Fixing My Brain with Automated Therapy
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- Опубліковано 1 вер 2022
- People laugh about this, self-soothing engines sputtering through a nosedive. Not me. | Directly support me and watch exclusive videos by joining Nebula at go.nebula.tv/jacob-geller
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Sources:
The Distance Cure (Hannah Zeavin, 2021)
The Therapy App Fantasy: www.thecut.com/article/mental...
“What is Cognitive Behavioral Therapy?” www.apa.org/ptsd-guideline/pa...
Computing Machinery and Intelligence (Alan Turing, 1950)
Visual Media Used: Eliza, UnearthU, Reflectly, Bloom, Youper, MoodMission, “Hour of Power”
Music Used (Chronologically): Mii Plaza (Wii), The Star-Spangled Banner, Instrument of Surrender (Disco Elysium), Consideration (Eliza), Daily Rituals, UnearthU (UnearthU), Determination, Unease, Jealousy (Eliza), Graydo (Stealth Inc. 2), Sentient (Gavin Luke), No Biscuits for a Bad Dog (Jerry Lacey), The Triumphant Return to Earth (Kilian Flowers)
Thumbnail Credit: / hotcyder
Description Credit: "The Sunset and the Purple-Flowered Tree" by Joshua Jennifer Espinoza
Additional footage provided by Getty
Additional music and sound effects provided by Epidemic Sound
Wanna hear me talk about Betterhelp, Talkspace, and the workers behind the apps? Check out that companion video, exclusively on Nebula: nebula.app/videos/jacob-geller-the-people-behind-therapy-apps/
Yes finally keep it up King 👑
Hello Mr Geller. How are you this evening?
Great video King👑
"Why do I have bad mental health?"
"Also, its my duty to regulate and worry about the government"
Bro your freaking out because a thought.
Where is the government.
Did it touch you?
Your freaking because of illusions.
Like ha. No wonder your mental health is shit.
You think that your correct about the world and that it's necessary to freak out because those beliefs.
As long as you keep up this illusion, you won't be happy.
2 DAYS AGO?
"Rather than figuring out how to make a computer therapist act most like a human, automated therapy has instead chosen the psychological approach that makes a human most resemble a computer"
Holy fucking shit you're good at this.
It's good to keep in mind too that machine learning is based around building & training *models*, little boxes that receive inputs and try to reproduce outputs (based on training data) as best as possible (as defined by the scoring functions used during training). Current "artificial intelligence" is an extension of reproduction of rote information, and it's still hard to move past that. Generalized generalization in machine learning is still a long ways away.
@@bb010g I would consider our brains similar in that regard, made up of billions of discrete cells working together to create something more. The scoring functions are determined by chemicals rather than some mathematical formula. All our individual neurons do is react to incoming signals, and the current chemical balance of that neuron.
@@tiggerbiggo I can't argue with this but still disagree
People have always compared the brain to the current most complex thing we can think of, books, machines, computers
This feels like something we haven't completely discovered and until something more complex comes along we likely won't ever fully understand the brain
That's what all AI does, though.
It doesn't find the human in the machine, it finds the predictable, repetitive machine in the human.
@@blakksheep736 That's not what AI does.
He just speedrunned therapy glitchless 100% category. Man's a legend
pretty sure apps count as a sequence break, it's any% at best
Therapy TAS any%
I'd suggest someone makes this a speedrun category, but this feels a little dark for that.
“I cannot tell you to simply breathe to relax when the air you breathe maybe poison” I feel like this words perfectly describes our present and the upcoming demand for mental health care.
Those are my sentiments towards my kid. This video was uploaded on her fifth birthday.
Been thinking about this. yeah....
“i also can’t help but notice how many of these apps boast productivity as one of their major sources of personal growth. it’s not a terrible goal, but productivity alone does not make you happier or healthier or more emotionally regulated. it does, however, make you a better *worker.”*
holy shit, dude. i wanted to drop to my fucking knees at that line
But tbh I think thats a lie. The more productive I am the better I feel usually. Unless I take it too far and burn out.
To be fair, I wouldn't be surprised that a group of startup people honestly thinks that the goal of therapy is to be more P R O D U C T I V E
Hi! I just wanted to say, as a psychology student, that the reason productivity is usually so thoroughly emphasized in therapy is due mostly to the ‘self-determination theory’ which indicates that satisfaction with life has three prime criterion: autonomy, relatedness, and competence. Productivity satisfies both autonomy (because if you’re productive you make money) and competence (because being productive usually means you’re skilled at whatever you’re doing) so that’s why it’s emphasized a lot. (Also a big part of a lot of mental illness is being unable to muster motivation!) having said that, I’m not exactly going to outright dismiss the idea that it also serves the purpose illustrated by Mr. Geller. (Though that is speculation [admittedly justified] as opposed to the theory above which has verifiable weight in psychology and therapy)
@@nathanialsenda5370Please don’t ignore how capitalism comes to play an any of this.
Some people will never be capable of being productive or well skilled because of disabilities. These people deserve to be happy still.
I recently read a study that talked about that, and there's a big point I have that can help: autonomy was not so much recognized as "ability to do things" as "doing things that you find value in." If you don't think school is valuable but you're good at it, that's not going to satisfy that need, and I think part of it could easily be the all-consuming profit motive at the heart of capitalism that minimizes the value of anything not deemed efficient or productive. If you have, say, a video game that you really like, being good at it (for example, being a speedrunner and pushing the world record) can do wonders for the autonomy and competence needs both. Similarly, relatedness is another word for the social need- the need to feel connected to other people, whatever form that takes for you.
And, also, research cannot be funded by good intentions. You can't eat that. So the perverse motivations of capitalism push away research from more effective things for something as 'small' and 'meaningless' as the health of the individual. CBT is something that can be quickly and cheaply tested rather than more long term therapies, so that's what gets funding. It's fucked.
The reason Chad Varah started the hotline is very interesting:
"Varah began to understand the problems facing the suicidal when he was taking a funeral as an assistant curate in 1935, his first church service, for a fourteen-year-old girl who had taken her own life because she had begun to menstruate and feared that she had a sexually transmitted disease. He later said "Little girl, I didn't know you, but you have changed the rest of my life for good." He vowed at that time to encourage sex education, and to help people who were contemplating suicide and had nowhere to turn."
That’s really sad story. Sex education is so important. Having your period with now knowledge of what’s happening must be extremely scary.
That is super messed up background. Poor child
It's so tragic because her dead could be prevent if her caretaker simply give their child FUCKING PROPER GODDAMN SEX EDUCATION
A true chad.
I wonder what that little girl would think if she knew. I may not know that much about him, but I can deeply respect Chad for his decision to just *do* something about it. Poor girl.
9:17, as someone with psychosis that includes scary paranoid delusions “everything you can imagine is real” is really not what I want to hear from a mental health app omg
That's like horror movie type stuff, it might as well be saying stuff that makes it look like it's aware
That's all well and good AI but I don't really want the phantoms in m grey matter to be real
Well then Good News everyone! The AI app just recently told a guy to off himself and he did!
@@neglectfulsausage7689 ?
Made me laugh XD, seriously though, that's horrifying.
"Wake up to a sunrise." Bruh I don't get home until 11pm, you aren't getting me out of bed until 9 am lol CBT has always struck me as the "rise and grind" mindset of therapy.
Oh yeah, I find CBT so useless and even annoying. It definitely doesn’t work on me.
Based seija pfp
You're not alone in that feeling. Cbt was not only useless but also detrimental to mental health
Hey! I'm getting my masters right now in mental health counseling and tonight I led a discussion in my practicum class about app companions for treatment. I just wanted to let you know that your video came up and really invigorated the room. Your work is doing great things, and I wanted to thank you. In some small way you have enriched the future of the counseling field.
That's so cool!!!
That's amazing
I'm also getting my masters in social work and plan on citing him in an assignment about having to recommend apps to clients with specific diagnoses. Many thoughts about ethical issues have been plaguing my sleep because of it! Sent it to my professor right after watching it lol
@@JessMess415 hi! i'm currently getting my bachelor's in social work & considering a master's degree. if you'd like to share, do you have any thoughts/advice on grad school, or the field in general? :)
@@roslynnet hey! I have a lot of thoughts so I’ll try to keep it succinct lol
#1 tip is to not go directly from undergrad to a masters social work program!! Go out and get some hands on work experience with whatever population/social cause etc that you are interested in first. This will help with deciding what program would be the best fit for you, makes you more attractive to admissions, and will hopefully help prepare you to get the most out of your time in graduate school.
Be aware that many universities have programs both online and on campus- I did a remote program at a prestigious university that is an 8 hour drive away and didn’t get to take advantage of all the benefits of the campus and the schools resources. However, I can’t imagine how much more difficult it would have been to have to manage my time if I’d had to go to a physical classroom multiple times a week instead of just logging on to zoom.
Either way, good luck!
No matter how hard I try, I will never disassociate the acronym CBT from cock and ball torture. Thanks for the CBT recommendations Jacob
For some, that could also be a form of therapy I suppose ;)
hey, whatever selfcare practice cultivates more joy, happiness and positivity in your life
after watching this i think ima stick to your idea of CBT as well
Funny comment, thank you Bong Jesus.
I should not have read this comment before I was done with the video. It's really hard to keep a straight face.
I'm not even kidding, I had a therapy consultation booked for today, was terrified out of my mind about it, considered cancelling it because I've never been to therapy before and the thought of talking about my feelings with a stranger makes me want to shrivel up and die, and then you uploaded this video. I did the consultation. Your videos are great, keep it up!
Proud of you!
eyy go you!!
yeah!!
Eyyy congrats! That’s a tough thing to do, glad u got through it lovely stranger ^-^
@@JacobGeller Thank you so much!
I disengaged with CBT when I was asked to write a list of why flashing lights might be able to hurt me, and why this was probably not the case. I’m often fully rational in my panic, I’m aware that over stimulation cannot physically hurt me, but cannot control the fact that it is simply too much for me. At no point was it ever discussed that my ability to work through over stimulation might not be fully fixed by reframing or reasoning, but that it might have an underlying cause.
As someone with sensory issues, I feel you. I know eye contact isn't gonna kill me, but oh my god it's so fucking PHYSICALLY PAINFUL
that's such bullshit too because like, flashing lights absolutely can hurt you, even without photosensitive epilepsy, a light flashing can prevent your pupils from properly acclimating, and a bunch of light hitting a dialated pupil is absolutely unambiguously painful, and could totally damage your eyes over time, fuckin hell, it's like if they asked you to write a list of reasons why you should totally totally keep running if your ankles hurt, and why this would probably not cause you to twist or break them
What makes me confused is that when cbt has been used with me, they don't even mention maybe just. GETTING AWAY FROM THE LIGHTS?! they've always acted like it is something I must mentally get past. Something I HAVE to work through. They never told me that I have the option to disengage, ever.
That's horrible and a terrible understanding of spd. The metal processes for battling overload I've found most effective all boil down to: acknowledge the problem, to myself, or if needed, others. Do the easiest most practical thing to reduce the problem. Step outside for 20 mins to calm down, wash my face, choose soft, comfortable clothes, put on sunglasses and headphones... and if none of that helps, just go home and try to unwind if I can, bc it's a real, physical reaction that just happens to be more intense then the averge person experiences but is functionally not very diffrent. (Everyone hates extremely loud noises! I'll just hit my pain limit sooner!) And honestly most people I've explained this to get it, (someone once compared it to the netflix show daredevil which I thought was funny but fair enough) because its NOT totally alien. Most people experience some version of sensorary overload at some point, maybe when they have a headache, or have drank too much, or are extremely stressed. The fact that a medical professional thinks its "all in your head and thus can be safely ignored) is bizzare.
oof. reading through these comments has opened up my eyes and i think i might finally understand why therapy didn't work for me either. every therapist i had tried CBT and diagnosed me with anxiety but years on i finally saw a psychiatrist and found out i have adhd and autism.
