Why is therapy expensive but at the same ineffective?

[Rasheed]

Why is therapy (by therapy I mean psychology therapies...) expensive but at the same ineffective?

[Recursoinominado]

They haven't figure out how to actual heal psychological matters but therapy is still a good option for most people even if it doesn't actually SOLVE problems, but is good to vent, talk to a professional, elaborate personal matters etc. 

[Jodistrict]

Janov explained talk therapy as the equivalent of receiving 30 mg of Prozac.   It feels good to have someone listen to you.  So the client gets addicted to the attention and once addicted is willing to pay a high price for something that won’t change him in anyway.

[Basman]

Professional therapy is expensive because it is an extension of medicine, which has always been costly. To be a fully fledged therapist, you have to undergo many years of training. Not anyone can be a licensed therapist. And there are more people who want to go to therapy than there are therapist. Those are all factors that contribute to the price.

There are loads of studies that show that most people who have gone to therapy benefit from it (about 75%). Therapy isn't ineffective. I wonder how you came to that conclusion exactly? It does take time though and you have to find a good therapist that you vibe with to get the most out of it.

Therapy isn't a complete solution in of itself however. You have to be interested in wanting to work with yourself and manage your issues. Therapy requires active participation from the patient to be most effective. Sometimes coaching might be more appropiate, depending on what you are looking for exactly.

Humans are very complicated. 

[Farnaby]

28 minutes ago, Recursoinominado said:

They haven't figure out how to actual heal psychological matters but therapy is still a good option for most people even if it doesn't actually SOLVE problems, but is good to vent, talk to a professional, elaborate personal matters etc. 

Not true at all. There are a lot of things we don't know about mental health issues and the human psyche, but there's also a lot we do know about the mechanisms that maintain and worsen these issues and what we need to do to change that.

Venting is ok and it can be "healing" to an extent because we tend to carry a lot of shame around our issues, but it usually doesn't solve things. It can but it can also turn into mental masturbation. Finding out what is negatively impacting your mental health and changing your habits is what solves things. And if you have experienced trauma, you may need to work on that as well. 

[r0ckyreed]

Therapy isn't ineffective.  Therapy in many places in the United States is almost too cheap.  You can literally go to a university counseling center and get free counseling from an intern at some places.  Other places offer free community mental health for low-income folks, but such places aren't as commonplace as private practices that will charge you $100-200/hour. 

At the same time, for what the therapist has to deal with, I feel like therapists get significantly underpaid compared to other professions.  Therapists save lives, at least the good ones anyways.

[Tudo]

42 minutes ago, Jodistrict said:

Janov explained talk therapy as the equivalent of receiving 30 mg of Prozac.   It feels good to have someone listen to you.  So the client gets addicted to the attention and once addicted is willing to pay a high price for something that won’t change him in anyway.

Interesting... are you a psychiatrist or psychologist?

[Jodistrict]

"I have set for myself a rather daunting task: to demonstrate that no therapy that uses words as the predominant mode of treatment can succeed at creating any profound change in the patient. This includes all insight therapies, cognitive therapy, rational emotive therapy, hypnotherapy, psychoanalysis, biofeedback, eye movement desensitization and reprocesssing (EMDR), and guided imagery/directive daydreaming. 

All of these can help, but none can make a profound change in personality or provide profound, lasting relief. I would have disagreed with this proposition when I originally practiced psychoanalytic, insight therapy many decades ago. My patients agreed that they felt differently after treatment, and believed that they had made major changes in their lives. Now I am more than skeptical. I have now seen what more is possible. Profound personality change is impossible on the level of words, or even on the level of emotions; there is no venting or “getting it out,” such as crying and screaming, that will bring about any true or lasting change. For true and lasting change to occur, deep levels of the brain must change physiologically, enabling key structures within the brain to recalibrate to optimal, healthy levels. Furthermore, such change will only come about when those parts of the brain that hold deeply imprinted memories can connect neurochemically with the parts of the brain that underlie the more rational, thinking aspects of our minds, such as the frontal neocortex. No amount of talk-based therapy will ever bring about such a connection because there is little activation of the subcortical structures that mediate the deeply imprinted memories, yet this connection is vital if more substantial progress in psychotherapy is to occur.

Conventional psychotherapy has been imbued with the belief that good mental health is a product of your mind—a result of your thinking, logical, rational, prefrontal cortex; in brief, that you can think your way to health.

Yet neurosis, a physical and mental deviation of a normal system, is not laid down in the brain as an idea but as an experience, one that leaves a physiological trail. Because of this, any psychotherapy that relies on words and ideas cannot change neurosis."

Janov, Arthur. Primal Healing: Access the Incredible Power of Feelings to Improve Your Health (Kindle Locations 226-229). New Page Books. Kindle Edition. 

