Writing this as an LMSW with 2+ years of seeing clients under my belt, this is basically how I see my role. I’m not imparting Ancient Wisdom or some magical mantra, how can I when I’m a regular schmuck like you?
Instead, I’m forcing you to look at things you might not reflect too deeply about on your own and also making you look at the parts of your life that makes your skin crawl. Not because I enjoy watching you squirm, but because its hard for us to do this ourselves and we are really good at avoiding those messy questions we have about what matters to us or why we are consistently dissatisfied.
People who do therapy and get a complex about it have completely missed the point. If it’s working, it should open up a better understanding of your processing system and discover your preferences, as Scott said. Though I lightly disagree and do think all of us have hidden compartments as it relates to what we might value and prefer. Just to different degrees.
I agree to this extent: therapy, and people's experience with it, are heterogeneous. There's no one thing that therapy is "like." I don't doubt that some experiences with therapy are good. But I share your initial judgment that most therapy is bad.
I wonder to what extent asexuality and aromanticism can be explained by preference alexithymia for sexual and relationship partners, respectively. I don't think all; it's plausible to have no strong desire for any kind of sex or relationship, just like some people don't enjoy food at all as much as others. On the other hand, exploring different types of sex and relationships requires much more effort and risk than trying different foods, and if you don't realize what you're missing out on, you might never do much exploring.
The problem with Western therapy is that it's SO generic. If your marriage sucks, you need specific skills to make it work or alternatively I guess help finding a new partner you can be happy with. All of these things require hands on training in relevant practical skills and help with meeting three right kind of people. So a matchmaker or a life couch. Same thing if your problem is job or health or lack of good friendships - you need professional classes, social clubs, gym coach and so on. Just sitting on the couch and talking is based on ideal of mind over matter, whereas in reality humans require a right environment and skills that can only be learned through practice rather than abstract reasoning. For alexithymia it might be acting classes to practice and recognize expression of different emotions. Also it's important to recognize that people are often stuck in a local maxima and making changes is likely to initially make things worse, with no guarantee that they will ever get better. Are you really likely to improve your life long term after divorcing a cheerleader? Anyway, when such changes are undertaken, someone will need a lot of hands on support rather than just talk to get to the other end.
I’ve never met any of these overly therapists folks who feel they are better than anyone else. Is the ratio really any higher than among other groups-MDs, lawyers, yoga instructors, etc?
One more thing, in passing. My experience is that good therapy depends upon a match of the modality, practitioner, and client. There some pretty meh practitioners out there, and some modalities that I judge are less effective than others. But in the hands of a good practitioner l, even a meh modality can yield good results. And even if both practitioner and modality are meh, but are a good fit for a particular client, there can be good results. And this is without going into how easy or hard it is for the client to access their issues and their causes.
Typo in the last paragraph? Fails to parse for me. "Weirdly, the original complaint a lot of people happened with the polyamory memoir that started this discussion was ..."
I think as far as True-Selfing goes, the best way to find what you are missing is to examine really closely the things in your life that don't work or aren't working, usually around social interactions. But to do this you first have to avoid blaming everyone else or other things on the thing that didn't work well and acknowledge that it's worth examining regardless of what the causative factors may be (basically, being a scientist about it and not deciding the conclusion before doing the investigation).
Why assume finding your "true self" is a good thing? Sure, they might be miserable in their current situation, but at least they have the fortune of not knowing that there's an alternative. But if they find out they do have desires that can potentially be fulfilled, how far will they go to accomplish that? Even in the example you gave, that knowledge ultimately resulted in a divorce, and that's still a relatively benign example. What if their desires completely alienate them from society? What if they have desires that can only be fulfilled through hurting others?
Desire is a dangerous, volatile thing. People without it are relatively harmless and docile. For the sake of a stable society, shouldn't we keep any unnecessary desire from flourishing?
This seems like survivorship bias to me. I mean, you're already Scott Alexander.
For the rest of us, becoming what we want to be requires a messy process that might end up failing. But we have to change to become extraordinary (ironically people like Scott, who already have it made, are flexible enough to have the best odds of opportunities of further upward momentum coming from an unexpected angle).
I used to be totally dominated by other people's preferences, but now I've discovered my true self. But is this a reasonable thing to believe? It sounds like an over-update. Much therapy takes place in a time of crisis.
The biggest problem with therapy culture (not therapy, but the ecosystem/discourse around it) is not the true-selfism but (1) continuing pathologisation of normal human experiences leading to the creation or reinforcing of notions of people as both fragile and damaged and lacking resilience. See: the idea that pretty much everyone is traumatised, likely by their childhood experiences (2) outsourcing of emotional support to professionals not by necessity but because of belief that friends and family don't know how to provide it and could be dangerous (3) last but biggest, encouraging endless inward looking self-focus instead of engaging with the external physical and social world, this includes looking for internal solutions to externally solvable problems and centering internal experiences over intersubjective ones.
Disclaimer: I had actual therapy after traumatic bereavement, it was useful; and because I think by talking still see a "counsellor" I pay to sit there and listen to me talk at her without a feeling I'd need to reciprocate. So not anti therapy at all.
Is there an opposite situation where therapy can also help someone aware of their preference but perhaps not aware that their prioritisation of these is done to a level that makes it difficult to interact with them? I say this considering that at a lot of evangelists of therapy culture don't come across as people following cultural expectations but people who are genuinely opinionated about the correctness of their preferences, and for all the criticisms of various sorts of therapy, I don't think they reinforce that level of belief.
This exactly describes what I think is going on with jhanas - I don't think people are actually achieving transcendent joy, I think they're just detaching themselves from their emotions and convincing themselves they are, just like the guy who convinces himself he isn't angry while slamming doors.
The way I think of it is that you’re always trying to get to a best-fit curve. Nobody gets everything they want all the time. Nobody is ever at a state of rest where things don’t need to be assessed and reassessed. You might want something at a 10 but you settle for the thing you want at a 7 because you need to accommodate some other moral imperative. We’re a buffet table of wants and motivations and I think it can be a mistake to over-identify any single one of them as your primary self. You’re the music of those things, not any single note.
Is there a word for people who understand their moods but don't understand the reason behind them very well? Like the difference between:
"I'm angry because Fred is a stupid moron coming to my office to waste my time" vs.
"I'm angry because a work task went badly, a meeting ran long, I'm hungry, and I thought I was about to have lunch but now Fred has come to my office to talk to me. Fred isn't doing anything wrong but I feel angry at him for other reasons."
The second guy is much much more likely to be nice to Fred and to control and understand his anger. He might tell Fred to come back after lunch instead of getting in a fight. It's not implausible to me that therapy could help turn person 1 into person 2, or help with a more continuous case where someone is generally unhappy or angry because of something in their lives they hadn't really thought about.
'Maybe “finding your true self” just means “being able to access your preferences, the same way non-alexithymics do as a matter of course”.'
Meh. 'Finding' your True Self is just a bad model. Too simplistic and removed from base reality to be useful.
The brain is a network with many different structures and substructures, that form factions with varying access to consciousness, all competing, cooperating and often being very confused. There is no specific part or coalition of it, that's more true, than any of the others. You can create a self-conception, that harmonizes conflicting preferences and minimizes prediction error reliably, makes you generally thrive.... and hopefully it will last longer than next Tuesday, if you're lucky. But this is not some hidden gem deep inside a person, that just needs to be discovered. It is rather a self-propagating process that you have to build, maintain and often adapt to changing environments and requirements.
I don't think getting in touch with your "true self" is necessarily a good thing. To take the food analogy, should we encourage people to get in touch with their "true" preferences for hamburgers, crisps, and sweets? To take the sexuality analogy, should we encourage people with paraphilias to get in touch with their "true, authentic selves"?
In regards to advice that people do or don't need:
I've put a lot of work into improving my kinesthesia. For quite a while, I'd talk about it as though this was something that would be good for everyone and I couldn't understand why most people weren't very interested in doing it.