Brilliant commentary on CBT and "pull yourself up by your own boot straps". I've just finished dealing with an abysmal psychiatrist who refuses to recognise trauma and a family genetic history of anxiety and depression ....going straight to the "you need to just think yourself better" talk, as if the other factors didn't exist. Self help and thought changing alone is often not enough when it comes to complex problems.
Ugh, psychiatrists. In my (admittedly limited) experience, they just kinda suck. I've seen three or four, and every one of them has been stuck up and a bad listener. A couple tried to give me therapy, knowing full well that I had a regular therapist, and was only going to them for meds. Now I get my meds prescribed by a psychiatric nurse practitioner, which I cannot recommend enough.
"You need to just think yourself better"
As if that hasn't described what I've been doing. If that's all they're going to tell me then I think reading this comment counts as completing that kind of therapy. I can't stand when people tell me to feel better but ignore the reason why. "Stop feeling that burning sensation" like ma'am I'm standing in a fire.
@@chaotickreg7024 right like, even if I was mentally sound the world is literally falling apart. I do not know how to be okay when my house has a leak, a family member committed suicide, I can't afford to eat, I'm trying to work and go to school simultaneously. The issues aren't even in order lol but it's like holy fuck I'm just fucked I don't think anything can really "fix" this. That's what's hard. I'm trying to make more money. Like 80% of my issues can be solved with money. Maybe not the dead family members. But hey what can you do.
Yeah journaling and meditation and other mindfulness stuff ONLY helps if you have a, atleast relatively "normal" mind. I needed medication, and realistically getting on it was only done through years of isolation that led to intense introspection if my own issues 😅 I basically had to do my own therapy which is crazy in retrospect when I was close to not being here so many times and through so many self destructive habits lol
Yeah, that's why I've basically sworn off going to any therapist who primarily uses CBT and is able-bodied. Because when you're a disabled person living in an ableist society whose very architecture and city planning make it near impossible for you to hold the majority of jobs, having some anxiety about your life isn't some byproduct of a negative internal script, it's just a rational reaction. And paying to have that reality dismissed is, quite frankly, irritating beyond belief and a waste of time for everyone involved.
Hey! Fun fact, my dad is Lawrence Murphy, the first person to do online therapy, and has spent the past 20 years working on the ethics and considerations. He used to get laughed out of conventions or have people storm off during his presentations, showed em now eh
That's wild!
Your dad is a hero.
Why did they laugh or storm off? Were they therapists, or was this a convention for people who get therapy?
@@TheEndKing conventions for other therapists. At the beginning of his career they called the internet a fad, later they called it unethical, then ineffective, now they see that it's perfectly ethical and effective
@@IrishCaesar Probably helps that they had no choice but to use it a little while back.
i honestly had to laugh at the "pay money to be shown margaret thatcher quotes" part. my god, why would i ever do that lmaoo
Goddamn how much better would the world be if all Margaret Thatcher quotes were locked behind a paywall tho?
@@addammadd In a strange twist of irony, having to pay for the "honor" of reading Thatcher quotes is exactly what that demon would've wanted.
"learn to knit, crochet, and sew"
Me, listening to this while sewing together a dress to go with the cardigan I crocheted: looks into the camera like I'm on the office and points out the growing number of antidepressants my physician keeps prescribing since I can't afford therapy
oh another fellow crocheter !!
i found crochet really helps me relax when i'm feeling low. i hope you'll find the help you need 💐
its as condescending as when someone says "have you tried yoga or running?"
if only we could stare into the camera like the office
Crochet just makes me more stressed cuz it's not perfect AND it makes My arm hurt. I don't like it anymore.
Sewing, knitting, crochet, embroidery and (my current fave) cross stitch are all incredibly wonderful activities for adhd addled brains like mine.
It sounds like it would be cheaper to get your own psychology degree and treat yourself than actually see a therapist
1. Student loan debt says hi
2. A big part of therapy is speaking your thoughts out loud to an outside, unconnected perspective. That's why your therapists can't be your friends. And that's why also you can't be your own therapist. Sorry to disappoint
college degrees are classically cheap
that is the plan i will be entirely self-sufficient in every way and this will be good for me i think
I am feeling: PRETTY GOOD about: A NEW JACOB GELLER VIDEO RELEASE, and I am feeling: HAPPY about this
How do you feel after: SOMETIMES GREAT SOMETIMES SO VERY SAD
What do you think about being happy about this?
That bit felt so dystopian. Like in the future we're just gonna live in cubes and report how we: FEEL each day. Scary stuff.
@@bugjams Most people already live in shapes and share their feelings. The bad part starts when its unwanted but required, or vice versa.
@@adamkilby2273 ??
The four horsemen of CBT:
1. Cock and ball torture
2. Cognitive behavioral therapy
3. Closed beta testing
4. ???
Core Body Temperature
Concor’s Bad Tuseday. An N64 classic
There's a bank called "Community Bank and Trust" in my town. I drive past a big sign with CBT written on it in big red letters on a white background every day I go to work.
Children's Ballet Theater
@@sagecolvard9644 Oh yes. I love going to CBT for a withdrawal.
CBT has been hilariously ineffective for me. I do not know why I was put into it, but I was put into it after a psychiatric stay. In my experience it felt like someone telling me all my issues are just in my head and I need to learn to get over it.
That’s because half the time it’s what it is. It cyclically blames us for our own brains functioning. It’s psychology colored toxic positivity
Your issues are in your head, if they were outside your head you wouldn't need therapy, and of course you should overcome those issues.
I was depressed for years and now I actually contribute to society because I decided to get over the issues in my head 👍 highly recommend it.
Cbt fortunately isn't the only therapy out there. It is the therapy that insurances love because of the quick return rate and more structured/formulatic methods. So it's often very highly promoted. I'm sorry you had a bad experience with it. If you have the availability, I recommend going to a few different LPCs to get a better section of therapists to help. I genuinely hope you get the help you need.
A friend of mine had a similar experience, and it turned them away from trying therapy completely. I was interested in cbt when I learned about it in psych classes, knowing it was the method with the most evidence, but clearly it can't work for everyone, and alone it probably isn't enough for just about anyone.
We ARE our heads. We aren't a little ghost that drives a meat car around, we're right in here. Fix the meat and fix the us. But.... The meat has to live in a house and the house has to not be leaking too. So I think fixing and treating the brain is super important and it's not nothing, 'all in the mind' shoosh to be dismissive, we ARE our mind. But a healthy mind can't stay healthy in an unhealthy environment, so social support and treating external stuff is important too.
I'm legit on the verge of tears because of this video. CBT never worked for me, I felt invalidated and cast aside. When I asked, *demanded*, to be put in DBT, to be treated how I wanted to, I was ignored. I knew my thought patterns. I have lived with them all my life. I know how to redirect them, I know where they come from, and to be refused that knowledge of myself, when I was already in such a vulnerable place, hurt me further. I was near-delusional, at points, and I wonder if that refusal of my mind contributed to the degradation of my mind.
When you mentioned the Petersonian ideology that CBT can easily fall into, that really clicked things into place.
When I graduated from my therapy program, it was alongside somebody else. We had been taking different courses and treatments, just happened to enter the program at the same time, so he didn't know my therapist and I didn't know his. Sitting on that chair, his therapist comes up to congratulate him and give him advice to carry on, and reminds him that if he's in doubt of himself, just think back to what Jordan Peterson says.
I often wonder if that therapy program did me more harm than good. It had many upsides, of course, but the things in my treatment I wanted, demanded, needed-those were things that went ignored. As an autistic person, it was just a reminder of the trauma inflicted upon me, the trauma of being forced to live in a system(s) antithetical to my very existence. CBT as an overreaching of capitalism, of something to be automated, of a set-time program to be churned through-that puts into words what I'd buried inside me.
Damn, ik what you tak about, I feel like a waste of resources, (I’m lucky to live in a rich country!) but I still can’t shake the thought of how much better a poor well functioning person would be in my current position than me … do I care to much about what others think, maybe? Because when I think I’m egotistical for killing my self (I just thot I did a favor) … you don’t know me … maybe I’m just smart and know that I’m dragging others with me and should let my self go, I really don’t know … what to do … at all! Best advice is to be your self, if if I’m not wrong, but I don’t know whom I am my self …
I am frequently reminded online how overall lucky I have been in life to have such robust and thoughtful support for my own complex mental health situation (which also includes autism), thanks to posts like yours. It makes me appreciate how I've been lucky to actually receive proper, responsible support most of the time. I am also reminded how many people are not so lucky as I have been.
Hearing your story is incredibly frustrating for me because I know it didn't have to be that way. I've lived a better, if still not perfect, version of it. In my experience with CBT it also wasn't what I needed, but unlike with you, my therapist recognized it before I did and adjusted their approach and eventually directed me towards more effective options, rather than insisting the problem is all my own personal failings. I may have wasted some time on a treatment not right for me but at least I wasn't pushed to continue it once it became clear it wasn't right, and at least it wasn't used to force individualist values down my throat. What happened to me was the normal difficulties of addressing a mental health issue, not the result of a system trying to control me. But then there are people like you who become victims instead of patients.
I feel like it's important to remember and to reinforce the point made at the end of this video (which, to be clear, you seem to understand. This is more just a reaffirmation). CBT is not, in and of itself, harmful or bad. It is, in fact, extremely effective at acute symptom reduction, which is a step that is often necessary before other treatment can even begin. The problem is in how the system is utilizing it, treating it as if it's the sole solution instead of one tool in a whole suite required to successfully treat mental illness. In how the dominant systems have repurposed it as a tool to further their own goals rather than those of the people the tool is intended to help. It's a subversion of its purpose, one driven by the very nature of the society it exists in. I suspect that a large part of why my experience was so different was the context. I live in Canada, where individualist solutions aren't quite so ubiquitous as they are in the US. I was receiving treatment from a non-profit (CMHA) that doesn't have a profit motive. My treatment was free and voluntary and self-guided to a significant degree. While some of the differences between our experiences will come down to individual differences between therapists, I can't help but suspect that the primary reasons lie in the differences in context. It shows, in more ways than one, how the idea that the only way to improve one's situation is with one's own efforts is a lie. Outside factors matter and are not always within an individual's control. There is a limit to how much a person can do to "fix" themselves. Our societies need to reflect that reality if things are going to get better, and clearly right now that is frequently not the case.
@@Jimera0 Thank you for your long and thoughtful comment ❤️ I live in Canada as well, which honestly just points to a broader problem, if this is an issue spanning across countries.
@@Jimera0 i'm glad i went back watching this video to find these comments,i really needed it today
yes!! cbt was awful for me. im so glad other feel this way-- but i am also sorry you had to go through that. i'm glad you're out of it!!
That tweet about the Kim Kitsuragi jacket really caught me off guard and put me in handcuffs because I'm guilty.
Been saving up for one when I should save up for rent.
That’s a real tweet
to be fair making kim smile even a bit has done more for my mental health than any of these apps ever would
I had really considered it but I remembered I have Jacket’s Jacket from Hotline Miami that I bought in like 2014 that I’m still trying to slim into.
The good news is if you get evicted, you have a sweet jacket to keep you warm.
@@andshescallingacab4346 honestly youre so right
“Breath lightly when needed, deeply when able, and treasure the air, a force of life.” As someone who is deeply aware that he needs therapy and doesn’t have the money to go, that line brought me to tears.