[Leo Gura]

Working one on one with people is very time consuming and emotionally draining.

[Michal__]

Try to teach a few people individually how to do whatever you are good at for free (or for a fee because why not) just to see how it feels and to learn something new.

Now try to imagine how it would feel if you couldnt just simply refuse to work with people who are hard to work with.

Edited February 7, 2023 by Michal__

[vladorion]

Therapy can be effective for healing trauma but it has to be a modality that actually works.

It can be a very slow process though if one has a lot of trauma and defence mechanisms.

Venting is not therapy.

[Jacob Morres]

Therapy is often ineffective but can be effective with the right therapist and fit 

Like they can teach you emotional management tools, help you process trauma, listen to your issues 

You can also generate insight on issues, find solutions. Conversations to a trusted person can be helpful for this 

 

Problem for me I found is therapists that I don't trust + don't make me feel safe. These therapists are very counterproductive. Kind, empathetic and trustable therapists are Key. 

Also, I found that certain therapists don't have the right skills for your issue. For example- if a therapist is not trauma informed and is trying to help with trauma. Or if you have OCD and the therapist isn't trained + skilled in modalities best suited for OCD. You have to do your research, figure out what modalities is best suitable and find who would best fit your issues 

Also get clear as fuck with what you need help with. Without clarity and intention, you will be going through the motions 

Also, Fuck people who say everybody should go to therapy. I used to say this too and I appreciate the pro therapist movement. But not everyone is ready for it, needs it, doesnt work for everyone, or can be better suited for something else. Therapy is great but there are a ton of things you can do 

 

Edited February 7, 2023 by Jacob Morres

[Jodistrict]

The predominant therapy in America is cognitive therapy with its claim to be evidenced based

In criticizing cognitive therapy, Janov makes the distinction between statistical truths and biological truths:

“Cognitive therapy seeks statistical truths to corroborate their hypotheses and theories; these theories are too often intellectual constructs that do need statistical validation. We are after biological truths beyond mathematical facts. The studies I cite do not prove anything. What they do is indicate a kind of universality, a continuum, to all kinds of organic life. These studies are corollaries, not separate, inviolate realities; a kind of intellectual genuflection to the left brain. But without contact to the right brain those realities are confined to the intellectual. Anything can be true with statistics because they ignore biologic realities. They can be manipulated in all ways. All this may escape those who have no entry into the right-brain unconscious, where history and feelings lie.

Those in cognitive therapy are able to “feel better,” but confuse that with getting better because they can use language and words to suffocate pain. They use thoughts to anesthetize feelings and imagine and think that all is well.”

“There is a world of the deep unconscious that needs to be explored; an unconscious from our animal legacy. That unconscious can never be understood in verbal language.”

Janov, Arthur. Primal Healing: Access the Incredible Power of Feelings to Improve Your Health (Kindle Locations 137-141). New Page Books. Kindle Edition.

Janov based his primal therapy on biological facts.  However, it has had mixed results.  In my opinion, he has the correct approach but his therapy was developed in the 1960s when knowledge of the brain was even more limited than today.  

What is needed is a Manhattan Project level initiative to do the biological investigation needed to come up with a science based psychotherapy.   Realistically, the government is the only entity that can fund this.  When you think of it, the US spent 3 trillion dollars on a useless war in Iraq.  For 500 billion dollars, a therapy could be developed, say for 10 to 20 sessions, which would cure a wide range of neurosis.  The savings to the medical and social systems (e.g., healthier people needing less care, a reduction of violence), would more than pay for it.  But the current state of consciousness of society considers war and conflict to be valid solutions. 
 

[puporing]

It can help just, most therapists are unhealed healers and missing the spiritual link and therefore depth, and often just too young and inexperienced with life still. You can tell how deep and experienced someone is with how they do therapy and there's a whole range out there that has little to do with credentials. 

Some of them are not in it for the right reasons and more for the prestige and income level. If the heart of the therapist is not in the right place, there's easily a conflict of interest because they want to earn more and project sickness and frailty onto you so you keep going back, I've seen it myself. They are in a position of power that can subtly or not subtly manipulate so that you are almost "hypnotized" to give up your own authority.

The rates that get charged is also like that of lawyers where they're protected by a board rather than based on competence. I would say this fee structure itself incentivizes corruption and preying on the vulnerable over compassion. The more compassionate ones tend to heavily discount and move to the public sectors or you can tell they try to give you the most within a short frame of time (or show some sign that they care about your financial health also), instead of dragging things out.

Effective therapy requires some degree of selflessness and this is a rare trait in general. 

