Why is therapy bad so often?
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collected some scattered thoughts here:
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@slatestarcodex post on therapy books all promising to bring about revolutionary change but all therapies seeming about equally okay in studies. i have many thoughts:
1. what if therapies start out effective but people adapt to them over time
slatestarcodex.com/2019/11/20/boo
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skimming back over this + the original SSC post and i think i am more confident in the "people develop resistance to therapy techniques" + "therapists get worse at passing them on" combination
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what this implies, quite regrettably, is that talking about e.g. IFS too much in public will eventually make it work worse 😬
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That just means therapists are bad tho doesn't it?
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Like, if you're not dealing with resistance to change and meta-reaistance what even are you doing? Don't you notice your clients getting more and more resistant over time?
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antibiotic resistance doesn't mean doctors bad
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Doesn't it? It seems to come largely from overproscribing them.
Seems fairly analgous.
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I guess it could be a useful analogy if CBT resistance was from *overprescription* but I don't know that that's happening?
In any case my point is that if you see a doctor and they can't treat resistant bacteria that's not because they're individually inept
Same for therapists
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I agree that if treatment methodology resistance is from overprescription then maybe therapists as a group should look into that
"Sorry I'm going to urge you to keep catastrophizing - if you stop you may build CBT resistance"
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i think this is happening basically, although "keep catastrophizing" is not the thing i'd recommend to do instead
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5 (cont). and meanwhile i suspect CBT-style countering can actually suppress the relevant emotional material more. it's like trying to shut up a crying child instead of finding out what they're crying about - not only are they still upset, now they trust you less
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Huh I *have* heard this complaint about CBT. So maybe there could be a systemic CBT resistance problem.
I'm still doubtful. Is there really enough ambient CBT to create a suppressive resistance effect? I don't think I see it.
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enough for scott to write an entire post about it anyway
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