Later, I came to understand that I was on the numb side of typical kinesthesia. I started out on what might be considered the subtly clumsy side of normal. Functional, but not generally physically skilled, except for good dexterity.
I was surprised to find there was a reason I would occasionally fall down. My legs were so tight that I didn't step forward enough unless I swung my lower leg around the outside. If I didn't swing it high enough, I'd catch my toes on the ground and fall. In a sense, not a big deal when I was a kid, but it's much better not to be falling now.
I wasn't trying to improve walking and it was a surprise when walking changed from something to be ignored to a moderate pleasure. I was driven by a sense that something was wrong and I needed for it to be better.
Athletes use Alexander Technique and Feldenkrais Method and such because they care a lot. Most people seem to be fairly comfortable with what they can do. They might even be concerned that trying to change their kinesthesia would make matters worse rather than better.
> You know how sometimes you pretend to like something because it’s high-status, and if you do it well enough you actually believe you like the thing? Unless I pay a lot of attention, all my preferences end up being not “what I actually enjoy” but like “what is high status” or “what will keep people from getting angry at me”.
Honestly, this quote never cease to horrify me every time I’m reminded of it.
Isn't this simply one of those cases where different advice is applicable to different people: some people would benefit from being more assertive, others from being more mindful of others, some would benefit from taking more risks and others from being more cautious, etc along any number of dimensions, and whether advice in a given direction is good or not depends more on who takes it than on the advice itself (with the unfortunate dynamic that people are more likely to seek out advice that supports their world view, which tend to move them further along an unhealthy extreme direction). I think this is something Scott himself wrote about on the previous blog, but I can't remember the title of that piece.
Going purely of vibes, it does seem the present zeitgeist puts too high a premium on authenticity and self-discovery, but presumably there are also people who would benefit from moving farther in that direction. It would probably be better to formulate advice in terms of set points rather than directions, "this is how much you should focus on finding your true preferences relative to other concerns, adjust up or down as needed", but such advice requires more work to formulate, won't fit as well into established narratives, and is less optimized for viral spread, etc.
I worry you haven't sufficiently defined therapy culture. I mean it seems to me you gave a really good argument for thinking and talking about your mental state in an intelligent and engaged way.
But that's not how I would understand the term. Indeed, I'd understand therapy culture as being related to genuine self-discovery in much the way DEI culture is related to fighting racial bias and inequality. It's a kind of way of speaking and talking that creates the illusion you are handling a problem without actually doing the hard work that might help so it tends to make it worse.
Also I don't like the whole true self language because it denies the extensive role we play in constructing who we are. Our preferences aren't just given out by god -- maybe some basic dispositions -- but you can learn to have quite different preferences on most things. It's mostly stuff very near core evo activities like mating that is really super sticky.
It seems to me that there are people out there who would benefit from following the 'therapy culture' advice, but that the people who are most prone to it are those who should be seriously considering the opposite of that advice.
Now that I'm in my mid-40s, I cannot imagine wanting to see a therapist for "self-discovery" or to find my authentic True Self. If anything, my biggest problem is that I have a concept of an authentic life at all! Existentialist philosophy was an infohazard. It seems that almost everybody else manages to get through the objectively horrifying process of aging by lying to themselves, pulling little tricks on their brain, or failing that just finding one distraction after another.
The search for your true self is the kind of thing you might find appealing if you felt you were writing your life's journey from scratch, but most people's lives past 40 are more like being called in by the studio to finish the last third of a script that some dude couldn't finish because he got coked out, and who cares anyhow because it's a sequel to some genre flick of no particular distinction. There are absolutely people who can motivate themselves to do the best possible job in that situation, but I doubt they are doing it by searching their souls to find and express the real and authentic.
If you had to give a ballpark estimate, how many people would you suspect fit this criteria?
Would you expect it to be more or less common in developed, high hierarchy-of-needs societies? Intuitively, I’d expect people to be less aware of their preferences when they’re in stressful situations, faced with more pressing concerns. That conflicts with the narrative of “therapy culture” as a luxury belief.
Hey, this is backwards. The analyst sits near the patient's head, a bit back from it so they are not visible to the patient. But maybe Blondie here wants to show off her looks?
I'm not sure whether I'm amused or dismayed that this *defense* of therapy culture includes (or at least strongly suggests) my own subculture's *critique* of therapy culture, i.e. "Therapists will just tell you to divorce your husband."
"Maybe she needed more therapy, not less! Or, at least, better therapy."
Hi Scott!
This points to an anti-generalization that I find myself saying to people more and more frequently. Someone has a bad experience at, let's say, the doctor and then generalize that the medical profession is filled with greedy crooks who order expensive irrelevant tests to cover their heinies. (Similar things can be said for other service professionals like chiropractors, lawyers, accountants, plumbers, etc.)
I struggle with migraines and went down that healthcare road myself and held that jaded perspective for a while. Standard treatments didn't work for me. But eventually, rather than live with the pain, I kept going. Found new doctors, tried new approaches, and created a treatment program that makes the migraines only a minor nuisance once every month or two rather than being an all-consuming black hole 4 times per week.
Looking back, one thing I learned is that there are good doctors and not-so-good doctors, and it makes a huge difference when you have a good one. This should be obvious, because we all know that there are clearly good teachers and not-so-good teachers. A good teacher meets the individual student where they're at rather than trying to apply a canned approach to every student. Well, many doctors, lawyers, accountants, chiropractors, therapists, etc. also take the canned one-size-fits-all approach. If they don't really care about the particulars of your situation, that's what you'll get. Or maybe they find you annoying or a hassle... Or maybe they can make more money if they spend less time on each patient...
At a college, students tell each other which professors are the good ones, but there often isn't that kind of discussion for service professionals. And so, when these issues come up, I make a point of guiding people to visit a specific chiropractor, rather than just to see "a chiropractor".
Your description of generalized prefrence alexithymia reminds me a little of Winnicott's idea of the "false self," which he argues is the result of inadequate mirroring in an individual's infancy, leading to them forming basically a hypervigilant/"compliant" relationship with the world, rather than a spontaneous one. He also argues that this sort of patient is impossible to do traditional psychoanalysis on, until their false self has been erradicated.
Therapy arose in the 19th and got big in the 20th century already, and what they now call "therapy culture" is its full mainstreaming. I don't think something quite this big would arise without answering to some need. And I don't think you need to look very far to find the need. Its early rise coincides quite well with the first wave of secularization of the West. People used to have spiritual advisors (some still do but it's no longer so mainstream). Someone with a professional role who you could talk to about your personal problems and dilemmas, and would (more or less try to) embody some accumulated traditional wisdom. I don't think it's much of a new insight that a good % of therapy is just a secular version of the same, with some changes. Now you're a paying client, which prices it out for many people (bad!), but also gives you choice and empowers you as client (good). The cultural core of the wisdom being applied is now somewhat scientifically attuned (good), but can be spiritually shallow (bad).
As to the question of the "true self", we have to be clear that we're not talking about some transcent self here, so the old debates about self vs no-self don't apply. The self we're talking about is the psychological self here, which is a fairly well-understood phenomenon. When the pieces of you at odds with each other, or exaggeratedly at odds with the world, or too porous, or whatever, get worked on and more or less integrated, you're still "yourself", with your personality and tastes and quirks, but with less suffering, less stuck, somewhat more sane, and probably more capable of embodying the kinds of personal virtues that make you happy and proud to be who you are in the long term. That's what "finding your real self" amounts to. It's good stuff.
Nowadays there has appeared a current of pushback against "therapy culture", and again it's not hard to pinpoint what kind of excess it's aiming at. We live in the era of performance of identity, awash in the mass manipulation generated by modern psychological marketing, unleashed by the lack of friction created by social media platforms. So if there's psychological self to be found, and a vague cultural awareness of it, there's immediately going to be thousands of shitty grifters trying to sell us ersatz versions of it for a subscription fee. And we should not underestimate the sheer impact of psychological marketing - people who are "well in their skin" are hard to sell shit to, so the entire enterprise is basically a globally self-optimized machine for making everyone feel bad about everything, from their body to the world we live in. So of course we do, and then we wonder where the "mental health crisis" may be coming from.
