Comment on What's the deal with male loneliness?

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Apytele@sh.itjust.works ⁨2⁩ ⁨weeks⁩ ago

As someone who works in mental health I’m actually with you but first I need to clarify that therapists don’t prescribe meds, psychiatrists do. Therapists usually have at least a bachelor’s usually a masters in one of a couple non-medical (or better stated, medical-adjacent) fields. A psychiatrist is a medical doctor who completed full medical school and a residency specializing in psychiatry. Even a doctorate in psychology is not a medical doctor. A therapist is going to talk to you and provide one of two basic functions: allowing you to vent / express your emotions to a completely supportive person, and teach social skills and emotional intelligence. Psychology = talking, psychiatry = drugs. This is an important distinction because while talk therapy is often more helpful than medications for certain disorders, it’s a lot more expensive to pay for an hour human emotional presence than having a doctor (even with their more specialized knowledge) listen for fifteen minutes then decide which neurotransmitters are maybe involved the most and picking a chemical from a list to throw at the problem and see what sticks.

Now even with therapy being more helpful for certain things, I don’t think it’s actually a good solution (or again, better-stated, a good long term solution). It’s definitely going to help with this kind of problem because the core issue is largely behavioral, not neurochemical, but first of all it’s putting our emotional wellness in the hands of capitalism which is… terrible. I cannot express how much that idea terrifies me.

But second of all, as someone who’s actually had 300h of therapy for a personality disorder, it starts to lose efficacy over time due to a lack of true emotional intimacy. Once you know the DBT manual front to back plus 100h of general psycheducation on pavlov and maslow, they’re not really doing skills teaching anymore, they’re just listening to you bitch. And listening to you bitch is… fine. But even that starts to lose efficacy when you start feeling like they have no idea what you’re actually talking about. I realized this recently when I had an extremely stressful experience at work and the therapist was like,“yeah that sucks” but my work friends were all like,“oh yeah she was waaay out of line you did exactly the right thing” because my therapist knew my account, but my coworkers knew more sides of the story and still sided with me and that just… meant a lot more.

And finally the other core issue is that true emotional connection, the kind humans truly crave, is reciprocal. A therapist has boundaries to maintain that are actually pretty critical to the function of the therapeutic process. The relationship being a completely one-sided support is the whole point. It prevents the abuse of the relationship by someone who knows both more about the person and more about human behavior in general to a person who is emotionally vulnerable for one reason or another. Having those boundaries preserves what therapy does the most good for. But that also means it’s going to feel hollow after a while because in the long term what people truly need is reciprocity so they can feel the satisfaction of also helping the other person (in more ways than a monetary transaction). Therapy can help you learn more about how to build those relationships, but it can’t replace those relationships, not in the long term anyway. I even see this in my own patients, I’m having to constantly reinforce boundaries that they’re pushing not out of malice but just because they’re instinctually craving a deeper connection than I can safely offer for either of our sakes.

Anyway I think you’re right, especially about the thirdspaces, but I do worry that people will be somewhat negatively reactive to the way you’ve expressed it here. When I’ve stated as much with this little background, even stating that my perspective is informed by extensive personal AND professional experience has pretty much every layperson getting out their pitchforks.

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