Should I consider it a rationality failure if I exhibit resistance to psychotherapy? I know that CBT is supposed to help a person overcome the sorts of maladaptive thinking & behavior patterns that got them in the kind of trouble that convinced them to seek out therapy in the first place. CBT psychotherapists are probably the most mainstream people to even promote more rational thinking. But I have trouble following through.
For one, I cannot answer certain questions in the frame which my therapist imposes because I intellectually reject the assumptions that underlie them. Even when they’re supposed to be established science. I just cannot map them unto my own experience. My therapist says I’m not giving her enough to work with.
For another, I do not fully agree with the psychological establishment on what constitutes “healthy”, adaptive, rational behaviour and would not like myself to adhere to even the closest variation on mental normality. There are areas of myself which I do not wish to display as “up for fixing”, and do not allow interference other than my own in those areas. I consider myself rational enough to debug myself, if and only if I decide an intervention is warranted. Otherwise, I like and accept myself as I am, I consider most of my traits, broadly speaking, as part of my ideal self, and would like to preserve most aspects about myself. While I’m not very sure that a therapist can or would be sufficiently subtle or insidious to modify me in a direction of which I do not approve, I’m worried that this is a possibility or that it is required in order to get any positive effects out of it.
For the record, I do therapy for ameliorating depression. The cause of depression is a failed relationship with someone I loved, which I may have allowed to get stuck in a negative feedback loop. (Then again, it’s probably likely it would have failed without any negative feedback on my part.) I’m on meds as well. It’s understandable to feel bad in this situation, I can’t help feeling bad about it, and I’m not sure what a therapist can do to help me out of it. If I can recover on my own and with the aid of antidepressants, without having to waste time on therapy for it, I’d gladly do it, but I have the lingering doubt that the shrink may be right after all and I might need to get my head checked.
For one, I cannot answer certain questions in the frame which my therapist imposes because I intellectually reject the assumptions that underlie them.
Examples? Just curious.
For another, I do not fully agree with the psychological establishment on what constitutes “healthy”, adaptive, rational behaviour and would not like myself to adhere to even the closest variation on mental normality. There are areas of myself which I do not wish to display as “up for fixing”, and do not allow interference other than my own in those areas. I consider myself rational enough to debug myself, if and only if I decide an intervention is warranted. Otherwise, I like and accept myself as I am, I consider most of my traits, broadly speaking, as part of my ideal self, and would like to preserve most aspects about myself.
Total armchair-psychologist kibitzing. This reads to me like someone who feels judged, or been repeatedly told that there’s something wrong with them that they should fix, or for some other reason is in an emotionally defensive position. My guess is if you felt less judged or more respected, following the shrink’s suggestions would feel more like giving some new habits a test drive than like ritually sacrificing parts of your identity.
If I can recover on my own and with the aid of antidepressants, without having to waste time on therapy for it, I’d gladly do it, but I have the lingering doubt that the shrink may be right after all and I might need to get my head checked.
I don’t know enough about psychotherapy efficacy statistics to say, but heuristically I tend to assume that experts are better at judging these things than non-experts.
A possibility to consider: there may be behavior changes that would have a highly positive impact to your future life (avoiding arguing habits which exacerbate relational strife, to make up an example), but that aren’t terribly relevant to getting out of this depressive slump. Have you tried the usual anti-depressive suspects (exercise and socializing)? When you feel better / at the beginning your next relationship, it might be worth revisiting some of the things which went wrong in the past to try to avoid them.
This comment should be read as informal musings for the purpose of collecting outside views.
For instance, she asked me to list the positive and negative traits of the significant masculine and feminine models in my childhood, in order for her to tell me what kind of relationship I am subconsciously looking for. Problem is, 1) I don’t remember people in my early life as strongly representative of their gender, because back then I didn’t have a strong idea of gender, I just divided people into kids and adults rather than male and female; 2) just because some people might have been my parents or caretakers or elementary teachers doesn’t mean I regard them as significant, just as more familiar than the rest; 3) to this day I don’t ascribe much valence to traits, I don’t view them as virtues or flaws, I consider them mostly neutral, with the potential of “positive” and “negative” expressions; 4) even so, back then I probably judged traits in a completely different light; 5) I really don’t see what any of this has to do with my current attitude to relationships, given that I have changed a great deal in the meantime, and whatever ways in which I resemble my parents (including in the matter of taste in partners) could probably be attributed to genetics. So yeah, impossible question.
