or a shallow life of little suffering?
I want to be more sensitive, not less, and that means more suffering too. Think of autonomy, of resilience, of agency, of relationship; less suffering is a too small a goal, too weak a measure of success.
I think that the question you raise is really interesting. Do we wish to be made less sensitive or more. In a way, medication and even pleasure can have the effect of numbing us. Personally, I have been described as lacking emotion at times, and too emotional at others. Both seem bad, and I am not sure which is worse. Of course, it is also about how we express emotions. When I was on an art therapy course, there seemed to be a lot of emotion and that felt false. However, the point where we switch off emotions is also worrying, and how do we navigate the way to the right balance for our own mental health and that of others?
I've taken medication and used talk therapy for depression and anxiety; I've benefitted some from both. What really worked was substantial change in life circumstances. I wasn't successful in engineering the changes that worked -- that came about by chance events.
I spent decades being a discontented person, and regularly sharpened the edges of discontent. [Fan the flames of discontent--old labor slogan] My expectations of what life was supposed to be like were not all that well grounded in reality, a good share of the time. As I got older, I found work life increasingly oppressive and stultifying.
A lot of my personal history became clear after I retired and began reflecting on my life. Theoretically with 20/20 hindsight, I could have thought about life differently and been happier.
Today I feel mentally contented, effective, and happy; I do happen to be hooked on an anti-depressant. I don't know whether it does any good--just that I experience very unpleasant withdrawal when I try to stop. I'll probably take it until the end.
I definitely believe that finding the right therapist is important for most people and that can be a long and arduous task. I have known some people going from therapist to therapist, desperate to find the right person. However, I do wonder how much is about our own individual approach and how much we project onto the expectations of the therapist. I do believe that it is partly relates to where we are and what exactly we are looking for in therapy.
You are the first to speak of the way in which I have mentioned nihilism in my introduction. I am not sure if it is a red herring or not, because I do think that the experiences of nihilism is a position of despair, but it is not simply the experience of depression, or is it? I once knew someone who sought enlightenment and could not find it. He struggled, with extremes of feeling high and low. He spent so much time in bed and felt flat and without any meaning. This seems to me to be the ultimate expression of nihilism. When someone gets to that point it is questionable to me how one can rekindle meaning. If the person was to enter into therapy it is unclear to me whether that would happen or not, because it seems that some powerful insight ot source of inspiration needs to be conjured up for that person. The individual may be seeking this or have gone past looking, but the question is where can it be found?
I think that both medication and life circumstances are important. The question is where can people begin? Medication is meant to be a starting point from which a person can begin to be balanced enough to begin to make changes. However, we could question whether this always happens. Ideally, therapy is a means to explore ways in which that can happen. But I believe that you are right in querying therapy as meaning change rather adjusting. I would imagine that this is a complex spectrum. Perhaps, some would see being without medication of any kind as ideal but it may not be realistic.
So many people in the population are on medication of some kind or another, such as ones for basic physical health, and, surely, medication for depression and anxiety is just as valid. One of the biggest problems for many, including myself, is the being able to sleep and that seems to be a complex mix of physical and mental. I am not sure that it can be addressed fully by therapy alone.
I am really concerned about the way people are being offered online therapy. It does seem to suggest the idea of people alone in rooms tapping away on screens, and right now I am aware that I am doing just that. However, I feel that I have fun on the forum for I wonder if that would be the case in online therapy. I am not sure that therapy is meant to be fun, or whether philosophy is is meant to be either, but I cannot believe that it is meant to be all drudgery. There has to be some sense of satisfaction or fulfillment of some kind or another.
When I spoke of the context of the person in the community seeking some kind of support, or therapy, I am thinking of the way in which people's needs may only be met on a shallow level in many communities. I am not saying that everyone's needs are identical and basic human interaction may be the most important for many. However, it may be that family and community life create more conflicts than outlets for some. Often, going to a GP or mental health team may occur within those circumstances.
I am familiar with depression because I have experienced it personally and I have worked with people experience it in in a mental health care. However, I am pointing to a blurry area for questioning: where do you differentiate between unhappiness and clinical depression? Anhedonia is a very real part of it, because lack of enjoyment colours our whole experience, but I think that it is a very complex topic. The question of nihilism is also about the experience of despair.
Turns out, 80% of depressions can be cured by not having a war where you live.
https://www.technologynetworks.com/neuroscience/news/people-in-war-torn-countries-are-five-times-more-likely-to-develop-anxiety-of-depression-320553
The view which I have experienced, seems to draw the line depending on the individual. I mean I think you can easily compare to physical things like pain for example. Pain can be discomfort or it can cause actual concrete problems. Regardless, you don't sit around contemplating whether different treatments are actually necessary. You try them out and stick to those that work best for the individual. Ideally, that is. Yeah there may be cases where they have tried to hammer in a screw for too long but you can't really let extremes define your main strategy.