I think part of the impoverishment in the public debate about therapy is the odd mystique it has, which of course is cultivated and encouraged by psychologists and psychiatrists, as well as the universities and hospitals where they must attend extensive extra school.
At bottom, therapy is just talking to someone -- often, that person is small-minded and not very smart, but sometimes that person is insightful, creative, imaginative, and attentive. People who haven't had much of that kind of conversation before often feel, correctly, that they have discovered one of the most valuable and incredible things in the world, something they didn't really know existed or was possible. They can think things they never would have imagined they might think, they can be freed from destructive assumptions, they can practice other ways of thinking and being.
You know... kinda like the experience of reading ACX/SSC! In other words, good therapy is just... you guessed it... rationalist practice!
This is an extremely partial and grudging defence indeed.
When people criticise "therapy culture" I don't think they're against the entire concept of ever talking to anyone about your problems. I think it's mostly about the language and attitudes of therapy escaping into the wild and being used by ordinary, ostensibly-healthy people to justify being jerks.
Therapy will often teach you to focus on yourself in a way that can lead to selfishness. A certain degree of selfishness is somewhat acceptable for people who have serious problems, in the same way that lying around in bed all day is acceptable when you're seriously ill. But when the therapy mindset is used by everybody then it leads to everybody putting themselves first.
When you decide your desires are "needs" then you can justify just about anything.
Honestly, I think that the whole discussion about preferences and "finding my True Self" treats these things as exogenous to the self, imposed from the outside and immutable.
Your preferences and your "True Self" are, to a large degree, mutable. Maybe not *consciously* mutable, but for everything but the most core things, these things can be changed. And in fact *are* being mutated every time you make choices and take actions.
So your "True Self" is the one *you are currently defining by your actions, choices, and beliefs* on a day-to-day basis. And the challenge isn't to *find* this True Self, it's *creating the best True Self you can*.
As was said in the context of making RPG character choices, "Choose Different". You are the one defining your character as you go. There are no "out of character" events, there are only "my character is changing" events.
extremely niche comment that won't be explained, if you know you know:
>You know how sometimes you pretend to like something because it’s high-status, and if you do it well enough you actually believe you like the thing? Unless I pay a lot of attention, all my preferences end up being not “what I actually enjoy” but like “what is high status” or “what will keep people from getting angry at me”.
I'm guessing this friend isn't *actually* lintamande, but the quote definitely reminds me of Sevar.
So Scott, are you talking about all psychotherapies, or about freeform talk-about-whatever therapy? If the latter, I wish you'd make that clear. CBT practitioners like me do time-limited, problem-focused treatments, and that's very different. The goals are not vague, and it's quite possible to assess whether and how much the person's problem has changed. Unless you're inclined to think that CBT, too, is mostly bogus, I wish you would make it clear that it's not in the scorned-with-a-few-grudging-exceptions category.
Also, I'd like to speak up about some ways that freeform talk therapy can be genuinely helpful to people, beyond the way you mentioned. One is to provide a place where people can unburden themselves of disturbing secrets. A guy once came to me ostensibly for treatment of a form of OCD, but he made it clear as soon as we discussed the OCD that he was absolutely unwilling to try to dismantle it. He was about 90% convinced that his OCD concerns were valid fears, and that his compulsions were necessary to keep him safe. So I said, OK, let's talk over your life for a few sessions and see if there's some other way I can be helpful. Within a couple sessions he disclosed that he had a sexual kink that nobody knew about, and that having it made him feel ugly and grotesque and separate from "normal people." So we talked in detail about his kinky interests, and I gave him some information about his kink (it's actually a common one, and last time I checked the literature people with that kink were found not to be less healthy than other people, just higher on openness to experience). And he could see that I was not creeped out by what he'd told me. And all that greatly diminished the shame he felt. So now, about a year later, he's totally "out" with his kink to his friends, and is not having trouble finding woman who like it too, or are curious to give it a try. His life's a lot better, and he spends a lot less time ruminating about OCD-related matters.
Some people come to a therapist without any secret to disclose except that they are terribly lonely, and nothing they have tried has fixed that. Some of them have good social skills and are able to "make friends," with people, but secretly feel disconnected from the friends they've made. Others are stuck in a marriage that feels dead, but are unwilling to consider divorce until the children are older. For these people, seeing a therapist is like visiting a friend. They have someone who is interested in them and wishes them well. That alone makes them feel much better, sometimes enough better to change some problematic things in their lives. I have seen therapy of this kind referred to scornfully as "buying friendship," and I actually think the term is fairly accurate, but the scorn is not so justified. All friendships involve some sort of transaction -- there are things the friend expects you to give, such as sympathetic interest in their breakup, or reassurance about something. In some ways it's cleaner to just pay cash. And I wouldn't call it fake. I don't think most of us are faking interest and goodwill. I'm not. It's one of the bonuses of being a therapist, getting to know and care about people you ordinarily would never even meet, and would not feel an affinity for if you did. The therapist just has to steer clear of expecting from the patient what they would expect from a full, real-life friend -- expecting the other person to get them, take an interest, sympathize, etc. In a lot of ways being someone's paid friend is not greatly different from sex work, which I also think is a legitimate and valuable service.
There is a question of "how to" for preference alignment, and if therapy is the answer then so be it. There is also a question of how malleable our preferences are, and whether it makes sense to develop preferences that more easily attained. If preferences are malleable and therapy can make them cheaper, then so be it.
What I don't see is how preferences anywhere in this matrix would necessarily finger "therapy culture" as the solution. Is this definition of "therapy culture" the complete set of non-medication solutions?
All of this seems to be assuming that "doing what *I* want" is desirable. One alternative I've seen is
"The attitude behind the move was concisely expressed in 2010 when a contestant on a Chinese dating show told her blue-collar suitor: "I'd rather cry in a BMW than smile on a bicycle." The statement went viral." -- Adam Minter
All of this self-centeredness is called "internally directed" in psychlogical lingo, and it's valorized in US culture, but many other cultures prioritize being "externally directed", that is, doing what society and everybody around you expects.
Then again, there are food fads that sweep US culture, along with food status characteristics. ("My farmers' market has bigger, better, fresher tomatoes than yours.") It helps when flaunting your status-gaining attitudes to consciously believe that you actually prefer those things, especially in a culture that valorizes adhering to your authentic self. It's not automatic that stating out loud what you actually prefer is the best strategy, *especially* in the Darwinian snake pit of status competition that is high school.
In regard to polyamory, I would expect that to be quite a mess. For one thing, different people have vastly different preferences for how to run their love lives and (looking at history) there's no reason to believe that we can match up people so the various matches don't contain strong disalignments in preferences. Should people openly express the disalignment between what they've got and what they want, be aware of it but suppress mentioning it, or push it out of sight into the subconscious?
I can relate to both: ignorance of feelings and ignorance of preferences. I have kinda got much better with the first one, however at times it feels I have just learned to guess my emotions by the secondary effects. Like, once I literally said “my girlfriend is always so unbearable whenever I drink coffee”, only to realize it’s not a fact about her.
However, the alexithymia of preferences is harder — I cried reading “Better than Two”, feeling “oh wow you could live like that??”. And still it took some time for me to find that “I want”
However, I wouldn’t think it’s an illness. From where I grew up — post-Soviet Ukraine, and then studied in Russia — there are lots of people who seem to be out of touch with their emotions. Coming to Canada, it surprised me how everyone could be so mature and adult with their emotions.
I’d bet it’s a developmental phase. Same as that other Scott’s post about how the gods are “literally real” for people 3000 years ago, or for kids 2-3-4 years old today. Same way, maybe some people (or cultures) are just stuck in that phase for longer?
I distinctly remember “learning” how emotions feel, and glorifying feeling of terror because it was the first one that became available. I loved reading Stephen King for a while, because that was the only way to feel emotions
"But that’s the same kind of complaint as “sometimes people without ADHD take Adderall”, not “Adderall is a scam”"
Is there any number of people without ADHD taking Adderall that can make it a scam? If Adderall really works to treat ADHD, but also 50% of the population gets a bullshit diagnosis and a prescription, you have to admit *something* is a scam, right? Would it be fair to call that thing "ADHD culture"?