Total armchair-psychologist kibitzing. This reads to me like someone who feels judged, or been repeatedly told that there’s something wrong with them that they should fix, or for some other reason is in an emotionally defensive position. My guess is if you felt less judged or more respected, following the shrink’s suggestions would feel more like giving some new habits a test drive than like ritually sacrificing parts of your identity.
The paragraph you quoted here doesn’t have to do with any ways in which I’ve been evaluated by actual people in real life. I have read extensively on psychological topics, especially those related to personality types and disorders, psychological schools, advice, and so on. Many times I have recognized myself in descriptions of “how not to be like”, while descriptions of healthy, adaptive traits & behaviors—things like being warm-hearted, optimistic, and bereft of ideas about one’s own exceptionality—just didn’t appeal to me. I expect my therapist and me don’t really see eye-to-eye on “if it ain’t broke, don’t fix it”.
A possibility to consider: there may be behavior changes that would have a highly positive impact to your future life (avoiding arguing habits which exacerbate relational strife, to make up an example), but that aren’t terribly relevant to getting out of this depressive slump. Have you tried the usual anti-depressive suspects (exercise and socializing)? When you feel better / at the beginning your next relationship, it might be worth revisiting some of the things which went wrong in the past to try to avoid them.
This could be true, yes. I don’t go into therapy for any other reason than to maybe at some point stop feeling sad all the time, and yet there are enough other areas in which a therapist might believe intervention is warranted. I haven’t had the energy for vigorous exercising lately, but, for what it’s worth, I take stupendously long walks around the city; as for socializing, I get some human interaction daily, even though it’s not of the fun, energizing kind.
I don’t blame myself much for this failed relationship; I think the most likely hypothesis is that I just stumbled upon a maddeningly attractive person who simply happened to have completely different tastes, and nothing I could have done or tried could have made them love me. Hit and miss, basically.
Hypothesis: it is your therapist who has no idea what s/he is doing.
Hypothesis: it is you who are making this unnecessarily harder than it needs to be.
Hypothesis: CBT may not be what is needed for your particular case.
Hypothesis: something else nobody has considered yet.
How confident do you feel to assign respective probabilities to these hypotheses?
I consider myself rational enough to debug myself, if and only if I decide an intervention is warranted. Otherwise, I like and accept myself as I am, I consider most of my traits, broadly speaking, as part of my ideal self, and would like to preserve most aspects about myself.
I don’t live inside your head, so I can’t be sure, but this part sounds like you have strong mental tools to get out of your depression at your own pace and on your own terms. I wouldn’t worry much.
Well, thanks. I’ve considered all of these possibilities, but I can’t say for sure which one is more probable than the others; to any given one I’d respond “maybe”.
Should I consider it a rationality failure if I exhibit resistance to psychotherapy?
What is this sentence like without the word rationality?
I just cannot map them unto my own experience. My therapist says I’m not giving her enough to work with.
Can you articulate to your therapist why you are having difficulty? It could be that the two of you are not a good match, or it could be that she can work with you, so long as you’re open.
While I’m not very sure that a therapist can or would be sufficiently subtle or insidious to modify me in a direction of which I do not approve, I’m worried that this is a possibility or that it is required in order to get any positive effects out of it.
If you’re good at fixing the parts of yourself that you let yourself fix, you should expect that the thing you would get the most benefit from fixing is likely to be a part of you that you don’t let yourself fix.
My recommendation here is to differentiate long-term and short-term changes. You can make significant changes on a probationary basis, and change them back if they aren’t working out for you.
I’m not sure what a therapist can do to help me out of it.
Broadly:
A narrative shift. Therapy could propose, or help you discover, a narrative that fits your situation but has a more hopeful interpretation.
A mental behavior shift. Therapy could help you identify the beginning of negative spirals, and cut them off before they get too strong.
A social behavior shift. Therapy could help you interact with and relate to people in a different way.
Those three are highly related, and so they can’t really be separated—but it is useful to think of them on different levels.
