Counter-Therapism Rule
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A thread of the posts by @cait.bsky.social. They read as follows:
I had my first talk therapy session with my new therapist and she hit me with the “you’re very self-aware” ☹️
not the “pleasure to have in class” of therapy
that’s right, I know all the tools and have developed countertools so they no longer work. welcome to thunderdome
We don’t negotiate with therapists.
We don’t negotiate with the rapists
I’ll take “The rapists” for 400
They never negotiate with you
What about philanthropist, Africans, dyslexics, children, that sorta thing?
They are not rapists they are ropists.
wait what? isnt… being self-aware a good thing?.. pleasure to have in class? i have got to beissing something here.
Self-awareness is a good thing, but it’s also the bottom of the barrel when fishing for compliments. In therapy, specifically, the implied sentiment is, “Well, at least you know how fucked up you are.”
She’s making the comparison to the “pleasure to have in class” line, because it’s similar. If a teacher genuinely has good things to say about a student, it’s probably going to be more specific (i.e. – they were inquisitive, a quick study, made their peers laugh, etc). “Pleasure to have in class,” by contrast, is a generic compliment that doesn’t really say anything.
EDIT: Okay, so based on a few of the latest responses, I felt that I should clarify something. I don’t think people who use these phrases intend for them to be insults or demeaning in any way—this includes Cait’s therapist in the original post. It’s just that it can be perceived that way, which is what I think the post was making fun of.
If you’re also an introspective, self-critical person, please don’t take someone saying this to you as an affirmation of your faults. It’s almost certainly an innocuous and genuine observation.
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Ever since I played Control I only read that as Object Of Power
it stands for Object Oriented Programming, actually
/s
Oh my god I literally just now got why my therapist kept saying that. I hate people do this and then expect me to get it. Especially therapists they should know better. If you try to sugarcoat it I won’t get it almost guaranteed. Fucks sake what a waste of a time she was. Should have known something was up with how defensive about Israel she was…
I don’t think your therapists necessarily meant it in an insulting way.
Oh. Yeah, time for a new therapist, then. Can’t expect healthcare professionals to share all of your political beliefs, but not simping for genocidal ethnostates is a pretty low bar.
Oh this was years ago I wasn’t good at saying no to people and standing up for myself. Also kept believing what others said over what I thought since my memory is bad and I zone out a lot.
A therapist should keep that shit to themselves, regardless of what their political beliefs are. My psychiatrist is a Catholic, but if he started telling me that I should go to church I’d be looking for a new psychiatrist.
Holy shit, your therapist should not be debating politics with you! That’s right up there with your therapist trying to convert you to their religion or praying with you. That’s a line that shouldn’t be crossed.
I don’t the only that’s necessarily what your therapist was getting at.
I’m not defending her stance on Israel btw. Also her stance on Israel might imply religious beliefs and that’s a whole other conversation.
However, I disagree with the commenter that said self-awareness is a good thing.
If you want to go through life empowering others, avoiding doing any harm of any kind, and leaving the world somehow better for your existence, then yes self awareness is a good thing.
However, if you want to be happy, satisfied, and go through life being comfortable and not require therapy, then self awareness is most definitely not a good thing.
That is to say, self awareness is highly correlated with anxiety and depression.
Curse you, autistic introspection!
I have to disagree. Self-awareness made me feel better about myself, not worse.
You know what requires therapy? Having a gnawing sense that you’re a failure or a coward or something like that. That’s what a lack of self-awareness will get you. That is to say, you’re going to have some opinion about yourself no matter what, and without self-awareness it’s going to be a distorted one.
I can’t handle the idea of paying someone like that even a single time, I’d feel so ripped off and violated.
As a psychotherapist, working with people who are self-aware is a pleasure. I wouldn’t ever say that to someone if not meant as a genuine compliment.
Although I believe not many of our patients actually are as self aware as they think. I think we as humans often are good in introspection where it’s easy and comfortable to do so, while glaring over pretty blatant cognitive errors in some other parts, and this is usually where problems arise and disorders develop. And interestingly some people seem to think of themselves as someone who’s perfectly introspective but just for some external, unchangeable factor immune to any kind of positive change. Maybe they could feel irritated about the compliment, because in their minds it reinfoces their idea of being helpless against their problems (in the sense of: I already know everything, it’s just not possible to change anything or I would’ve already done that)? I could imagine that’s how I would feel, but of course it’s just a guess.
