Any thoughts on this critique of therapy?
January 29, 2025 3:03 AM Subscribe
This article trashing psychodynamic therapy has me shook and I'd like to hear people's thoughts.
I've been in group therapy for many years. I've always known psychodynamic therapy is NOT a science. I've regarded therapy as an open conversation for the most part.
However, I myself have been wondering whether genetics is largely at play and whether we disregard it far too much.
This article made me feel uncomfortable as it more or less dismisses the early childhood and ACEs theory.
I do believe for example, that I'd still be shy and quiet whatever family I was raised in. But I struggle to believe that what I've observed of my siblings who have suffered significant traumas in their early years, has not had a huge effect on their personality now.
I wanted to know peoples thoughts on the twin studies he cites as well, as it does sound pretty convincing.
I've been in group therapy for many years. I've always known psychodynamic therapy is NOT a science. I've regarded therapy as an open conversation for the most part.
However, I myself have been wondering whether genetics is largely at play and whether we disregard it far too much.
This article made me feel uncomfortable as it more or less dismisses the early childhood and ACEs theory.
I do believe for example, that I'd still be shy and quiet whatever family I was raised in. But I struggle to believe that what I've observed of my siblings who have suffered significant traumas in their early years, has not had a huge effect on their personality now.
I wanted to know peoples thoughts on the twin studies he cites as well, as it does sound pretty convincing.
I did psychodynamic for years. Cognitive behavioral was a revelation. Should have started earlier. YMMV.
posted by captainscared at 3:54 AM on January 29 [1 favorite]
posted by captainscared at 3:54 AM on January 29 [1 favorite]
This author seems to be massively missing the point: that families, and by extension all relationships including therapist-client ones, are what conditions good or ill mental health. We learn how to deal with being human through our relationships with other humans. That’s why ACEs matter, less because they’ve happened than how people around you have taken care of you and helped you to deal with them, or otherwise.
I’m surprised that allegedly psychodynamic training teaches that families have no influence on personality. Unless I misread that in the article. Looking forward to further comments.
I also wondered offhand how good or how challenged (in forming effective therapeutic relationships with their particular clients) this particular therapist is in their work.
posted by lokta at 4:18 AM on January 29 [3 favorites]
I’m surprised that allegedly psychodynamic training teaches that families have no influence on personality. Unless I misread that in the article. Looking forward to further comments.
I also wondered offhand how good or how challenged (in forming effective therapeutic relationships with their particular clients) this particular therapist is in their work.
posted by lokta at 4:18 AM on January 29 [3 favorites]
I read about 70% of that article on Aeon yesterday, & then bailed. It's a totally valid point that many forms of therapy lack an evidential basis - and it's almost trivially true that any kind of intervention will sometimes have adverse effects. Same could be said for penicillin.
There are also many anecdotal reports from people for whom therapy of whatever kind has been successful.
Why does therapy work for some people & not for others? Epidemiologists and health services researchers and practitioners and policy makers need to know the answer to that question - they care whether a given intervention is widely effective over a given population. It's a complex question & there are a lot of confounders in the data - genetics & cultural factors not least, as the article describes.
But as individual service users, we don't need the answers to population-level questions. We really only care whether it's working for us. If your therapy group feels like a useful part of your life, then stick with it. It doesn't matter whether it would be an effective intervention for somebody else - only for you.
posted by rd45 at 4:25 AM on January 29 [24 favorites]
There are also many anecdotal reports from people for whom therapy of whatever kind has been successful.
Why does therapy work for some people & not for others? Epidemiologists and health services researchers and practitioners and policy makers need to know the answer to that question - they care whether a given intervention is widely effective over a given population. It's a complex question & there are a lot of confounders in the data - genetics & cultural factors not least, as the article describes.
But as individual service users, we don't need the answers to population-level questions. We really only care whether it's working for us. If your therapy group feels like a useful part of your life, then stick with it. It doesn't matter whether it would be an effective intervention for somebody else - only for you.
posted by rd45 at 4:25 AM on January 29 [24 favorites]
Sunflower88, you might find this podcast On Trauma and Vegetation Gods - the link has some text summary - about the history of treating trauma in different cultures, helpful.
posted by Zumbador at 5:25 AM on January 29 [4 favorites]
posted by Zumbador at 5:25 AM on January 29 [4 favorites]
It's widely known that the relationship accounts for the majority of therapeutic outcome, over and above specific methodologies, techniques, interventions, etc. I see the author basically saying they're abandoning the dogma of certain of schools of thought in order to focus back on the relationship. Certainly not revolutionary.
Some of this article does resonate with me, as a therapist. I do feel like a relational sex worker at times, and feel that much of what I offer could be replaced by solid friends/family, but that so many do not have that. I feel that the dogma of all the different schools of therapy is misguided and frankly quite annoying. I lament that much of the general public sees us therapists as imbued with some special knowledge or solution that really, we don't have. I'm disturbed by the pathologization of many very normal/human experiences and behaviours. I'm concerned about labels becoming an easy way to dismiss a person (eg narcissist), and increasing isolation resulting from us becoming more and more intolerant to each other's human flaws.