"I cannot tell you simply to breathe when the air you breathe may be poison" is... One of the most powerful condemnations of a purely individualistic outlook I've ever seen. That line hit me like a hammer
I started crying at that point too.
as someone whos been in and out of various therapists offices for most of my life, and has been with my current one for 10 years, and managed to get my suicidal depression into remission; the platonic ideal of someone getting therapy....
that line hit me like a ton of bricks. its so fucking true. im actually going to share it with my therapist.
I keep coming back to this one line. And as wildfire season always threatens to come around where I live, I suspect I will be clinging to it for quite a while longer.
I'm currently working on some tabletop games with strong apocalyptic themes, in part as a way to deal with all of . . . this. I'm going to use this line at some point in one of them.
there are two types of commenter in this world:
1. I need help, I'm drowning trying to manage my life and cannot afford therapy. This video really struck a chord.
2. cock and ball torture lmao
I'm glad to hear Jacob enjoyed his extended CBT sessions. Very wholesome :)
💀
let's hope it wasn't _too_ painful ;)
Amazing.
these comments are killing me pLEASE
I’m glad to hear that Jacob Geller found his therapy session GOOD/HELPFUL/INTERESTING. IF he needs a session later, THEN he can always return to the app!
I feel like the most terrifying thing about that part where Youper talks about using your data is that there’s no option to say “no”
The options we saw weren't Youper asking for consent to collect data. If you go back and pause the video (go from 42:35 ) as that exchange progresses you'll see it ask: "Are you interested in letting me share your anonymous data with researchers to improve mental health?"
Granted, the video cuts to the next thing before we can see if there was an option to not give consent. I can't imagine it doesn't allow for a "no" after asking a direct question like that, though. Jacob would have pointed out that there was no option to decline if that were the case.
The fact these apps feel the need to collect data is still terrifying, of course, but not as sinister as it first looked.
@@TimelessTransience oh I know it’s not a literal legal confirmation of consent but it still feels like they’re presenting the illusion of asking you
@@TransSappho Yes, my only point was that they actually ask right after
wake up babe, new jacob geller video just dropped
This is actually me
fsrt Yeah let’s go 😆
In all seriousness I’m so happy :”)
“Wake up babe it’s time to reconsider your reality.”
Literally the high point of my day
Day just turned 100 times better
I appreciate the critical analysis of CBT. This is exactly why a GOOD therapist will be dynamic and use a combination of methods. For example, using talk therapy to delve deeper into the root cause of symptoms while also discussing coping and reframing tools. IMO, sticking to only to one style of therapy without any flexibility is usually not helpful.
when i was younger i received cognitive behavioural therapy and not only did it not help me, it made me worse. everyone around me treated CBT like it was a perfect be-all-end-all solution, so when it didn't work for me i came to the conclusion i was broken and beyond the help of therapy. in my experience it was very "oh you're anxious? have you tried calming down?" and "oh you don't know how to connect with your peers? have you tried talking to them?" just so condescending and completely failed to address the underlying issues. breathing exercises are nice but what's the point if we're not going to address or resolve _why_ i'm anxious in the first place? i was so relieved the first time i heard someone say, hey actually, CBT doesn't work sometimes. depending on what you're going to therapy for, sometimes it actually hurts more than it helps
of course it's proven to be very beneficial for a lot of people and that's why it's still used so widely. but i have to admit i always feel a satisfying sense of vindication every time i see CBT criticised
As a person who's had trouble connecting with people, I feel that "have you tried talking to them" so hard. Not necessarily heard it from a therapist (mainly because I haven't found one yet), but from pretty much everybody in my life. "What's the worst that could happen?" - I don't know, all the things that have happened so often before and that I cannot deal with very well, perhaps? Lots of people can't understand that things that are easy to brush off for them might be tough on others.
Thanks for this Jacob. I'm a crisis worker. My job is mostly scrambling to break the fall of people who tumble through our tattered safety net, hoping that they don't hit the ground too hard. I want you to know that you sharing your human perspective is incredibly healing in itself. Getting unsanitized honesty is itself a breath of clean, smog-free air. You yourself are a big part of making all of this better. Shit, I feel better after watching this. I mean it. I'll be recommending this video to some of my clients.
God dammit that description of your job was so
Idk man. Fuck. It hit real good.
Real hard.
that job description is really just wow
As someone that’s called a crisis line before only to be tearfully told “I’m so sorry, but there aren’t any resources in your area that are going to help you” when hitting rock bottom and homelessness - thank you for everything you do. I can’t imagine how taxing it is to hear the personal stories and circumstances so many people facing crisis situations are going through, all of the time. I hope you take good care of yourself and have a nice day!
Shit I need a crisis worker. Although I don't feel like I deserve it, someone else should get the help because i feel too far gone
@@lewpz Are things better for you now?
I would like to personally congratulate you on looking the audience dead in the eye and saying CBT without missing a beat
well, of course he didn't miss a beat. you actually can't spell CBT without saying 'beat'
Yeah the latter half of the video was weird, I wasn't expecting him to kink shame people into cbt so much
@@duncanrodriguez2725 digital CBT? Is that like an aneros?
Chicken Bacon Tomatoes is great! Idc what anyone says!
After doing counseling and taking a bunch of development and psych classes I totally forgot about the OTHER CBT lol
I did CBT and exposure therapy for phobia/anxiety as a kid and it worked great for me. But watching this I'm just thinking about how much I use the principles of both in training my horse. One of the things that (good) horse trainers want is for the horse to not be a robot, to be engaged with their surroundings even as they're listening to you. But if you go too hard on the "if I do this, you must do that" and "if x happens, you must do y", you get a horse that's shut down and just going through the motions. Had a lesson with a trainer today for the first time since I bought my horse and we spent a lot of time standing still and letting her process and think. Maybe that's horse-centered training, like person-centered therapy.
If you let her go somewhere she wants to go or do things in her own kind of way sometimes (adapting them) then you’re practicing Getsalt therapy with her too!
I'm UK based, and recently my work gave us private health insurance. In the digital seminar with the person from the company she mentioned therapy, and said that it was entirely anonymous and all they would share with our employer was the general themes discussed, not who said them. I told my team later that it made me uncomfortable and they brushed it off, saying it just made sense. I'm gonna stick with my £50 a session therapy that I can only afford once or twice a month....
Therapy should never be reporting back to an employer, you were right to be concerned. Report them.
@@roleat honestly, sounds like a massive breach of confidentiality, few workplaces should have any business in therapy sessions except in providing them. Therapists should share nothing outside therapy sessions but are bound by duty to protection from harm
Yikes I'm glad you didn't take it, that sounds horrible. Anonymous or not it's not hard to link quotes to people you know
as someone studying to be a psychologist- terrifying! also these apps were my only resource for not killing myself when I was 14. thank you for talking about it with so much nuance, as always. hope you're doing better now
haha yeah these apps were also the only mental health “treatment” I had access to as a teenager! It’s certainly a weird experience to look back on - being in genuine crisis and having nowhere else to turn, and so downloading one of these mental health apps in the hopes that they would make everything better - only to slowly come to understand all the problems and sinister implications that come with them. Our mental health care system is so broken, and it’s so much weirder when you can’t even consent to your own medical treatment and so only have access to a handful of apps of dubious efficacy and privacy for help. This video was such a thoughtful and nuanced exploration of a topic I’ve been fascinated with for years, and I’m so glad that Jacob decided to cover it.
It’s awesome that you’re studying to be a psychologist by the way - the work they do is so important. Wishing you the best of luck!
So glad that you're still with us! Tremendous respect for you surmounting your suffering and not giving up. We are born to overcome!
@@BULLTRONHERO Well said, all of you. It's a hard path you're walking, but I believe that you can do it. And as a recently licensed therapist, I can tell you: the fight is worth it.
I'm glad you are here,a d studying psychology.
thank you everyone!!! you're all very kind. it's a weird and scary experience, and it's a weird and scary world we live in. thank you for cheering me on - I'm doing my best!
I used to have a grey patch of hair on the back of my head, something that was constantly brought to my attention since I was around 7, which was also around the time I also started feeling depressed. On day during my mid 20s my wife pointed out that it disappeared about 6 months after I moved in with her. That was when I realized that the aforementioned patch of grey hair was there because of stress.
What a coincidence then that it happened to disappear after distancing myself from my abelist family that always made me feel bad for existing. My life further improved after dropping out of University, and abandoning education systems altogether. Despite what my parents and "professionals" said, my personal problems did not exist because of my "autism", but rather because I always had to deal with the stress of navigating ableism in my day to day life, both interpersonally and systemically. My "disability" was always seen as something to be "fixed" or "overcome", not something to be worked with.
It often felt like my parents blamed my disability to avoid talking about deeply rooted problems within the structure of our family, something that has even affected all of my siblings nagatively.
Covid was a weird time, because being forced not to see my family made me realize how much seeing them made me feel uncomfortable.
Bless my wife, for being the only person who actually sees me as a person with feelings and emotional needs. I don't think a theopy app, let alone most theopists, could have helped my navigate a problem as complex as this. How could it? This has taken me over 20s years to figure all this out in retrospect.
I am in a better place now.
I can only relate to this. I come from an ablist household where my autism was something that could be fixed if I only tried hard enough. I remember that when I was 14, I made the concious choice to shut my mouth and let my parents believe that I could fix it. The alternative would be that they would need to carry the feeling that t hey couldnt fix it.
Now that I am 30, I realize that my disabillity deserve compassion and accomodation, not shame and judgement. Due to circomstances I currently live at home and I notice now how much of a tool it took on my body and soul. I felt like a failure, an imposter and completely out of touch with reality. It turns out that I experienced exactly 0 power in my life due to a meriad of circomstances and that there is so much power in that knowledge.
@@elyaequestus1409 Oh what do you know, we're practically the same age!
I heavily relate to this reply, and I completely agree with you. I was eventually considered the "good son" because, like you, I just shut my mouth and stopped causing trouble. In reality I just stopped trying to be heard because I felt completely powerless.
@@SleepyMatt-zzz I understand that.
I hope you receive therapy to proces these events and find a way to move on from the situation.
I have received trauma focused therapy and I must say that it makes a world of difference.
Don't take her for granted.
It took a long time to reach this point, but I am happy for you, stranger; I hope the place you're in stays good and lasts for as long as it can.
One I've tried is called Finch. After the first few weeks I lost interest, but it's cute. It's similar to Mood Mission but with a lot more personality. You're raising this little bird and the way you do that is through various tasks. It helps you manage basic self care like brushing your teeth or whatever other task you want to do. All of it basically gives you points to help with your bird. There's also the little journaling thing where it'll point out key words and recognize names and show you what notable things were connected to what emotion.
I actually adore Finch and been using it for months. I’m not great at self-care actions especially when I’m stressed so actually planning everything out so that I can have space to take care of myself has helped build some habits. Plus it doesn’t shame you for not checking in or not completing stuff. And it’s the only reason I journal lol. I love pet games and customization so it was perfect for me.
cbt has never worked for me but I actually love finch. I think it helps I used it to wean off of using social media as a diary.
Same. I got Finch and I thought it was cute, but I have not touched it in months since then
@@CalmClamFam Saaame. I used it consistently for like a week and then never used it again
I like Finch
It isn't a live fixer by any means, but I mostly see it as a routine reminder app and I actually grew to care for my bird a lot and be excited enough in the rewards that I sometimes even journal there
Sly little app, makes me monologue sometimes
I honestly have a lot of issues with CBT, mainly because of its central concept of naming most “bad” thoughts as illogical, or a cognitive distortion. But what if it’s not? Autistic people may feel anxious or paranoid about feeling like people don’t like them, because of a lifetime of evidence of that being true. CBT would say no, that’s not true, you are experiencing cognitive distortion. Except that we aren’t. People often are more hostile to us, because of our autistic traits. Same thing applies to folks with trauma.
