Ask HN: Has anyone here turned around their life in their 40s?

That's huge! Congratulations, you should feel proud of making a positive change like that. Many, many people do not recover and don't make it. Many of them don't _want_ to.

Life is largely dictated by our pesky brain and how we view the world. 46 isn't _that_ old, you still have a ton of life ahead and if you view it from the lens of breaking free from your own personal prison, finally getting the opportunity to experience the fresh air of tranquility, you might just realize the future is indeed bright and not dim.

Good luck friend.

Metacognitive Therapy. Effectively, when dealing with persistent unwanted thoughts, it teaches you to let them pass without judgement / evoking response, and to divert your attention elsewhere. I find that this complements CBT well if one has already done the work of recognizing that some thoughts are unrealistic distortions. Proponents of MCT seem to bash CBT needlessly; they needn't be mutually exclusive, and at any rate, evidence suggests that CBT is generally effective (and there's a much larger body of it than for MCT).

> someone who keeps you accountable and committed to a course of treatment/training. Many people could probably do these things by themselves, but many others struggle to keep it up for one reason or other.

It depends on preference and self-efficacy, notwithstanding that intrinsic motivation is necessary whichever way. However, most people don't seem to realize that self-administration is an option, and walk away from the prospect of therapy entirely if they deem it too costly.

The other problem is, as with personal trainers, whether you'll have a good one is a roll of the dice. Trainers have a perverse incentive to divert people to use machines and away from compound movement exercises like deadlifts. Similarly, many therapists don't offer much insight or homework. And all the while you can leverage the most powerful approaches by yourself at zero cost.

Seeing a pro is still a decent heuristic, most people will want to avoid the labor of doing research which can be daunting, tiresome, and is a skill in itself. Pressing the "just tell me what to do, here's money" button is arguably more optimal depending on the circumstances.

There are many modern meta analysis assessing the (in)efficacy of psychoanalysis and comparing it to other approaches, such as cognitive behavioral therapy (which is the gold standard nowadays) and other approaches, which back my arguments.

I am not really interested in going more deeply about this, but I encourage you to research it, if you are interested. There is a lot of research about this.

And by the way, I am sure that you can also find meta analysis which will tell you that psychoanalysis works. This does not mean that it is necessarily true (or at least, not for the reasons that people think it is true), for various reasons, some of which I'm sure you can deduce.

The problems with psychoanalysis are not just about its (substandard) efficacy. There are many other troubling issues with this practice.

This is why it is important to follow a field of study and what current scientists, field practicioners/experts and academics know (from various disciplines and fields of study, in order to get a consensus as best as possible), and not just read some isolated meta analysis and extrapolate conclusions from it.

> I think you’re jumping the gun a bit.

I think what I'm talking about is pretty well established at this point, it's not news for someone who works in this field.

I suggest you do more research before arguing about a field you don't seem knowledgeable about.