From my experience of working within mental health care, the diagnosis of depression is sometimes complicated. If lack of enjoyment and despair come without other symptoms of clinical depression, such as feelings of low esteem, difficulties sleeping, changes in appetite and other activities of daily living the diagnosis of depression is questionable. In some cases, two different psychiatrists may assess someone and come to differing conclusions. Also, it all depends on what is treatable. Some people seem to respond better to treatment, especially antidepressants, than others. This is sometimes at odds with clear diagnosis categories, and seems to come down to biochemistry. But I am not saying that there is not more to it, such as the wish to feel differently.
I do believe that we have to try out different options available, and if they are specific psychosocial options we don't have automatic access to them. We may have to be referred for options, including therapy, unless we are able to afford it privately, and the medical clinicians often act as the gatekeepers in deciding what may be offered.
That's be my guess too.
Do you work in mental health care? I have too, until last May. I am unsure if I plan to go back into this. However, I do experience depression at time, but and do seek help. I think that many are struggling currently but are probably suffering alone. You say about psychosocial interventions but I don't think there is much of that available for people currently.
No. It is not simply being depressed but it is an important fact of experience nihilism. It all occurred back in 2017 when my best friend and I (we both love philosophy, ethics, psychology, etc...) decided the experience about nihilism. Nevertheless back then I was already experiencing it because I did not like the life I was living.
Talking about it during months we entered in a difficult situation where we reached not feeling sad but at the same time not having a goal/purpose in life... So I and my friend did not know what to feel about it. We were even close tl end our friendship because nihilism says nothing has a "reason" to believe by.
The months keep passing and we started becoming more "adults" in our 20/21 years old so we learned something about nihilism: This feeling happens sometimes when you are depressed but also when you have stimulus around that give you the opportunity of thinking in other thing instead of being like a vegetable "standing" there with zero reason. I accepted myself (as my friend did) and then my life went better.
In this point, I do not know if nihilism will back again in my life. I hope not. It will depend in my behaviour and stimulus around me.
That's not the conclusion of the study cited. Even a cursory read shows that. The very first sentence is "People living in countries that have experienced armed conflict are five times more likely to develop anxiety or depression", which means that 80% of depression/anxiety could have been prevented by not having a war. The study says nothing about curing it.
PTSD is without doubt caused by trauma. Does not having that trauma anymore cure it?
Depression can not be labeled by a philosophical position. It seems to me that being a nihilist could be very freeing; and I can well envision an ecstatic nihilist. Your friend wasn't depressed because he was a nihilist. He was depressed, and coincidentally he may or may not have been a nihilist, or a Presbyterian, or a Druid, or a logical positivist, or a Marxist, Karl or Groucho. None of those intellectual orientations would bear upon a person's depression, which is something else entirely.
Yes, I agree that nihilism and depression are rather different, although in some cases there can be an overlap. Nihilism is a way of seeing the world and I have had points of that and it is distinct from clinical depression. However, on a couple of occasions I dwelled on the absence of meaning to the point where I felt depressed. The sense in which I say that I felt depressed was one in the I felt unable to do my usual daily activities.
That is how I consider depression to be and it is as if the world loses its brightness and colour.
It is interesting that you say that you believe that whether your nihilism will come again will depend on stimulus and your own behaviour because that is more how I feel about potential depression than nihilism. However, each person's personal perspective is a bit different. Nihilism for me is more about a philosophy of life, whereas depression is my mood related to events, mainly those in my own life. However, I do see it as a whole blurry spectrum and that is why I brought nihilism into a discussion about therapy.
I do agree that it is possible to be ecstatic as a nihilist. However, I believe that it is complicated because for some the nihilism leads to suicidal despair. Some people with despair over lack of meaning in life do present to mental health services, looking for possible interventions. We could ask to what extent is despair a mental health problem?
Yes. I think after my personal experience I defend it depends a lot of circumstances. We are agree that nihilism and depression are completely different but in some cases depression somehow can drive you to nihilist ideas.
It will depend in the stimulus because I guess when you are having an active life (work, studies, friends, etc...) it is quite difficult to experience nihilism. I was the opposite. I remember wasting a lot of time of worth living in my nihilism era. When I change my mind and discovering other motivations, nihilism started being something from the "past"
It is literally a blurry spectrum as you said. Because do not know how "randomly" appears and you do not know how to avoid it. Also, in the way of living a nihilist life you can hurt others when they see you quite "absort" from reality.
Nevertheless, I still have the door open because I cannot confirm I will never live it again. I hope the next time as you explained, it would be more philosophical rather than depend on circumstances (sadness, depression, low motivation) that provoked the past experience.
When you just observe the beauty of the latest week's beautiful scandinavian sunrises and sunsets, you get pretty ecstatic in the progress. Or if you listen to certain parts of "Down Down" with Quo. What does saving the world really add?
You mention the ecstatic and I do get states of that too, but I do know some people who experience continual flatness. They are always miserable. I often get euphoric about music and sometimes music about despair enables me to get high, as if it is transmitted.
