23 comments

[ 2.8 ms ] story [ 62.5 ms ] thread
Don't miss the review of all therapy books ever that's linked at the end of part I. For one thing, it's hilarious, and for another, the context it adds is pretty helpful.
Very interesting read, well explained and somehow 'feels right'. I didn't think psychotherapy could work until it was explained to me this way.
In two words, cognitive dissonance
But why, and how not to?
“ And then Richard was instantly cured, and never had any problems speaking up at work again. His coworkers all applauded, and became psychotherapists that very day. An eagle named “Psychodynamic Approach” flew into the clinic and perched atop the APA logo and shed a single tear. Coherence Therapy: Practice Manual And Training Guide was read several times, and God Himself showed up and enacted PsyD prescribing across the country. All the cognitive-behavioralists died of schizophrenia and were thrown in the lake of fire for all eternity.“

What the hell inspires people to write these insane rants?

I would consider that hilarious, well deserved mockery of an author overselling their argument. It certainly didn't read as a "rant", insane or otherwise.
Agreed, the quoted passage is not a rant; it’s a cute joke.

The GP probably skimmed the article and reacted too quickly.

That's probably the best bit of the whole piece.
It's a pretty well known copypasta meme... see here: http://www.wikicu.com/Copypasta, section called "Someone was teaching a class"
For the HN-reading 22-year-old out there who is trying to climb out of that first unspeakably horrible episode of mental illness, and as part of that, trying to grok what psychiatry really is: at this point in history, models (theoretical or other) are great and can drive progress in psychiatry, but don't for one minute believe any hype like this, from the reviewed book's Amazon page:

"Ticic and Hulley equip readers to carry out focused, empathic therapy using the process found by researchers to induce memory reconsolidation, the recently discovered and only known process for actually unlocking emotional memory at the synaptic level."

Just, no. It's not even worth refuting. What happens at the synaptic level, and what happens at the emotional level, the experience of emotions? We are not meaningfully closer to bridging that gap than we ever have been. Despite great advances in brain science, that sort of talk still belongs in philosophy, not science or medicine.

This is not to say that UTeB or EIEIO or whatever model doesn't hold promise for those of us with lived experience of mental illness. The evidence base for talk therapy continues to evolve. Just ignore any kind of "unlocking secrets" talk. We aren't there yet. We aren't close. But on the web pages that sell books, we are always on the verge of...

Yeah, I mean things like PTSD exist in the brain for a reason, you were in a situation where some action almost ended your life, so now you are frightened by it. Undoing or expelling that kind of information from your brain is really difficult.
Thanks for this comment.

". . . only known process for actually unlocking emotional memory at the synaptic level."

With this, they've taken what may (or may not, I don't know) have taken a legitimate, professional approach to therapy and put it on par with snake-oil charlatanry, on the level of "dynamic neural retraining" practitioners who claim to effect neuroplastic changes in specific areas of the brain with zero evidence; something that researchers have yet to do. It's just CBT performed by "life coaches". It's interesting that the FDA doesn't come down on these sorts of unsupported medical claims.

Thanks for this comment- do you think you could reach out to me? Contact information is on my about, thanks
Hi Malp. What is the reason for your inquiry?
Your comment resonated with me and I was curious to see if you had any other insight that you might be able to share- however, the comments section of an HN post seemed too public for the subject matter.
Wait, does this imply that ruminating and getting blackout drunk could be an effective form of therapy?
It would certainly explain its popularity as a coping mechanism!

To be a little bit more forthright -- I'm not sure the fundamentally dissociative pharmacological pathways that alcohol stimulates are close enough to the psychedelic ones that SA talks about later on in the post to be fungible.

>> The predictive model output the anxiety, using reasoning like “if you talk, people will hate you, and the prospect of being hated should make you anxious – therefore, anxiety”, but not any of the intermediate steps.

That really makes it sound like poor Richard was some kind of robot with an AI that used some kind of machine learning algorithm to build models etc.

It sounds a bit silly to be honest, like taking an analogy ("the human mind builds a model of the world"), mashing it up with some currently trendy terminology ("machine learning model") and then running with the result until it's stretched out to an absurd extent and you can't tell what the words mean anymore.