Obviously all of this is with caveats and exceptions, but there it is. I went into this field to help people but often feel conflicted about my work and my role in the psychological industrial complex. I think the author overstated for clicks/views, but I do see some truth here.
posted by EarnestDeer at 5:28 AM on January 29 [28 favorites]
Some of this article does resonate with me, as a therapist. I do feel like a relational sex worker at times, and feel that much of what I offer could be replaced by solid friends/family, but that so many do not have that. I feel that the dogma of all the different schools of therapy is misguided and frankly quite annoying. I lament that much of the general public sees us therapists as imbued with some special knowledge or solution that really, we don't have. I'm disturbed by the pathologization of many very normal/human experiences and behaviours. I'm concerned about labels becoming an easy way to dismiss a person (eg narcissist), and increasing isolation resulting from us becoming more and more intolerant to each other's human flaws.
Obviously all of this is with caveats and exceptions, but there it is. I went into this field to help people but often feel conflicted about my work and my role in the psychological industrial complex. I think the author overstated for clicks/views, but I do see some truth here.
posted by EarnestDeer at 5:28 AM on January 29 [28 favorites]
+1 on Abigail Shrier fandom as a serious hit to credibility.
I don't know. I think this article treats the concept of personality as an afterthought and doesn't do nearly enough to define what the author means by it and how it intersects with the context and goals of therapy. Frankly, duh that in key ways we fundamentally are who we are and different people respond to similar events differently, but also duh that our childhood experiences impact our beliefs about ourselves, other people, and the world and shape our approaches to relating and thinking.
There is clearly some insider baseball weariness here about dogmatic beliefs in the field, but this misses how individualized the practice of therapy is; personally, the therapy I've had as an adult has dipped in and out of childhood where relevant, but it hardly lives there or even focuses on it overmuch. It meets me in the moment, which is regardless of how much of who I show up in the world as is due to experience and how much to genetics (or a secret third thing; I have thoughts).
The sex work analogy is obnoxious and unnecessary, and the argument that therapy is intended to happen "rather than attempting to engage with family or friends about painful and sensitive matters" instead of as a support for doing those things is spurious. I am not a therapist but am professionally trained in another form of "being for another" and as the author says right up top, "doing it well takes experience, intelligence, wisdom and knowledge." We do not live in a culture that prepares most people to do it well. Experiencing what happens when you get to be in that kind of relational environment is meant to feed back into living, not to replace it.
Overall: some food for thought, sure, but nothing really groundbreaking and certainly nothing that supersedes your own self-knowledge.
posted by wormtales at 6:00 AM on January 29 [5 favorites]
I don't know. I think this article treats the concept of personality as an afterthought and doesn't do nearly enough to define what the author means by it and how it intersects with the context and goals of therapy. Frankly, duh that in key ways we fundamentally are who we are and different people respond to similar events differently, but also duh that our childhood experiences impact our beliefs about ourselves, other people, and the world and shape our approaches to relating and thinking.
There is clearly some insider baseball weariness here about dogmatic beliefs in the field, but this misses how individualized the practice of therapy is; personally, the therapy I've had as an adult has dipped in and out of childhood where relevant, but it hardly lives there or even focuses on it overmuch. It meets me in the moment, which is regardless of how much of who I show up in the world as is due to experience and how much to genetics (or a secret third thing; I have thoughts).
The sex work analogy is obnoxious and unnecessary, and the argument that therapy is intended to happen "rather than attempting to engage with family or friends about painful and sensitive matters" instead of as a support for doing those things is spurious. I am not a therapist but am professionally trained in another form of "being for another" and as the author says right up top, "doing it well takes experience, intelligence, wisdom and knowledge." We do not live in a culture that prepares most people to do it well. Experiencing what happens when you get to be in that kind of relational environment is meant to feed back into living, not to replace it.
Overall: some food for thought, sure, but nothing really groundbreaking and certainly nothing that supersedes your own self-knowledge.
posted by wormtales at 6:00 AM on January 29 [5 favorites]
It means that the effect of your family environment – whether you are raised by caring or distant parents, whether in a low-income or high-income family – matters very little...
cites a study self-described:
“primarily middle class (average family income was $25,000 to $35,000)”
Even two centuries ago, G W F Hegel... didn’t obsess about childhood
See previously
posted by HearHere at 6:18 AM on January 29 [3 favorites]
cites a study self-described:
“primarily middle class (average family income was $25,000 to $35,000)”
Even two centuries ago, G W F Hegel... didn’t obsess about childhood
See previously
posted by HearHere at 6:18 AM on January 29 [3 favorites]
At the risk of making a no true Scotsman argument, my takeaway from the article is that there are a lot of bad therapists and unhelpful therapeutic modalities, and that this therapist may have been one of them. I don't think this means psychodynamic therapy is never helpful.
The author's discussion of personality, ACEs, and trauma appears flawed to me. If ACEs are not, on their own, a strong predictor of negative psychiatric outcomes, that doesn't mean that trauma-centered therapy is never appropriate for those who do have subjective experiences of trauma. Something can be helpful for one person and not another.
I find the cross-cultural analysis interesting in theory and very boring in this context. People in Sri Lanka may find different meanings in adverse experiences, but that doesn't mean that Westerners can will themselves into a more "appropriate" reaction to suffering. (Weird how Western thinkers only seem interested in the Global South when they're making a rhetorical point.)
Finally, I disagree with the author that "truly horrendous" childhoods are rare, and I can only boggle at this sentence: "More than a quarter of Americans have cut off a family member; it is statistically improbable that most of these estrangements are for the sort of egregious abuse we might imagine merits it." Truly a wild statement to make in 2025, when more than a quarter of Americans are supporters of a political movement rooted in toxic disregard for other people's human rights. Is it any surprise that some of their kids feel a need to process their childhoods in therapy?