Edited February 7, 2023 by puporing

[Ulax]

Imo, there is very effective therapy out there. However, there are a lot of therapists who I think lack depth in their practice (i.e. don''t treat the core issues), and also competence.

I think in a few hundred years psychotherapy will be incredibly good compared to today, even in a hundred years. I think we live in somewhat of a dark age of mental health. Though again I think its important to reiterate that I think there are various effective practioners out there. 

So living in this time period of humanity I think ensuring effective psychotherapy requires being strategic in what practioner you choose to engage with and also working, where possible, on your own healing.

[tuku747]

Belief that something is ineffective renders it as such. 

[The Blade]

Things are often both expensive and ineffective.  Look at the Segway.  

[Razard86]

On 2/7/2023 at 0:46 PM, Jodistrict said:

"I have set for myself a rather daunting task: to demonstrate that no therapy that uses words as the predominant mode of treatment can succeed at creating any profound change in the patient. This includes all insight therapies, cognitive therapy, rational emotive therapy, hypnotherapy, psychoanalysis, biofeedback, eye movement desensitization and reprocesssing (EMDR), and guided imagery/directive daydreaming. 

All of these can help, but none can make a profound change in personality or provide profound, lasting relief. I would have disagreed with this proposition when I originally practiced psychoanalytic, insight therapy many decades ago. My patients agreed that they felt differently after treatment, and believed that they had made major changes in their lives. Now I am more than skeptical. I have now seen what more is possible. Profound personality change is impossible on the level of words, or even on the level of emotions; there is no venting or “getting it out,” such as crying and screaming, that will bring about any true or lasting change. For true and lasting change to occur, deep levels of the brain must change physiologically, enabling key structures within the brain to recalibrate to optimal, healthy levels. Furthermore, such change will only come about when those parts of the brain that hold deeply imprinted memories can connect neurochemically with the parts of the brain that underlie the more rational, thinking aspects of our minds, such as the frontal neocortex. No amount of talk-based therapy will ever bring about such a connection because there is little activation of the subcortical structures that mediate the deeply imprinted memories, yet this connection is vital if more substantial progress in psychotherapy is to occur.

Conventional psychotherapy has been imbued with the belief that good mental health is a product of your mind—a result of your thinking, logical, rational, prefrontal cortex; in brief, that you can think your way to health.

Yet neurosis, a physical and mental deviation of a normal system, is not laid down in the brain as an idea but as an experience, one that leaves a physiological trail. Because of this, any psychotherapy that relies on words and ideas cannot change neurosis."

Janov, Arthur. Primal Healing: Access the Incredible Power of Feelings to Improve Your Health (Kindle Locations 226-229). New Page Books. Kindle Edition. 

I agree that true lasting change is structural. The internal structure needs to change.

[Jodistrict]

Janov believes that cognitive therapy is only a coping strategy.  But to help coping it actually strengthens the ego making a real cure more remote.  It may help you cope but doesn’t cure the underlying trauma which is deep in the reptilian brain.  Worse, cognitive therapy doesn’t take feelings seriously.  For example, telling someone they have a choice of what they feel, is not treating feelings seriously.  It’s the underlying traumatized brain structure that creates the feeling and drives thoughts.  

 “ Cognitive therapy is massive distraction. The patient sometimes feels better, even oft times feels better, but self-deception is not therapy; it is brainwashing. Denial is a nice, temporary expedient; it makes life tolerable, but the price can be heavy later on—possibly premature death or early disease and a return to symptoms.”

“Few, if any, professionals have seen the depths of the unconscious and observed the pain imprinted there. Therefore, they cannot know what nurture really is and what it can do to us.”

“Therapists can dress this up, but it is still the “power of positive thinking.” It is YMCA counseling writ in scientific patois. It is, “Put a smile on your face and you will feel happier.”  As simplistic as that sounds, it is essentially what behavior and cognitive therapies are about: behavior changes feelings, as opposed to feelings driving behavior. Yes, the cognitivists can try to help patients develop a more positive attitude, but the patient’s whole system may well be enmeshed in a pessimistic one, ingrained from birth—an engraved physiology of pessimism.”

Janov, Arthur. Primal Healing: Access the Incredible Power of Feelings to Improve Your Health (Kindle Locations 2173-2176). New Page Books. Kindle Edition.
 

[Breakingthewall]

On 7/2/2023 at 6:46 PM, Jodistrict said:

Yet neurosis, a physical and mental deviation of a normal system, is not laid down in the brain as an idea but as an experience, one that leaves a physiological trail. Because of this, any psychotherapy that relies on words and ideas cannot change neurosis."

This is true. words are not enough, not at all. if you want real change, it's a very difficult thing to do. mental pathways are real energy patterns. They are very solid structures. you have to have a great instinct and courage to be able to make real changes