The question that would be uppermost in my mind when choosing a therapist: does the therapist like me? I´m not sure this is a good question. Perhaps it´s a question that´s more revealing of my own interpersonal difficulties than anything else, but I don´t see the point of paying someone to help me who doesn´t basically think I´m a good guy.
This inquiry might be the basis for an interesting experiment. Do clients fare better with therapists who like them?
I think that's a great question to ask, and some of the reasons you might not think so, or the average person might not think so, are an indication of the field taking itself too seriously. If people thought of therapists as experts in caring about others and having meaningful conversations, then the question "Does this therapist like me?" would be leveraged more, I think. Instead, people think therapists have a bunch of specialized knowledge about the brain, and so it's sort of like asking if your podiatrist likes you: it doesn't matter that much.
As for an experiment on that, it's a good idea, and I'd be surprised if someone hasn't poked around it. I'll keep an eye out. Thanks for reading and commenting.
Great post. When I advise people to look for therapists, I tell them that about 80% of therapists are worthless, 10% are okay, and 10% are amazing. In my experience the traditional credentialing system provides zero information in identifying which ones are amazing. I had a highly credentialed therapist at a prestigious university who was worthless, and have had interesting non-traditional therapists who were amazing.
Separately, I'd encourage you to read Liah Greenfeld's Mind, Modernity, and Madness, which makes a neo-Durkheimian case that modernity itself has, over the last several centuries increased rates of functional mental illness, especially among Anglo-spheric and nearby northern European nations.
Thanks Michael, for the comment and recommendation. I'll read your review and perhaps the book, too, since it seems up my alley.
I agree with your breakdown on therapist quality. I suppose the good news is that mediocre therapists can deliver solid benefit nevertheless, especially if much of the benefit can be explained by placebo, having a dedicated time to think through problems, speaking about problems (as opposed to thinking about them), and so on.
I also think that intelligence as traditionally defined is irrelevant to being a good therapist. If, for example, genuine listening is more important than correct diagnosis - because diagnoses are kind of a sham - then you don't need a degree from Harvard. Or, for that matter, a degree that takes 7 years and costs $100k+. In fact, the more therapists rely on being intelligent in the traditional sense, the more distracted they are from doing their job well, IMO.
I completely agree that being intelligent in the traditional sense is irrelevant and may possibly be counterproductive to quality therapy. This strikes me as spot on, " the more therapists rely on being intelligent in the traditional sense, the more distracted they are from doing their job well."
Ultimately I'm in favor of lineage traditions rather than academic credentials for many human fields. In education, Montessori, Waldorf, and Reggio Emilio are lineage traditions which have developed outside the standard academic system. Of course the martial arts often have well developed lineage systems, as do some traditions of yoga, meditation, etc. Body work also has lineage traditions, with Rolfing, craniosacral therapy, etc. Music and artistic traditions also recognize lineages to an extent.
We should expect these lineage traditions to break apart over time, with various disciplines modifying the practice or claiming that they are the true, authentic lineage. That is okay.
But as long as academic credentialism reigns, it will be difficult to grow these lineage traditions. The average person believes that the academic credential actually means something. The examples listed above recognize lineages precisely because they've mostly formed outside the academic system.
"I like history because it often changes the landscape of current possibilities in liberating ways."
"Even as a therapist, I’m not so sure that therapy and medication are better solutions to mental anguish than religion, community, necessity, exercise in natural settings, and so on"
Terrific post! Such honest and insightful writing. Where psychology meets philosophy.
Appreciate these...it's always nice when someone is able to flag a few good ones from the massive pile. I'll have a look. Thanks for reading and sharing.
This is a fascinating post; I loved the historical perspective.
The question that would be uppermost in my mind when choosing a therapist: does the therapist like me? I´m not sure this is a good question. Perhaps it´s a question that´s more revealing of my own interpersonal difficulties than anything else, but I don´t see the point of paying someone to help me who doesn´t basically think I´m a good guy.
This inquiry might be the basis for an interesting experiment. Do clients fare better with therapists who like them?