Yesterday, I had a really strange experience. I had been feeling run down, with a slight sore throat and lack of appetite, but not so bad that I had to stay in bed. My mood was about average and, then, for no apparent reason, I felt this intense warm energy pulsating through my body and a sense of euphoria which lasted for a couple of hours, until I fell asleep. The heat sensation was a strange one because, normally, I don't like being hot, especially in bed. However, this almost felt like some kundalini experience of awakening.
Nihilism is a word used in many ways. Bottom line any world view that supports or triggers depression - whether it be Christianity or nihilism - still requires intervention. Plenty of suggestions on mental health support websites for this.
Lots of younger men tend to go through periods of bleakness it seems. Some like to call this nihilism, perhaps it sounds less banal.
Existentialism and nihilism was very popular when I was young. Most of us found the proposition of nihilism a cheerful alternative to the false values of a religion or an off the rack suburban worldview. Nihilism meant being free to invent yourself as much as you felt able to.
Only one person I knew developed suicidal despair and a heroin addiction to manage it. He had a mental health issue and fortunately with treatment he recovered, but it took close to a decade.
Perhaps there are hard and soft nihilists. The hard nihilist says that 'nothing matters', not even their own life and, perhaps, this results in them withering and possibly dying. I suppose this has more to do brain chemistry and/or life circumstances than philosophical reflection.
The soft nihilist says there are no transcendent values, no external source of meaning, nothing. I am free to invent myself. This could be considered exciting.
PTSD is a very interesting area in relation to therapy because often people who have this do not get a full response to treatment by medication. They often seek therapy because they need help processing their experience. If people have been in the army they may get diagnosed with PTSD, however, many people who have complex traumatic history get given the label of borderline personality disorder. Have you come across this approach to trauma in the labelling by some professionals?
Yes, all the personality disorders are strongly associated with post trauma behaviour and dissociative states. More commonly borderline for females; anti-social PD for males. Yep, trauma needs psychosocial support, talking and, perhaps, medication - depending on the complexity of the trauma. It takes time and resources to overcome.
I believe that it is not possible to predict future states of mind, because sometimes it as if they arise out of nowhere, as well as life events being unpredictable. Certainly, that is my own experience. Perhaps, what we are able to do is to think about how depression and nihilism can be distinguished because disentangling the two can be difficult. I have come across people who find this so hard to do because they feel unable to articulate these experiences.
You are absolutely correct. My enthusiasm for social and environmental influences on mental health got the better of me. But do you not think that prevention is even better than cure? Therapy can sometimes have the social function of making social problems into personal ones, in rather the way cholera treatments of old failed to address the sanitation problems of crowded living in cities, that led to the frequent epidemics. Clean water does not cure cholera, it merely prevents it.
Existentialism is on of the other feelings I remember experiencing it but not as hard as nihilism. I am agree in the point that the concept of nihilism can be used in different perspectives. Nevertheless I never had it in a religious perception because I always been atheist. So my nihilism period never came from a believing crisis of God.
As you said there are literally hard or soft nihilist. I mean as I said previously it dependes a lot od circumstances. I remember one of friend of mine who was experiencing nihilism said to me he was scared because nihilism could kill philosophy so he decided not getting further information about it.
When I was nihilist I remember waking up with lack of ambition and saying to myself "just another day until the end comes" but exactly in this difficult situation I started a new period that I keep in nowadays.
It is certainly the basis of CBT as a treatment that depression can be treated by changing thinking, and through addressing negative thoughts, altering self defeating behaviour. In some ways it is the therapeutic application of philosophy.
Yes. Completely agree with you. It is impossible know what the future holds. Sometimes it can be even scaring. At least we already established that nihilism and depression are quite different experiences of living. For this reason I do believe nihilism can back or go many times during lifetime because is another philosophic way of living.
Nevertheless, depression is a hard pathology that has to be treated as quickly as possible. Because I guess it is even worse feeling sad rather than "not having a life purpose yet" how nihilism predict.
I think that it is important to treat depression, but it is getting so common for doctors to prescribe antidepressants routinely. I am not opposed to this but do think that sadness is becoming a bit too overmedicalised. Also, the other complicated is becoming overdependent, upon them and it can be difficult to come off them. I have seen people being treated by ECT as well. I was initially opposed to it, especially as some people experience memory loss due to it. However, it does seem to work wonders for some, especially elderly people. Generally, even doctors don't seem to know why and the way it works is a bit of a mystery. But I am not sure how ECT would address nihilism.
It definitely seems that women are more likely to get diagnosed with borderline whereas men with antisocial personality disorders. I have to say that I find the whole area of personality disorders. However, there is a lot of stigma and I think that the label PTSD would be preferable in many ways. When I worked in an acute admissions unit, a lot of the staff were very judgemental in their attitude and the term 'PD' was often used by some of the staff in a critical tone.
