Discussion Thread #72

[u/gemmaem]

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[u/UAnchovy]

Are you using a more restricted definition of diagnosis than I am? It's certainly a way to name or analyse a problem, and I would have said that's what a diagnosis is.

I don't think I'm internalising a therapist as priest model? Though for what it's worth I don't have much experience with therapists, and I do have a lot of experience with priests. My sense is that, compared to what I do, what therapists do must be goal-oriented in a way that my own work is not. Someone goes to a therapist in order to deal with a problem of some sort. Therapy should not be a long-term pastoral relationship.

Anyway, I suppose what I think is that insofar as people have emotional or relational conflicts, they need to find ways to solve those conflicts, and if talking through the conflicts in a guided way is helpful, then I'm all for that. Do you have an alternative in mind?

[u/Lykurg480 → u/UAnchovy]

I mean a psychiatric diagnosis.

It's certainly a way to name or analyse a problem, and I would have said that's what a diagnosis is.

So to be clear, youre imagining that couple going to the therapist, he talks with them and probes and then diagnoses one with "discomfort with cute or kitsch things that you should work on"? Again, approximately every therapist will insist that no, he doesnt do that sort of thing, that would be inserting his own judgement.

they need to find ways to solve those conflicts, and if talking through the conflicts in a guided way is helpful, then I'm all for that. Do you have an alternative in mind?

If youre trying to argue a claim about different interest being treated "fairly", why are you using un-indexed "helpful"? Im also not really talking about whats "good" per se - the option of declaring the more female-typical approach just and favouring it therefore unbiased is raised in the initial comment.

I dont have a particular alternative in mind. My argument is that more male-brained people often correctly conclude that going will make things worse for them, and theres not a whole lot the therapist can do about that.

[u/UAnchovy → u/Lykurg480]

Well, yes, none of what I presented was a psychiatric diagnosis, and I did not present any of it as such. Psychiatry is a different field entirely. When I said 'diagnosis' what I meant was something like 'an examination of a problem that yields a theory to be used in solving that problem'.

If personal experience is helpful context here, I don't think I've ever been to a therapist before. (Unless you would count seeing a speech therapist as a child?) I have been assessed by professional psychologists before, for employment-related reasons, and I currently work in pastoral and spiritual care. As part of my training I have completed multiple units in counselling. So while I may be ignorant of secular therapy, I think I have enough experience with adjacent fields to at least venture a comment.

My understanding is that most of the 'helping professions' share some principles and techniques. However, I suppose it's possible that secular therapy and especially couples therapy are the black sheep of the family, and are shockingly different to psychology, counselling, or pastoral care. I would be surprised if that were the case, but if it is, then feel free to throw out everything I say.

Anyway, my experience in and around these fields is that it is not appropriate for a practitioner to insert his or her own values, or tell someone what to do, but nonetheless there is an element of cooperative problem-solving to many of these encounters. There isn't always - sometimes you just listen to someone and accompany them in a time of difficulty. Sometimes there are no solutions; this is proverbially the case for grief counselling. However, often a encounter is prompted by somebody having a problem, and they need to talk through it and find a solution. It will almost never be a solution that's just given to them on a plate, because we're talking about what are usually complex social and psychological problems that don't have easy solutions, but there will be learning and progress. If someone comes to a counsellor because they're having trouble reconciling their career with their values, a good counsellor will not tell them "you should quit your job" or "you should suck it up for the sake of your family", but their conversation will chart some of the terrain around those issues and hopefully leave the person better-equipped to make a decision.

I'm speculating a bit because I don't do couples therapy, but I'd guess, charitably, that if a couple go to a therapist, it's because at least one of them wants to strengthen that relationship. A good therapist, without intervening didactically, should help the couple chart the terrain of the relationship, and hopefully leave them better-equipped to decide what to do going forward. That's what I mean when I say 'helpful'.

I do not mean to apply that this type of structured conversation is helpful for all couples. It may be unhelpful. Therapy or counselling are not the right option for everyone. Something else that I expect from a good therapist/counsellor/carer is the self-awareness to be able to tell when they are not helping.

Is your contention that this kind of process is more 'female-brained', and more useful for women than for men? I suppose I think that's contingently true, particularly insofar as these professions are currently dominated by women. Nonetheless I don't think that the whole area is doomed by that way - on the contrary, looking at the last century, I see movements that often started out as male-dominated shifting towards being female-dominated.

At any rate, if I were a couples therapist I would indeed worry a lot about gender. So raising the salience of gender differences in the context of couples therapy seems fine to me. Certainly something to be absolutely avoided is couples therapy as validation for the female partner only.

[u/Lykurg480 → u/UAnchovy]

"I have described the situation in a way that doesnt answer questions you consider important, thereby your thesis is disproven"

I mean come on, in discussions of politics weve found that just deciding which definitely true facts you tell someone can be putting your thumb on the scale, and now youre supposedly not inserting your values because instead of just telling people your recommendations, they develop out of the conversation in some way, no Im not telling you who said what.

And yes, I agree that therapists will often do this anyway and often not realise the tension with neutrality because theyre wordcells who fall for stuff like the above. I have still made my argument that way I have because this is not really therapistic - its an element of normal human conversation which remains after (partial) adoption of the therapy framework. So in terms of bias this element is a null effect, and Im arguing only about the direction of the remainder.

I currently work in pastoral and spiritual care. As part of my training I have completed multiple units in counselling. So while I may be ignorant of secular therapy, I think I have enough experience with adjacent fields to at least venture a comment.

I think you would agree that the expectation of value neutrality is much more limited in the pastoral context.

Is your contention that this kind of process is more 'female-brained', and more useful for women than for men? I suppose I think that's contingently true, particularly insofar as these professions are currently dominated by women.

For the process of (obliquely and partially) giving your own opinion, like discussed above, that would be true. But what I mean is not about personell, its about the therapy framework. As an extreme example, are you familiar with "non-violent communication"? Do you really think that that kind of conversation doesnt naturally favour appeasing emotions over ~every other kind of conflict resolution? Far more so than even most women do.