I’m realizing one of the fundamental problems with the field of mental health and therapy is the contradictory nature of knowing a person vs. not knowing. A therapist is supposed to have a certain level of professional detachment. But this also means they are unable to be in your corner the way a close friend would, preventing them from providing similar benefits. A therapist also just has a very limited scope of knowledge about you. Most of their information on you is based on the assumption that you’re a reliable narrator about yourself and your life, which may not be the case. I imagine there’s probably some training to look for signs of being an unreliable narrator, but overall, it’s not like they can just go check with other people you know to see if your stories are straight.

But even if everything you present is accurate, even if they read between the lines and learn tics you have, all they are seeing is “therapy you” during a very limited time frame. They don’t see how you are with friends, family, when you’re out and about, etc.

In short, they don’t really know you and if they did really know you, it would be hard for them to do their job in a professionally detached way. But without knowing you, most of what they can prescribe is generic advice. And that works some of the time. Like deep breathing techniques for anxiety, sure, that applies to a lot of people. But it’s also advice you can find with a web search. I think there is something valuable in basic back and forth with a professional, but beyond that, I’m not sure it does much and it might make things worse if the therapist is professionally compelled to get you to “change”. They can frame it as wanting to help you change in the ways that you want to change, but underneath that is the professional compulsion to show improvements relating to a standardized mental health designation of chronic issues.

I suspect a lot of people these days just need someone to talk to and that’s part of why turning to an LLM as “therapy” is enough for them. Because for them, they don’t really need the limited effectiveness therapy process in the first place. They just need something like the distance of talking to a therapist without feeling like they’re being pushed in a certain direction. I mean, isn’t it a bit weird that even in romantic relationships, the common refrain is you shouldn’t get into a partnership expecting to change someone, but in therapy, it’s basically the opposite; the expectation is that you come out different somehow. But if a romantic partner, a person who you’d expect to know you better than almost anyone, is not supposed to be someone who changes you, what qualifies a single individual who doesn’t know you from very limited conversation sessions to help you change?

P.S. Did not realize this would come out so long. Thought about doing it as a post in freechat, but don’t want it to come across as a broader anti-mental-health-field message. I have nothing against the intention of the field as a whole. Just have problems with it in practice and the logistical limitations of it.