Could an Outsider Recieve and Benefit From Culturally-Specific Therapy?

With respect @Former-Member, I don't think many patients are sufficiently knowledgeable to really know if they are being helped or not. I think many would be just as helped, and a whole lot richer themselves, if they had got into a discussion with a complete stranger who compassionately listened, and simply gave a damn. Or a family member they could confide in and who would sit and discuss their concerns for an hour every week. Most think that because they aren't as bad as they were initially, that all is well. It doesn't matter that their treatment is ongoing, that they are only going from one medication to another, or one dosage to another, or one procedure to another, (now we'll try this), and that treatment is relentless with no end in sight.

Therapist competence should be a given. Far too many of us have not found it to be so. Human suffering is not something anyone should become indifferent to and those being paid to alleviate and cure pain should constantly remind themselves of this.

Hmmmm. It's got some interesting takes @Appleblossom . I like the 3 umpire analogy. Kinda wondering if thinking like an"umpire" is the best approach. Not sure what tweaks to the analogy I'd suggest, though.

Wouldn't load for me @Appleblossom, but I saw in the address bar mention of Allen Frances (sp?), so I offer a video from Paula J. Caplan whom @chibam introduced me to several years ago. I think she is fantastic even though I've never been able to find the time to look at her others, but I would be surprised if they were any different to the clear and spirited one below. She mentions Allen Frances not so warmly.

“There Are No Rules About Psychiatric Diagnosis — And That Must End!” Paula J. Caplan, NARPA 9/4/14 - YouTube

www.youtube.com/watch?v=tgilBaRbulc&t

I guess to truly know someone, it is necessary to know them over time.

@wellwellwellnez I am not big on anything that increases competitiveness and the distance between people. I liked that analogy as is.

Also looking at Paula Caplan ... again ... whose book is an expose about her experience with the fellow I just linked about ... and the DSM 4 ... seems there really is a crisis in confidence in the system.

I have to say I feel my trust was betrayed and my son harmed by similar issues they bring up.

@Former-Member

Help seeking is important, but we do have to be sure that it is in fact help that is dispensed.

@Historylover, you beat me to it with the Allen Frances call. 😉 I, too, recognized the name immediately and immediately remembered that video.

But respectfully, I can't say I agree too much with your suggestion that:

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@Historylover wrote:

...I don't think many patients are sufficiently knowledgeable to really know if they are being helped or not.

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And TBH, that view would worry me, if it were adopted widely, as it undermines the relevance of the patient's opinion as to whether their being helped, and transfers the right to make that determination over to so-called "knowledgeable" people.

Where I think the confusion lies is whether or not help will be delivered, in repayment for playing the therapist's game. Because we're conned by the media into believing that therapists ultimately do help their patients. So if the therapist wants you to take pills, you take their pills. If they want you to do stupid breathing exercises, you do stupid breathing exercises. If they want you to go on a mindless excursion, you go on a mindless excursion. And you do all this under the presumption that if you do what they want you to do, they'll ultimately repay the favor by doing what you want them to do.

So, when your caught in the middle of that process, not realizing your being scammed, your probably going to be under the mistaken belief that you are getting help. But, I think, most of us are savvy enough to recognize that we haven't actually been helped yet. We can look at our lives at any given point in that process and recognize that they aren't any better. But we retain the illusion that tomorrow, the therapist will start delivering.

If you'd asked me, in the middle of my therapy: "Have you been helped?" I wouldn't have hesitated to answer: "No." But, if you had asked me: "Are you getting help?", I would've answered: "Yes."

Because they tell you that therapy is a lengthy procedure, and so they con you into being patient when you don't get results; unawares of the fact that your never going to get results.

For that matter, it's easy enough to fall in to the same sort of pitfalls with the general community, but you tend to hold the therapy profession up to a higher standard, you know? Like their professionally and legally obligated to help the people who turn to them, and not exploit them.

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@Former-Member wrote:

I agree that there are many times when improving an individual’s circumstances would have a huge impact on their mental health, but I also don’t think that this inherently makes therapy unhelpful. Sometimes changes to circumstance are not possible...

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To be honest, @Former-Member , I find that idea quite horrifying, particularly in the context of the way we deliver mental healthcare today.

First of all, I believe that while there is a kernel of truth to that statement, it is grossly over-used to explain the otherwise unjustifiable uselessness of therapists.

Take it in the context of the previously mentioned article, which was talking about ethnic people who were depressed/suicidal because they were chronically unemployed. So... we're saying that it's not possible for an ethnic person to have meaningful employment? Is that our excuse for why the therapists don't help?

What about lonely Joe? Are we saying it's not possible for him to have a girlfriend?

What about poor Leah, still stuck living with her parents at 28, when many people her age have been rehoused into apartments, with new families of their peers. Are we telling her it's not possible for her to ever be housed with people she can connect with?

Or what about poor Debbie, who gets thumped at school and has been tarred with all sorts of abhorrent labels? Are we telling her that it's not possible to extract her from that toxic environment? Or to expell her tormentors from it?

And I think all of them certainly have the right to ask: "How come these sorts of things: jobs, love, achievements, new adult families, are possible for a majority of the population, but not for me? Who the hell singled me out for a mandatory shit life, and what the hell gave them the right to do so?" And they are entitled to a full, proper answer from the people who would pronounce that changing their circumstances is not possible.