I had a traumatic childhood and see psychodynamic therapy as a tool with a pretty specific use case - considering the current popularity of CBT, I think that's a mainstream opinion. I do agree with the author that our cultural narrative about trauma is flawed - as a younger person, I assumed that all of my issues were due to trauma, but turns out I am also queer and neurodivergent. Coming to an understanding of my identity as intersectional in this way was really hard when the trauma loomed so large. But I think that's an issue with our culture, not just current psychotherapy.
Tl;dr, psychodynamic therapy is not for everyone and some of its proponents have silly ideas, but the way this article talks about ACEs and the subjective experience of trauma strikes me as reductive and dismissive.
posted by toastedcheese at 6:30 AM on January 29 [17 favorites]
The author's discussion of personality, ACEs, and trauma appears flawed to me. If ACEs are not, on their own, a strong predictor of negative psychiatric outcomes, that doesn't mean that trauma-centered therapy is never appropriate for those who do have subjective experiences of trauma. Something can be helpful for one person and not another.
I find the cross-cultural analysis interesting in theory and very boring in this context. People in Sri Lanka may find different meanings in adverse experiences, but that doesn't mean that Westerners can will themselves into a more "appropriate" reaction to suffering. (Weird how Western thinkers only seem interested in the Global South when they're making a rhetorical point.)
Finally, I disagree with the author that "truly horrendous" childhoods are rare, and I can only boggle at this sentence: "More than a quarter of Americans have cut off a family member; it is statistically improbable that most of these estrangements are for the sort of egregious abuse we might imagine merits it." Truly a wild statement to make in 2025, when more than a quarter of Americans are supporters of a political movement rooted in toxic disregard for other people's human rights. Is it any surprise that some of their kids feel a need to process their childhoods in therapy?
I had a traumatic childhood and see psychodynamic therapy as a tool with a pretty specific use case - considering the current popularity of CBT, I think that's a mainstream opinion. I do agree with the author that our cultural narrative about trauma is flawed - as a younger person, I assumed that all of my issues were due to trauma, but turns out I am also queer and neurodivergent. Coming to an understanding of my identity as intersectional in this way was really hard when the trauma loomed so large. But I think that's an issue with our culture, not just current psychotherapy.
Tl;dr, psychodynamic therapy is not for everyone and some of its proponents have silly ideas, but the way this article talks about ACEs and the subjective experience of trauma strikes me as reductive and dismissive.
posted by toastedcheese at 6:30 AM on January 29 [17 favorites]
As an addendum, I just did a quick PubMed search and there are a number of studies about PTSD in survivors of the 2004 tsunami? I'm not knowledgeable enough to evaluate them, but it makes me really skeptical of the claims here. This author describes their field as "unevidenced," but it doesn't appear that their ability to evaluate social science research has improved since they came to this realization.
posted by toastedcheese at 6:37 AM on January 29 [3 favorites]
posted by toastedcheese at 6:37 AM on January 29 [3 favorites]
I kind of have four reactions – hopes it helps you.
One is, what kind of psychotherapy is she talking about? And with kids, I’m not sure psychotherapy has been shown to be as effective as say, play therapy. I wish the author had gone into this more.
Two is, I don’t think the evidence for ACE score vs. outcome is really completely in because the measurements are not yet necessarily consistent. I do think it’s good for people to be aware that the science on this is not all that sciency in some ways (I think the physical health aspects are increasingly so though.) But that's not the same as concluding that they don't matter - I think that's suspect.
Three, there is always, always, always a backlash against believing people about the impact of trauma, particularly hidden traumas like abuse, so I think it’s important to take this in cultural context that way.
Four though, honestly I think there is some truth at the margins there. I had a bad therapist who was very traditional about focusing on recalling memories, and that therapy was actively bad for me. When I found a therapist who supported me both in working through issues that were in the present but also allowing for what came up around those issues (Gestalt-trained therapist with a rich background in therapy with women dealing with abuse issues) it was life-changing. It wasn’t forever though – 5 years, and that includes the fallout of the death of my daughter.
I have observed people over decades where I thought their whole identities became “needs therapy” and I really can’t say but it felt like they were pretty stuck in the idea that talking about their pasts would solve their presents. I believe it’s a handshake – you do need to understand some of your past, enough to understand the impacts of it in some of your responses and fears and concerns and feeling like shit, but then you also need to focus on the present and go out and do things and test reality and try new ways of relating and set your ethical guide to how you will interact with others and all those things.
So I can see how if you are a therapist focused on the first piece, you’ll start to disbelieve in it.
And probably some of that really is personality-based. My sister knows about our shared past, has no memory of almost anything before she turned 16, doesn’t want to, and is by all indicators a very successful (super successful professionally – top 2% of her area) and happy adult. It works for her. But that doesn’t mean I didn’t need therapy or that my personality is weak. I’m just as a happy and successful to the degree I want to be – I don’t want her career.
Anyways, I think it’s always important in therapy to ask every 6 months or so whether it’s creating good change. There will be times it sucks, but if it sucks and sucks and sucks, then it’s probably not the right therapy. If you can see growth in your life, whatever that means for you, then hey.
posted by warriorqueen at 6:42 AM on January 29 [6 favorites]
One is, what kind of psychotherapy is she talking about? And with kids, I’m not sure psychotherapy has been shown to be as effective as say, play therapy. I wish the author had gone into this more.