As Jacob said, it’s all about making perfect little workers, who can “contribute to society”.
If someone has genuine distortions of reality, CBT can be helpful. But it is for a very specific type of mental illness, and for some types it is disastrous
this literally happened to me in therapy the other day. i was told that it was cognitive distortion and i needed to reframe my thoughts more positively-but i have an entire lifetime of evidence that points to me being mistreated no matter what i do. i’ve got no clue where to stand on this
CBT therapy was wonderful for treating my OCD. I highly recommend it as someone's go to if they are struggling with that disorder. My experience of getting a 30 minute Zoom once a week where 15 minutes of that was spent calculating my depression score with a five point scale was one of the worst therapy experiences I have ever had. Shout out to that time I asked this poor overworked underpaid therapist which CBT technique you're supposed to use if you're too depressed to shower or feed yourself and her response was just 👁 👄 👁
I did CBT for a bit after going to a series of more analysis-focused therapists, basically I had already learned to connect reasons and outcomes in my mental health and analyse stuff, but still wasn't sure what to do about it. Gotta say, I had major resistance to the process, and it was obvious that my therapist had a completely different perspective on mental health than I do, but I did appreciate that the therapy was basically taking the brain and learning some methods of making it work for you. Still a mystery to me why my psychiatrist recommended a CBT therapist to a person she herself diagnosed borderline traits in, but hey, seems to have worked out OK - I'm a year out now with no real relapses. At the end of the day, I feel like some elements of CBT can be useful for a lot more people, if implemented into a system that's less... idk, conformation-focused
thank you for bringing up the autism thing. it's so true - sometimes things ARE NOT cognitive distortion. they're just flat out true. I am physically disabled and am sometimes very stressed or sad over it, and I feel like society is against me. I was told that "society isn't against you - reframe those thoughts!" ...except that's untrue. society IS against me, and other disabled folks. I've had too much experience with people looking down on me, telling me I'm "lazy", employers treating me like garbage and pushing me beyond what I can do - not to mention the entire US medical system is built to make a PROFIT, not to help anyone. therefore, CBT wouldn't do a damn thing to help my stress when it is TRUE that society and government as a whole (at least where I live) is against disabled people.
Have you tried gaslighting yourself harder?
As somebody who likes computers and likes programming the instant I heard automated therapy the first thing I thought was, dang that is absolutely ripe for abuse, skinner boxes, automated abuse, data harvesting, dependence. Like no matter how sincere the developers are any app like this will end up subjected to the pressures of the free market.
But I was always told in high school that the free market solves everything?!!! I’m so confused and scared now. You mean the free market isn’t accounting for the needs of each individual?!!
@@russellg1473 I don't believe you know what the "free market" means
When he listed the apps and what they do, I automatically added "...and harvest your data." to the end for each of them.
@@Blacklands it's part of the price
Yep. Try getting insurance that covers treatment for mental health after using such an app, and be prepared to not get jobs after great interviews for unexplained reasons.
I'm neurodivergent, I'm on the autism spectrum, and working with most real life therapists often feels like working with these same limitations you're talking about here. So much of therapy itself starts to feel just as automated, there isn't a level of understanding to individual problems but rather just a recitation of known treatments, like an algorithm feeding me answers that have worked for most people, but fails to take into account my needs. In fact I spent much of my life undiagnosed because the professionals were too busy feeding me these lines instead of looking for the underlying problem.
Working with a therapist that has training in and an understanding of autism is a completely different experience for me. I don't feel like I'm struggling to explain myself to someone who just isn't getting it, and the treatment options are often better suited to my individual needs. The right therapist and treatment is so important when it comes to mental health.
And finding someone who has that experience and knowledge? That’s been frustratingly difficult. Especially once you factor in insurance and who they’ll even allow you to see. Not to mention navigating insurance itself, just another highly automated one size fits all system that doesn’t work.. Mental health is the last place we need this sort of mindset. It’s better than nothing, but it’s kind of a rotten solution. Just like the rest of the one size fits all solutions out there I suppose.
Totally relate. I’m in a weird boat because I was actually diagnosed autistic at a young age and given years or treatment around that, but it was actually ADHD instead. There’s overlap, but I don’t present with a lot of the traditional symptoms associated with guys. So I was missed, and now doing ADHD and trauma related therapy it’s SO MUCH BETTER!
@@duncanbug The misdiagnosis between Autism and ADHD is staggering and pretty sad. I have both, and it's fucking hell most of the time. But I'm here, vibing, living with what I can. :']
I can really agree with that, I've been lucky enough to have some pretty good therapists and psychiatrists in my time, but there's a reason those are still plurals. It's just very hard to find someone who understands sometimes, even knowing just isn't the same as really understanding, and sometimes it's that deeply human understanding some people have of you that can make all the difference - or any.
In my country I have access to near-free ($10 per session, up to a yearly maximum of a few hundred dollars) mental health care, but the only care offered is CBT, at least if you lack any neurodivergent diagnosis.
It's pretty clear to me that, just like is said in the video, CBT is the most "efficient", it quickly fixes symptoms. Thanks to being having the lowest cost, it's chosen as the be all end all solution.
If you want something else you'd better be pretty rich because private therapy is something you'll have to pay for out of your own pocket.
I’m glad you left this comment. I have felt exactly the same way in most of my therapy sessions. I have ADHD and I have my suspicions about autism (just don’t have the money to get a professional opinion) and at some point, the conversations feel automated to some degree. I feel like I’m not making progress anymore. I’m glad to know that I’m not the only one.
this is the reason why a lot of people conclude therapy 'doesn't work for them' because as effective as CBT can be in a general sense, it is being used as a cure all, where it in reality is a potentially helpful piece of what would ideally be a full more rounded idea of therapy. For me personally, CBT has been really ineffective because of how much it depends on me to have control over my intrusive thoughts. DBT (Dialectical Behaviour Therapy) on the other hand has been a lot more effective for me, I'm in a group therapy setting, so still inacessible to a lot of folks who don't live in areas with resources but, the thing I like about DBT is that it doesn't put positivity on a pedestal, it focuses more on neutrality and developing coping skills. You don't have to reframe your thoughts, because accepting the problem is the first step to adressing it. DBT also certainly isn't a cure all, I'm sure there's a lot of people who different therapies would work better for, but for me, CBT always landed me in the feeling bad for feeling bad loop.
Dropping this comment in part way because I lose my train of thought but CBT, at least in my area of the UK, almost feels like a way to palm off people who need intense help.
When I was at my lowest, the hospital who I had urgently visited in a crisis, referred me for CBT style lectures. One session a week for 6 weeks, about 45 minutes away from home with 30 other people.
I sing CBT's praises for helping me overcome my severe OCD as a child, and it can be useful for reframing anxious thoughts but it did not touch trauma recovery for me. At least, in the way the NHS has implemented it.
I've tried CBT apps since and it almost comes across as patronising. It can make it feel like it's your fault for not thinking better. When ultimately, as you are just saying at this current point in the video, what about unchangeable circumstances? Anyway, that's just my little thought on CBT, having been put through mutliple programs of it
TLDR I think CBT therapy makes me uneasy because of the way it has been utilised as a replacement for intensive help in my country
The NHS approach to CBT seems to be to prescribe it to *everyone*, no matter what mental (or even physical) health condition you’re presenting with, in hopes that you’ll just go away and leave them alone after you’ve finished your little 8-week course or whatever it is. Very one-size-fits-all, and useless if you’ve got any deeper problems than a bit of situational anxiety or mild depression. If you’re dealing with complex trauma, it’s not gonna do shit (ask me how I know lol 😉)
ive had to trudge through many public therapy systems in my life, and each and every one is cbt. its useful for reducign some of my phobias and such - but i'm so tired. there's things beyond my anxiety.
On the one hand, the phrase "automated therapy" fills me with fear, but on the other had I can't hear the phrase "CBT" without thinking "Cock and Ball Torture", so this is going to be an interesting watch.
...... BYE
What other definition is there
Cocknitive Ballhavior Therapy
Same I can't take it
@@WhatEverComesToMlnd Cocknitive Ballhavior Thorturapy
“help them be functional” is always a sticking point for me, because there’s always assumed in “functional” that there’s an appropriate “function” a person should be performing that they’re failing to fulfill.
I mean, you wouldn't be seeking help if you didn't think there was some function you couldn't do alone.
Guess we should just let people wallow in misery.
@@AJX-2 I imagine for many this function is not something you cherish doing in the first place, but it's just something you're required to do
Capitalism
as far as the institutions are concerned, that function is "labor". no?
I really appreciate the emphasis on CBT not being a tool meant to be used alone. I know it was very helpful for me with learning to be gentle on myself but it’s a bad starting point for the overwhelmed and has finishing returns after you get past the basics. As a therapist, no amount of coping skills I give my clients come close to situational changes (getting accommodations, dropping that stressful class, family members being more accepting), but the system would rather point its finger at one person who’s the problem, who needs to have their brain “fixed”
You’ve just put into words my exact issue with CBT. I have CPTSD and borderline, as a result of years of childhood abuse and trauma. CBT feels like a bandaid over a bullet hole, and has done nothing but made me feel even more helpless. It’s so important to realize that CBT is not an end-all-be-all to therapy, especially for people with more complex mental illnesses.
Especially, in your case specifically, if it’s not coming from a trauma-informed care approach. Psychotherapy can only help you do so much, I’d recommend asking about trauma work. Brainspotting is a relatively new approach; evidence-based, and is very exciting for a lot of folks in the field.
"the real meat is the extended CBT sessions" I love the video and I think it was genuinely super thoughtful and informative but I laughed for like 10 minutes at this
Was just gonna write something like that. That one caught me by surprise.
That must have been an intentional joke
"Honey can you please pass the butte-UH AH AHHHHH AHHHHHHHHH"
Lmaooooooo
FROM WIKIPEDIA
THE FREE ENCYCLOPEDIA
Regrettably, the questionares and "Depression number" are referencing the PHQ-9, which is a fairly standard metric used by behavioral health centers across the US. It rubs me the wrong way too.
Can you elaborate on why it bothers you? Esp in a setting with a therapist, having a metric as well as whatever qualitative data the therapist is gathering seems like it'd be advantageous. Do you not like how the PHQ-9 is applied broadly, or just in the case of these online automated 'therapy' suppliers?
@@xxturbanboyxxful I can't answer for the OP here, but the thing that bothers me about it is even on a good week I'm probably around a 13 - but that's more down to ADHD and life in general than any kind of depressive disorder.
I don't know how anyone who isn't fully delusional scores less than 10 tbh. I almost always wind up underreporting just to keep sessions from getting derailed.
Also scoring thoughts of self-harm/suicide exactly the same as just being distracted or frustrated seems bizarre to me. Obviously it's the job of the therapist to put this stuff in context but the very act of ticking boxes to determine your sadness level is fundamentally weird and off-putting.
@@KSignalEingang I think the impossibility of honesty is really understated in mental health contexts, especially vis a vis underreporting. Like, everyone knows what they can’t say, or can guess what they probably shouldn’t, if they don’t want to be 302’d. (And if they do, they’ll say whatever they can - if lucid at all - to get out of there. As is often necessary). Or they just feel uncomfortable telling the truth - many of the people most in need of therapy are least capable of engaging in any kind of conflict, who’d have guessed - or not seeing the point in it. I’ve often told a therapist I’ve been feeling better when nothing could be further from the truth. (I’ve also had therapists insist I’m getting better, even when I don’t feel that I am, or have been. Maybe they were right). When you know exactly what someone would say, and you just don’t want to have to reply, why not avoid that conversation altogether? Why not just write down the magic number you know they want to hear? (Or will hear, no matter what you say?)
