Our minds are sooooo much more powerful than we can currently understand. Especially in terms of our connections to one another. Ive had some frightening instances of intuition that cant be explained away.
And life is much better since Ive entertained the idea that magic may exist, but magic is only processes that we cant explain yet.
> The patient’s knowledge that their therapist has a Ph.D. contributes more to their healing than whatever their therapist happened to learn (or unlearn) in those 5-7 years.
Do Ph.D.-level therapists on average have better outcomes than non-Ph.D. level therapists? I don't think that is the case.
I remember once reading something to the effect that the more years of experience a therapist has, the better their outcomes. But I'm not sure about training. Let me know if you find something. My guess would be no. Which would mean that Ph.Ds deliver less healing per dollar since they charge more :)
By the way I owe you a response to the other articles you sent me, which I have read...just haven't written the response
> I remember once reading something to the effect that the more years of experience a therapist has, the better their outcomes.
Our results show a significant decrease in client outcomes over time in three domains: general distress, life functioning, and anxiety, albeit small-sized effects. Our findings also indicate that therapist caseload and baseline severity were not associated with predicting client outcomes and that, unexpectedly, the severity of therapist caseloads decreased over time. These findings underscore the importance of a nuanced understanding of therapist effectiveness, challenging the assumption of universal improvement with experience.
This is a comment of genuine awe and appreciation for your work. I recently discovered this Substack and am amazed by the depth and quality of your writing. It’s remarkable that it hasn’t yet gained the widespread recognition it deserves—an evolutionary perspective from a psychotherapist feels like an absolute goldmine.
Regarding the concern that informing people about the placebo effect might diminish its power—I found this article (and the entire psychiatry series) incredibly insightful. Being in the 99th percentile for neuroticism, I’ve often worried whether I’m “doing therapy right” as a client—should I take notes after sessions? Should I study psychoanalysis? Am I doing enough—should I try psychedelics or EMDR? Reading this has been a revelation. For the first time, I feel like I can exhale and enjoy the ride. Thank you for that.
Well, this will make my entire week. Thank you very much for saying so, and I'm happy to hear this has helped you relax. I do think that burden of "doing therapy right" can get in the way of a helpful, enjoyable ride, and that enjoyment itself is too often neglected in therapeutic work. I've had many friends, family, and clients make casual comments to the effect that therapy is hard and requires work. I usually push back against this. I've had plenty of clients who were able to get better despite having an absolute blast in session and not putting any hard work into it at all. Whether therapy is "hard" is another element that doesn't really matter. All that matters is that people are given a chance to talk about what they want to someone who genuinely wants to understand.
Our minds are sooooo much more powerful than we can currently understand. Especially in terms of our connections to one another. Ive had some frightening instances of intuition that cant be explained away.
And life is much better since Ive entertained the idea that magic may exist, but magic is only processes that we cant explain yet.
Totally. Well-said.
> The patient’s knowledge that their therapist has a Ph.D. contributes more to their healing than whatever their therapist happened to learn (or unlearn) in those 5-7 years.
Do Ph.D.-level therapists on average have better outcomes than non-Ph.D. level therapists? I don't think that is the case.
I remember once reading something to the effect that the more years of experience a therapist has, the better their outcomes. But I'm not sure about training. Let me know if you find something. My guess would be no. Which would mean that Ph.Ds deliver less healing per dollar since they charge more :)
By the way I owe you a response to the other articles you sent me, which I have read...just haven't written the response
> I remember once reading something to the effect that the more years of experience a therapist has, the better their outcomes.
Our results show a significant decrease in client outcomes over time in three domains: general distress, life functioning, and anxiety, albeit small-sized effects. Our findings also indicate that therapist caseload and baseline severity were not associated with predicting client outcomes and that, unexpectedly, the severity of therapist caseloads decreased over time. These findings underscore the importance of a nuanced understanding of therapist effectiveness, challenging the assumption of universal improvement with experience.
https://psycnet.apa.org/doiLanding?doi=10.1037%2Fcou0000763
> By the way I owe you a response to the other articles you sent me, which I have read...just haven't written the response
No worries!
This is a comment of genuine awe and appreciation for your work. I recently discovered this Substack and am amazed by the depth and quality of your writing. It’s remarkable that it hasn’t yet gained the widespread recognition it deserves—an evolutionary perspective from a psychotherapist feels like an absolute goldmine.
Regarding the concern that informing people about the placebo effect might diminish its power—I found this article (and the entire psychiatry series) incredibly insightful. Being in the 99th percentile for neuroticism, I’ve often worried whether I’m “doing therapy right” as a client—should I take notes after sessions? Should I study psychoanalysis? Am I doing enough—should I try psychedelics or EMDR? Reading this has been a revelation. For the first time, I feel like I can exhale and enjoy the ride. Thank you for that.
Well, this will make my entire week. Thank you very much for saying so, and I'm happy to hear this has helped you relax. I do think that burden of "doing therapy right" can get in the way of a helpful, enjoyable ride, and that enjoyment itself is too often neglected in therapeutic work. I've had many friends, family, and clients make casual comments to the effect that therapy is hard and requires work. I usually push back against this. I've had plenty of clients who were able to get better despite having an absolute blast in session and not putting any hard work into it at all. Whether therapy is "hard" is another element that doesn't really matter. All that matters is that people are given a chance to talk about what they want to someone who genuinely wants to understand.
Thank you again for your uplifting comment.