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PaperclipPerfector  1yr ago (text post)   25230 thread views

Culture War Roundup for the week of October 30, 2023

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I would be curious to see the efficacy of therapy on reducing suicide rates among men in particular. I imagine it's tricky to disentangle selection effects: people who go to therapy are more likely to be suicidal than the general population, but suicidal individuals who go to therapy are probably less suicidal than suicidal people who don't go to therapy.

Therapy-as-it-actually-exists does seem to be less efficacious for men than women. Enough to make it have no effect? Not sure.

Therapy-as-it-actually-exists does seem to be less efficacious for men than women

Is that true, or do women just actually like therapy?

Full disclosure- I think therapy works for trauma and phobia related issues, and is useful for management strategies on depression/anxiety issues, and maybe has some applicability to rarer issues(eg the vanishing penis syndrome Scott wrote about) or for managing mental health care when there’s 20 different providers, but is basically hokum outside of that. And functionally all hokum works on the basis of empathizing with the mark and then telling them what they want to hear. Women like empathy where men as often find it annoying. So women like therapy in a way men don’t, but it has the same effectiveness for both. And obviously that leads to women pointing to it as useful even when time and drugs/life changes did the heavy lifting, while men point to it as stupid and useless in the same circumstances.

I wonder what the overlap is between liking therapy and believing in other hokum (eg astrology, acupuncture).

I dunno. For people who don’t actually have a problem it seems like a one to one trade off with psychics, so I’d expect it’s actually negative.

Yeah, my understanding is that most of the therapy techniques were designed based on female patients, and therefore focus more on things like feelings rather than solutions to object-level problems. However competent ones exist, and will tailor their style based on the needs of their patient (or at least identify when they aren't a good fit and refer them to other therapists with a better-suited style). A suicidal man seeing Jordan Peterson isn't going to get a bunch of mamby pampy nonsense about "aw, I'm sorry to hear that, how does that make you feel?", they're going to get "that sucks, life sucks, but your life isn't over, let's come up with an actionable plan for how to make it suck less" and then having an actionable plan helps fix your mental state because you have a goal you can work towards (and once you enact the plan your life is objectively improved and that helps your mental state). Even a good therapist can't unilaterally fix your life for you, but they can help convince you to fix your own life and figure out how instead of wallowing in self-misery and inaction.

Why would therapy be less effective for men? I’ve heard moreso that men don’t want to start going to therapy for various reasons (associating therapy with leftism is a new one for me, which I don’t really understand) but it’s a very useful tool to have.

And there’s more than one way to practice it - cognitive behavioural therapy has been found to be effective for anxiety, depression, PTSD, ADHD, and more, and I can’t conceive of a reason it would be less effective for men.

A couple factors. One major one is the gender of the therapist: therapists are something like 3/4 female, and trending more female. This leads to several issues. For one, treatment methodologies get skewed, in terms of renown, research, and funding, toward those that female therapists prefer. Therapists are more capable of empathy toward people like them, and oftentimes patients react better to therapists who have a similar background as them.

Another, more speculative angle is that mental health issues can be intrinsic (caused by how people interpret their experiences) or extrinsic (caused by the experiences themselves). This is a bit murky: e.g. if you're depressed and traumatized because you were in a war and saw your best buddy blown to bits, that's pretty extrinsic, but perhaps some interpretative work could genuinely help alleviate the pain. But I do think it's a meaningful distinction, and therapists would be better suited to intrinsic issues. If women's issues are more intrinsic and men's more extrinsic, therapy would be less effective at effectively addressing the average male issue than the average female one.

I’m not sure there’s a difference between how the emotions from how interpret the experience vs. the experience itself? Mental issues are by definition intrinsic. Not all soldiers develop PTSD after experiencing a traumatic event - there seems to be many variables influencing its development, such as age, pre existing conditions, support network, even genes (I’m reading that PTSD is 30-40% heritable). And there’s depressingly large amounts of women that have PTSD from sexual assaults and physical abuse - while only a small minority of men become soldiers in the west.

I’m also not sure what you mean by women’s mental issues being more intrinsic? Anxiety, depression, addiction and abusive relationships would be common reasons the average westerner would go to therapy, and I don’t see how there’s a difference in “cause” there when it comes to gender?

Why would therapy be less effective for men?

One reason might be that therapists consider masculine qualities and attributes to be pathological, and thus treat men like broken women.

Therapy culture is very blue coded. Therapy culture seemingly embraces fragility as a virtue.

That hasn’t been my experience. I did CBT and there it was quite focused on tracking my emotional state and finding actions to regulate it, and more ordinary talk therapy where I was pushed to be more assertive, recognise abusive relationships and be more emotionally resilient overall. therapy does encourage you to have more self-compassion and avoid emotional repression, but to me that’s the opposite of fragility. People who bottle up everything tend to be very brittle - seeming solid until it gets too much and they shatter.

Effective forms of therapy can exist while 90%+ of therapy sessions are useless or actively harmful.

A patient who is cured might only need 5 sessions. A patient whose condition doesn't improve may have 1 session per week forever.

In this model, even if half of patients are cured by therapy, something like 99% of sessions are a complete waste of money.

Therapy culture. Not all therapy. But also I think your assumption is people can either be emotional or bottle up emotions. Stoicism is another path.

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