I've never seen a first principles critique that objected to the basic idea of therapy. No one seems to think that talking about your problems couldn't possibly help anyone ever. Critiques of therapy culture always sound to me like people claiming ADHD is overdiagnosed, and "but Adderall really helps people with ADHD" does not address the complaint of someone who thinks ADHD is extremely rare.
Other than your specific and insightful example of alexithymia, I don’t think the notion of a true self is a helpful one.
When someone wants something, typically what they they’re aware of wanting is some intermediate—a step towards an ultimately unconscious objective. For example you might be aware that you crave a beer, but what you really want is intimacy (beer to bar to meet artificially uninhibited person to increase likelihood of intimacy). And beneath intimacy is some other unconscious objective beneath which is another and another and you can keep drilling down to the inevitable raw impulse. I don’t think a person is best defined by this, in the same sense that a car isn’t best defined by its ignition. I think humanity is best defined by all the social/cultural/ethical/practical obstacles between impulse and its realization.
Incidentally, this also relates to the way rapidly advancing technology is hollowing out society by removing many of these obstacles between raw impulse and its realization. Having things increasingly available on demand is undermining the feelings of gratitude and sacrifice and purpose at the core of stable communities.
Perhaps is is easier to start with the opposite. There are such things as pretending, or being forced to do something, or being forcefully prevented from doing something; either by literal force or by a threat. So, as a first iteration, "true self" is how one thinks / feels / acts in absence of external forces that push them to thinks / feels / acts differently.
But there is also learning, in various forms (learning facts, getting experience, discovering new things, changing one's mind...). Learning can change how one thinks / feels / acts, so... does it mean that learning changes one's "true self"? Also, there are various kinds of learning, from reading books to brainwashing, experience can be empowering or traumatizing. Is the impact of the forceful kind of learning different in principle from a currently acting force? Are you supposed to unlearn some things to achieve your "true self", and which ones exactly?
Now again, some things do *not* change, even in long term. Despite many things I have learned and changed my mind about, three decades after I started reflecting on these things, I have similar traits (e.g. intelligence, introversion), hobbies (e.g. math, science fiction), values (e.g. rationality, philanthropy). It is not exactly the same, but it feels like... a natural extrapolation of my previous self. Some of that could be blamed on biology; maybe quite a lot. When I tried to do something against my nature, I sometimes learned a lot, but then I returned to some more advanced version of the original thing. So it seems that the "true self" can evolve, but not in an arbitrary direction.
The law of equal and opposite advice applies to therapy -- some people ignore themselves, those people should start paying more attention to themselves; other people ignore the world around them, those people should start paying more attention to the world around them. Some people need to find their "true self"; some people need to learn new facts and gain new skills. Many people choose the opposite of what they need: the ones focused on themselves decide they need to know even more about themselves; the ones distracted from themselves decide they have no time for such silly things.
Both options can be abused by people who want to manipulate you. You can be pushed away from your "true self", and the abuser will declare such concept silly; or you can be pushed towards something that the abuser says is your "true self", carefully navigating you to reach the predetermined conclusion. There is a related dynamic in gender roles: men are often told to stop suppressing their emotions and show their true feelings, but when it turns out that their true feelings at given moment are socially inappropriate, e.g. they are angry or horny, or they feel sad or afraid at the moment when they are expected to be strong, they are socially punished for such self-expression.
As I see it, finding your "true self" mostly means overcoming everyday distractions and considering your long-term preferences, and also identifying external pressures and finding out what you would want to do in absence of those pressures. Then, maybe you can plan how to overcome those forces and act on those preferences. And then you need to stop dreaming and actually do it.
Unawareness of preferences vs the toxic therapy-talk as two kinda-opposed traps that one can be reminds me of something Scott wrote about before. Therapy mindsets are in the water supply and perhaps now some people are getting an overdose. https://slatestarcodex.com/2015/07/16/cbt-in-the-water-supply/
I think the criticism of therapy culture needs some refinement to figure out exactly what it is.
- I have a friend with probably BPD whose life was literally turned around by cognitive behavioral therapy. The change in her life and her ability to function was night and day.
- Less drastically, I don't think most people would disagree that having someone thoughtful to talk out your problems with might help, in the same way that a personal trainer can help with fitness or a life coach can help you achieve goals.
- That said, I suspect that the critics of therapy culture have some narrower complaints that are more interesting.
This post seems so incredibly wrong it might not even fit into the "not even wrong" category. The number of people eating PB&Js who hate peanut butter (as a totally bizarre example), jelly, or bread and can be cured with therapy is approximately zero. The true problem with therapy is that it tells peanut butter haters that hating peanut butter is fine. Almost all therapy is re-enforcement of terrible behaviors such as complaining about things that take less time to do on your own than they take for you to ask your spouse to do, pretending your chemical addictions are normal, justifying abnormal behaviors, etc.
The rare therapist is the one who tells a 36 year old woman that her husband is actually quite good because he works and loves his kids. And that therapist is the only one who is correct in 99.99% of situations.
Or...follow me here...y'all have intamacy aversion. Self esteem issues. Narcissism.
Just try to be better and less self absorbed. Jfc you are a psychiatrist. Humans are socially monogamous creatures. This isn't hard to understand. You steal fish rather than fish yourself. You avoid diving into the deepblue and risk drowning for your meal. You'd rather feast on the floaters or steal the catch from the mouths of those who risked it all.
As an atheist I plead with you Scott to find jesus.
Just as a side note: preference falsification is a thing of course https://en.wikipedia.org/wiki/Preference_falsification. And, as a non US person, have always found Americans to be universally alexithymia - affected.
To the point now - I personally find it incredibly annoying when people ask for my "favorite" (movie, food, book, etc., even friend!). One software provider whose password recovery mechanism asked me to input ONE in a choice of 10 "favorites" just made me despair - I could not find ANY clear favorite in a list of ten categories. Not everyone has a single clear top preference. In anything. And no it doesn't mean that it's all the same to me. I have setsof likings, just no clear rankings inside those sets of likings. And, "different" does not imply a ranking. Generally speaking, I like diversity more than anything else. Which fits of course the whole polyamory theme.
Therapy culture is another auto-brainwashing phenomenon invented by society to voluntarily entrench conformity. What's worse is most people who would actually benefit from therapy lie on some personality disorder spectrum, and are the worst candidates for psychotherapy for they don't see anything amiss. I think the result of therapy is partially determined a priori. The result is a falsehood, just like everything else. Everyone dies anyway, there's no point.
It is very important to keep in mind that although we all have preferences, some of which we may discover later in life, many of those preferences – perhaps all of them — are malleable. Foods we once found distasteful, after we’ve made them a part of our diet for a while, come to be enjoyable. We hate running or rising early, but after choosing to do it for a while, we come to take great pleasure in it. This is especially true for things that are good and healthy. Over time, we come to love things that at first we did only through difficult choice. It would be a huge mistake to imagine that we discover our true selves simply by identifying the things we currently prefer, or to imagine that our “true self” is little more than our present cravings.
I don't know a Greek word for it, either, but this "preference alexithymia" reminds be on what Maslow has written on what he called the "pseudo self" (in "Toward a Psychology of Being"). Traumatised people, often children, whose wishes and preferences are denied for long enough, will become blind to them. Their own idea of themselves is subsumed by internalised standards of others.
Writing this as an LMSW with 2+ years of seeing clients under my belt, this is basically how I see my role. I’m not imparting Ancient Wisdom or some magical mantra, how can I when I’m a regular schmuck like you?
Instead, I’m forcing you to look at things you might not reflect too deeply about on your own and also making you look at the parts of your life that makes your skin crawl. Not because I enjoy watching you squirm, but because its hard for us to do this ourselves and we are really good at avoiding those messy questions we have about what matters to us or why we are consistently dissatisfied.