Therapy definitely seems to help with trauma, more especially the psychoanalytic kind because it seems to focus on the past. I have come across people with OCD, who also had a history of trauma and they were given behavior programs to address their OCD and felt that their trauma was ignored in the context of a CBT approach. One other therapy which people often say that they feel benefits trauma is art therapy. I began, but did not complete training in art psychotherapy. Unfortunately, in England and I don't know about in other countries, art therapies seem to be becoming marginalised and I think that this is because they are not seen as cost effective.
I think ECT will not make an impact to a patient who is experiencing nihilism. I guess this happens due to nihilism is just a way of thinking not a mental illness. Therefore, as you commented, I am also opposed to this technique. It is old and I guess it not provides good results in the most of cases.
Yes these are the main reasons why we are agree that depression has to be taken care of immediately. Nevertheless, it is a complex situation where professional do not know how to act properly so they decide just to give antidepressants and see what happens. Let's remember here that this one of the biggest problems of modern societies. They tend to take a lot of antidepressants. I do not know what to say here because I am not a specialist but I guess it is not a good recommendation take chemical drugs so quickly despite the context of where we at. For example, as you said, elderly people or those with critical situation whom not have another path to find a solution.
Of course, another option available for some people is over the counter remedies. Doctors seem to have mixed opinions about this and some are opposed to it. I know that most psychiatrists caution against it but that is because it can interact with prescribed medications. In particular, one of the most popular remedies for depression, St John's Wort is dangerous if mixed with prescription antidepressants and other forms of medication.But, once when I went to one GP and said that I felt that I needed something for anxiety and sleeping, the doctor suggested that I went to a health shop and looked for something.
The best remedy I found was Passiflora and I do use it for sleeping frequently and it is virtually free from side-effects. I tried Valerian and it made me feel awful. If I buy any remedy I try to do a bit of research on it. I did try CBD oil capsules briefly and apart from being expensive, I didn't notice anything at all. I have also tried some Bach Flower Remedies and aromatherapy oils and wasn't sure whether they had any effect or not. But, I do think that trying methods to help us relax is worthwhile. However, I think That some people can get carried away with remedies and it can be dangerous if people don't know enough about what they are doing, and, for example, just take mega doses of vitamins which they probably don't need. But I am an experimenter and I even play self hypnosis CDs in bed sometimes.
If one simlpy likes living, going to ones not-so-fantastic job, do whats needed in the family and then just chill, driving ones wife half crazy by saying no to all fany plans for the future, does that qualify a guy to the ranks of the soft nihilists?
All over the world you find this. It is unfortunate, but a reflection of the difficulties of working with this cohort who are deemed almost untreatable (for the most part) and time consuming (as in needing years). This sets them up as 'difficult' in relation to the high volume, rapid turn around work of clinical services.
There is no reason why a nihilist needs to be living in miserable circumstances. In fact it could be argued if a person is living comfortably, and they accept nihilism, they are not merely reacting to their situation. They are actually choosing their ideas based on the merits of the idea. It would certainly be easier to be a nihilist whilst living in a Soviet gulag, say, in 1950. But do you really own a philosophical system brought on by circumstance? That's a thorny one.
Say that Sam the child painter grieves the recent death of her parents. She dreams to become a world-renowned painter someday but right now she is sad and anxious about how she'll be faring in a world without her parents. She is suffering and it is natural that she is. Nobody has to treat her with therapy to remove her suffering; one can even argue that she has a right to this suffering. If Sam goes back to painting, uses her grief as motivation, and continues to strive for her goals in life even with the great suffering she feels, there is no need for therapy regardless of whether she's depressed or not (but I suspect that the official definition of depression has more to do with the weakening of the Will to Life and not necessarily on emotional suffering so maybe she's not depressed in this situation?). If I am correct, this is called sublimation. However, if the grief from the death of her parents render her unable to sleep, eat, and strive for excellence in her field, if her will to life becomes shoddy and continues to be so for an extended period, then this I think is when therapy gains value.
Speaking for personal experience, I had never gone for professional therapeutic help, but when the pandemic punched me in the face my world view was like this: "that striving for excellence both in my crafts and duties is ultimately meaningless so I should just lead a life that minimizes suffering. Striving to live, striving for excellence, it's the root of suffering so I should just stop it." I didn't seek help as I was satisfied with this philosophy but not long after I broke down in tears in front of my family when we were casually chitchatting during dinner. They didn't necessarily offer comfort, but they did provide me with words that I think really put me 'back on track.' I don't know if what I experiences classifies as any kind of professional therapy, but that experience had been very therapeutic for me.
In the instances I wrote above, I am pointing out to how people who experience suffering shouldn't be seen as needing of therapy, regardless of whether someone has psychiatric disorders or not, insofar as this suffering doesn't weaken one's Will to Life. Suffering and stressors are essential factors of human life and I don't think we should get rid of them if they're nothing detrimental to us.
There are some approaches to therapy that don’t pathologize the client , but instead see their difficulties as arising out of the inevitable stucknesses and confusions that our explorations of life lead us into from
time to time. They see their role as a partnership with the client in a kind of combined philosophical and scientific investigation into creative ways the client might reconstrue their circumstances rather than seeing themselves merely as victim of those circumstances.