@@KSignalEingang its definitely understood that underreporting is a significant barrier to making this a truly efficacious therapy tool. If this is just done during intake, then its a forgivable formality. If this happens every session, then either you need far more intensive treatment, or the therapist is not doing anything remotely based in empathy.
For context, i typically score a 24+ on any given day, with 16 being red letter days of comparative happiness. But my therapist isnt going down that list each week, since they know my operational baseline.
@@xxturbanboyxxful It bothers me because mental health feels like such a complex, contextual and nuanced thing that my overthinking ADHD brain simply can't conceive of summing it all up within a set of simple numbers. And as I only have my own experiences to go on, I have no access to points of comparison to even understand if my perception of the metrics match anyone else's.
Ok so it won't prescribe anything to help me deal with my bipolar... but that Kim Kitsuragi jacket sure would make me smile everytime I put it on for like, at least a month or two lol.
Man, you are my favourite UA-cam creator. I've been struggling to describe my issues with the productivity-focused nature of CBT and I felt like I was going a bit mad. The best thing I could do was describe it as "neoliberal" and that didn't mean much to my non-politically charged family and friends. Thanks for giving me back-up on this one.
CBT really helped me (when it was connected with talk therapy) but holy fuck it is SO neoliberal. No wonder corporations like it so much.
@@Lifesizemortal k
@@Lifesizemortal there are problems in psychiatry but leading with this in an unrelated discussion just makes it look like you have a personal axe to grind. Psychiatry is bad because they're incentivized by capitalism towards quick solutions over in-depth, personalized treatment.
@@Lifesizemortal I certainly believe you're speaking from experience, because I frankly don't think that anyone who's seen the full scope of psychiatry could walk away with the conclusion you've drawn. It's a perspective that's only attainable if you're not getting the full story. That said, I totally understand that a lot of the norms and institutions within psychiatry are deeply patronizing and completely focused on short-term gains (to the exclusion of in-depth solutions). And I absolutely understand how someone who has been forced to reckon with that when they needed help would walk away feeling so bitter about the whole thing. I'm sorry you had to experience that.
I think the institution and culture of psychiatry is deeply flawed, but it's not without merit. One thing I like to tell people is that purely medical psychiatry is a pretty new thing. Did you know that originally, psychiatrists could only be created from existing therapists? Psychiatrist was like a prestige class for therapists who wanted additional training. When that was the way things worked, it seemed like a sensible model: anyone who we entrust with mind-altering drugs must have a strong and foundational understanding of psychology and mental health treatment first. With that in mind, the medications were just a supplement to the existing treatment model (typically consisting of talk therapy). I personally find this very sane and reasonable - and as a therapist, I've considered getting the credential in order to help my clients in a more self-contained way. However, one of the many problems we have today is that most psychiatrists are basically just medical students, whose understanding of mental health treatment consists almost solely of "throw drugs at the problem." And that is a massive issue, for many reasons. Especially because, in my experience, drugs never solve the problem on their own. Drugs are useful tools that can assist people in their recovery; for example, an antidepressant might help someone maintain enough motivation to implement new habits that will help them fight off their depression (especially if they were too depressed to respond to talk therapy prior to medication). However, I would never, EVER expect that throwing medicine would actually fix the problem. And unfortunately, we have a lot of people who are trained to think in that framework - and a lot of corporate interests who want to keep it that way.
Thank you for coming to my TedTalk. This video is very personal for me. To anyone reading this message: I hope you are doing well, wherever you are.
@@Lifesizemortal Your personal experience does not discredit the potential efficacy of an *entire* field of medical study and treatment. You’re throwing out the baby with the bathwater with such a useless generalization, And there are plenty of people who’s personal experiences could contradict yours.
Hell, i have personal experience too. I’ve had a shitty psychiatrist once, so I moved on and kept looking elsewhere. My adhd meds virtually saved my life once I did find a compatible treatment.
After two decades of being in various types of therapy I've found that CBT in particular can be near indistinguishable from gaslighting if not used thoughtfully. When a therapy centers around replacing 'thought distortions' with more realistic or useful thoughts that then brings up the question of who decides what's real or useful.
If a human with years of training can cause serious psychological harm via a mistake or misjudgment then I can't imagine how dangerous it could be in the hands of something with the emotional intelligence of an AI. That's not to say CBT is inherently bad or unhelpful, it's just a tool that needs to be used with a great deal of care. Probably more care than an AI can provide.
I’m encouraged that I’m not the only one who felt gaslighted by cbt
you've put my frustrations into words, alongside this whole video holy shit
i feel so assured
@@ToriKo_ i feel it's the assumption by some cbt practitioners that your anxiety is unwarranted, but we live in a shitty world where a lot of our anxiety is warranted....
i know CBT means cognitive behavioral therapy but my brain immediately goes to the other acronym
@@slevemcdichael4481 not unwarranted, unhelpful. It's like he said, having a five hour anxious meltdown about climate change isn't going to make the world any cooler.
I'm glad you made this video. I currently work as a CBT therapist and whenever I see these automated CBT apps my first thought is often how can these apps recreate 'The Therapeutic Relationship'. We talk about this a lot in therapy and its basically your personal relationship with your therapist, and my relationship with my clients changes person to person. For some, I am a bubbly and funny person, for others I am serious and to the point and for others I am soft spoken and reassuring. Not only this, but an app cannot LISTEN to you the way that a therapist does. It can read what you type, it can understand the meaning of your words but it cannot listen.
I think that probably why you found Bloom to be the best, as Mike and Sharnita (whilst not perfect for everyone) are able to offer something as close to the therapeutic relationship as possible.
I wanted help from my therapist to understand my feelings, and why I felt the way I felt, and unpack a lot of trauma. My therapist shut me down and diverted me to DBT. (Which is similar to CBT.) It wasn't what I wanted and I felt like it was largely unhelpful in unpacking those big feelings. I'm already quite good at mindfulness and such. But just because I can get through the day, doesn't mean I've properly processed trauma. This video really nailed CBT/DBT on the head. It's one size fits all, and doesn't help people that need more specified aid.
I hope you have been able to find a new therapist
@@PhotonBeast unfortunately no... My financial situation and the healthcare system where I live make this very challenging.
I was not expecting a Jacob Geller video criticizing the institution of psychiatry and its history of being used to reinforce the capitalist productivity mindset, but I am all here for it.
Perfect timing as well. I may or may not have been struggling with mental breakdowns ahaha… just kidding, I managed to get over them… for now, anyway
I love me some critique of therapy, especially since it's so often used as a cure-all on the internet. The Boys had a fantastic scene involving a therapy group working through their trauma as "collateral sufferers", think survivors of superheroes fucking shit up, but the twist is that the group is organised by the evil corpo that employs the superheroes, and they push the victims to either blame themselves or to kill any want for justice.
@@joujou264 Damn! Glad I saw your comment. I need to watch the boys
A functional human being is a robot for them.
@@lyrablack8621 Just be aware that the scene I'm referring to is really only one scene, it's not pivotal or anything. The main plot revolves around how awful superheroes really would be if they existed and were organised in a corporate structure.
tremendous video. it's one of many options but CBT has been tremendously helpful for me for just managing day to day, and realizing that kind of internal change is really possible. Cognitive Behavioral Therapy is pretty good too.
i know every comment is some variation of this but i still wanted to post it and that's ME looking out for MY mental health.
@@LeoVader i read this like 8 times, just absolutely confused!! and then it finally hit me lmao
I came here to make a long response about how I’ve found CBT skills helpful, but the therapeutic approach of most CBT therapists tend to feel very much like gaslighting… then I finished reading
Jeez are your friendly bits inside of you now? I don't understand how anyone could enjoy CBT.
Thank you so much for this video. This verbalizes so many of the problems I have with CBT. For a lot of marginalized patients/ppl CBT can often feel like glorified gaslighting. I’m sure it can be helpful for some people but it’s so important that a wide variety of therapeutic approaches be accessible for people.
CBT hurts :(
makes me think of the AI art conversation going on
where AI art isn't inherently bad and can be a very useful tool, but hmmmmmm i wonder how it's actually going to be used and who's going to profit
I also immediately thought of that! I saw the similarity between therapy/psychology and art, two fields once thought to be strictly human, as far away from the machine as could be, but now starting to be encroached upon by the very beginnings of the robot revolution.
an actual good "self care" app that i recommend is finch. you have a little finch bird and journaling about the prompts it gives you gives your bird energy to go on adventures. when it comes back, you can have a cute interaction and ive been doing it pretty much every day for like 3 months? anyway, it just helps me separate my thoughts and my little bird is really cute now
Can you mess up? Can the finch end up dying or running away, like a tamagachi?
@@TheEndKing I know it's messed up but the idea that you could just outright *lose* at therapy and kill your (bird) therapist is so funny to me
@@scarlettscented "Oops, your finch started badsleeping...maybe you *shouldn't* quit drinking like you wanted to do!"
@@TheEndKing nope! it'll send you a notification if you haven't checked in but there's no bad things that happen if you don't do anything
Cute birds are indeed cute.
I like this about them.
You're ability to shift from dread and video games to mental health apps is very impressive. Amazing work as always!
No matter the subject, a Jacob Geller video is never complete without a generous serving of dread.
Correction: His ability to shift from dread and video games to dread and mental health apps is very impressive.
Still amazing work as always, though.
I mean this video also had dread and video games
I recently started psychotherapy after years of CBT and i prefer it so much more. I definitely felt the bootstrappy, productivity-focused, symptom targeting vibe of CBT. While psychotherapy is still a simulated relationship it focuses on narratives, which is not something a computer can understand. Im starting to understand the story i tell myself about who i am. The story is the ROOT of all my anxiety, so i feel im not just patching symptoms but healing the source of the problem
It’s easy to chastise spiritual practices, but bhuddism quite literally feels like your interacting with a piece of extremely advanced(and fundamental) technology that’s built out of words and is held inside of a book.
It’s just brilliant info on how to manage and organize your emotional thought processes such that they can all be opportunities for fulfillment.
I my self, have just barely started.
(Not a cureall, just something that does help many people, everyone needs their own path for healing)
I think part of the Eliza program's success might actually relate to a concept referred to in Nonviolent Communication, a type of interrelational, language based therapy which emphasizes the importance of remaining attuned to empathy, finding ways to collectively meet our personal needs, and highlighting even the precise words we use to communicate those feelings. a "rephrasal" is what they call it - seeking the deeper meaning of what someone is expressing, and then repeating it back to them in your own words to make sure you understood it. from that point, they can clarify or specify the feeling until you are both on the same level of understanding. they talk about this... physiological "sigh of relief" that tends to happen once a person feels truly understood, which is usually the most groundbreaking point of a therapeutic session with NVC. just... being understood.
here's the example they use in the first chapter:
I was presenting Nonviolent Communication in a mosque at Deheisha Refugee Camp in Bethlehem to about 170 Palestinian Moslem men. Attitudes toward Americans at that time were not favorable. As I was speaking, I suddenly noticed a wave of muffled commotion fluttering through the audience. "Theyre whispering that you are American!" my translator alerted me, just as a gentleman in the audience leapt to his feet. Facing me squarely, he hollered at the top of his lungs, "Murderer!" Immediately a dozen other voices joined him in chorus:" Assassin!" "Child-killer!" "Murderer!"