People who do therapy and get a complex about it have completely missed the point. If it’s working, it should open up a better understanding of your processing system and discover your preferences, as Scott said. Though I lightly disagree and do think all of us have hidden compartments as it relates to what we might value and prefer. Just to different degrees.
I agree to this extent: therapy, and people's experience with it, are heterogeneous. There's no one thing that therapy is "like." I don't doubt that some experiences with therapy are good. But I share your initial judgment that most therapy is bad.
>Imagine someone with generalized preference alexithymia.
Can I imagine a utility function calculator subsystem which keeps throwing arithmetic exceptions? :-)
I wonder to what extent asexuality and aromanticism can be explained by preference alexithymia for sexual and relationship partners, respectively. I don't think all; it's plausible to have no strong desire for any kind of sex or relationship, just like some people don't enjoy food at all as much as others. On the other hand, exploring different types of sex and relationships requires much more effort and risk than trying different foods, and if you don't realize what you're missing out on, you might never do much exploring.
The problem with Western therapy is that it's SO generic. If your marriage sucks, you need specific skills to make it work or alternatively I guess help finding a new partner you can be happy with. All of these things require hands on training in relevant practical skills and help with meeting three right kind of people. So a matchmaker or a life couch. Same thing if your problem is job or health or lack of good friendships - you need professional classes, social clubs, gym coach and so on. Just sitting on the couch and talking is based on ideal of mind over matter, whereas in reality humans require a right environment and skills that can only be learned through practice rather than abstract reasoning. For alexithymia it might be acting classes to practice and recognize expression of different emotions. Also it's important to recognize that people are often stuck in a local maxima and making changes is likely to initially make things worse, with no guarantee that they will ever get better. Are you really likely to improve your life long term after divorcing a cheerleader? Anyway, when such changes are undertaken, someone will need a lot of hands on support rather than just talk to get to the other end.
I’ve never met any of these overly therapists folks who feel they are better than anyone else. Is the ratio really any higher than among other groups-MDs, lawyers, yoga instructors, etc?
One more thing, in passing. My experience is that good therapy depends upon a match of the modality, practitioner, and client. There some pretty meh practitioners out there, and some modalities that I judge are less effective than others. But in the hands of a good practitioner l, even a meh modality can yield good results. And even if both practitioner and modality are meh, but are a good fit for a particular client, there can be good results. And this is without going into how easy or hard it is for the client to access their issues and their causes.
What is the evidence that therapy culture (or perhaps, just therapy) actually makes people better off, on average?
Typo in the last paragraph? Fails to parse for me. "Weirdly, the original complaint a lot of people happened with the polyamory memoir that started this discussion was ..."
I think as far as True-Selfing goes, the best way to find what you are missing is to examine really closely the things in your life that don't work or aren't working, usually around social interactions. But to do this you first have to avoid blaming everyone else or other things on the thing that didn't work well and acknowledge that it's worth examining regardless of what the causative factors may be (basically, being a scientist about it and not deciding the conclusion before doing the investigation).
Why assume finding your "true self" is a good thing? Sure, they might be miserable in their current situation, but at least they have the fortune of not knowing that there's an alternative. But if they find out they do have desires that can potentially be fulfilled, how far will they go to accomplish that? Even in the example you gave, that knowledge ultimately resulted in a divorce, and that's still a relatively benign example. What if their desires completely alienate them from society? What if they have desires that can only be fulfilled through hurting others?
Desire is a dangerous, volatile thing. People without it are relatively harmless and docile. For the sake of a stable society, shouldn't we keep any unnecessary desire from flourishing?
This seems like survivorship bias to me. I mean, you're already Scott Alexander.
For the rest of us, becoming what we want to be requires a messy process that might end up failing. But we have to change to become extraordinary (ironically people like Scott, who already have it made, are flexible enough to have the best odds of opportunities of further upward momentum coming from an unexpected angle).
I used to be totally dominated by other people's preferences, but now I've discovered my true self. But is this a reasonable thing to believe? It sounds like an over-update. Much therapy takes place in a time of crisis.
The biggest problem with therapy culture (not therapy, but the ecosystem/discourse around it) is not the true-selfism but (1) continuing pathologisation of normal human experiences leading to the creation or reinforcing of notions of people as both fragile and damaged and lacking resilience. See: the idea that pretty much everyone is traumatised, likely by their childhood experiences (2) outsourcing of emotional support to professionals not by necessity but because of belief that friends and family don't know how to provide it and could be dangerous (3) last but biggest, encouraging endless inward looking self-focus instead of engaging with the external physical and social world, this includes looking for internal solutions to externally solvable problems and centering internal experiences over intersubjective ones.
Disclaimer: I had actual therapy after traumatic bereavement, it was useful; and because I think by talking still see a "counsellor" I pay to sit there and listen to me talk at her without a feeling I'd need to reciprocate. So not anti therapy at all.
Is there an opposite situation where therapy can also help someone aware of their preference but perhaps not aware that their prioritisation of these is done to a level that makes it difficult to interact with them? I say this considering that at a lot of evangelists of therapy culture don't come across as people following cultural expectations but people who are genuinely opinionated about the correctness of their preferences, and for all the criticisms of various sorts of therapy, I don't think they reinforce that level of belief.
This exactly describes what I think is going on with jhanas - I don't think people are actually achieving transcendent joy, I think they're just detaching themselves from their emotions and convincing themselves they are, just like the guy who convinces himself he isn't angry while slamming doors.
The newly inserted paragraph three cleared up my question. Not having heard of therapy culture I usually assume therapy is some form of CBT.
The way I think of it is that you’re always trying to get to a best-fit curve. Nobody gets everything they want all the time. Nobody is ever at a state of rest where things don’t need to be assessed and reassessed. You might want something at a 10 but you settle for the thing you want at a 7 because you need to accommodate some other moral imperative. We’re a buffet table of wants and motivations and I think it can be a mistake to over-identify any single one of them as your primary self. You’re the music of those things, not any single note.
Is there a word for people who understand their moods but don't understand the reason behind them very well? Like the difference between:
"I'm angry because Fred is a stupid moron coming to my office to waste my time" vs.
"I'm angry because a work task went badly, a meeting ran long, I'm hungry, and I thought I was about to have lunch but now Fred has come to my office to talk to me. Fred isn't doing anything wrong but I feel angry at him for other reasons."
The second guy is much much more likely to be nice to Fred and to control and understand his anger. He might tell Fred to come back after lunch instead of getting in a fight. It's not implausible to me that therapy could help turn person 1 into person 2, or help with a more continuous case where someone is generally unhappy or angry because of something in their lives they hadn't really thought about.
'Maybe “finding your true self” just means “being able to access your preferences, the same way non-alexithymics do as a matter of course”.'
Meh. 'Finding' your True Self is just a bad model. Too simplistic and removed from base reality to be useful.
The brain is a network with many different structures and substructures, that form factions with varying access to consciousness, all competing, cooperating and often being very confused. There is no specific part or coalition of it, that's more true, than any of the others. You can create a self-conception, that harmonizes conflicting preferences and minimizes prediction error reliably, makes you generally thrive.... and hopefully it will last longer than next Tuesday, if you're lucky. But this is not some hidden gem deep inside a person, that just needs to be discovered. It is rather a self-propagating process that you have to build, maintain and often adapt to changing environments and requirements.
I don't think getting in touch with your "true self" is necessarily a good thing. To take the food analogy, should we encourage people to get in touch with their "true" preferences for hamburgers, crisps, and sweets? To take the sexuality analogy, should we encourage people with paraphilias to get in touch with their "true, authentic selves"?
In regards to advice that people do or don't need:
I've put a lot of work into improving my kinesthesia. For quite a while, I'd talk about it as though this was something that would be good for everyone and I couldn't understand why most people weren't very interested in doing it.
Later, I came to understand that I was on the numb side of typical kinesthesia. I started out on what might be considered the subtly clumsy side of normal. Functional, but not generally physically skilled, except for good dexterity.