Of course despair is a mental health problem. But a person experiencing despair need not be a nihilist nor vice versa. There are two distinct things: (1) How you feel; and (2) Crap you read. It's important not to confuse the two. Especially these days when the mainstream media is devoted to publishing crap that makes people feel bad, in order to drive clicks.
By the way the left wing Gestapo came for Dr. Seuss today, and I am in despair. The Cat in the Hat was my very first book, and I take this personally. "When they came for Mr. Potato Head I said nothing because I wasn't a starchy plant tuber ..."
https://apnews.com/article/dr-seuss-books-racist-images-d8ed18335c03319d72f443594c174513
I appreciate you bringing up different ways to help. It is a difficult topic to discuss because what could be more ripe for one's own bullshit than to talk about getting past it.
I have encountered a number of helpers and was helped by most of them blowing me off. Some portion of that was insight and some portion was force protection. If one embraces the self-knowledge model, expect unwanted results. We attract certain elements and learn or not from the arrival.
So, other people have problems I don't. But my problems are connected to theirs. The diagnostic approach is important. Is the model based upon relative levels of wellness or degrees of infection?
Both measures suck in critical ways.
I don't do clinical psychology, but in what limited experience I have it's certainly something I've encountered more than once, so unless that's a coincidence my guess would be that it's quite prevalent, yes.
From what I understand, however, PTSD isn't the right diagnosis either, as CPTSD (Complex Post Traumatic Stress Disorder) is a separate condition with different neurological symptoms, different manifestations (which are partly responsible for the misdiagnoses) and therefore requires different therapeutic treatment. But I'm not an expert in this field.
I do agree.The people we turn to for help, including counsellors and therapists, can be the ones who give us the most difficulties. One of the problems can be when they think that they know what's best for us, or even understand us, better than we do ourselves. When I was in therapy, I had a therapist who said he could see what I was saying from a more objective point of view. Even though counsellors and therapists are not meant to give advice, I think that it is likely that many do.
Ultimately, the quest within therapy is to gain self knowledge. This may or may not happen. Sometimes, I find reading books on therapy and related topics better than going to see a therapist. I don't know if this is because it cuts out some of the stress of talking to the other person, although it this would seem to defeat the whole idea of needing to be listened to. Alternatively, I do wonder if it is because the writers of the books are more insightful and wise than the people who have have jobs as therapists. Generally, I find reading books by 'wise' writers one of the best forms of therapy personally, because it often gives me the best insights which I can reflect on in the process of acquiring self knowledge.
Yes, by a very large margin prevention is definitely better than the cure.
Quoting unenlightened
Can it? Is this just a suspicion of your, or do you have any evidence to support it?
There are two aspects to this -
Firstly, you're right. If we successfully treat those who are damaged by the way we've set up society, then it has the effect of making it appear as though that damage is remediable and so less concerning - but what's the alternative - let people suffer deliberately so that we force them to martyr themselves to the greater cause - that seems a little harsh?
Secondly, as the article says, depression is often a response, but it also causes behavioural changes which have an impact on the environment of others. It's possible (in fact I think it personally very likely) that the very reason why we're not making any improvements in the way our society functions is because of the damage living in it causes to our mental health. Addressing that damage may well be a step toward removing the conditions of its cause.
You are right to say that Complex Post Traumatic Disorder is a diagnosis in its own right, even though people who have other disorders may have a significant history of trauma. Part of the problem is the whole question of labels. They are useful for clinicians in thinking about treatment options but they can be stigmatising. That was the point I was really making about the label of personality disorder.
In thinking about this, one other area is the antipsychiatry movement. Writers such as RD Laing and Thomas Szaz looked at ways in which diagnostic labels can be used to pathologise misery and suffering. Such writers argued that it created a whole myth of mental illness. This movement went out of fashion, probably because it underplayed the reality of mental illness. However, the antipsychiatry movement does offer some insight for critical thinking about the way psychiatric labels are applied to individuals.
I think you've answered your own question there. The anti psychiatry movement had a point, and one which I don't think has really been taken up as much as it should, but it's their own fault their message didn't get across.
Mental illness is a real thing because there are people who's lives can be improved by treatment. We might just as well say that prosthetic limbs are stigmatising because they create a myth that we ought to have two limbs rather than one.
The problem is, with mental illness, it's too easy to diagnose an illness as the result of a failure to function according to some societal norm rather than a failure to function according the person's own preferences. That is gradually changing (although third world backwaters like America are very slow to progress). The solution is to press this change to happen faster. It's not to abandon the thousands of people who really do need psychiatric help just to make a political point.
Yes I agree. I think the trauma model is sound and that there is potential value in treatment and prevention both.
Quoting Isaac
Again we largely agree, though I think you are more optimistic. The use of Ritalin, for example, to treat an overly rigid curriculum and un-engaging teaching seems more to be spreading than retreating. Psychiatry as substitute for corporal punishment - the chemical cosh returns.