Two is, I don’t think the evidence for ACE score vs. outcome is really completely in because the measurements are not yet necessarily consistent. I do think it’s good for people to be aware that the science on this is not all that sciency in some ways (I think the physical health aspects are increasingly so though.) But that's not the same as concluding that they don't matter - I think that's suspect.
Three, there is always, always, always a backlash against believing people about the impact of trauma, particularly hidden traumas like abuse, so I think it’s important to take this in cultural context that way.
Four though, honestly I think there is some truth at the margins there. I had a bad therapist who was very traditional about focusing on recalling memories, and that therapy was actively bad for me. When I found a therapist who supported me both in working through issues that were in the present but also allowing for what came up around those issues (Gestalt-trained therapist with a rich background in therapy with women dealing with abuse issues) it was life-changing. It wasn’t forever though – 5 years, and that includes the fallout of the death of my daughter.
I have observed people over decades where I thought their whole identities became “needs therapy” and I really can’t say but it felt like they were pretty stuck in the idea that talking about their pasts would solve their presents. I believe it’s a handshake – you do need to understand some of your past, enough to understand the impacts of it in some of your responses and fears and concerns and feeling like shit, but then you also need to focus on the present and go out and do things and test reality and try new ways of relating and set your ethical guide to how you will interact with others and all those things.
So I can see how if you are a therapist focused on the first piece, you’ll start to disbelieve in it.
And probably some of that really is personality-based. My sister knows about our shared past, has no memory of almost anything before she turned 16, doesn’t want to, and is by all indicators a very successful (super successful professionally – top 2% of her area) and happy adult. It works for her. But that doesn’t mean I didn’t need therapy or that my personality is weak. I’m just as a happy and successful to the degree I want to be – I don’t want her career.
Anyways, I think it’s always important in therapy to ask every 6 months or so whether it’s creating good change. There will be times it sucks, but if it sucks and sucks and sucks, then it’s probably not the right therapy. If you can see growth in your life, whatever that means for you, then hey.
posted by warriorqueen at 6:42 AM on January 29 [6 favorites]
Abigail Shrier’s Bad Therapy has too much culture war nonsense in it, but it does make some good points and I wish a less ideologically driven writer would publish in that area. A couple of years ago I'd read The Body Keeps Score and I was shocked to discover that it was pop science woo. Too much of Shrier’s book is taken up with ranting about fake problems or issues that only pop up in wealthy school districts.
However, I myself have been wondering whether genetics is largely at play and whether we disregard it far too much.
Genetics, the physical environment, hormones--future people will probably look at psychodynamic therapy the way we look at the four humours. However, we're not future people, so we work with what we have. In general, I think that if therapy is helping someone do what they want to do in life, then they should continue with it. If it's not working, try something else.
posted by betweenthebars at 7:36 AM on January 29 [1 favorite]
However, I myself have been wondering whether genetics is largely at play and whether we disregard it far too much.
Genetics, the physical environment, hormones--future people will probably look at psychodynamic therapy the way we look at the four humours. However, we're not future people, so we work with what we have. In general, I think that if therapy is helping someone do what they want to do in life, then they should continue with it. If it's not working, try something else.
posted by betweenthebars at 7:36 AM on January 29 [1 favorite]
I'm pretty sure I just read (or skimmed towards the back half) someone's midlife crisis. He's been pursuing a path, he's lost faith, and now he's overcompensating. It happens with true believers of every stripe.
Lots of motivated reasoning and cherry picking going on.
Which isn't to say there isn't a lot of valid criticism on the topic, but this particular author very much seems to be airing his crisis of faith.
posted by Tell Me No Lies at 8:17 AM on January 29 [11 favorites]
Lots of motivated reasoning and cherry picking going on.
Which isn't to say there isn't a lot of valid criticism on the topic, but this particular author very much seems to be airing his crisis of faith.
posted by Tell Me No Lies at 8:17 AM on January 29 [11 favorites]
Having lived and done therapy in both North America and the UK, I'll add that, in my experience, therapists in the UK are more aligned with the Freudian tradition. That includes his disciples, as well.
I think it's also reasonable to assert that much of the Anglo world has moved away from Freud significantly, and in some cases, completely. Heck, even zeitgeist-y approaches like attachment theory were developed by lapsed (or in the case of Bowlby, exiled and excommunicated) Freudians. So when I read this article, I see it more as a pretty specific rebuke of the more psychoanalytic/Freudian/Jungian approaches, and only tangentially about other modalities (even though it mentions a few).
Make of it what you will, but the conclusion at the end--that the author now focuses on resentment and eliminating it--sounds a lot like what many mindfulness-oriented therapists do now...just perhaps not so much in the UK.
posted by yellowcandy at 8:40 AM on January 29
I think it's also reasonable to assert that much of the Anglo world has moved away from Freud significantly, and in some cases, completely. Heck, even zeitgeist-y approaches like attachment theory were developed by lapsed (or in the case of Bowlby, exiled and excommunicated) Freudians. So when I read this article, I see it more as a pretty specific rebuke of the more psychoanalytic/Freudian/Jungian approaches, and only tangentially about other modalities (even though it mentions a few).
Make of it what you will, but the conclusion at the end--that the author now focuses on resentment and eliminating it--sounds a lot like what many mindfulness-oriented therapists do now...just perhaps not so much in the UK.
posted by yellowcandy at 8:40 AM on January 29
Oh, and my brother's first pass at his psych thesis was going to concern the psychological development of twins. About the time he hit this...