I’ve never been in therapy, but I find it almost impossible to map certain psychological concepts and questions to coherent internal things. It’s like when someone describes political liberalism as “the belief that government should be bigger”: It’s not total nonsense, but it doesn’t connect with solid, and it’s probably a sign of confusion if you feel that you can give a categorical answer.
Or another way: Trying to apply these concepts to myself feels like asking if some Canadian guy more culturally Japanese or Spanish (extroversion/introversion, high/low self-esteem, inner/outer locus of control, masculine/feminine). I can see that certain percentage of the world population is really clearly Japanese or Spanish, but what’s the meaning of saying this Canadian guy is more Japanese, or even that he’s more Japanese in contexts X, Y, and Z, and more Spanish in environments P, Q, and R?
What is this sentence like without the word rationality?
Purposeless. The very reason I ask this on LessWrong is that I care about being more rational, less biased, more clear-headed etc., and I have some worries that my resistance to psychotherapy is a clue that I’m failing at this. That I have biases I’m clinging to.
Can you articulate to your therapist why you are having difficulty? It could be that the two of you are not a good match, or it could be that she can work with you, so long as you’re open.
The thing is, I don’t have much of a choice. I met her through my cousin and for that reason she agreed to receive me without payment. I can’t afford paid therapy; I have tried another therapist previously and I pretty much spent $40 just to hear that she doesn’t think I’m eligible for psychotherapy. I think I’d have been happier if I had spent the money on meds.
If you’re good at fixing the parts of yourself that you let yourself fix, you should expect that the thing you would get the most benefit from fixing is likely to be a part of you that you don’t let yourself fix.
I didn’t say this originally because it would have been a mouthful, but I’m also sane enough to recognize when a cherished trait of mine is actually maladaptive and self-modify in that direction. I’ve undergone significant changes in recent years, that cannot be solely attributed to “growing up”. I’ve even tried my hand at extraversion, from the starting point of an incurable introvert, because I believed it would get me closer to my goals. (It mostly turned out to be a great way to increase spendings on alcohol and decrease time left for productive pursuits, but maybe I’m not in the right social circle.)
Thanks for expanding on what therapy can do for me.
On of the most important things for therapy to work is to have an alliance between the client and the therapist. It’s important to have an agreement about where you want to go.
To me it seems like you have no idea where you want to go that’s more specific than “I don’t want to be depressed.”
While I’m not very sure that a therapist can or would be sufficiently subtle or insidious to modify me in a direction of which I do not approve, I’m worried that this is a possibility or that it is required in order to get any positive effects out of it.
To get positive effects you indeed have to allow change.
On the other hand everybody has the right to suffer as much as the want. You are allowed to have “being happy” not on top of your list of priorities.
To me it seems like you have no idea where you want to go that’s more specific than “I don’t want to be depressed.”
Well, yes, basically. I said as much to my psychotherapist as well.
To get positive effects you indeed have to allow change.
My question is, change in what? There’s little I can change about my beliefs that would improve my mood, aside from becoming implausibly optimistic about my future. Change in baseline happiness? For one, that seems genetically determined; for another, when I don’t get my heart broken I’m in a stable, content, neutral disposition, so it’s not that. Change in goals? I’ve considered that, but it’s just the kind of thing to make me more depressed, seeing as I’m not bloody asking for much if I want to have one relationship with a person of my choosing (a hypothetical someone in my future, not the lost cause I’ve been pursuing) in which nobody’s deceiving anybody; it feels a lot like admitting defeat.
On the other hand everybody has the right to suffer as much as the want. You are allowed to have “being happy” not on top of your list of priorities.
There’s little I can change about my beliefs that would improve my mood, aside from becoming implausibly optimistic about my future.
How do you think you know that? Maybe some of your beliefs or aliefs are causing wrong actions that are making you sad. From what you say elsewhere in your comment, it sounds like your depression is triggered by romantic failure, so changes to beliefs that help you relate to people better probably could improve your mood. In fact, your particular case of wanting “a relationship . . . in which nobody’s deceiving anybody” sounds like a good one for CBT. (Or rather for fixing with rationality-type changes in general, I don’t know enough about CBT vs. other therapies to really say.)