IMO, therapists grossly overuse the claim that a patient's circumstances can't be improved to explain away the fact that they do bugger all to help their patients, and that the system doesn't even want to help it's patients.

But even if we narrow the discussion down to that proportion of patients who's circumstances genuinely cannot be improved; how then do we justify the system's unwavering browbeating of "thou shalt not commit suicide!", even upon patients who can't be helped? When a person is stuck with a standard of living that is less desirable then death, and "those circumstances can't be changed", then how on earth is it ethical to condemn them to enduring that hopeless hell longer then necessary? Condemning them to a very long wait for cancer to come along and (very painfully) liberate them, because it would be "immoral" for them to liberate themselves?

If I seem a bit wound up about this, that's because this is exactly the fate my therapist condemned me to! And let me tell you, it is wrong, wrong, wrong! There is no way that being sentanced to prompt death by some genocidal regime can be worse then the soul-crushing emptiness I've had to wallow through in the 10 years since I was released from therapy; nor the years/decades I am yet to senselessly wallow through, waiting for cancer/heart attack to give me the release I ache for like you can't imagine, and which I have bloody well earned by now!

So, to any system that would acknowledge that "sometimes circumstances can't be changed", I say you must consequently openly acknowledge that "sometimes suicide is the best option.", and stop skewing the public with your cruel, B.S. slogan: "No matter who you are or what your going through, help is available, so call Lifeline!"

Maybe then, if they were forcibly bound to acknowledging the fact that a person who can't be rescued from a fate worse then death has every right to die, they would not be so fast and loose in dishing out their pronouncements that "this patient's circumstances can't be corrected."

I must make a comment regarding your statement that:

"When it became apparent that science could never replace Christianity without offering a moral code to direct peoples' lives and shape social norms".

@chibam, moral codes preceded christianity by untold centuries, millenia even. Aesop, born 620 to 564 BCE, was telling morality stories long before christianity; and Confucius was said to have been born 551 to 479 BCE.

I would expect all cultures had moral codes long preceding christianity, which is just one of countless.

@chibam, I see your point, but you have completely misunderstood the intent of my statement re:

...I don't think many patients are sufficiently knowledgeable to really know if they are being helped or not.

@chibam replied: "And TBH, that view would worry me, if it were adopted widely, as it undermines the relevance of the patient's opinion as to whether their being helped, (and transfers the right to make that determination over to so-called "knowledgeable" people."–I certainly didn't imply that!).

No, I am saying that, while patients may experience change in their condition from having someone listening to them, or being medicated etc., many are simply becoming habituated to treatment, and the condition for which they sought help many years ago is simply being masked. If they were to come off medication, how is their condition different to that for which they sought treatment years before?

Do any of us with less knowledge really know if our mechanic is not deceiving us when he says that we need such-and-such done to our car, or if our repair man isn't overcharging us or, for many, if the nice man who rang to advise that there is a problem with our NBN isn't scamming us? We don't. We simply trust because we assume they have greater knowledge and the same integrity as we do. Until we learn otherwise.

We assume we are being helped, but the many people making complaints, joining meetings, on-line sites and investigating the therapy situation for themselves speak to dissatisfactory results, and total disillusionment with 'the system'.

Shouldn't we be able to voice valid concerns that there are those, like myself and so many others, who have been deceived and had our lives destroyed by unscrupulous operators–done so respectfully and professionally, and bring that to others' attention; or do we just continue with this money-spinning charade, allowing vulnerable, trusting and naive people to be similarly, unconscionably treated while assuming they are being helped?

Sorry, @Historylover , I did understand the intent of your original statement. But I was attempting to play devil's advocate for a moment, and demonstrate how that idea could be abused by people with dishonorable intentions.

You are right of course, in that many people are getting scammed by the system without even knowing it is happening. TBH, I don't know how we deal with that, aside from warning patients to be wary of scammers, giving them the warning signs to look out for, and making it more common practice to frequently evaluate the patient's progress against their desired outcome(s).

And it's important that that last step is done much more thoroughly then it is done today, and in isolation from the therapist.

When I was in treatment, the only external evaluation my treatment got was that I had to fill out one of those K-10 forms every six months, and that I was asked by my GP how the treatment was going - except I had signed away my doctor-patient privelage in order to get the Medicare discounts on my therapy! I had no legal guarantee that he wouldn't just go off and repeat everything I said to him to my therapist. So I always had to tell him my treatment was going fine. But if my doctor-patient privelage had been intact, I would've practically screamed at him: "No! That woman is a nightmare! Please, get me out of this mess!"

So we need a much better evaluation system then that.

And we need a much fairer approach toward advising patients to be patient with their treatment; because currantly, that idea is being used to subdue patients' expectations for therapy down to the point where they effectively accept the fact that nothing is improving, because they've all been shamed into believing that they are obliged to wait years for what ought to really be achieved in a couple months at most. We need to secure the patient's freedom to call out the differance between "slow progress" and "no progress".

I probably came down on your post harder then was warranted, @Historylover . Sorry.

I guess that sentance just struck a nerve. Reminded me of the time my first therapist wouldn't listen to me when I kept trying to voice my disappointment with the absence of any improvement in my life. He just kept telling me: "Well, you look better!" And because he was the expert, that was the end of the conversation.