I was surprised to find there was a reason I would occasionally fall down. My legs were so tight that I didn't step forward enough unless I swung my lower leg around the outside. If I didn't swing it high enough, I'd catch my toes on the ground and fall. In a sense, not a big deal when I was a kid, but it's much better not to be falling now.
I wasn't trying to improve walking and it was a surprise when walking changed from something to be ignored to a moderate pleasure. I was driven by a sense that something was wrong and I needed for it to be better.
Athletes use Alexander Technique and Feldenkrais Method and such because they care a lot. Most people seem to be fairly comfortable with what they can do. They might even be concerned that trying to change their kinesthesia would make matters worse rather than better.
> You know how sometimes you pretend to like something because it’s high-status, and if you do it well enough you actually believe you like the thing? Unless I pay a lot of attention, all my preferences end up being not “what I actually enjoy” but like “what is high status” or “what will keep people from getting angry at me”.
Honestly, this quote never cease to horrify me every time I’m reminded of it.
Isn't this simply one of those cases where different advice is applicable to different people: some people would benefit from being more assertive, others from being more mindful of others, some would benefit from taking more risks and others from being more cautious, etc along any number of dimensions, and whether advice in a given direction is good or not depends more on who takes it than on the advice itself (with the unfortunate dynamic that people are more likely to seek out advice that supports their world view, which tend to move them further along an unhealthy extreme direction). I think this is something Scott himself wrote about on the previous blog, but I can't remember the title of that piece.
Going purely of vibes, it does seem the present zeitgeist puts too high a premium on authenticity and self-discovery, but presumably there are also people who would benefit from moving farther in that direction. It would probably be better to formulate advice in terms of set points rather than directions, "this is how much you should focus on finding your true preferences relative to other concerns, adjust up or down as needed", but such advice requires more work to formulate, won't fit as well into established narratives, and is less optimized for viral spread, etc.
TYPO: Should be: "The original complaint a lot of people *had* with the polyamory memoir"
I worry you haven't sufficiently defined therapy culture. I mean it seems to me you gave a really good argument for thinking and talking about your mental state in an intelligent and engaged way.
But that's not how I would understand the term. Indeed, I'd understand therapy culture as being related to genuine self-discovery in much the way DEI culture is related to fighting racial bias and inequality. It's a kind of way of speaking and talking that creates the illusion you are handling a problem without actually doing the hard work that might help so it tends to make it worse.
Also I don't like the whole true self language because it denies the extensive role we play in constructing who we are. Our preferences aren't just given out by god -- maybe some basic dispositions -- but you can learn to have quite different preferences on most things. It's mostly stuff very near core evo activities like mating that is really super sticky.
This post from Scott's old blog comes to mind here:
https://slatestarcodex.com/2014/03/24/should-you-reverse-any-advice-you-hear/
It seems to me that there are people out there who would benefit from following the 'therapy culture' advice, but that the people who are most prone to it are those who should be seriously considering the opposite of that advice.
Now that I'm in my mid-40s, I cannot imagine wanting to see a therapist for "self-discovery" or to find my authentic True Self. If anything, my biggest problem is that I have a concept of an authentic life at all! Existentialist philosophy was an infohazard. It seems that almost everybody else manages to get through the objectively horrifying process of aging by lying to themselves, pulling little tricks on their brain, or failing that just finding one distraction after another.
The search for your true self is the kind of thing you might find appealing if you felt you were writing your life's journey from scratch, but most people's lives past 40 are more like being called in by the studio to finish the last third of a script that some dude couldn't finish because he got coked out, and who cares anyhow because it's a sequel to some genre flick of no particular distinction. There are absolutely people who can motivate themselves to do the best possible job in that situation, but I doubt they are doing it by searching their souls to find and express the real and authentic.
“The unexamined life,” I suppose.
If you had to give a ballpark estimate, how many people would you suspect fit this criteria?
Would you expect it to be more or less common in developed, high hierarchy-of-needs societies? Intuitively, I’d expect people to be less aware of their preferences when they’re in stressful situations, faced with more pressing concerns. That conflicts with the narrative of “therapy culture” as a luxury belief.
Hey, this is backwards. The analyst sits near the patient's head, a bit back from it so they are not visible to the patient. But maybe Blondie here wants to show off her looks?
I'm not sure whether I'm amused or dismayed that this *defense* of therapy culture includes (or at least strongly suggests) my own subculture's *critique* of therapy culture, i.e. "Therapists will just tell you to divorce your husband."
"Maybe she needed more therapy, not less! Or, at least, better therapy."
Hi Scott!
This points to an anti-generalization that I find myself saying to people more and more frequently. Someone has a bad experience at, let's say, the doctor and then generalize that the medical profession is filled with greedy crooks who order expensive irrelevant tests to cover their heinies. (Similar things can be said for other service professionals like chiropractors, lawyers, accountants, plumbers, etc.)
I struggle with migraines and went down that healthcare road myself and held that jaded perspective for a while. Standard treatments didn't work for me. But eventually, rather than live with the pain, I kept going. Found new doctors, tried new approaches, and created a treatment program that makes the migraines only a minor nuisance once every month or two rather than being an all-consuming black hole 4 times per week.
Looking back, one thing I learned is that there are good doctors and not-so-good doctors, and it makes a huge difference when you have a good one. This should be obvious, because we all know that there are clearly good teachers and not-so-good teachers. A good teacher meets the individual student where they're at rather than trying to apply a canned approach to every student. Well, many doctors, lawyers, accountants, chiropractors, therapists, etc. also take the canned one-size-fits-all approach. If they don't really care about the particulars of your situation, that's what you'll get. Or maybe they find you annoying or a hassle... Or maybe they can make more money if they spend less time on each patient...
At a college, students tell each other which professors are the good ones, but there often isn't that kind of discussion for service professionals. And so, when these issues come up, I make a point of guiding people to visit a specific chiropractor, rather than just to see "a chiropractor".
Kind regards,
DB
Your description of generalized prefrence alexithymia reminds me a little of Winnicott's idea of the "false self," which he argues is the result of inadequate mirroring in an individual's infancy, leading to them forming basically a hypervigilant/"compliant" relationship with the world, rather than a spontaneous one. He also argues that this sort of patient is impossible to do traditional psychoanalysis on, until their false self has been erradicated.
(Relevant paper: https://psptraining.com/wp-content/uploads/Winnicott-D.W.-1965.-The-maturational-processes-and-the-facilitating-environment.pdf#page=133)
Therapy arose in the 19th and got big in the 20th century already, and what they now call "therapy culture" is its full mainstreaming. I don't think something quite this big would arise without answering to some need. And I don't think you need to look very far to find the need. Its early rise coincides quite well with the first wave of secularization of the West. People used to have spiritual advisors (some still do but it's no longer so mainstream). Someone with a professional role who you could talk to about your personal problems and dilemmas, and would (more or less try to) embody some accumulated traditional wisdom. I don't think it's much of a new insight that a good % of therapy is just a secular version of the same, with some changes. Now you're a paying client, which prices it out for many people (bad!), but also gives you choice and empowers you as client (good). The cultural core of the wisdom being applied is now somewhat scientifically attuned (good), but can be spiritually shallow (bad).
As to the question of the "true self", we have to be clear that we're not talking about some transcent self here, so the old debates about self vs no-self don't apply. The self we're talking about is the psychological self here, which is a fairly well-understood phenomenon. When the pieces of you at odds with each other, or exaggeratedly at odds with the world, or too porous, or whatever, get worked on and more or less integrated, you're still "yourself", with your personality and tastes and quirks, but with less suffering, less stuck, somewhat more sane, and probably more capable of embodying the kinds of personal virtues that make you happy and proud to be who you are in the long term. That's what "finding your real self" amounts to. It's good stuff.
