therapy redux

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[This is a response to guest post:]

I agree that CBT is superficially the perfect rationalist therapy. I was a maybe a bit too harsh on CBT in my recent post. Research shows that it works as well as any other therapy. I’m a bit annoyed though that everyone points to CBT when there are plenty of other research-based therapies out there, and just because CBT is one of the most researched therapies, it doesn’t necessarily mean the effect size is any greater, etc., etc.

I do think that “feared truths” keep us from updating beliefs in the face of evidence. If an evidential conclusion implies no emotional impact, it seems that the brain updates easily. If an evidential conclusion implies negative emotions, then parts of the brain update reluctantly, if at all. It’s an odd evolutionary situation. Maybe it’s just evolutionary randomness or maybe this weird updating has a fitness benefit. Either way, it seems to cause more suffering than it alleviates. It’s part of the tragic aspects of the human condition.

I try very hard to notice when I’m resisting an update. I try very hard to see why I’m resisting an update, what feared truth or meaning about the world that it would imply. And then I try to explore whether *that* belief is accurate, and so forth. This is all with gentleness, trying to accommodate the resisting parts, recognize their truth and validity and so forth. Often I’ll eventually find that these almost preverbal parts of myself have a valid and useful intuition that cuts across the normal ways I have of looking at the world. But all this is very, very, very hard. It is sometimes much easier to do with another person there, all things being equal.

And here’s what drives me crazy about CBT. The “thoughts and beliefs” that people say or write down in order to challenge often do not map very well to the “actual thoughts and beliefs” that the person holds. Call it naive CBT, maybe. I guess it’s like anything else, there’s a bad way to do it and a good way.

I agree that people act from tiny, primed parts of themselves, whatever it loudest in the moment. They get jerked around by stimuli in the environment and random stimuli in their own heads.

I agree that there are an infinite number of actions available in any moment. At every moment the brain presents false choices and false dichotomies (“I can do this or that but neither work!”). In fact, there are all sorts of counterintuitive ways to carve up “action space,” some better than others.

I would point out though, of course, that not all futures are available in any moment, and not all actions lead to what futures are available. The future is probabilistically constrained, actions have consequences, not everything is possible or probable. Most people reading this have a relatively forgiving reality to live in though. Many mistakes are possible to recover from, things are never as bad as you think, etc., etc.

I agree that therapy “opens up new non-silly options.”

So I guess a few things jump out at me regarding self-modification.

I guess there are two types of self-modification I would make a distinction between. I’ll call them “in frame” and “out of frame.”

With “in frame” modification, what you want is “legible.” You know what you’re looking for, you strive for it, maybe you even strive for it obliquely–you know that aiming directly at it isn’t the best way to get it.

The other type of modification, you don’t know what’s going to happen until it does. It’s unpredictable, it’s surprising. There’s the quote, “Enlightenment is an accident; Meditation makes you accident-prone.” I think there’s probably an analogous state of affairs for therapy. If your world-space, your ontology, shifts, and your epistemological practices shift, it’s difficult to understand what the heck is going on while it’s happening or even days or years later. I guess you do learn to more effectively role with it, though.

Anyway, these days I try to aim more for relatively safe but unpredictable and surprising changes, rather than changes I can predict in advance. Openness, vulnerability, surrender, something, something, trust but pay attention but relax and let go… Hmm…

Anyway, girl stuff? Agent of Good? Would it be useful to expand in those directions?

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