1) You have an idea about what to change about yourself. You go to a psychotherapist and tell him: “Hey, I want to change XYZ about myself.” Then the psychotherapist says: “I think that would be good for you, I think I can bring you there, let’s work together to get you there.”
2) You give up control and let the psychotherapist mold you. He will work on changing things about you he considers supoptimal. That requires trust and going into a vulnerable state.
There’s little I can change about my beliefs that would improve my mood, aside from becoming implausibly optimistic about my future.
I think that’s unlikely to be true. Most people hold a bunch of crappy beliefs. Maybe even aliefs.
I don’t get my heart broken I’m in a stable, content, neutral disposition, so it’s not that.
Generally antidepressants aren’t given out to get people over a breakup. How long ago did that event happen?
I’m not bloody asking for much if I want to have one relationship with a person of my choosing
That’s a goal where a therapist or relationship coach could help you develop in a positive direction.
If your present therapist isn’t up for that goal, you are open to search for a different one.
I don’t know much about CBT for depression but it seems to me it is more about the connotations of thoughts, not their denotations. They work on defusing thoughts like “I can never do anything right” and the issue is not really whether its denotation is objectively true (btw not, but anyway) but how its connotation generates negative feelings. Perhaps, you could discuss with the therapists how to keep the denotations of some thoughts but express then in different words with way more positive connotations?
I don’t have too many of these thoughts. The closest one is probably “By all means, someone like me shouldn’t have much trouble finding a quality partner, therefore the only possibility left is that I’m a soulless alien who cannot connect to other people and this fact is obvious to everybody except me.” Of whose implausibility I’m fully aware, so I don’t really take it seriously.
Should I consider it a rationality failure if I exhibit resistance to psychotherapy? I know that CBT is supposed to help a person overcome the sorts of maladaptive thinking & behavior patterns that got them in the kind of trouble that convinced them to seek out therapy in the first place. CBT psychotherapists are probably the most mainstream people to even promote more rational thinking. But I have trouble following through.
For one, I cannot answer certain questions in the frame which my therapist imposes because I intellectually reject the assumptions that underlie them. Even when they’re supposed to be established science. I just cannot map them unto my own experience. My therapist says I’m not giving her enough to work with.
For another, I do not fully agree with the psychological establishment on what constitutes “healthy”, adaptive, rational behaviour and would not like myself to adhere to even the closest variation on mental normality. There are areas of myself which I do not wish to display as “up for fixing”, and do not allow interference other than my own in those areas. I consider myself rational enough to debug myself, if and only if I decide an intervention is warranted. Otherwise, I like and accept myself as I am, I consider most of my traits, broadly speaking, as part of my ideal self, and would like to preserve most aspects about myself. While I’m not very sure that a therapist can or would be sufficiently subtle or insidious to modify me in a direction of which I do not approve, I’m worried that this is a possibility or that it is required in order to get any positive effects out of it.
For the record, I do therapy for ameliorating depression. The cause of depression is a failed relationship with someone I loved, which I may have allowed to get stuck in a negative feedback loop. (Then again, it’s probably likely it would have failed without any negative feedback on my part.) I’m on meds as well. It’s understandable to feel bad in this situation, I can’t help feeling bad about it, and I’m not sure what a therapist can do to help me out of it. If I can recover on my own and with the aid of antidepressants, without having to waste time on therapy for it, I’d gladly do it, but I have the lingering doubt that the shrink may be right after all and I might need to get my head checked.
Examples? Just curious.
Total armchair-psychologist kibitzing. This reads to me like someone who feels judged, or been repeatedly told that there’s something wrong with them that they should fix, or for some other reason is in an emotionally defensive position. My guess is if you felt less judged or more respected, following the shrink’s suggestions would feel more like giving some new habits a test drive than like ritually sacrificing parts of your identity.
I don’t know enough about psychotherapy efficacy statistics to say, but heuristically I tend to assume that experts are better at judging these things than non-experts.
A possibility to consider: there may be behavior changes that would have a highly positive impact to your future life (avoiding arguing habits which exacerbate relational strife, to make up an example), but that aren’t terribly relevant to getting out of this depressive slump. Have you tried the usual anti-depressive suspects (exercise and socializing)? When you feel better / at the beginning your next relationship, it might be worth revisiting some of the things which went wrong in the past to try to avoid them.