Nowadays there has appeared a current of pushback against "therapy culture", and again it's not hard to pinpoint what kind of excess it's aiming at. We live in the era of performance of identity, awash in the mass manipulation generated by modern psychological marketing, unleashed by the lack of friction created by social media platforms. So if there's psychological self to be found, and a vague cultural awareness of it, there's immediately going to be thousands of shitty grifters trying to sell us ersatz versions of it for a subscription fee. And we should not underestimate the sheer impact of psychological marketing - people who are "well in their skin" are hard to sell shit to, so the entire enterprise is basically a globally self-optimized machine for making everyone feel bad about everything, from their body to the world we live in. So of course we do, and then we wonder where the "mental health crisis" may be coming from.
I think part of the impoverishment in the public debate about therapy is the odd mystique it has, which of course is cultivated and encouraged by psychologists and psychiatrists, as well as the universities and hospitals where they must attend extensive extra school.
At bottom, therapy is just talking to someone -- often, that person is small-minded and not very smart, but sometimes that person is insightful, creative, imaginative, and attentive. People who haven't had much of that kind of conversation before often feel, correctly, that they have discovered one of the most valuable and incredible things in the world, something they didn't really know existed or was possible. They can think things they never would have imagined they might think, they can be freed from destructive assumptions, they can practice other ways of thinking and being.
You know... kinda like the experience of reading ACX/SSC! In other words, good therapy is just... you guessed it... rationalist practice!
This is an extremely partial and grudging defence indeed.
When people criticise "therapy culture" I don't think they're against the entire concept of ever talking to anyone about your problems. I think it's mostly about the language and attitudes of therapy escaping into the wild and being used by ordinary, ostensibly-healthy people to justify being jerks.
Therapy will often teach you to focus on yourself in a way that can lead to selfishness. A certain degree of selfishness is somewhat acceptable for people who have serious problems, in the same way that lying around in bed all day is acceptable when you're seriously ill. But when the therapy mindset is used by everybody then it leads to everybody putting themselves first.
When you decide your desires are "needs" then you can justify just about anything.
Honestly, I think that the whole discussion about preferences and "finding my True Self" treats these things as exogenous to the self, imposed from the outside and immutable.
Your preferences and your "True Self" are, to a large degree, mutable. Maybe not *consciously* mutable, but for everything but the most core things, these things can be changed. And in fact *are* being mutated every time you make choices and take actions.
So your "True Self" is the one *you are currently defining by your actions, choices, and beliefs* on a day-to-day basis. And the challenge isn't to *find* this True Self, it's *creating the best True Self you can*.
As was said in the context of making RPG character choices, "Choose Different". You are the one defining your character as you go. There are no "out of character" events, there are only "my character is changing" events.
extremely niche comment that won't be explained, if you know you know:
>You know how sometimes you pretend to like something because it’s high-status, and if you do it well enough you actually believe you like the thing? Unless I pay a lot of attention, all my preferences end up being not “what I actually enjoy” but like “what is high status” or “what will keep people from getting angry at me”.
I'm guessing this friend isn't *actually* lintamande, but the quote definitely reminds me of Sevar.
So Scott, are you talking about all psychotherapies, or about freeform talk-about-whatever therapy? If the latter, I wish you'd make that clear. CBT practitioners like me do time-limited, problem-focused treatments, and that's very different. The goals are not vague, and it's quite possible to assess whether and how much the person's problem has changed. Unless you're inclined to think that CBT, too, is mostly bogus, I wish you would make it clear that it's not in the scorned-with-a-few-grudging-exceptions category.
Also, I'd like to speak up about some ways that freeform talk therapy can be genuinely helpful to people, beyond the way you mentioned. One is to provide a place where people can unburden themselves of disturbing secrets. A guy once came to me ostensibly for treatment of a form of OCD, but he made it clear as soon as we discussed the OCD that he was absolutely unwilling to try to dismantle it. He was about 90% convinced that his OCD concerns were valid fears, and that his compulsions were necessary to keep him safe. So I said, OK, let's talk over your life for a few sessions and see if there's some other way I can be helpful. Within a couple sessions he disclosed that he had a sexual kink that nobody knew about, and that having it made him feel ugly and grotesque and separate from "normal people." So we talked in detail about his kinky interests, and I gave him some information about his kink (it's actually a common one, and last time I checked the literature people with that kink were found not to be less healthy than other people, just higher on openness to experience). And he could see that I was not creeped out by what he'd told me. And all that greatly diminished the shame he felt. So now, about a year later, he's totally "out" with his kink to his friends, and is not having trouble finding woman who like it too, or are curious to give it a try. His life's a lot better, and he spends a lot less time ruminating about OCD-related matters.
Some people come to a therapist without any secret to disclose except that they are terribly lonely, and nothing they have tried has fixed that. Some of them have good social skills and are able to "make friends," with people, but secretly feel disconnected from the friends they've made. Others are stuck in a marriage that feels dead, but are unwilling to consider divorce until the children are older. For these people, seeing a therapist is like visiting a friend. They have someone who is interested in them and wishes them well. That alone makes them feel much better, sometimes enough better to change some problematic things in their lives. I have seen therapy of this kind referred to scornfully as "buying friendship," and I actually think the term is fairly accurate, but the scorn is not so justified. All friendships involve some sort of transaction -- there are things the friend expects you to give, such as sympathetic interest in their breakup, or reassurance about something. In some ways it's cleaner to just pay cash. And I wouldn't call it fake. I don't think most of us are faking interest and goodwill. I'm not. It's one of the bonuses of being a therapist, getting to know and care about people you ordinarily would never even meet, and would not feel an affinity for if you did. The therapist just has to steer clear of expecting from the patient what they would expect from a full, real-life friend -- expecting the other person to get them, take an interest, sympathize, etc. In a lot of ways being someone's paid friend is not greatly different from sex work, which I also think is a legitimate and valuable service.
There is a question of "how to" for preference alignment, and if therapy is the answer then so be it. There is also a question of how malleable our preferences are, and whether it makes sense to develop preferences that more easily attained. If preferences are malleable and therapy can make them cheaper, then so be it.
What I don't see is how preferences anywhere in this matrix would necessarily finger "therapy culture" as the solution. Is this definition of "therapy culture" the complete set of non-medication solutions?
All of this seems to be assuming that "doing what *I* want" is desirable. One alternative I've seen is
"The attitude behind the move was concisely expressed in 2010 when a contestant on a Chinese dating show told her blue-collar suitor: "I'd rather cry in a BMW than smile on a bicycle." The statement went viral." -- Adam Minter
All of this self-centeredness is called "internally directed" in psychlogical lingo, and it's valorized in US culture, but many other cultures prioritize being "externally directed", that is, doing what society and everybody around you expects.
Then again, there are food fads that sweep US culture, along with food status characteristics. ("My farmers' market has bigger, better, fresher tomatoes than yours.") It helps when flaunting your status-gaining attitudes to consciously believe that you actually prefer those things, especially in a culture that valorizes adhering to your authentic self. It's not automatic that stating out loud what you actually prefer is the best strategy, *especially* in the Darwinian snake pit of status competition that is high school.
In regard to polyamory, I would expect that to be quite a mess. For one thing, different people have vastly different preferences for how to run their love lives and (looking at history) there's no reason to believe that we can match up people so the various matches don't contain strong disalignments in preferences. Should people openly express the disalignment between what they've got and what they want, be aware of it but suppress mentioning it, or push it out of sight into the subconscious?
OH MY GOD. I feel so seen by this post.
I can relate to both: ignorance of feelings and ignorance of preferences. I have kinda got much better with the first one, however at times it feels I have just learned to guess my emotions by the secondary effects. Like, once I literally said “my girlfriend is always so unbearable whenever I drink coffee”, only to realize it’s not a fact about her.
However, the alexithymia of preferences is harder — I cried reading “Better than Two”, feeling “oh wow you could live like that??”. And still it took some time for me to find that “I want”
However, I wouldn’t think it’s an illness. From where I grew up — post-Soviet Ukraine, and then studied in Russia — there are lots of people who seem to be out of touch with their emotions. Coming to Canada, it surprised me how everyone could be so mature and adult with their emotions.
I’d bet it’s a developmental phase. Same as that other Scott’s post about how the gods are “literally real” for people 3000 years ago, or for kids 2-3-4 years old today. Same way, maybe some people (or cultures) are just stuck in that phase for longer?