Fortunately, I was able to focus my attention on what the man was feeling and needing. In this case, I had some cues. On the way into the refugee camp, I had seen several empty tear gas canisters that had been shot into the camp the night before. Clearly marked on each canister were the words "Made in U.S.A." I knew that the refugees harbored a lot of anger toward the U.S. for supplying tear gas and other weapons to Israel.
I addressed the man who had called me a murderer:
I: Are you angry because you would like my government to use its resources differently? (I didn't know whether my guess was correct, but what is critical is my sincere effort to connect with his feeling and need.)
He: Damn right I'm angry! You think we need tear gas? We need sewers, not your tear gas! We need housing! We need to have our own country!
I: So you're furious and would appreciate some support in improving your living conditions and gaining political independence?
He: Do you know what its like to live here for twenty-seven years the way I have with my family-children and all? Have you got the faintest idea what that's been like for us?
I: Sounds like you're feeling very desperate and you're wondering whether I or anybody else can really understand what it's like to be living under these conditions.
He: You want to understand? Tell me, do you have children? Do they go to school? Do they have playgrounds? My son is sick! He plays in open sewage! His classroom has no books! Have you seen a school that has no books?
I: I hear how painful it is for you to raise your children here; you'd like me to know that what you want is what all parents want for their children-a good education, opportunity to play and grow in a healthy environment . . .
He: Thats right, the basics! Human rights-isn't that what you Americans call it? Why don't more of you come here and see what kind of human rights you're bringing here!
I: You'd like more Americans to be aware of the enormity of the suffering here and to look more deeply at the consequences of our political actions?
Our dialogue continued, with him expressing his pain for nearly twenty more minutes, and I listening for the feeling and need behind each statement. I didn't agree or disagree. I received his words, not as attacks, but as gifts from a fellow human willing to share his soul and deep vulnerabilities with me.
Once the gentleman felt understood, he was able to hear me as I explained my purpose for being at the camp. An hour later, the same man who had called me a murderer was inviting me to his home for a Ramadan dinner.
- Marshall B. Rosenberg, Ph.D.
I loved the game Eliza. There's a moment late in the game we're a patient begs you to drop the facade, and asks to just speak to you as a person. It's a great game.
That's actually the very first patient you see in the game!
@@JacobGeller It's been so long since I played it! I should reply it soon!
Did. Did they think saying "psych!" about spending $240 on their app would lower your depression score.
Eliza is designed to sort of parrot whatever you say back at you, and then segue from there... this is just active listening, which is what the majority of us need most when we've had a rough day.
Ironically, dude created the AI to be kind of shit, and accidentally created the best listener and it made you know it. Best therapybot on accident, despite intentions.
I'm so happy to hear that you were able to endure those extended 10 minute long periods of CBT, it must've been pretty good!
My health insurance requires a referral from a doctor to see a therapist. Having been anxious and depressed for 15+ years, I've always struggled filling out the anxiety and depression questionnaires. Anxiety and depression felt "normal" to me so I'd score low. I'd explain to my doctor that I was pretty sure my normal wasn't normal and be met with "well, you're functioning at work so you seem okay." Like whether I can hold down a job is the only thing that matters. I told her I come home from work and I can't convince myself to go for a walk because tying my shoes seems like an insurmountable task. But I have a job. So. I'm fine.
I changed doctors. Told new doctor this and she referred me to a therapist and gave me a prescription for Lexapro. Meds have made me feel like me for the first time in over a decade. I want to do things again. It's wonderful. The therapist I was able to see didn't feel like a good fit. He told me I seemed fine and should try productive hobbies to distract myself from anxiety and depression (wow. Definitely never thought of that myself...). I might try seeing someone else at some point, but seeing any therapist is a major undertaking. Finding one that you actually mesh with even more so.
That makes so much sense… same with me I’m doing normal but it’s my normal which isn’t normal which means I’m doing bad but to me I’m doing normal 😢 wish someone could jump into my mind and tell me what was going on
I hope you're doing well on your journey. Going from therapist to therapist can be draining and somewhat ironically quite depressing. But man, sticking with a therapist or psychologist you don't like? It's so much worse. I thought it was better than seeing no one but I was wrong.
That all sounds super similar to my experience, too. I waited and waited to look for any help because I was "doing fine at work", and it wasn't until I was right on the edge of breaking down completely I could go talk to someone.
I'm really glad you've gotten the good you have. I feel like a whole new person, and I hope you've continued to find success as well. 🫂❤️🩹
That all sounds super similar to my experience, too. I waited and waited to look for any help because I was "doing fine at work", and it wasn't until I was right on the edge of breaking down completely I could go talk to someone.
I'm really glad you've gotten the good you have. I feel like a whole new person, and I hope you've continued to find success as well. 🫂❤️🩹
"Breathe lightly when needed, deeply when able, treasure the air." This made me well up in tears. Therapy is too expensive for me, I cannot bring myself to pay for mental health services when at times groceries are hard. I know I need it, I want to get better. I have even tried to go in the past and paid for 'cheaper therapists' who costed only a fraction of what others charge. My issue is that even the cheapest of therapies makes it so my partner and I have to sacrifice to get it for me. It makes me feel horrible and guilty, and worse of all, more broken. I would welcome an actual helpful A.I. that I could anonymously talk to that would genuinely respond and try to assist me through my ups and downs. But something of that magnitude, would most certainly in our capitalist society, cost a chunk of money. Round and round we go, I suppose.
have you considered walking off into the woods and never coming back
@@jooot_6850 I doubt they'll find therapists in the woods, let alone ones that shun the concept of currency, and moreso that they would want to stay there indefinetly.
Write to yourself in your notes app, describing the day, what happens, every little detail. Then, reread it later, when you're able to think logically. That way, you can analyze what the fuck is happening :) that shit helped me a lot :D
This. It made me tear up too.
as someone practicing as a low level cbt practitioner i couldn’t agree more with your comments about cbt. the amount of clients i’ve worked with who are facing real world systematic difficulties like racism at work, horrific working hours, housing difficulties, etc. and protocol tells me to say: ‘have you tried letting go of these worries?’ like you said, cbt has an extensive evidence base because it is the easiest to study using quantitative research methods, which has led to it being pushed as the first line treatment for everyone (in the uk anyway) in place of more personalised therapy methods that aren’t as quantifiable. in my opinion, cbt can be beneficial for some but it shouldn’t be used for everything because it can be very invalidating for a lot of people, incl those who are simply reacting to unjust external circumstances
That tape recorder is actually really interesting to me because ever since I was young I've had the habit of holding what is pretty much one sided interviews or therapy sessions with myself.
It doesn't happen very often maybe once or twice a month and kind of just starts naturally while I'm doing something else but it has helped my own mental health a ton.
I wish we could kill the term “artificial intelligence” and replace it with “algorithmic tool” because there’s nothing “intelligent” about it. It’s not making choices, the choices have already been made by the programmers.
I really enjoyed the video
Thank you for putting closed captions 😭 almost none of the youtubers I watch do and the auto-generated ones aren’t very accurate
You need to watch better UA-camrs :(
my first ever therapy sesions as a teenager experiencing undiagnosed autism and abuse were cbt. they tried to teach me how to overcome negative thoughts and make eye contact. they didnt ask me about my home life or the real, underlying question of why i was suddenly so anxious as if out of nowhere.
this went on for years - going through different therapists and getting nowhere. i thought it was something wrong with me, intrinsically.
i was finally switched the psychotherapy and began medication and id never had such a big improvement. this ended when i turned 18 and didnt qualify for child therapy any longer.
last year after a bad spell i started doing cbt again. but this time it was the best experience in my entire history of therapy. it ended up being more of a combined psychotherapy and cbt approach. my therapist actually factored in my trauma and caught me how to overcome my deeper rooted issues with a cbt approach.
part of overcoming trauma that is no longer actively in your life is having to 'rewire' your brain in order to teach it that youre no longer in danger.
however while youre still actively going through that trauma then there is no amount of 'rewiring' what will change your circumstances - only make you feel even more that it is your fault for being unresponsive to therapy. this includes social issues like being homeless, living paycheck to paycheck, or being a minority and surrounded by bigots. the only real solution is social support and societal change.
"breathe lightly when needed, deeply when able" - I like that a lot.
"The real meat [of the app] is the extended CBT sessions"
_Nervous sweating_
glad that this went in the direction i was hoping it would. i've thought an awful lot about the weird way we treat mental health issues these days, and i think this did a good job helping me make connections between things i hadn't seen, as well as reassure me that i'm not alone and crazy in this.
agreed, “is it any surprise that a psychological approach built around reducing symptoms rather than finding causes would be so popular” is the most succint way to describe how even therapy has been compromised by "market forces"
... or maybe we're ALL alone and crazy in this. Maybe we always have been. Who knows? I sure don't. I'm alone and crazy. Not a reliable source at all.
@@ahobimo732 I actually think we're more isolated and alone and aliented by socitey then people have been.
previously for much of history we lived in tight communal tribal bands and extended family structures, there's a lot to suggest thats how humans were meant to interact with each other and being isolated like we are is extremly bad for our mental health. its a different level of social support
@@chriss780 As one of a member of the human species, I attest that being isolated has little effect to my mental health. Human being is a social creature out of survival necessity, and if being alone doesn't threaten survival chance in the safer future we're slowly building, then the "social creature" requirement for humanity might be gone in successive generations.
@@chriss780 Yeah, I think you're onto something. Not sure what we're supposed to do about it, but it does seem like human society is evolving into something that is not particularly good for humans.
My actual thoughts and feelings about this are pessimistic to say the least. I tend to keep those to myself, because I don't want to upset people.
My comment about us all being alone and crazy was meant more on an existential level. Like in life generally, each one of us is always just alone in our head, deciding what makes sense as we go along.
I so want an actual game based on this. Like a really hard game where you try to out psychology an AI.
a simultaneously inspiring and terrifying video to watch right as ive spent the last month or so trying to find the right therapist for my neurodevelopmental disabilities 😭 but going into this comment section im glad im not alone. the psychiatric institution and therapy as a market might be horrible but at least we (people who have experienced its faults) have each other, eh?
That's messed up!
This reminds me, there was a scene in the movie “Overdrawn at the Memory Bank” where the main character is unhappy living is a capitalist dystopia and the company mandates that he goes to therapy so that he can be a model employee. The therapist is doing nothing more than reading what the computer prompts her to do and the machine never questions if the dystopia is why he is unhappy or questions anything deeper. Just tell the main character that he is stressed and tells him he is required to take a vacation, a vacation he will need to pay for out of pocket and can’t afford.
There are so many problems with the world, therapy can help with some, but for many only systemic change can relieve us.
I've only watched this movie through the MST3K theater.
That last part about how we can't just blame people for trying to use medicine and therapy to better their lives instead of trying to change the system hits hard as someone who loves Mark Fisher's philosophy. People often go for the wrong assumption that he meant that when in reality, is more complex. Yes, we have to admit that the world is not helping our mental health, but we can't just... let it destroy us and drown us in apathy
Yes we can, and should.
@@gotmilkbutt well that's defeatist...
@@gotmilkbutt apathy's a tragedy
@@josequilesmacia4978 not the optimal option
And boredom is a crime
$500 a month is literally insane.
Oh no... I have anxiety and already know how to crochet!
I'm a long-time fan of all of your content, but this video hits so hard for me and makes my own experience feel very validated. As somebody who works in the treatment industry, it can seem totally ineffective and useless to resort to the usual CBT/DBT-esque responses of reframing your own expectations and mind in order to feel better about things going on around you. Hearing enough people's experiences in life which can be remedied by attacking "roots" of problems but ultimately won't because of barriers in politics and the private sector. The amount of people I have seen at the wrong level of treatment and having barriers to their treatment because of insurance issues (and relatedly, class issues) is shocking. The entire industry is built around and dictated by insurance dollars. Criticizing insurance is a tired argument, but ever-apt.