This comment should be read as informal musings for the purpose of collecting outside views.
For instance, she asked me to list the positive and negative traits of the significant masculine and feminine models in my childhood, in order for her to tell me what kind of relationship I am subconsciously looking for. Problem is, 1) I don’t remember people in my early life as strongly representative of their gender, because back then I didn’t have a strong idea of gender, I just divided people into kids and adults rather than male and female; 2) just because some people might have been my parents or caretakers or elementary teachers doesn’t mean I regard them as significant, just as more familiar than the rest; 3) to this day I don’t ascribe much valence to traits, I don’t view them as virtues or flaws, I consider them mostly neutral, with the potential of “positive” and “negative” expressions; 4) even so, back then I probably judged traits in a completely different light; 5) I really don’t see what any of this has to do with my current attitude to relationships, given that I have changed a great deal in the meantime, and whatever ways in which I resemble my parents (including in the matter of taste in partners) could probably be attributed to genetics. So yeah, impossible question.
The paragraph you quoted here doesn’t have to do with any ways in which I’ve been evaluated by actual people in real life. I have read extensively on psychological topics, especially those related to personality types and disorders, psychological schools, advice, and so on. Many times I have recognized myself in descriptions of “how not to be like”, while descriptions of healthy, adaptive traits & behaviors—things like being warm-hearted, optimistic, and bereft of ideas about one’s own exceptionality—just didn’t appeal to me. I expect my therapist and me don’t really see eye-to-eye on “if it ain’t broke, don’t fix it”.
This could be true, yes. I don’t go into therapy for any other reason than to maybe at some point stop feeling sad all the time, and yet there are enough other areas in which a therapist might believe intervention is warranted. I haven’t had the energy for vigorous exercising lately, but, for what it’s worth, I take stupendously long walks around the city; as for socializing, I get some human interaction daily, even though it’s not of the fun, energizing kind.
I don’t blame myself much for this failed relationship; I think the most likely hypothesis is that I just stumbled upon a maddeningly attractive person who simply happened to have completely different tastes, and nothing I could have done or tried could have made them love me. Hit and miss, basically.
Hypothesis: it is your therapist who has no idea what s/he is doing.
Hypothesis: it is you who are making this unnecessarily harder than it needs to be.
Hypothesis: CBT may not be what is needed for your particular case.
Hypothesis: something else nobody has considered yet.
How confident do you feel to assign respective probabilities to these hypotheses?
I don’t live inside your head, so I can’t be sure, but this part sounds like you have strong mental tools to get out of your depression at your own pace and on your own terms. I wouldn’t worry much.
Well, thanks. I’ve considered all of these possibilities, but I can’t say for sure which one is more probable than the others; to any given one I’d respond “maybe”.
What is this sentence like without the word rationality?
Can you articulate to your therapist why you are having difficulty? It could be that the two of you are not a good match, or it could be that she can work with you, so long as you’re open.
If you’re good at fixing the parts of yourself that you let yourself fix, you should expect that the thing you would get the most benefit from fixing is likely to be a part of you that you don’t let yourself fix.
My recommendation here is to differentiate long-term and short-term changes. You can make significant changes on a probationary basis, and change them back if they aren’t working out for you.
Broadly:
A narrative shift. Therapy could propose, or help you discover, a narrative that fits your situation but has a more hopeful interpretation.
A mental behavior shift. Therapy could help you identify the beginning of negative spirals, and cut them off before they get too strong.
A social behavior shift. Therapy could help you interact with and relate to people in a different way.
Those three are highly related, and so they can’t really be separated—but it is useful to think of them on different levels.
(Not the OP, but musing on part of this)
I’ve never been in therapy, but I find it almost impossible to map certain psychological concepts and questions to coherent internal things. It’s like when someone describes political liberalism as “the belief that government should be bigger”: It’s not total nonsense, but it doesn’t connect with solid, and it’s probably a sign of confusion if you feel that you can give a categorical answer.
Or another way: Trying to apply these concepts to myself feels like asking if some Canadian guy more culturally Japanese or Spanish (extroversion/introversion, high/low self-esteem, inner/outer locus of control, masculine/feminine). I can see that certain percentage of the world population is really clearly Japanese or Spanish, but what’s the meaning of saying this Canadian guy is more Japanese, or even that he’s more Japanese in contexts X, Y, and Z, and more Spanish in environments P, Q, and R?