I distinctly remember “learning” how emotions feel, and glorifying feeling of terror because it was the first one that became available. I loved reading Stephen King for a while, because that was the only way to feel emotions
"But that’s the same kind of complaint as “sometimes people without ADHD take Adderall”, not “Adderall is a scam”"
Is there any number of people without ADHD taking Adderall that can make it a scam? If Adderall really works to treat ADHD, but also 50% of the population gets a bullshit diagnosis and a prescription, you have to admit *something* is a scam, right? Would it be fair to call that thing "ADHD culture"?
I've never seen a first principles critique that objected to the basic idea of therapy. No one seems to think that talking about your problems couldn't possibly help anyone ever. Critiques of therapy culture always sound to me like people claiming ADHD is overdiagnosed, and "but Adderall really helps people with ADHD" does not address the complaint of someone who thinks ADHD is extremely rare.
Other than your specific and insightful example of alexithymia, I don’t think the notion of a true self is a helpful one.
When someone wants something, typically what they they’re aware of wanting is some intermediate—a step towards an ultimately unconscious objective. For example you might be aware that you crave a beer, but what you really want is intimacy (beer to bar to meet artificially uninhibited person to increase likelihood of intimacy). And beneath intimacy is some other unconscious objective beneath which is another and another and you can keep drilling down to the inevitable raw impulse. I don’t think a person is best defined by this, in the same sense that a car isn’t best defined by its ignition. I think humanity is best defined by all the social/cultural/ethical/practical obstacles between impulse and its realization.
Incidentally, this also relates to the way rapidly advancing technology is hollowing out society by removing many of these obstacles between raw impulse and its realization. Having things increasingly available on demand is undermining the feelings of gratitude and sacrifice and purpose at the core of stable communities.
The "true self" thing is tricky.
Perhaps is is easier to start with the opposite. There are such things as pretending, or being forced to do something, or being forcefully prevented from doing something; either by literal force or by a threat. So, as a first iteration, "true self" is how one thinks / feels / acts in absence of external forces that push them to thinks / feels / acts differently.
But there is also learning, in various forms (learning facts, getting experience, discovering new things, changing one's mind...). Learning can change how one thinks / feels / acts, so... does it mean that learning changes one's "true self"? Also, there are various kinds of learning, from reading books to brainwashing, experience can be empowering or traumatizing. Is the impact of the forceful kind of learning different in principle from a currently acting force? Are you supposed to unlearn some things to achieve your "true self", and which ones exactly?
Now again, some things do *not* change, even in long term. Despite many things I have learned and changed my mind about, three decades after I started reflecting on these things, I have similar traits (e.g. intelligence, introversion), hobbies (e.g. math, science fiction), values (e.g. rationality, philanthropy). It is not exactly the same, but it feels like... a natural extrapolation of my previous self. Some of that could be blamed on biology; maybe quite a lot. When I tried to do something against my nature, I sometimes learned a lot, but then I returned to some more advanced version of the original thing. So it seems that the "true self" can evolve, but not in an arbitrary direction.
The law of equal and opposite advice applies to therapy -- some people ignore themselves, those people should start paying more attention to themselves; other people ignore the world around them, those people should start paying more attention to the world around them. Some people need to find their "true self"; some people need to learn new facts and gain new skills. Many people choose the opposite of what they need: the ones focused on themselves decide they need to know even more about themselves; the ones distracted from themselves decide they have no time for such silly things.
Both options can be abused by people who want to manipulate you. You can be pushed away from your "true self", and the abuser will declare such concept silly; or you can be pushed towards something that the abuser says is your "true self", carefully navigating you to reach the predetermined conclusion. There is a related dynamic in gender roles: men are often told to stop suppressing their emotions and show their true feelings, but when it turns out that their true feelings at given moment are socially inappropriate, e.g. they are angry or horny, or they feel sad or afraid at the moment when they are expected to be strong, they are socially punished for such self-expression.
As I see it, finding your "true self" mostly means overcoming everyday distractions and considering your long-term preferences, and also identifying external pressures and finding out what you would want to do in absence of those pressures. Then, maybe you can plan how to overcome those forces and act on those preferences. And then you need to stop dreaming and actually do it.
Unawareness of preferences vs the toxic therapy-talk as two kinda-opposed traps that one can be reminds me of something Scott wrote about before. Therapy mindsets are in the water supply and perhaps now some people are getting an overdose. https://slatestarcodex.com/2015/07/16/cbt-in-the-water-supply/
I think the criticism of therapy culture needs some refinement to figure out exactly what it is.
- I have a friend with probably BPD whose life was literally turned around by cognitive behavioral therapy. The change in her life and her ability to function was night and day.
- Less drastically, I don't think most people would disagree that having someone thoughtful to talk out your problems with might help, in the same way that a personal trainer can help with fitness or a life coach can help you achieve goals.
- That said, I suspect that the critics of therapy culture have some narrower complaints that are more interesting.
This post seems so incredibly wrong it might not even fit into the "not even wrong" category. The number of people eating PB&Js who hate peanut butter (as a totally bizarre example), jelly, or bread and can be cured with therapy is approximately zero. The true problem with therapy is that it tells peanut butter haters that hating peanut butter is fine. Almost all therapy is re-enforcement of terrible behaviors such as complaining about things that take less time to do on your own than they take for you to ask your spouse to do, pretending your chemical addictions are normal, justifying abnormal behaviors, etc.
The rare therapist is the one who tells a 36 year old woman that her husband is actually quite good because he works and loves his kids. And that therapist is the only one who is correct in 99.99% of situations.
Or...follow me here...y'all have intamacy aversion. Self esteem issues. Narcissism.
Just try to be better and less self absorbed. Jfc you are a psychiatrist. Humans are socially monogamous creatures. This isn't hard to understand. You steal fish rather than fish yourself. You avoid diving into the deepblue and risk drowning for your meal. You'd rather feast on the floaters or steal the catch from the mouths of those who risked it all.
As an atheist I plead with you Scott to find jesus.
Just as a side note: preference falsification is a thing of course https://en.wikipedia.org/wiki/Preference_falsification. And, as a non US person, have always found Americans to be universally alexithymia - affected.
To the point now - I personally find it incredibly annoying when people ask for my "favorite" (movie, food, book, etc., even friend!). One software provider whose password recovery mechanism asked me to input ONE in a choice of 10 "favorites" just made me despair - I could not find ANY clear favorite in a list of ten categories. Not everyone has a single clear top preference. In anything. And no it doesn't mean that it's all the same to me. I have setsof likings, just no clear rankings inside those sets of likings. And, "different" does not imply a ranking. Generally speaking, I like diversity more than anything else. Which fits of course the whole polyamory theme.
Therapy culture is another auto-brainwashing phenomenon invented by society to voluntarily entrench conformity. What's worse is most people who would actually benefit from therapy lie on some personality disorder spectrum, and are the worst candidates for psychotherapy for they don't see anything amiss. I think the result of therapy is partially determined a priori. The result is a falsehood, just like everything else. Everyone dies anyway, there's no point.
How many people go into therapy to "find their true selves" Vs dealing with trauma and its maladaptive consequences?
It is very important to keep in mind that although we all have preferences, some of which we may discover later in life, many of those preferences – perhaps all of them — are malleable. Foods we once found distasteful, after we’ve made them a part of our diet for a while, come to be enjoyable. We hate running or rising early, but after choosing to do it for a while, we come to take great pleasure in it. This is especially true for things that are good and healthy. Over time, we come to love things that at first we did only through difficult choice. It would be a huge mistake to imagine that we discover our true selves simply by identifying the things we currently prefer, or to imagine that our “true self” is little more than our present cravings.
I don't know a Greek word for it, either, but this "preference alexithymia" reminds be on what Maslow has written on what he called the "pseudo self" (in "Toward a Psychology of Being"). Traumatised people, often children, whose wishes and preferences are denied for long enough, will become blind to them. Their own idea of themselves is subsumed by internalised standards of others.