It can be, though quite often anxiety can manifest as being too self-aware all the time, to the point that it’s getting in the way of actually enjoying life.
aaaaah yes fair i can see that, sounds a smol bit like me but bit more negative… good to know.
It’s also worth pointing out, I think, that if you’re only aware of your weaknesses and such, but don’t/can’t recognize your strengths, then you’re not really that self-aware
I feel that’s kind of getting into gate-keeping territory. Self-awareness imo just requires a person to be aware of themself, and whether that person is self-critical or self-appreciating is a different analysis of that awareness.
I’d argue self-appreciation and self-deprication can both get in the way of self-awareness. Someone experiencing clinically significant grandiosity is likely lacking in self awareness just as someone experiencing clinically significant negative self talk (i.e., cognitive distortion) is likely lacking in self awareness
This seems to come down to a difference in definition. You are viewing self-awareness as only able to be positive, and having an implied lack of bias.
I don’t expect either of those, I just view it as someone thinking about how they think or act, regardless of whether bias exists in that process. It’s all self-awareness.
I am not at all viewing it as only able to be positive; it should be accurate. Why call it awareness if it’s not reflecting reality?
That’s not self awareness, that’s meta cognition
Metacognition is a sub-portion of self-awareness that does not look at behavior. They’re intrinsically tied to one another, but self-awareness is broader than metacognition.
I’m not saying either of our definitions are incorrect - ‘self-awareness’ changes meaning somewhat depending on whether it’s being used philosophically, psychoanalitically, etc. And the fact it’s now used by the general public its meaning naturally shifts. I am saying your definition is more exclusionary, though, treating it more as a virtue to strive for rather than just an action one takes.
Functionally, if the only self-awareness is accurate self-awareness, then it can only be an advantage, and thus positive.
I would also argue that awareness does not need to be reflective of reality - you can be aware of hallucinations you are experiencing, or you can be aware that you are experiencing hallucinations. Both are awareness, but only one is more accurate to reality.
That’s fair, I glossed over the “act” part of your statement
Also fair, but the context here is it being used as a compliment from a therapist
Ah I see, I misunderstood what you meant by positive; I thought you were referring to the bit about being aware of your strengths.
I do think exclusively accurate self-awareness can absolutely be a disadvantage though.
Mm- I think I agree semantically, like technically it can mean that, but it’s pretty confusing. Consider how the session note looks when written each way:
Client reported experiencing auditory perception in the absence of external stimuli.vs
Client reported awareness of auditory perception in the absence of external stimuliThe latter, to me, sounds self contradictory
Alright I think we’re about on the same page now. It’s more how we are perceiving the compliment by the therapist.
Like, yes, self-awareness in itself is important for self-improvement, and some folks completely lack the habits of introspection and self-analysis, so at least having self-awareness is good. I would say that it’s more a first step, though, a skill that can be leveraged for improvement.
I’ve previously had a similar conversation with one of my former therapists where he commented on my self-awareness, but did later talk to me about my anxiety and self-conciousness being from that self-awareness. Essentially, focusing on how I’m acting and thinking, and making too harsh of judgements on minor mistakes or inconsequential failings.
That’s apart of why I don’t view self-awareness as the state of being accurately dialed in about yourself yet, but instead just in the habit of noting your thoughts and behaviours, regardless of whether you’ve actually figured out your biases or not yet.
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“You’re very self-aware” is basically a meme in the corners of the internet that discuss trauma. It’s a genuine compliment on the part of the therapist, but also an implied admission that they won’t be able to help you.
You’re already aware of the observations they would make and the tools they would propose, so you might as well skip to the end and look for another therapist.
oooooh wow… gosh yea… thanks for sharing.
Is there actual evidence that CBT actually works? It’s always thrown out there as something that helps, but it doesn’t. It doesn’t work.
It depends if you’re really into it. Personally I don’t like my testicles being hurt.
My understanding is that it’s the best method we have at the moment, but might still be ineffective for as much as half of all patients who undergo it.
So, yeah, it kind of sucks, but no other intervention has a better body of evidence behind it. Our understanding of mental illness is unfortunately just very limited.
I seem to recall that, consistently, the quality of the therapeutic relationship is the most important factor for improvement. In other words, get a therapist you like rather than one specialized in a certain branch of therapy 🤷♀️
a horrifying amount of what determines the quality of any treatment for anything is just finding a person whose #1 priority is trying to make you feel better, rather than make money or just get through patients ASAP
Yes! In fact, that’s its biggest selling point. It’s an evidence-based therapy.