The extremely sparse data set doesn't help things either. IMHO, psychological twin studies should be taken with a grain of salt.
posted by Tell Me No Lies at 8:44 AM on January 29 [2 favorites]
"There is a genetic correlation in how events affect twins, but only events that affect them individually and that they had a hand in making. There is no correlation for family events even if they affect the twin and none in any case for events that the twin had no hand in."...he decided the rabbit hole would go too deep.
The extremely sparse data set doesn't help things either. IMHO, psychological twin studies should be taken with a grain of salt.
posted by Tell Me No Lies at 8:44 AM on January 29 [2 favorites]
I wanted to know peoples thoughts on the twin studies he cites as well, as it does sound pretty convincing.
He greatly overextends the findings of twin adoption studies, since even that very body of research finds sharing a genome accounts for, on the high end, 60% or so of the variance on certain outcome measure. This means even in these high-end cases, ~40% of the variance is not explainable by genetics alone. That number is not what has been found for all outcome measures, which means that for these many other outcome measures, the % of variance explained by non-genomic factors must necessarily be even higher. More broadly, the field of behavioral genetics has really moved on from the "nature vs nurture" framing that he relies heavily on--these days it's much more "gene x environment," where the interest is in understanding the way genes and environment mutually influence each other. The rise of epigenetics as a discipline has lent a lot of research support and momentum for this framework.
It's widely known that the relationship accounts for the majority of therapeutic outcome, over and above specific methodologies, techniques, interventions, etc. I see the author basically saying they're abandoning the dogma of certain of schools of thought in order to focus back on the relationship. Certainly not revolutionary.
my takeaway from the article is that there are a lot of bad therapists and unhelpful therapeutic modalities, and that this therapist may have been one of them. I don't think this means psychodynamic therapy is never helpful.
What really struck me reading this: despite using the labels "psychodynamic" and "psychoanalysis," he was ultimately disillusioned by something that psychoanalysis isn't. And in response, he changed his way of working to--very ironically--resemble more of what psychoanalysis actually is. I truly don't know what to make of that - whether that means he's a bad therapist, or he's engaging in bad-faith, or who knows what else. As the old saying goes: on the internet, nobody knows if you're actually a dog.
I think the author overstated for clicks/views, but I do see some truth here.
I feel similarly, as a psychoanalytic psychologist. It's very apparent that psychotherapy sensibilities have made their way into mainstream culture and discourse, but I'm inclined to see it less as a problem with psychotherapy (and there are problems, don't get me wrong) than as an outcome of contemporary cultural and technological trends coming together. There's an unavoidable craving for some recognition of our humanity and subjectivity, especially in the face of capital's encroachment on all domains of life, and therapy is--for good reason--a place where people have found that. But at the same time, the drive of capital always demands there to be more and more satisfaction, and in adopting that attitude ourselves, we easily go overboard and apply (I think unwittingly for the most part) the various procedures and practices of psychotherapy in ways that don't make sense or turn out to be actually harmful.
That's all I'll say on that point, because I'm gonna need to put on my tinfoil hat if I keep going.
posted by obliterati at 9:57 AM on January 29 [7 favorites]
He greatly overextends the findings of twin adoption studies, since even that very body of research finds sharing a genome accounts for, on the high end, 60% or so of the variance on certain outcome measure. This means even in these high-end cases, ~40% of the variance is not explainable by genetics alone. That number is not what has been found for all outcome measures, which means that for these many other outcome measures, the % of variance explained by non-genomic factors must necessarily be even higher. More broadly, the field of behavioral genetics has really moved on from the "nature vs nurture" framing that he relies heavily on--these days it's much more "gene x environment," where the interest is in understanding the way genes and environment mutually influence each other. The rise of epigenetics as a discipline has lent a lot of research support and momentum for this framework.
It's widely known that the relationship accounts for the majority of therapeutic outcome, over and above specific methodologies, techniques, interventions, etc. I see the author basically saying they're abandoning the dogma of certain of schools of thought in order to focus back on the relationship. Certainly not revolutionary.
my takeaway from the article is that there are a lot of bad therapists and unhelpful therapeutic modalities, and that this therapist may have been one of them. I don't think this means psychodynamic therapy is never helpful.
What really struck me reading this: despite using the labels "psychodynamic" and "psychoanalysis," he was ultimately disillusioned by something that psychoanalysis isn't. And in response, he changed his way of working to--very ironically--resemble more of what psychoanalysis actually is. I truly don't know what to make of that - whether that means he's a bad therapist, or he's engaging in bad-faith, or who knows what else. As the old saying goes: on the internet, nobody knows if you're actually a dog.
I think the author overstated for clicks/views, but I do see some truth here.
I feel similarly, as a psychoanalytic psychologist. It's very apparent that psychotherapy sensibilities have made their way into mainstream culture and discourse, but I'm inclined to see it less as a problem with psychotherapy (and there are problems, don't get me wrong) than as an outcome of contemporary cultural and technological trends coming together. There's an unavoidable craving for some recognition of our humanity and subjectivity, especially in the face of capital's encroachment on all domains of life, and therapy is--for good reason--a place where people have found that. But at the same time, the drive of capital always demands there to be more and more satisfaction, and in adopting that attitude ourselves, we easily go overboard and apply (I think unwittingly for the most part) the various procedures and practices of psychotherapy in ways that don't make sense or turn out to be actually harmful.