Yes, that's true, actually - the progress (where it's being made) seems to be confined to adults at the moment. I don't think we're going to see a return to the bad old days of asylums for the 'sexually deviant' etc, but as usual we treat children as second class citizens and any progress made in the adult world may trickle down in fifty years (or not).
I think the treatment of children in schools (and in the homes sometimes) is tantamount to abuse and those psychiatrists, teachers, and parents who support it should be criminalised. For some reason, baffling to me, children's rights (something I've campaigned for all my professional life) is not an issue either side of the political spectrum cares much about - I guess if you don't vote you don't count.
Your point about therapy approaches which don't pathologise but see it as necessary for life issues is important. However, part of the problem comes down to funding. In England, most but not all therapy is costly, whereas you can access it without payment through for free through the NHS system although there are often long waiting lists.However, getting referred for therapy is complex and mostly comes through mental health teams, so that is where the use of diagnosis comes in.
Also, the need for therapy is often seen as based on the severity of the mental health problems. I knew a woman who was fairly pleased when she got diagnosed with borderline personality disorder because she realised on that basis she would be able to access forms of therapy which would have been otherwise not available for her.
Many private therapists work as self-employed and in their own homes. Often, the way they make their living is through giving therapy to trainee therapists. These people are the ones willing to pay because it is mandatory for most trainee therapists to be in therapy while training and many qualified therapists may continue to be in therapy. This means that psychotherapy and art therapy can become almost a closed circle. Also, the person pursuing a career a career in art therapy is also taking the path of personal therapy, and knowing oneself.
I have known people diagnosed with mental health problems who have found great meaning in the antipsychiatry movement. When I did my mental health nurse training, I don't think that the approach even got any mention at all. The main way I knew of the antipsychiatry was because I studied the sociology of mental illness as part of sociology 'A' level, meaning that I studied it prior to any formal study of psychiatric disorders. I was really impressed by Laing's book, 'The Divided Self' for his whole critique of the way in which contradictions in messages in socialisation in the family give contradictions messages. I think that this is an important idea which is worth holding on to and should be embraced within psychiatry more.
There is an inherent tension within psychiatry between trying to adjust people to fitting in to the norms of society and of enabling them to find ways of fulfilling their own aspirations. The people who are seen as more outside the norm may be viewed as more unwell. I am sure this varies according to social contexts. Within psychiatry in England, I think that there has been a positive move towards recovery based models of care, which are aimed at people identifying their own goals to work towards. There are even recovery colleges, which run courses for working on specific issues. Another move is the existence of crisis telephone helpline, so I would say that things may be going in a positive direction.
Your point 'despair is a mental health problem' is interesting, but it is a very debatable one. That is because on, one hand, it can be a cognitive state resulting from brain chemistry. Some people who are in a state of extreme despair, notice an immense relief due to antidepressants, whereas others don't notice much at all. Of course, it can be about adjusting the dose or of finding a different one which works. However, the opposing arguments against despair as a mental health problem is the one in which despair can be seen as a response to horrible life conditions.
One book about and despair is 'Suicide and the Soul' by James Hillman, which looks at the whole meaning of despair and what it means to live without hope. Hillman looks at the whole way in which suicidal thoughts and feelings exist for people. He also looks at the way in which the whole meaning of despair needs to be faced in its profound depths. He suggests that the suicidal ideas may exist like a whole wish for some kind of symbolic rebirth within life.
I do agree that suffering is part of life and it doesn't necessarily call for medication or therapy, but I do think it is variable. One factor is that some have family or close friends to turn to and others don't. It would be ideal if we all had people to turn to when we going through really unpleasant experiences, and could be equally supportive in listening to others. Perhaps this ideal is not stressed enough in Western culture.
I think that you make a very good point in saying about the way in which will is important and in most of the literature on depression which I have read this does not seem to be really explored. I do believe that it is possible for a person's sense of will to be broken. I am sure that will plays a major factor in biochemistry, with potential implications for depression and physical illness. It may be that is the whole will which may have to be repaired or healed within therapy.
I believe the biggest change in Western countries since WWII has been the de-prioritization of children and their needs along with the prolongation of adolescence well into adulthood (the proliferation of adult-children).
The article you yourself linked to does not indicate that "the left" had anything to do with this. It was simply a business decision made by the publishing company unprompted by external political influences.
From the article:
"The decision to cease publication and sales of the books was made last year after months of discussion, the company, which was founded by Seuss’ family"
"Random House Children Books, Dr. Seuss’ publisher, issued a brief statement Tuesday: 'We respect the decision of Dr. Seuss Enterprises (DSE) and the work of the panel that reviewed this content last year, and their recommendation.”
The article also says that The Cat in the Hat will continue to be published. Sounds like your reading skills haven't progressed beyond that.