Just go on google scholar, type in “CBT meta analysis” and read the results
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Google Scholar is scholar.google.com.
scholar.google.com/scholar?hl=en&as_sdt=0%2C44&q=…
Sorry, I’m convinced meta analyses are garbage written by the least capable academics. They create yet another “study” that supports X or Y position without testing anything at all–that outsiders use to further an X or Y agenda. More meta-studies based off other meta-studies! It’s mountains of useless bullshit.
How brain-rotted do you have to be to think this says anything? “We reread the articles and they still say the same thing… because… they’re written.” Maybe we should perform another meta-analysis on the same articles! Third time’s the charm!
The underlying papers are of no use at all:
Like holy shit, really? This is your foundation of evidence that CBT works? Just look at the proponents of CBT–it’s a magical, effective treatment for everything under the sun! I can’t take it seriously, especially when it’s pushed as being as effective as medications.
I had some blood work done and it indicated that I would likely have a negative or poor response to an antidepressant I’d been taking for nearly a year. I’d tell the doctors that it does absolutely nothing, but they kept increasing the dose and insisted it would do something positive. It never did. These are the same disinterested, bullshit doctors that would tell you to engage in CBT.
All the therapists would gaslight you into believing it’s all your fault: just think your way out of it. Fucking bullshit. Absolute puerile bullshit.
The reality is I suffer from something that has a genetic component to it: crippling depression that runs in the maternal family. No. Talk therapy doesn’t do shit. No. CBT doesn’t do shit. Appropriate drugs actually work and I’m now in a so much better place after living my whole life with crippling depression, anxiety and panic attacks. I finally feel able to live a normal life. Do you know how much money and time I’ve wasted on talk-therapists? They’re not doctors. They’re complete time-wasters. They should be banned as I’m convinced they perpetuate harm.
Even proponents of talk-therapy have that fundamental caveat that absolves them of everything: it could take years before you see any results. It’s all con-artists selling snake-oil. Psychology is such a bull shit field.
Meta analysis is actually the best class of scientific evidence. A meta analysis looks at the totality of research on the subject. Because any single study can yield different results, scientists need to do many studies. Certainty in science comes from replication. If repeated studies show the same results, those results become more certain. If a new meta analysis confirms the result of an old meta analysis, it shows the results are likely to be accurate.
The new meta analysis included newer research. That conclusion is saying that the newer studies match the results of the old ones. That’s how science works. Nothing can be certain unless its replicable. Most science is like this. Papers are written by scientists for other scientists. Meta analysis from every field are exactly like this.
But any study like these looking for the general case. This analysis is making limited claims with strong certainty. This study is saying that, with a great deal of certainty, CBT has a small to medium effect on most people, but not all of those who get it.
There are many problems in medicine. You have encountered many of them.
Its clear CBT didn’t work for you, but that in no way means that the science is wrong, or that meta analysis, as a concept, are bad science.
The drugs that you are taking were studied in exactly the same way. There are analycies and meta analycies on their effects that will sound just as pointlessly reduntant as the one you looked at. That is the process.
How about this?
This is the “Wykes and colleagues (2008)” cited in the first sentence. The only reason your example paragraph sounds like that is because everything it wants to say has indeed already been written.
I’ll get back to you, probably over the weekend.
Sadly this is all medicine, I lost so much faith in it as soon as it wasn’t “extremely obvious problem with extremely obvious solution.” For the brain, it’s a much worse situation because we understand it so little. It turns into “throw random ideas at it and hope one works” and a lot of people are just lonely or needed lifestyle changes so it “works” for them :/
I agree with a lot of what you say, especially being forced into an “evidence” based system, I was like, who’s evidence? Because I can surface studies that show things you don’t support work, but anyway.
Ive gotten help from a talk therapist, she saved my life, but according to the healthcare system where I live now, there’s no evidence it helps and I can go fuck myself.
That’s why meta-analyses are so important. They look at every attempt at studying said thing and see whether it worked significantly more times than it didn’t, and why people don’t just cite a single study as conclusive evidence.
And what nuance do we lose in between?
That’s why writing meta-analyses is considered quite the task and why scientists only get to write them by invitation.
omg thanks for pointing that out
Therapy will not fix anything if you’re unwilling to make the effort to change.
At this point, if you still lack motivation, maybe it’s time to go the medication route. It helped me overcome the inertia.