That's all I'll say on that point, because I'm gonna need to put on my tinfoil hat if I keep going.
posted by obliterati at 9:57 AM on January 29 [7 favorites]
This author, at the very least, has some biases that haven't been unpacked. For example, describing adverse childhood events and trauma as "bad events [that] create indelible stains on our minds, stains that forever taint our experience of the world" is putting a lot of negative, judgemental, quasi-moral weight on the concept that I don't think is either justified or representative of the general theraputic perspective. If most therapists believed that ACE's were "indelible" then they wouldn't bother with them in therapy; this kind of therapy exists precisely because of the belief that those events don't have to "forever taint" people's lives, that therapy can help people process them and live happily.
teaching [children] that how they feel is not necessarily how things are, and that they may be held hostage by emotions if they don’t learn to move on from them. A child’s anger should not automatically be honoured, and their resulting difficult behaviour should most certainly not be rewarded with special accommodations.
This paragraph is also troubling; it's a misrepresentation of current best practices in childhood emotional social development that uses therapy-type language to broadly dismiss children's subjective emotional experience, suggest that children's emotions are not primarily driven by their real-world experiences, and dismiss the very concept of accommodations (a word which is primarily used in context to describe disability support) as "special rewards". The choice of anger as the representative emotion obscures the repressive, dismissive attitude of this section; imagine saying "a child's sadness should not automatically be honored" or "a child's pain should not automatically be honored" or even, "a child's happiness should not automatically be honored". Blech. I don't know whether the author realizes that they are advocating a return to the "children should be seen and not heard" worldview, but that's effectively what they are doing.
(As an aside, if adverse childhood events aren't real and also children's feelings should not be honored, then it is logical to conclude that physical punishment for children is a benign, or possibly even beneficial, parenting tool. Again, the author is not directly advocating this--but it is contextually a reasonable outcome of this argument.)
I also find the bare assertion that other cultures don't experience trauma deeply unconvincing. It is natural that mental health challenges are mediated by culture and expressed differently between cultures, or even that a specific culture may have a more or less successful way of dealing with one aspect of mental health. But any argument that depends on "our" culture being uniquely different from all the rest of humanity (for good or ill) demands quite extraordinary evidence. "We here in the degenerate west..." is the starting point for a lot of racist/eugenicist worldviews and for me that sends up a red flag.
posted by radiogreentea at 10:05 AM on January 29 [13 favorites]
teaching [children] that how they feel is not necessarily how things are, and that they may be held hostage by emotions if they don’t learn to move on from them. A child’s anger should not automatically be honoured, and their resulting difficult behaviour should most certainly not be rewarded with special accommodations.
This paragraph is also troubling; it's a misrepresentation of current best practices in childhood emotional social development that uses therapy-type language to broadly dismiss children's subjective emotional experience, suggest that children's emotions are not primarily driven by their real-world experiences, and dismiss the very concept of accommodations (a word which is primarily used in context to describe disability support) as "special rewards". The choice of anger as the representative emotion obscures the repressive, dismissive attitude of this section; imagine saying "a child's sadness should not automatically be honored" or "a child's pain should not automatically be honored" or even, "a child's happiness should not automatically be honored". Blech. I don't know whether the author realizes that they are advocating a return to the "children should be seen and not heard" worldview, but that's effectively what they are doing.
(As an aside, if adverse childhood events aren't real and also children's feelings should not be honored, then it is logical to conclude that physical punishment for children is a benign, or possibly even beneficial, parenting tool. Again, the author is not directly advocating this--but it is contextually a reasonable outcome of this argument.)
I also find the bare assertion that other cultures don't experience trauma deeply unconvincing. It is natural that mental health challenges are mediated by culture and expressed differently between cultures, or even that a specific culture may have a more or less successful way of dealing with one aspect of mental health. But any argument that depends on "our" culture being uniquely different from all the rest of humanity (for good or ill) demands quite extraordinary evidence. "We here in the degenerate west..." is the starting point for a lot of racist/eugenicist worldviews and for me that sends up a red flag.
posted by radiogreentea at 10:05 AM on January 29 [13 favorites]
As an aside, if adverse childhood events aren't real and also children's feelings should not be honored, then it is logical to conclude that physical punishment for children is a benign, or possibly even beneficial, parenting tool. Again, the author is not directly advocating this--but it is contextually a reasonable outcome of this argument.
Popping back in to add that my experience with Aeon, as a publication, is that it generally leans right-libertarian on matters of culture and politics. This implication would be right up their alley then.
posted by obliterati at 10:09 AM on January 29 [5 favorites]
Popping back in to add that my experience with Aeon, as a publication, is that it generally leans right-libertarian on matters of culture and politics. This implication would be right up their alley then.
posted by obliterati at 10:09 AM on January 29 [5 favorites]
I read your question this morning and then stumbled across this r/AskHistorians thread about whether ancient warriors experienced PTSD.
It’s not a direct answer to your question but has some interesting perspective.
As far as this bit:
“ Sri Lankans don’t see their civil war or their tsunami as traumatic – in fact, when an army of trauma counsellors descended upon the nation after the tsunami of 2004, the University of Colombo pleaded with them to cease seeing suffering as traumatisation as it was undermining people’s resilience. Sri Lanka happens to top the charts for wellbeing in the ‘The Mental State of the World in 2023’ report despite such denial of the gospel of trauma.”