Within two weeks two different children's companies made internal business decisions for their own products. Hasbro dropped the Mr. moniker for their Potato Head brand (they are keeping the Mr. Potato Head character), and Dr. Seuss Enterprises are ceasing publications of children's books that contain racist caricatures as they stated "ceasing sales of these books is only part of our commitment and our broader plan to ensure Dr. Seuss Enterprises’s catalog represents and supports all communities and families." Simply a long term business decision to protect the brand, and ensure continued audience appeal.
LOL. No. Nor does some corporate press release constitute evidence.
You speak of, 'Psychiatry as a substitute for corporal punishment_ the chemical cohosh returns'. I think that it is a far better idea to address behavioral disturbances in children through medication and therapy rather than simply punishing it. I am thinking of particular difficulties identified, such as ADHD and autistic disorders. There is a definite area of research correlating autistic spectrum disorders with genetics. One particular form of therapy which can be helpful for this is art therapy because it seems to enable communication without speech being necessary. Art therapy is often found to be a helpful way for working with other difficulties in children, including trauma. One helpful way of seeing trauma is offered by Rebecca Marks, in 'Understanding and Healing Trauma'. She says,
'Trauma causes a build up of physical anxiety, and our physical responses become the new enemy. Our biggest fear becomes fear itself.'
I do believe that trauma in children and adults needs to be worked with. It may be the underlying cause of many problems people have in life beyond childhood too.
I was talking about ADHD. It is hard not to notice how ADHD diagnosis and Ritalin and function as the social control of children. Even more disturbing, there are reports of isolation amounting to sensory deprivation being used in schools on a regular basis, that inflicted on adults would be classed as torture.
Autism is very different, and usually doesn't get a drug treatment precisely because it is a real condition of the psyche, a matter of what used to be called 'character' rather than a 'mental illness'. One does not 'cure' autism any more than one cures Down's syndrome, one adapts.
I don't have any experience of working in schools or mental health services for children, so I am not aware of any practices of sensory deprivation. It sounds very worrying.
I do believe that there is some relationships between ADHD and autistic spectrum disorders. That is because I am aware of many individuals who have been diagnosed as being on the autistic spectrum, and often diagnosed as having Asperger's syndrome, having been diagnosed as ADHD in childhood. One particular area of adjustment which is viewed in the research on Asperger's syndrome is the whole way in which these people seem to lack a theory of mind. They are often seen as lacking in empathy and this is connected to lack of ability to read other people's emotions and thoughts.
I have come across suggestions that some of the most creative thinkers, including Kant may have been on the autistic spectrum, but, of course, this is pure speculation. Would we say that Kant needed therapy? It is all a matter of perspective. Beyond the issue of autism, we could also ask what would have happened if other creative thinkers, such as Van Gogh and William Blake been seen from the standpoint of present day psychiatry. Perhaps they would have been prescribed antipsychotics and mood stabilizers, which are being combined commonly more recently. They might have experienced calmer lives, but would they have produced their greatest creative works?
Here's an oldish mention.
I had no idea this was happening and it seems as though it is within England, where I am. I did hear one woman saying that her son was put in seclusion and never really knew what she meant. I am familiar with the idea of seclusion in psychiatry and that is about someone being put into a padded area for safety to self and others, but only after an event of severe aggression. The idea in psychiatry is about managing violence and aggression safely, until medication works, and is not about punishment.
I do see your view of how people can begin seeking therapy, get labelled and end going down a whole chain of being seen as lesser and end up getting scorned and rejected. It is a sad reality which often makes people wish to avoid seeking therapy when they are feeling really desperate.Of course, this is in contrast to the way in which it is seen as necessary for all forms of suffering. So, it is hard for people to know at what point to ask for help. Some may be advised to do so by others, but even then, the advice may not always be the best. Perhaps, misconceptions about therapy are part of the problem and a whole demystification of the therapy process is needed.
On the other hand, I have known people who become so dependent on therapy. Perhaps this is a result of having someone who listens to their suffering. I think that the idea which I have seen in some CBT interventions, of trying to enable the person to become his or her and therapist is particularly helpful is one of the best. Also, I think that now, there are more self-help books which can make it possible to learn useful knowledge for working on personal problems without having to go down the official pathway of accessing therapy. Also, there are books which teach techniques of mindfulness meditation in other useful ones.
In one of my initial posts, I said that I thought on-line CBT therapy may be inadequate, but that probably applies to the point where people have got too unwell for this to be sufficient. However, for some people who are struggling mildly, such support available on-line may be worthwhile. I would say that it is when the person really feels that they are struggling beyond that which they can cope with that the need for professional help comes in. Hopefully, there will be more accessible therapies available and I think that this does vary depending on country and location.
One way to look at it is the emphasis upon diagnosis. One has to define it to support treatment. That approach makes sense from many points of view. It is difficult to imagine another way to provide help as an institution.
On the other hand, the institutions get it wrong many times. Or only partially right; for any variety of reasons.
The entire industry of mental health is....
Do you think that the reason why people have such an extended adolescence is because they never reach adulthood? Also, we could ask what does adulthood mean, and is about being independent responsibility?
