In my experience, talk therapy is pretty useless for dealing problems that arise from societal issues. It’s for people that have interpersonal and relationship issues that are otherwise totally fine with the world. When I was doing therapy I made progress on those two things but the therapist had nothing to offer for my depression stemming from class war, genocide, climate change, etc.

Also, in regards to living in delusion, therapy (and all medicine under capitalism) exists to “fix” workers so they can keep making money for the capitalists. Oh, you’re sad because a loved one died? Take this pill and get back to work.

I was once in group therapy. One of the other people there told about how being poor and on unemployment benefits took a toll of their mental health. The trained psychiatrist there, who worked out of a spacious and expensively furnished office with a great view and who had until that point had given off nothing but nice radlib vibes had no empathy, she directly berated them for complaining instead of being grateful for the meagre alms they received, telling them how they had “chosen” to be unemployed themselves. I lost all confidence in her at that moment.

That was my experience with therapy. The only thing I ever got from it was someone to talk to when I was completely isolated. Everything else felt very unsuited to the seriousness of my problems.

My guess is that they just don’t have the tools to really help with serious mental health problems. I have no real knowledge of what therapists are taught, but it seems like therapy is really more geared toward helping with less serious issues.

One thing I noticed is that there is no kind of consistency of treatment. They all seem to be just trying different unproven things and deciding what they think works. I’ve had therapists that want you to find some kind of spirituality, want you to try some weird device, want you to fill out worksheets, even had one that wanted me to smile in a particular way. It’s the wild west out there.

Oh yeah, I’m of the opinion that the whole system of therapy is fucked and that good therapists are fairly hard to find in a system which seeks to uphold the hegemony of a conception of “wellness” under the doom-spiral of capitalism. My last therapist was an older white person who had absolutely no advice for me dealing with a horrific anxiety disorder, severe OCD, ADHD, autism, and constant retraumatization from covid, capitalism, and the difficult family situation I was living in. She actually victim-blamed me once in the aftermath of a moment of physical violence and then when I confronted her about it later, she denied it and tried to gaslight me. She also kept harping on about me wearing a mask and taking covid precautions. I also had no idea of how to even breach the subject of being a Chinese trans person with her. It was such a bad experience that it put me off trying to find a therapist again for months, and now I’m trying again but with OCD-specific therapy this time.

Therapists are for middle class white people who feel a little sad or anxious sometimes, or are dealing with loss or whatever most of the time.

If you have an actual personality disorder or are autistic etc they are kind of fucking useless.

Every therapist I’ve ever had has been dogshit

When I told my last therapist about my anxiety she was like “oh why don’t you try aroma therapy to calm you down?” MOTHERFUCKER I need assistance leaving my own apartment to go grocery shopping I get so anxious, aroma therapy isn’t going to do jack shit

And yeah basically everyone I’ve ever had has been really disinterested. My last one even ended a session 15 mins early seemingly cause she got bored

My physiologist is okay cause she just gives me meds and we talk like once a month, she still misgenders me and shit so still trash but better than any therapist

Mental health services are a joke in the US

My therapist of four years resigned during the pandemic. She was really good, she had some of her shit together but I think she was mostly able to put on a mask for her job - which was a queer oriented service up here in seattle that dealt with people from all walks, it was work she probably liked, and she is the only good therapist i’ve ever had. My last session with her she rolled her eyes at that - she felt her colleagues were on her level and actually defended them - and I see what she said, but nah, nobody has fought like she did, nobody keyed in and got me to think about my own shit like she did - nobody could even pretend to give a quarter of the shit she did.