As an expert in nothing, I’d be curious about that culture’s attitude towards trauma and whether there’s a believe that acknowledging it is weak. And whether that in any way influences reporting on mental health. It seems like the author shared info and suggested that it had a simple and clear explanation instead or raising more questions, and I’m not sure that is the case.
posted by bunderful at 10:58 AM on January 29
It’s not a direct answer to your question but has some interesting perspective.
As far as this bit:
“ Sri Lankans don’t see their civil war or their tsunami as traumatic – in fact, when an army of trauma counsellors descended upon the nation after the tsunami of 2004, the University of Colombo pleaded with them to cease seeing suffering as traumatisation as it was undermining people’s resilience. Sri Lanka happens to top the charts for wellbeing in the ‘The Mental State of the World in 2023’ report despite such denial of the gospel of trauma.”
As an expert in nothing, I’d be curious about that culture’s attitude towards trauma and whether there’s a believe that acknowledging it is weak. And whether that in any way influences reporting on mental health. It seems like the author shared info and suggested that it had a simple and clear explanation instead or raising more questions, and I’m not sure that is the case.
posted by bunderful at 10:58 AM on January 29
Citing Abigail Shrier and then making any claims about mental health research—even legitimate, peer-reviewed, mainstream academic research—is like citing RFK Jr and Andrew Wakefield, then making claims about vaccine science research. The author might as well say “I’m a big fan of using poorly done, debunked research if its conclusions suit me, and making up dishonest and misleading claims about legitimate research to support my argument.”
I’m a therapist, and I believe there are many good and necessary critiques to make about the mental health field and psychotherapy. Including some things that could sound aligned with this person’s argument. However, this person is acting in bad faith.
posted by theotherdurassister at 11:26 AM on January 29 [4 favorites]
I’m a therapist, and I believe there are many good and necessary critiques to make about the mental health field and psychotherapy. Including some things that could sound aligned with this person’s argument. However, this person is acting in bad faith.
posted by theotherdurassister at 11:26 AM on January 29 [4 favorites]
A couple of thoughts....
As the parent of a child who has violent meltdowns, I found the "case study" about the child in the article very thin. It doesn't even mention the child's age. The implication that addressing the concerning behaviors with therapy is a kind of reward for the child that reinforces the behavior is, I think, totally bogus. I'm not an expert here but I think there are better modes for addressing disregulation in kids than talk therapy about past trauma. I'm glad this therapist decided to stop working with kids.
Also I was thinking about the Dar Williams song "What Do You Hear in these Sounds" which is very lovely and about her experience in therapy. Maybe you'd like it.
posted by hovey at 12:19 PM on January 29 [5 favorites]
As the parent of a child who has violent meltdowns, I found the "case study" about the child in the article very thin. It doesn't even mention the child's age. The implication that addressing the concerning behaviors with therapy is a kind of reward for the child that reinforces the behavior is, I think, totally bogus. I'm not an expert here but I think there are better modes for addressing disregulation in kids than talk therapy about past trauma. I'm glad this therapist decided to stop working with kids.
Also I was thinking about the Dar Williams song "What Do You Hear in these Sounds" which is very lovely and about her experience in therapy. Maybe you'd like it.
posted by hovey at 12:19 PM on January 29 [5 favorites]
I think this guy is so full of it there's no room for even the most elementary understandings of genetics, physiology, or evolution; in all of which he sees only what he wanted to and thinks he knows already.
And he has absolutely no clue about justice. Would he counsel Jimmy Savile's victims to get over their "resentment" about their abuse and the way they were told to shut up, and experience "gratitude" instead? Or kids who were raped by their fathers or uncles?
posted by jamjam at 2:58 PM on January 29 [4 favorites]
And he has absolutely no clue about justice. Would he counsel Jimmy Savile's victims to get over their "resentment" about their abuse and the way they were told to shut up, and experience "gratitude" instead? Or kids who were raped by their fathers or uncles?
posted by jamjam at 2:58 PM on January 29 [4 favorites]
Sounds like your underlying questions are:
- “am I broken, was I born to be broken because of genetics”
No. As people have said, a whole whack of research has now shown most things are a mix of nature and nurture. Schizophrenia and bipolar disorder are highly heritable, otherwise there are pretty much equal contributions from genes and environment.
- “is there hope for me if I work on things”
Yes. Always! Brains change structure and function in response to experience even in adulthood. Even in old age!
- “is therapy the way to do that and if so what kind”
This is the controversy I guess.
I honestly think maybe 10-15% of therapists of any stripe are any good or worth the time and expense. And, I strongly believe the field needs reform focusing on more accountability and oversight re therapists, and easier access to eg ombudspeople for clients, because abuses of power are almost built into the dynamic. I mean if you’re lucky you might run into a good therapist, and I hope you do.
The core things I think most agree are usually goals of therapy are: trying valued but scary things with support, finding meaning in experience, establishing intimacy and trust in others, accepting yourself, building community, achieving career and avocational goals.
So in addition to therapy if that is helping, at risk of being reductive, I would say, look for opportunities in life that could help with the things you need to address. (Eg writing can be a way of making sense of your life, autobiography is therapeutic for many. Other art forms too. We can always push ourselves to take little risks, and reach out to people more often.) I have definitely found it to be true that relationships and life experiences have done more to help me grow than therapy, hands down. In terms of focused talk, peer support (even online) >>>>>>>> therapy (for me, YMMV). Which isn’t to say it doesn’t help people, it can and does.
posted by cotton dress sock at 5:36 PM on January 29 [1 favorite]
- “am I broken, was I born to be broken because of genetics”
No. As people have said, a whole whack of research has now shown most things are a mix of nature and nurture. Schizophrenia and bipolar disorder are highly heritable, otherwise there are pretty much equal contributions from genes and environment.