Purposeless. The very reason I ask this on LessWrong is that I care about being more rational, less biased, more clear-headed etc., and I have some worries that my resistance to psychotherapy is a clue that I’m failing at this. That I have biases I’m clinging to.
The thing is, I don’t have much of a choice. I met her through my cousin and for that reason she agreed to receive me without payment. I can’t afford paid therapy; I have tried another therapist previously and I pretty much spent $40 just to hear that she doesn’t think I’m eligible for psychotherapy. I think I’d have been happier if I had spent the money on meds.
I didn’t say this originally because it would have been a mouthful, but I’m also sane enough to recognize when a cherished trait of mine is actually maladaptive and self-modify in that direction. I’ve undergone significant changes in recent years, that cannot be solely attributed to “growing up”. I’ve even tried my hand at extraversion, from the starting point of an incurable introvert, because I believed it would get me closer to my goals. (It mostly turned out to be a great way to increase spendings on alcohol and decrease time left for productive pursuits, but maybe I’m not in the right social circle.)
Thanks for expanding on what therapy can do for me.
On of the most important things for therapy to work is to have an alliance between the client and the therapist. It’s important to have an agreement about where you want to go.
To me it seems like you have no idea where you want to go that’s more specific than “I don’t want to be depressed.”
To get positive effects you indeed have to allow change. On the other hand everybody has the right to suffer as much as the want. You are allowed to have “being happy” not on top of your list of priorities.
Well, yes, basically. I said as much to my psychotherapist as well.
My question is, change in what? There’s little I can change about my beliefs that would improve my mood, aside from becoming implausibly optimistic about my future. Change in baseline happiness? For one, that seems genetically determined; for another, when I don’t get my heart broken I’m in a stable, content, neutral disposition, so it’s not that. Change in goals? I’ve considered that, but it’s just the kind of thing to make me more depressed, seeing as I’m not bloody asking for much if I want to have one relationship with a person of my choosing (a hypothetical someone in my future, not the lost cause I’ve been pursuing) in which nobody’s deceiving anybody; it feels a lot like admitting defeat.
Please don’t.
How do you think you know that? Maybe some of your beliefs or aliefs are causing wrong actions that are making you sad. From what you say elsewhere in your comment, it sounds like your depression is triggered by romantic failure, so changes to beliefs that help you relate to people better probably could improve your mood. In fact, your particular case of wanting “a relationship . . . in which nobody’s deceiving anybody” sounds like a good one for CBT. (Or rather for fixing with rationality-type changes in general, I don’t know enough about CBT vs. other therapies to really say.)
There are basically two ways:
1) You have an idea about what to change about yourself. You go to a psychotherapist and tell him: “Hey, I want to change XYZ about myself.” Then the psychotherapist says: “I think that would be good for you, I think I can bring you there, let’s work together to get you there.”
2) You give up control and let the psychotherapist mold you. He will work on changing things about you he considers supoptimal. That requires trust and going into a vulnerable state.
I think that’s unlikely to be true. Most people hold a bunch of crappy beliefs. Maybe even aliefs.
Generally antidepressants aren’t given out to get people over a breakup. How long ago did that event happen?
That’s a goal where a therapist or relationship coach could help you develop in a positive direction. If your present therapist isn’t up for that goal, you are open to search for a different one.
I don’t know much about CBT for depression but it seems to me it is more about the connotations of thoughts, not their denotations. They work on defusing thoughts like “I can never do anything right” and the issue is not really whether its denotation is objectively true (btw not, but anyway) but how its connotation generates negative feelings. Perhaps, you could discuss with the therapists how to keep the denotations of some thoughts but express then in different words with way more positive connotations?
I don’t have too many of these thoughts. The closest one is probably “By all means, someone like me shouldn’t have much trouble finding a quality partner, therefore the only possibility left is that I’m a soulless alien who cannot connect to other people and this fact is obvious to everybody except me.” Of whose implausibility I’m fully aware, so I don’t really take it seriously.
But your rational part does understand it is mostly just number of approaches done multiplied by your looks, and everything else is secondary?