Ultimately, the role that bottom-lines and increasing capital play in treatment cannot be understated. The treatment industry is largely for-profit. Therapeutic knowledge will tell you to set boundaries and make decisions which distance yourselves from your abusers. What happens when the abusers are institutional, and can very well include the institutions which have the therapy? Treatment is completely capitalist and has aggressive marketing and sales techniques. Despite exorbitant prices, social workers and practitioners are still underpaid. They work long hours and face burnout and second-hand trauma. This isn't even to mention the incredibly unethical facilities in residential treatment, especially for youth. Even when considering the legislative and political structures which help to maintain this system, are those not also determined by the dollars of corporate interests? It's infuriating and I'm glad that you're bringing this perspective.
Thank you for making this video.
That's an excellent point
😴
As a fellow therapist, thank you for giving a voice to the things I struggled to say. It's good to know we're not alone out here.
The thing about like, "in traditional therapy, CBT would be one of many tools a therapist uses" is that, sadly, no, overwhelming therapists practice CBT almost exclusively, lack training in other methodologies, and get remarkably defensive about seeking other methodologies/skepticism towards CBT. It's such a quick, effective (for the capitalist needs of modern therapy, ie keeping people workplace-ready), and marketable treatment that can be neatly packaged to patients that it's increasingly difficult to find therapists who practice anything else, particularly in less populous areas.
true. i remember the therapist i went to when i was fresh into my 20's being frustrated with me because i didn't want to do CBT worksheets and reminding me i have to put in the work for therapy, but nothing else was suggested so it made me think i was just bad at therapy.
facts. took years for me to get into dbt which is what i actually needed. i don’t think i had ever even heard of dbt until my third hospitalization
also, my dbt therapist costs $150 per week bc they didn’t take any insurance
This is what I suspect to be one of the primary reasons why you have to "shop around" for therapy which actually works. Under capitalism, it is incredibly difficult to find someone with a genuine flexibility in their approach, as any hard and fast rulebook that is proven to be even minorly effective above background noise is absurdly profit incentvized. The market cares not for what is best, merely what is cheapest to employ (and thus most profitable) for the task at hand. CBT is great in many ways and this is not an indictment of it at all, but it is hardly a panacea for mental health. Currently, to be an effective therapist for a range of clients is inherently going strongly against the grain of market forces, suicide in this fundamentally inhuman market paradigm.
@@juliac6256 what is dbt?
Hey, Jacob. I'm currently in the process of getting my undergraduate degree in Psychology, with the goal being to specialize in Clinical Psychology and hopefully earn some type of doctorate. To say this entire video is relevant to my chosen field and my personal interests of passion is a big understatement.
While I don't know how much I'll be involved in distant/automated therapy, if at all, the blunt discussion on the systems therapies are made under will very likely be a subject I tackle someday. Plus, it's nice knowing the current state of automated therapy apps, the good and the bad. I'll be keeping this video in the back of my mind and will likely share it around, when possible, with professionals who may be interested. Perhaps even use it as a citation for a paper, if I can.
Thanks for this video and the ever-densely introspective content you put out on a regular basis, Geller. You may not be a psychologist in a formal sense, but you tap into the essences of psychology way more often than you think.
I have to be honest - I am *incredibly* glad that I'm not living in the US. Mental health is definitely an issue here in Germany too, and I definitely can't say that I'm unaffected, but the simple knowledge that I can always just go to therapy without it costing me a single cent (beyond the health insurance that gets deducted automatically from my gross wages, so it never even shows up in my net earnings anyway - it's money I never see as having any access to in the first place) is just incredibly reassuring.
To be honest, the idea of feeling your mental health decline and fray and not being able to do a thing about it because you can't afford professional help is ... terrifying. Horrifying even. Worse still the idea that big, soulless corporations would then seek to exploit this sort of helplessness as just another income stream.
When it comes to ADHD, Autism and conditions of similar ilk, CBT is almost patronizing. It usually teaches one to mask or stop behavior instead of working with it. In some ways, it’s useful for building skills that can make a person with ADHD seem “normal” and “productive” but outside of skills that are good for a worker, may not do much. Often it recommends a “distraction-free workplace” in order to force work (which as a college student with ADHD can be required) and to me it doesn’t feel like I am addressing the problem that my brain can’t focus unless I have adrenaline or some sort of stimulant. I’ll do the work, sure, but I’ll be very uncomfortable and in my head, I won’t feel very successful when it comes to tackling my condition.
With depression you just need to pull yourself up by your bootstraps even though depression makes it hard to even get up (dopamine is needed for muscle movement). With ADHD you’re too lazy/procrastinating even though your condition makes tasks hard in it if itself. It’s not like people with these conditions are doing these thing intentionally. CBT alone doesn’t feel right.
It’s the same feeling when an old therapist told me I didn’t need much help because I was able to sometimes keep my foot/leg from twitching if it bothered other people. She told me this even after I confessed that it made me uncomfortable to do so.
It's been really helpful for me with ADHD. But also it doesn't feel like enough. This hits deep.
I was depressed for a very long time because I'm Autistic.
People, namely professionals, assume that the depression that comes from ADHD and Autism is a byproduct of our genetic disposition, but actually asking a depressed disabled person reveals a different story. Most people who have these disabilities actually have very reasonable explainations for being depressed, such as loneliness, poverty, and being misunderstood. It's definetly a systemic and abelist problem. Disabled people don't feel defective or inadequate in isloation, that is an idea that has been imposed onto us.
We are always viewed as a problem to be fixed, when really it is society's ironically Autistic obsession with conformity and productivity that needs to be addressed.
For me, it helped a lot with specific things like not falling into anxiety spirals when my Adderall causes heart palpitations by recognizing external triggers, or trying to avoid really hyperbolic catastrophe language about my problems that made it seem pointless to keep going. It didn't replace meds, but meds without CBT resulted in a lot of wasted energy on my part. Meds finally made the wheels spin, but CBT let me re-learn how to steer.
I don't think the core of CBT is capable of or has any justification for being able to replace medication, but I have had some experiences with therapists who don't understand the etiology of these conditions and don't educate themselves, so I can totally believe you had practitioners like this. I just think that it's a gross overreach of the therapy to try to use it for that kind of thing, but it has more potential if you don't expect it to be a floor wax AND a dessert topping.
I hate this talk about masking. Why do people say it was wrong of my therapists to teach me to sit still long enough to learn to read?
I know from many years of experience, there's no cbt solution for running out of dopamine. Do drugs, kids.
Hi Jacob, I want to start by saying I'm a long time fan of yours and I think this is the first time I am commenting on any of your videos. This video perfectly explains why I quit studying psychology. in 2017 I graduated with a bachelors in psychology and had passed my GRE and gotten all my stuff together for grad school. I didnt go. I didnt go for a lot of reasons, but this video explained it in a way I have been unable to for 5 years. I was working at a boys home as an intern my last year of school. the kids were runaways, or had drug offences that kind of thing. I shadowed their therapists and worked in the cottages with them to help them build more life skills and to learn how to not reoffend. we had one kid who knew how the system worked, his grades were fine, and he had held back any violent urges he had for months, but I knew from talking to him, it was an act to get out of the program and get sent home.
I explained this to his counsellor, and asked why we hadnt tried to break down the actual wants that were leading him to offend in the first place (he was from a poor community, his father had sold drugs, the only rich people he had ever met in life were drug dealers, and because he had been raised to associate power with wealth he wanted the fastest means to become rich, which was selling heroin) I explained some things we had covered in my studies on how to break this thought process down, how to replace it with a new one, we always used the idea of a house to explain psychology in my program, if the foundations cracked it doesnt matter how well you build the walls or roof, eventually they will crumble because the foundations damaged, so you find the broken part, issolate it, and work on resolving it. I said if we had him shadow other people, teachers, maybe some of the other adults who worked in the program etc, and showed them that while they were not as wealthy as the people who sold dope in his life maybe it could show him that there is a slower, but much safer way to achieve the item he actually wanted. his counsellor said "he has hit all of his goal numbers, so even if it's just an act, there is nothing I can say to the judge to get him to stay in the program any longer" it didnt matter that 2 weeks after he got released he was back, for selling drugs again, all that mattered was, he had hit his metrics
CBT is a nice frame work, but so much of modern mental health counselling is just this, meet the metrics. the human element is missing. it reminds me of a saying I once heard about IBM helping with systems for census taking in the 30s, by making the governement look at its people through a machine, the state itself slowly became a machine. people were no longer people, but punches in a card.
As someone currently studying psychology, is there another path forward if I have this same disillusionment? I still have so much interest in at least the idea of helping others, but I know that most of what awaits me on the other side of my degree is just capitalism with a mask. What do you do now, and did you ever see some occupation or cause or even a general idea that you would want to see psychology students of the future looking at, or are you left fully disillusioned?
@@C0n0li0 so after college I worked for Intuit for a while doing tech/tax support, turns out taxes are pretty easy to learn, as are computers and studying counselling does wonders for dealing with people during really stressful situations. after I quit Intuit in 2020 I got a job at a highschool doing IT, worked at a start up selling a website builder, and now I work as a pricing coordinator at a trucking company, basically filling out spreadsheets day in day out, deciding what lanes should cost to our clients. you'll notice these jobs still require some human interaction, but on my terms.
The part of this story I left out, because it's still kind of hard to talk about is when I was working at that boys home, I was one of the only men who applied for the internship, so they put me back behind the fence with the criminal offenders. My kids were from bad homes, and had lived hard lives. But they were kids, and just like anyone they can only live with what you give them. I thought I did a lot of good there, but a moment from that job that will never stop haunting me was we had a kid who was 13, his mom had stopped showing up to visitation. sad right. he realized that no one on 2nd shift could leave at night until he went to bed and he wanted to call his mom, he tried 3 times, no answer, and he wanted to keep calling....all night. he refused to go to bed until we could do something, eventually he accepted he couldnt keep calling, but he still refused to go to bed, it was a power play. I told the other staff members, hes a kid he has been up since 6:30, he will go to bed, just play on your phones, wait it out.
I mentioned I was one of the few men to apply for a reason, because there were staffing issues, as such they had started scraping the bottom, including former prison guards. former for a reason. one of the guys working with me, was angry he couldnt leave, walked over to this kid and shoved him, hard. kid slapped his hand away, understandably. the guard said out loud "I now have it on camera that you have attacked me" and tackled this kid to the floor. rule at my location was, any restraint requires 2 guards for legal reasons. this guard is yelling at me to help him restrain this 13 year old. who is crying and screaming. I refused to help, but still I had trouble sleeping for weeks just remembering the shock and fear in that kids eyes as a 35 year old man held his face against a floor for 25 minutes while he fought to just breathe as this dude held him down.
there were other moments, like a colts benchwarmer who worked with us who beat the snot out of a kid so bad he had to get stitches, or a kid who had cheeked his meds and had a psychotic episode that resulted in him being restrained, put in our "time out room", a small room where we could move someone and lock them in while we waited for police to arrive....it happens, but he ended up smashing the window on the door out with his face. but there was more to me not going back to grad school...they dont do a good job teaching you about what you can leave at work and what you are going to take home. you can only compartmentalize so much.
my advice is this. help people still, but ask yourself some harder questions about what you want out of a job. I thought I would get fulfillment only from helping people, but after 6 years of working at a music store through college, that internship, and then intuit. When I am honest with myself, REALLY honest....all I really wanted was a fat paycheck and a lot of time to myself at the end of a day. its selfish and its capitalistic, but honestly I just want to leave work and not think about it for 16 hours. I want a job that pays enough for me to live comfortably and to not think about work when I'm not in the building.