- “is there hope for me if I work on things”
Yes. Always! Brains change structure and function in response to experience even in adulthood. Even in old age!
- “is therapy the way to do that and if so what kind”
This is the controversy I guess.
I honestly think maybe 10-15% of therapists of any stripe are any good or worth the time and expense. And, I strongly believe the field needs reform focusing on more accountability and oversight re therapists, and easier access to eg ombudspeople for clients, because abuses of power are almost built into the dynamic. I mean if you’re lucky you might run into a good therapist, and I hope you do.
The core things I think most agree are usually goals of therapy are: trying valued but scary things with support, finding meaning in experience, establishing intimacy and trust in others, accepting yourself, building community, achieving career and avocational goals.
So in addition to therapy if that is helping, at risk of being reductive, I would say, look for opportunities in life that could help with the things you need to address. (Eg writing can be a way of making sense of your life, autobiography is therapeutic for many. Other art forms too. We can always push ourselves to take little risks, and reach out to people more often.) I have definitely found it to be true that relationships and life experiences have done more to help me grow than therapy, hands down. In terms of focused talk, peer support (even online) >>>>>>>> therapy (for me, YMMV). Which isn’t to say it doesn’t help people, it can and does.
posted by cotton dress sock at 5:36 PM on January 29 [1 favorite]
I briefly skimmed through all of the articles he linked, which may well make me more knowledgeable about their contents than this author. Most articles are only tenuously linked to the topic the author is discussing, and even then they rarely support his conclusions. Of the two twin articles, one is just describing the data being collected for an ongoing longitudinal study of twins born in England and Wales between 1994 and 1996, and the other is quite dense but does not appear to draw any conclusions to back up the claim that "childhood events and parenting rarely matter that much in terms of how we turn out".
He then asserts, "But at the end of the day, without cherry-picking data conforming to what I learned in my training, the simple fact was this: twin sisters with identical genes raised in totally different families developed very similar personalities, while adopted sisters with no genetic links raised in the same family had very different personalities". However, the article in Developmental Psychology he's referencing is actually about how siblings who experience more parental negativity have more depressive symptoms and antisocial behavior than their better treated siblings, which directly contradicts his point!
I could go on. If nothing else, it's an egregious abuse of citations.
posted by fox problems at 7:23 PM on January 29 [4 favorites]
He then asserts, "But at the end of the day, without cherry-picking data conforming to what I learned in my training, the simple fact was this: twin sisters with identical genes raised in totally different families developed very similar personalities, while adopted sisters with no genetic links raised in the same family had very different personalities". However, the article in Developmental Psychology he's referencing is actually about how siblings who experience more parental negativity have more depressive symptoms and antisocial behavior than their better treated siblings, which directly contradicts his point!
I could go on. If nothing else, it's an egregious abuse of citations.
posted by fox problems at 7:23 PM on January 29 [4 favorites]
The theories behind Freudian psychoanalysis are not really falsifiable, so that's a problem for the theoretical side of traditional psychoanalysis. But that doesn't mean psychodynamic therapy isn't an efficacious treatment. Most studies suggest it helps, on average, YMMV.
posted by shadygrove at 9:14 PM on January 29
posted by shadygrove at 9:14 PM on January 29
Abigail Shrier is a TERF and anyone who repeats her uncritically is not reliable.
posted by praemunire at 9:31 PM on January 29 [3 favorites]
posted by praemunire at 9:31 PM on January 29 [3 favorites]
Coming late to the party but I've been thinking about your post and my struggles with the article. I had a look at comments to the article and this response from the author (not sure how to quote that) helped me clarify where the problem lies. As a member of a number of minorities (migrant, lesbian, autistic) I have a visceral reaction to white dudes telling me not to harbour resentment and minimise my experience of xenophobia/homophobia.
25 January 2025
Hi Raul,
That is indeed the reason why I did not bring in Critical Race Theory and similar resentment based narratives - it breeds resentment and victimhood, splits society apart, and should be avoided. The past was imperfect, in all cultures and societies, just like the present is, let’s move towards making the future better. The sketchy claims of intergenerational trauma allow resentment narratives to pretend to have a modicum of scientific validity, and should also be treated with caution.
By contrast, I am all for community and collective connections - healthy communities that do not dwell on the sins of the great grandfathers, that do not sit on edge watching for micro-aggressions, that do not insist on healing but instead on growing - join me in them!
posted by coffee_monster at 3:21 AM on January 31
25 January 2025
Hi Raul,
That is indeed the reason why I did not bring in Critical Race Theory and similar resentment based narratives - it breeds resentment and victimhood, splits society apart, and should be avoided. The past was imperfect, in all cultures and societies, just like the present is, let’s move towards making the future better. The sketchy claims of intergenerational trauma allow resentment narratives to pretend to have a modicum of scientific validity, and should also be treated with caution.
By contrast, I am all for community and collective connections - healthy communities that do not dwell on the sins of the great grandfathers, that do not sit on edge watching for micro-aggressions, that do not insist on healing but instead on growing - join me in them!
posted by coffee_monster at 3:21 AM on January 31
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Excuse me, I must go fetch my enormous grain of salt before I finish reading this article.
posted by wakannai at 3:11 AM on January 29 [11 favorites]