I know that there's a great deal of research on-going in the social sciences attempting to figure out what happened to these folks, but I am sure that they are truly going to live up to their nickname as the "lost generation." Many of them would just assume never move away from their parents. That's a serious problem in and of itself.
Just the fact that so many have gone along with this entire woke religion thing will set them back ten to fifteen years at the minimum. Imagine believing that an entire race of people (and the one you happen to belong to) is racist? Would you hire somebody who thought like this?
I do think that our problems probably stem from our parents. Certainly, when I have been in therapy I have felt that I was dealing with a whole spectrum of problems in my own parents' thinking and philosophy. I have worked on these issues, but as it is, most of our parents still remain oblivious, and perhaps the views and thinking of our parents and past generations impact on our lives so much. I am not saying that we are in the position of supreme truth, but we are left to try to pick up the pieces, in deconstructing pictures of reality and demystifying ethical and social values.
What do you think happened? Parents are one thing, but there must be a bunch of factors.
I think that social conditions are also important. Personally, I live with about 10 to 12 people in one house, in London, so that all the rules of social distancing are absurd. There are so many people living in the house in which I am renting, and I don't even know all of their names. I do think that social and sociological questions are an underlying factor. I also think that we are living in such a way that we are almost considered as mere numbers and it is so difficult to find any cohesive sense of personal identity as we become part of the mass. Perhaps, my biggest sense of identity is having a voice on this site because in the world at large, I feel that I count for absolutely nothing.
I've been a working musician and done my share of piano bars while enjoying some of the humor that goes with the right people. I've avoided drugs but known others who have become alcoholics and had to take friends to AA meetings. I found it helped in ways therapy was incapable of duplicating.
Then one day when reading on Simone Weil I began to see why AA works. It helps a person to hit bottom rather than avoiding it. Since our suffering rules our lives it doesn't want to die and lose control. When we hit bottom we no longer defend our suffering and ask for help from the deepest part of our essence. I understood the importance of hitting bottom to attain freedom from needless defensive suffering which is often dominant in our lives
[i]"Grace fills empty spaces, but it can only enter where there is a void to receive it We must continually suspend the work of the imagination in filling the void within ourselves."
"In no matter what circumstances, if the imagination is stopped from pouring itself out, we have a void (the poor in spirit). In no matter what circumstances... imagination can fill the void. This is why the average human beings can become prisoners, slaves, prostitutes, and pass thru no matter what suffering without being purified."
"That is why we fly from the inner void, since God might steal into it. It is not the pursuit of pleasure and the aversion for effort which causes sin, but fear of God. We know that we cannot see him face to face without dying, and we do not want to die."
-- Gravity and Grace[/i]
Jack, what's real is on the inside. Don't worry about everybody else. Feeling alienated in an alienating culture is actually healthy. The key is in building up your internal strength (physically and mentally) so what's going on outside doesn't affect you nearly as much.
The folks who are really in trouble are those who keep acclimating to all the bizarre things going on. Much of this will pass, so you want to have your head together when better times arrive (and they will). This shit storm has been brewing for decades and will probably take another 10 years or so to play out, but much better times lie and the other side.
I do hold onto what's inside, and I do keep in touch with friends, even though I have not been able to meet up with people for a year. I do wonder how some people are coping. I have experience of working in mental health care before the pandemic started, and I do wonder how some of the people who were the service users are coping.
I think that this is a critical time for many, but perhaps it was an inevitable consequence of the way society was heading. I probably can cope with time alone more than many others can. It is a challenge for myself, and I cannot even begin to imagine how much of a challenge this can be for some who are not used to being alone at all. So, we might be speaking about the whole therapy of knowing oneself, as isolated individuals and perhaps that is the quest we must face. It is the time of knowing oneself as an individual being, in the full existential sense.
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There will be tens of millions of people who will develop all kinds of assorted issues, but as I am a great believer in the "equal amount of good and bad in everything" school of thought, there will also be a great deal of good to come out if it, as well. The next couple of years are not going to easy for many, many people, no doubt about that.
As much as we are social beings, you must get your individual act together before you will be of much good to anybody else. So many people are looking for others to save them and its just not going to happen. This is why taking care of yourself physically, mentally/emotionally, and spiritually is critical. Once you make so progress down this path, then you can see that you are truly in control of your life and others can only have a limited impact.
As you have stated, the time has come to discover who you are, what you are about, and what it is you are going to do. Unfortunately, this is the job to which few wish to apply.
I think that part of the problem is that many people have not been socialised to see the importance of getting an act together as an individual task. For many, ideas of how one can achieve a fulfilled life is connected to belonging and being immersed in a family or group. It is such a strong idea perpetuate in religion and education. Being a loner is often seen as odd, whereas now many have no choice to follow that path. Personally, I grew up as an only child, so I was always used to my own company but for people who have always been with others at most times, if they are forced to spend so much time in lockdown alone it is likely to be an extreme challenge. I have definitely heard that telephone support lines have been almost bombarded and, I am not surprised.