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ERP Therapy Sucks

taylor.town

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Re: ERP Therapy Sucks

#31

Post by raducu »

pringk02 wrote: post #24

I have OCD (or had?) I did a course of ERP with a very good therapist who I would put as the most important person in my life after my partner and family even though I hope to never need to speak to her again. It was a life changing experience in that my average day-to-day quality of life went from something like a 2/10 to a 9/10. I frequently fantasised about killing myself. At least once a day, from ages 12-32. Tho…

> 1. ERP is actively uncomfortable, that is the point. But there is a delicate balance to the level of discomfort.

Strong emotions can override reason (and wrong reason can create strong emotions that create tight loops/patterns one cannot escape), and there's no better way to train yourself out of a pattern then by rehearsing fighting the pattern and overcoming it.

One could be excused into thinking that that's all there should be about psychotherapy, but there exist meta-loops that spawn bad loops ad infinitum and you can spend a lot of time fighting the bad thing that can be seen and not understand why no real life progress can be made.

So for me, there are many many successful point therapies, and much much fewer higher level successful therapies where chatgpt or low skill therapists won't really help.

Re: ERP Therapy Sucks

#32

Post by pringk02 »

raducu wrote: post #31
pringk02 wrote: post #24

I have OCD (or had?) I did a course of ERP with a very good therapist who I would put as the most important person in my life after my partner and family even though I hope to never need to speak to her again. It was a life changing experience in that my average day-to-day quality of life went from something like a 2/10 to a 9/10. I frequently fantasised about killing myself. At least once a day, from ages 12-32. Tho…

> 1. ERP is actively uncomfortable, that is the point. But there is a delicate balance to the level of discomfort. Strong emotions can override reason (and wrong reason can create strong emotions that create tight loops/patterns one cannot escape), and there's no better way to train yourself out of a pattern then by rehearsing fighting the pattern and overcoming it. One could be excused into thinking that that's all…

> So for me, there are many many successful point therapies, and much much fewer higher level successful therapies where chatgpt or low skill therapists won't really help.

I definitely agree. I think I was very fortunate to find someone who specialised in and only did ERP and had a lot of experience. I hear a lot of stories in support groups of well-meaning therapists making things worse. The closest I came to killing myself was after three sessions of psychodynamic therapy (after getting sick of a lack of progress with CBT). All of that therapy was before I understood that I was suffering from OCD.

Re: ERP Therapy Sucks

#34

Post by te_chris »

I've got OCD and I've done CBT, ERP etc. As others have alluded to, you need to realise the work is never done. Recently I've found it more active, but this time - having recently read The Maps we Carry by Rose Cartwright, who was something of a poster-woman for OCD after her first book, Pure - I've tried to go deeper. CBT etc feel like prophylactics. They're certainly useful, but they don't address deeper things, such as learning to be as you are, to observe and integrate your anxiety etc.

This set me off on a harder path of more abstract therapy (I'm working with an integrative therapist who practices across IFS, Jungian etc), meditation etc. The book the untethered soul, by Michael Singer helped a lot to put everything into perspective - the therapy, the anxiety, the day to day - in a way that nothing else had really achieved for me.

Also, a key conclusion of Cartwrights is that individualised change/treatment is important, but it's worthless without community. I think she's deeply, profoundly right.

Re: ERP Therapy Sucks

#35

Post by kyle-rb »

jrflowers wrote: post #5

I like how the author says that they only started a few weeks ago and (contrary to the title) find it good, actually, but has already amassed the requisite expertise to advise other people not to seek out therapy from human beings if they don’t get the result they want from a chat bot. It is literally “My Mental Health is Improving Through Human Contact: Human Contact Might Not Be For You. The Only Way To Know Is By…

I think it's more like "I started exercising with a trainer and then realized I don't actually need to be paying the trainer all that money, because the exercise was the important part".

Re: ERP Therapy Sucks

#36

Post by pjc50 »

codeduck wrote: post #2

> Luckily, LLMs significantly reduce the effort/cost of therapy experiments. The day just started and I'm already done with it.

LLMs are a great technology if you don't care about the quality of results.

Re: ERP Therapy Sucks

#38

Post by rs186 »

pringk02 wrote: post #24

I have OCD (or had?) I did a course of ERP with a very good therapist who I would put as the most important person in my life after my partner and family even though I hope to never need to speak to her again. It was a life changing experience in that my average day-to-day quality of life went from something like a 2/10 to a 9/10. I frequently fantasised about killing myself. At least once a day, from ages 12-32. Tho…

Thank you, your post said everything I wanted to say. People should seek professional help when they need it.

Re: ERP Therapy Sucks

#39

Post by rs186 »

brador wrote: post #21

Minimised? Yes. But I’ve never seen a cured case of OCD, of any type.

Depending on whay you mean by "cure". Maybe there is always something left, but you get better at handling it over time, which is way better than getting completely lost and spending all your time and energy indulged in the obsession and your own fantasy.

Re: ERP Therapy Sucks

#40

Post by TomaszZielinski »

Another vote here against using LLM. Because if you do ERP incorrectly then you can even worsen the fear and make your life even harder.

Example:

You are afraid of dogs. LLM tells you to approach one to habituate your anxiety. You do that but the fear overwhelms you and you run away.

Brain’s diary: I avoided death, that beast would shred me to pieces in a moment.

(Note this is about „normal” anxiety and not OCD, but the idea translates.)

If you dont want (or e.g. cannot afford) a proper therapy, IMHO a book by a competent author is a much better choice than LLM. Or a few different books.

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