I still help people where I can, and I still counsel people here and there, non professionally, but people still ask for it at work or in my friend group. I mean I have a degree still, I CAN do it...I just cant be paid for it, so I help where you can, but carving ones self into a machine solely designed to solve peoples problems necessitates a lot, and I mean a lot of sacrifices.
I realized a bit too late in the process that I wasnt really willing to make those sacrifices to my mental health in exchange for maybe being able to help someone elses.
Shit, and this is probably part of why "the human element" is missing in the system. Its gotta be real hard to put yourself out there and genuinely help people day in and day out when you're swimming upstream in so many ways. CBT apps aren't as good as real trained therapists, but there isn't a good way of providing enough counselors for everyone that needs one...
i’m currently in a day treatment program and i’ve seen so many people leave that really shouldn’t have. one guy did coke in the bathroom with the group facilitator being aware and he had “a successful discharge” not even a month later. a girl bullied me for months, but because she wouldn’t admit to it, she had a successful discharge as well. one of the guys in there has called me slurs several times and he’s set for discharge within a month. i’ve been stuck here for nearly a year because i’m honest. i feel like something needs to be fixed, but i don’t know what.
@@jun_lan the thing is, often times the people running those programs either know the people are being dishonest and just turn a blind eye because of protocol, or are willfully ignorant because they just cant/dont want to internalize it anymore. I wish you nothing but the best in treatment, know that every step forward is progress no matter how small, and that you do have it in you to progress, even if its only a few percent a day. dont fault yourself for your honesty, it means you trust people around you more then those others did.
also that dude doing coke in the bathroom at a treatment facility? very cliché, think he put on a big shouldered white 80s suit before he did it too? maybe turned on some eddie money as background noise?
turing's concept of extra-sensory input is what i think we nowadays mean when we say "that person gives off ____ vibes" or like "the vibe or feeling i'm getting from you/them/etc" so in that capacity, vibes are just extra-sensory.
I haven't finished your video, but I'm extremely grateful for your thorough and nuanced discussion of CBT. Lately, I've been seeing horror story after horror story of people being further traumatized or neglected because their therapists are misusing CBT. As you mentioned, CBT is for cognitive distortions, such as being too afraid to drive because you got in a car accident last year, and it's damaging your ability to live a full life. What's more, it's for when you WANT to change. But I've heard stories of people having their therapist manipulate them into changing behavior that didn't meet their goals and portrayed them as the problem instead of the systems or people around them.
Just as you mentioned, CBT is A tool, not THE tool. If it doesn't work for you, then it's not the right tool for a job. You wouldn't blame a toaster for not being fixed because you tried to use a hammer.
As old as this video is, hopefully, someone will read this. And if that someone is you, then please know you are allowed to interview your therapist. You're allowed to push back and ask questions if something doesn't feel right. You're allowed to fire your therapist if they aren't listening to you. It doesn't mean you're defiant or refusing help. You deserve to have the same boundaries and autonomy as anyone else.
As someone who is deeply entrenched in the mental healthcare system as a patient, with over 10 years of consistent history at varying levels of care I'm sad to report that the over reliance of CBT is present EVERYWHERE. I'm not here to bash CBT, it is helpful, but the points you made criticizing it are 100% accurate. DBT (a similar module with CBT elements) did save my life, it helped me become a better person and a safer person towards myself but it is not the end all be all of treatment and I find more and more people are falling through the cracks of effective care because its treated as this magic bullet.
Its nearly impossible to find a therapist even willing to acknowledge the environmental stresses that contribute to mental health. I remember talking to a therapist about being suicidal because I didn't have food to eat and the looming threat of insurmountable debt if my account became overdrawn.. she "challenged" me to find a way to think positively about my situation, to find a way to reframe my thoughts around starving to death.. I did not see her again after that.
Its present in more intensive care facilities too, a lot of them only offer group CBT sessions and medication management with the occasional art therapy group thrown in there. There's no dedicated treatment to talk about WHY these symptoms present themselves, just a cookie cutter attempt to make them become more manageable, to make the patient more productive.
I've been guided through cognitive-emotive-behavioral therapy. (From the comments below, I can see why psychologists found an excuse to shoehorn the E into CEBT.) Personally, I found it very helpful once I was able to acknowledge this fact: My therapist cannot, will not help me fix my circumstances. My therapist can and will, however, help me learn to cope with my circumstances until I am not too depressed to work on changing my circumstances on my own. It wasn't so much "You already have all the tools you need to be happy, no matter what." It was more like, "We'll equip you with the tools you need to be functional, no matter what. Then we'll talk about how to use being functional to find happier circumstances."
How are every single one of your videos so informative and thought provoking. I love having them in the background and just thinking along with your words whilst I do other stuff.
This video really illuminated by bad CBT didn't help me and made me actively dread sessions. I thought I was somehow doing therapy wrong because no matter how much I tried to "reframe" my thoughts, it didn't actually help -- i KNOW my social anxiety is just in my head. Doesn't matter how many times I tell myself that though, my emotions aren't logical. Trying to logic my way out of my emotions isn't going to work, at least for me.
I didn't start getting better until I started medication, and while I don't want to only depend on it forever, it's helped SO MUCH. I feel like I actually have the bandwidth to find therapy that actually works (and I would, if I had the money 🙃). But I often think -- I've found therapy helpful before, but what happens when I walk out into the world and my wages are still lower than they should be? When my rent goes up? When I get pulled over by a cop as a Black person? Trying to startup-ify mental health is so sinister when you really think about it.
I've been keeping my existential dread ticking over with a mix of Stanley parable and Simon stalenhag. So its good to see the master back at it.
Simon Stalenhag is the SHIT, i havent read most of his stuff but Electric State was interesting as hell and had beautiful art
The Stanley Parable isn't therapy, unfortunately. But it can be a nice break from reality for a bit, ngl :))
based stalenhag fan
If you have Amazon Prime and haven't done so yet, please watch the Tales From The Loop series! It's gone so under-appreciated and I think it deserves so much more love!
I'm currently seeing a therapist (even with insurance it only knocks about $20 off each session...big oof) and she's very enthusiastic about CBT as a tool and I'm really not feeling like it's going anywhere. Your discussion on it helped me pinpoint why I'm not vibing with it, so I'll bring that up at my next session.
This was enlightening and I really appreciate that you took the financial hit to test SEVERAL apps to review. Good on ya man.
Good luck! I gave my therapist feedback about CBT methods not working for me and she shifted focus towards other methods of therapy which ended up working much better for me - so totally go for it.
How has it gone/has it gone yet?
Shrooms.
Your videos make me feel better, your voice is very soothing and your tone and pacing is calming.
Even on unsettling or unpleasant topics you make it bearable to watch.
It was really interesting how this started out only started out almost like a review of review of mental health apps and then slowly expanded into a history of the entire automated mental health field. Very well done.
This video really helped me understand why my last therapist did not help me at all and seemed to be unable to connect with me even slightly-- she used pretty much only CBT, while the reason I came to her was because of wanting to get an ADHD diagnosis. It was scarily similar to what you described with automated therapy tbh. Her only response to my months of trying to explain to her that I wanted it to seek more specialized help and even medication was over and over just "to ask myself why I wanted a diagnosis in the first place" because she thought that pattern of behaviour was "harmful" for me. Trying to talk to her FELT like being judged by a machine and only constantly asked to ~examine~ my thought patterns and behaviours instead of listening to what I was actually saying, which only led to me being incredibly anxious to say anything at all and as you said, giving up and just giving her a Bad-Thought-Pattern-ProofTM summary of my week with all of the dimension of my actual feelings and reasons for them completely removed because of her laser-focusing on the specific language i used. CBT did help me with some things though very superficial ones, but more so it really opened my eyes to why a lot of people distrust therapists or have bad experiences with them if you have a specific issue that needs more than just "learn to Think BetterTM". if i am suffering a paranoid delusion, i can't fix it by Thinking BetterTM and using The Good LanguageTM, i need comforting and assurance and understanding and walking through what is causing it and figuring out an actual coping strategy, no matter how ridiculous, and sometimes just for someone to allow me to vent so I can survive it. the field of psychology is still filled with issues and prejudices (g-d forbid you happen to have psychosis or delusions of any kind, for example) and capitalism is certainly not helping at all. It definitely didn't escape my focus how the main things the apps were focusing on were depressiong & anxiety, as if that is the only mental problem you can have, though many people-- including some therapists-- would like to pretend that that's the case.
Ugh, my first therapist also wanted to skip any sort of diagnosis and skip straight to "fixing", also using exclusively CBT. I can't believe he didn't understand how important knowing *why* someone feels something is as important as working to change it, and what a huge relief an official diagnosis can be to a lot of people.
One of the biggest problems I have with therapy is that my mental health problems all pretty much ultimately stem from one thing - my ADHD. Being neurodivergent has its side-effects, and those manifested in me as anxiety disorders and depression of various types throughout my youth. And, while I respect medical professionals... going to a neurotypical therapist for a problem that is effectively "caused" by your neurodivergency is a bit like going to your doctor with a broken tooth and them being like "Yeah, yeah, it's broken for sure. Here, you can take some pain meds, see if those help. Also, have you tried brushing twice a day?" Like, yeah, you fixed one of the symptoms, you have a cursory understanding of how teeth work and how to care for them, but the problem is ultimately that the tooth is broken, and it won't NOT be broken unless the right type of professional - a dentist - looks at it. And there aren't many "dentists" available... very few in fact, at least ones that are open about it, and trying to book those? Not a good situation.
Honestly this, I’ve got ADHD and have been struggling with severe depression (attempted twice but there was always stuff to stop me from doing it) and one thing I noticed from my last therapists were that I’d try telling them what was up, and they’d essentially be like “well it seems like this is bothering you” or something. I’m lucky in that I know pretty much all the things that are up with me, I can identify things about myself and be up front with it. My main problem is doing it, taking the steps to fix it, and the therapists usually aren’t really use to that so they’ll just try seeing what part of the script they can regurgitate to maybe figure out a solution… I don’t know, it sucks.
YES. Shit. Most of my problems also steem from my ADHD, and after trying a few therapists troughout months I'm just...I don't actually think therapy can help
@@chimedemon Wow. yeah same here, all my therapists comment on my self awareness and knowledge, i know what i like dislike and struggle with, but time and time again fail to take action. it's the stress and self hate from not doing things that makes everything else miserable. still, therapy doesn't feel like the entirely wrong direction.
I have severe OCD and have used a few different apps with automated therapy stuff to, honestly, amazing results. I get stressed talking to therapists so being able to manage my own symptoms felt amazing and helped me to reclaim my control over my head. Mixed with my Prozac I genuinely believe the apps I was using contributed to saving my life multiple times. Cognitive behavioral therapy was such a huge part of this and worked total wonders on my OCD, and while I still struggle with my disorder, I have the power and strength - and healthy coping mechanisms - to not only survive it but live happily with it.
All this to say I still laugh my ass off at CBT. Nothing like telling your loved ones you recovered from OCD with Prozac and a shitload of cock and ball torture.
Yeah as someone who used to have debilitating OCD myself (I have it way more under control now), I found that CBT + SSRI was helpful for mitigating compulsions and as a result, the obsessions causing the compulsions. That said, I would attribute most of my overall mental health improvements to escaping abuse, upward class mobility, psychedelics, and internalizing anarchist theory
I also have OCD, can I ask which apps you've had the most success with? I go to therapy, but every little thing adds up.
first video of yours I've watched and this is an incredible video essay, the tangents into other topics felt so well connected and were so interesting to hear about. looking forward to watching your other ones!