I think that's a great question to ask, and some of the reasons you might not think so, or the average person might not think so, are an indication of the field taking itself too seriously. If people thought of therapists as experts in caring about others and having meaningful conversations, then the question "Does this therapist like me?" would be leveraged more, I think. Instead, people think therapists have a bunch of specialized knowledge about the brain, and so it's sort of like asking if your podiatrist likes you: it doesn't matter that much.
As for an experiment on that, it's a good idea, and I'd be surprised if someone hasn't poked around it. I'll keep an eye out. Thanks for reading and commenting.
Great post. When I advise people to look for therapists, I tell them that about 80% of therapists are worthless, 10% are okay, and 10% are amazing. In my experience the traditional credentialing system provides zero information in identifying which ones are amazing. I had a highly credentialed therapist at a prestigious university who was worthless, and have had interesting non-traditional therapists who were amazing.
Separately, I'd encourage you to read Liah Greenfeld's Mind, Modernity, and Madness, which makes a neo-Durkheimian case that modernity itself has, over the last several centuries increased rates of functional mental illness, especially among Anglo-spheric and nearby northern European nations.
https://liahgreenfeld.com/2014/05/20/review-of-mind-modernity-madness-in-barrons/
Thanks Michael, for the comment and recommendation. I'll read your review and perhaps the book, too, since it seems up my alley.
I agree with your breakdown on therapist quality. I suppose the good news is that mediocre therapists can deliver solid benefit nevertheless, especially if much of the benefit can be explained by placebo, having a dedicated time to think through problems, speaking about problems (as opposed to thinking about them), and so on.
I also think that intelligence as traditionally defined is irrelevant to being a good therapist. If, for example, genuine listening is more important than correct diagnosis - because diagnoses are kind of a sham - then you don't need a degree from Harvard. Or, for that matter, a degree that takes 7 years and costs $100k+. In fact, the more therapists rely on being intelligent in the traditional sense, the more distracted they are from doing their job well, IMO.
I completely agree that being intelligent in the traditional sense is irrelevant and may possibly be counterproductive to quality therapy. This strikes me as spot on, " the more therapists rely on being intelligent in the traditional sense, the more distracted they are from doing their job well."
Ultimately I'm in favor of lineage traditions rather than academic credentials for many human fields. In education, Montessori, Waldorf, and Reggio Emilio are lineage traditions which have developed outside the standard academic system. Of course the martial arts often have well developed lineage systems, as do some traditions of yoga, meditation, etc. Body work also has lineage traditions, with Rolfing, craniosacral therapy, etc. Music and artistic traditions also recognize lineages to an extent.
We should expect these lineage traditions to break apart over time, with various disciplines modifying the practice or claiming that they are the true, authentic lineage. That is okay.
But as long as academic credentialism reigns, it will be difficult to grow these lineage traditions. The average person believes that the academic credential actually means something. The examples listed above recognize lineages precisely because they've mostly formed outside the academic system.
Yep, I agree with you there - and so would Illich :)
"I like history because it often changes the landscape of current possibilities in liberating ways."
"Even as a therapist, I’m not so sure that therapy and medication are better solutions to mental anguish than religion, community, necessity, exercise in natural settings, and so on"
Terrific post! Such honest and insightful writing. Where psychology meets philosophy.
Thank you, I very much appreciate that.
Here are a couple recent open-access meta-studies on the effects of psychotherapy that slightly contradict your views:
https://www.sciencedirect.com/science/article/pii/S0165032723006389
https://onlinelibrary.wiley.com/doi/epdf/10.1002/wps.20941
For example, psychodynamic therapy is probably less effective than CBT, especially in the short term. Otherwise, kudos for the post!
Appreciate these...it's always nice when someone is able to flag a few good ones from the massive pile. I'll have a look. Thanks for reading and sharing.
Oh, also I wonder if you've read this: https://academic.oup.com/book/54240/chapter/422452976
I had not, but once I got past the poor translation, it was great :) It will certainly help with Part II so thank you for sending it along.
I promise this is the last link from me, but here's a post I published today on a vaguely similar topic:
https://kapterev.substack.com/p/the-science-on-psychotherapy-what
Cool, will have a look.