The last few sessions she seemed to be genuinely cracking, like that professional mask came down and it was apparent she was just a human being with her own private disasters and stuff - I don’t wanna share her life but I realized that like, good therapists are kinda sacrificing themselves to do it i think - eventually you burn out from that kind of give-a-fuck if the strain is too high.

when I went in the psych ward I got to see an actual psychologist and the difference between that and some regular talk therapist was night and day. I made progress at a rate I would have never thought possible before. I was also able to enter a DBT program which I consider by far the most successful mental health intervention I have ever undergone. regular talk therapy with some guy with a bachelor’s degree isn’t very useful in comparison, I see it as akin to writing in a journal basically but with some accountability. for reference I am autistic, have had severe depression for almost a decade, and when I went into the ward I probably could have qualified for a personality disorder diagnosis like BPD. regular therapists can’t meaningfully help people like me but seeing the real brain docs did make a difference. obviously the shit part is that’s unaffordable for most folks, I was lucky enough to have my insurance cover it and I also don’t live in America where the whole system seems waay more hellish.

I got diagnosed with “cannabis use disorder” once because when the head shrink in the psych ward asked me if I smoked I responded “smoke what?” Deeply unserious profession.

Best therapists you’ll find for people who don’t have their shit together good outpatient rehabs. I’ve had a few therapists throughout my life but every person there has known exactly how to handle people who don’t have their shit together. I’m an alcoholic schizophrenic who was in an abusive relationship. I’ve gotten really good therapy so far, and so have other people I know who’ve gone to similar places.

I told one therapist how much I hated having to engage with capitalism, even in small ways like going to the shops and buying groceries, and her advice was to start a business about it.
Unfortunately, like with the drugs, you often have to try a few before you find the right one for you.

sometimes it seems like the actual help is gatekept behind having an attempt but it’s more likely that it really doesn’t exist.

just need a doctor who can prescribe communism, a social life, and companionship; and a magical pharmacy that has those in stock.

I’ve had some good trauma informed therapists at low points in my life.

I’ve also gotten some really bad advice and hot takes from talk therapists.

Experiences with psychiatry have universally been shit. Researching my own meds and asking a GP for them tends to work better. But I imagine they’re more hesitant to prescribe controlled substances like ADHD meds.

I never really had, and I still have like a lot of mistrust towards towards the mental health system, due to like something that happened a long time ago. Where like a psychiatrist mistakenly thought I was in crises and sic the police on me. I also didn’t have health insurance, so getting the ambulance bill + hospital bill + various other bills from different health professionals like a physician. I dunno it just taught me that to not seek help when in a crisis

From SPK (Sozialistisches Patienten Kollektiv)'s “Turn Illness into a Weapon”:

“The capitalist production process is at the same time a process that destroys life. It continuously destroys life and produces capital. […] Illness is the expression of the life-destroying power of capital. Illness is collectively produced: that is, in so far as the worker creates capital in the work process, which encounters him as an alien force, he collectively produces his own isolation. It’s therefore only logical that healthcare produced by capitalism perpetuates this isolation in that it doesn’t treat these symptoms as collective but rather treats them as individual bad luck, fault, and failure. However, capitalism produces, in the form of illness, the most dangerous threat to itself. Therefore it has to fight against the progressive moment in illness with its heaviest weapons : the healthcare system, the legal system, the police.”

Yeah, oof. As someone training to be a therapist these threads pain me. Parts of me want to be like “not all therapists!”, then I remember that I am constantly hurt, disturbed, and alienated by things my supervisors say and do. Even I have never really had a counsellor, therapist, or psychiatrist that I didn’t eventually hate

I still believe good therapists and good therapies exist, but they are so few and far between. Most therapists are eager to round off people’s edges with the (explicit or implicit) goal of conforming to neurotypical standards. I think there are real benefits to cognitive-behavioural approaches, which focus on shaping maladaptive/problematic/negative thoughts and behaviours - but these are not universal. I have more hope for the value-driven, person-centered kinds of care where a therapist can help someone find meaning, satisfaction, and joy in their life by helping them put their personal values into action.

I have no choice but to convince myself that I (and the other amazing, radical people I know and look up to) can make better care a reality, because the alternative is too grim.