To think therapy culture is turning self-reflection into self-obsession?

People often take a message from therapy that the therapist didn’t intend. I’ve lost count of the people who start a session saying “I did what you suggested” or words to that effect. And they have got the impression I was recommending a particular course of action. I’m more careful about that. But people hear what they want to hear.

Yep I agree, therapy gave my selfish ex validation for his behaviour and an excuse to opt out of family life. For example when I did the dropping off and picking up from the kid’s activities 3 evenings a week and he did the 4th, he stopped doing this after therapy. Apparently the therapist told him he needed more time for himself! We both worked full time but his office was within walking distance from the house, I travelled and worked longer hours. I also did all of the housework etc while he lazed around the house. Surely
the therapist should have been telling him that he was being a selfish twat rather than validating this and encouraging him to do even less? His DC don’t bother with him now as he was a shit father. I’m sure he’ll be in therapy again and it will all be their fault! 🙄

all this arguing is giving me a mental disorder

A choice he is making, surely. Or his anxiety prevents him from thinking he can get another job? Or his field isn’t very mobile, so other jobs don’t come up very often? Or he’s planning to stay put and get promoted out of the team that’s making him unhappy? Unless you’re sitting in on his sessions, you can’t have any idea how he’s doing or what he’s working on. What do you mean by ‘medical help for his anxiety’? A prescription for beta blockers will just cover up the symptoms.

Well no, but after two years he’s still miserable at work, stressed and paying the therapist every week…

And obviously you know better, do you?

i have a relative who has been having therapy for a couple of years, making good progress working through childhood bereavement. However, the reason he sought therapy was initially due to work burnout and anxiety. He is still in the same job, still anxious, the therapist says he just needs more therapy. I’m sure they know their job, but as a concerned relative, I think getting out of the toxic workplace and possibly some medical support for the anxiety would help alongside. It almost seems that his past trauma is blamed for everything.

I don’t know what you mean when you say “the one and only paper you keep quoting from does not say how”? The paper literally focuses on the mechanism of harm?

“One such explanation is that universal interventions increase young people's tendency to notice and focus on negative emotions and other symptoms, and that this attention and awareness can lead to negative effects in several ways [7,16, 17, 18]. First, increased awareness may lead to rumination, where young people passively and repeatedly think about their emotions either alone (rumination) or with a friend (co-rumination) [13,19,20]; this process has been shown to increase symptoms [21,22]. Second, it may be that universal interventions increase awareness of negative emotions but do not provide enough effective guidance on how to manage or reduce them, and this increased awareness in the absence of a resolution increases distress or other symptoms [18,23]. Some authors have proposed that this may be particularly likely to occur in young people already experiencing high levels of symptoms [18]”.

The numbers are references to study’s with primary data which explore this issue. If you’re genuinely interested, I would read the whole article.

I’ve seen very good workshops covering this type of thing under this scheme so know it’s happening.

The one and only paper you keep quoting from does not say how and you still haven’t suggested an alternative.

I don’t think that suggests the workshop will cover cover physical feelings, feelings, thoughts etc at all. (You said; Also some of the workshops being done will cover physical feelings, feelings, thoughts etc.”. I still don’t see any evidence this workshop will cover any psychoed, as it seems to be an information workshop on moving to secondary school).

You say you see no evidence, but I have quoted a peer reviewed paper (which you mistakenly claimed was an opinion piece) which has cited several studies with primary data showing that mental health education in schools can cause potential harm, including worsening anxiety, low mood and difficulties with relationships. I can’t show any clearer evidence that mental health education in schools can be potentially harmful.

I don’t think we’re going to agree, which is fine. We’re coming at it from different perspectives, and I understand as a professional people might not see things the way I do. We can agree to disagree and get on with our Saturdays! I do think we agree on the core issue that more needs to be done to support children and MHSTs are a great start.

I think “themed group work or information workshops. We have also been supporting the transition between schools and have been working with the year 6 classes going up into year 7.” pretty much does suggest otherwise.

And again I see no evidence against mental health education.

The comment I was replying to originally (not to you, but if you’d have read the thread, you would understand the context, particularly given you replied “what mental health education? What research”) stated “I think if the basics of CBT were taught in school – that thoughts lead to feelings which lead to behaviours but that you can change/disrupt the process – then you'd have much more self awareness within a couple of generations.
I'm not talking about giving children therapy, but helping them to understand how and why people think the way they do; it should be popular subject!”

Mental health education is not the same as therapy, and I have already highlighted one paper which highlights how this can be harmful, citing several other papers which show this with their own primary data.

There is no workshops being done, afaik, that cover the basics of psychoed, for the reasons I’ve mentioned - the evidence is inconclusive. None of the links you provided suggest they will do anything other than increase availability of 1-1 therapy and work systemically with teachers and wider systems (in line with the three objectives of MHSTs).

As a psychologist, I do understand that professionals can adjust materials and focus for the audience (as I’ve done many times). What we don’t do is put on workshops or classes that have no evidence base, when we could be spending our time delivering evidence based individual or systemic interventions.

No I did not say that( re CBT) and you actually said:-

“There’s quite a lot of research now indicating that mental health education in schools can increase distress and mental health difficulties in children. I think supporting children living in poverty and addressing parental mental health difficulties will have a much bigger impact.”

So “ mental health education” not CBT, what is harmful about mental health education?

Also some of the workshops being done will cover physical feelings, feelings, thoughts etc. What is harmful about that? You do realise professionals can adjust materials and focus according to audience?

None of the links you posted mentioned anything at all about psychoeducation classes teaching the basics of thoughts, feelings, physical feelings and behaviours though? This is what the evidence is saying is potentially harmful and was the original comment of yours I replied to.

I’m a huge supporter of MHST. What they do (1-1 therapy, supporting school staff and liaising with external agencies) is great and very, very helpful. What they don’t do is teach kids CBT in a group with no 1-1 support, which evidence suggests is potentially harmful. This is what you originally said would be helpful, and what I originally said has been shown to be potentially harmful. Not the concept of MHSTs themselves.

In my experience of both providing and receiving therapy, I think it would be very upsetting to realise what is going “wrong” (cognitive distortions, avoidance, physical responses like fight and flight etc) but be given no support to address this. Having an awareness of the issue and having the tools to manage it is not the same thing.

There is no mention in the guidance about implementing CBT (or any other therapeutic) psychoed classes in school, which is likely because the evidence shows there is potential harm.

I think its more likely that prevention has never really been a focus, money and research tends to focus on treatment. But it would be money well spent to head off problems before they develop. Apparently that is in the NHS plan going forward so fingers crossed.

And to the poster who mentioned DBT - I agree, but you know that this developed out of CBT, right?

I think there is a wider shift going on - from what sociologists would call collective cultures to a more individual oriented one, probably through the expansion of american culture through SM. In the past, people who were concerned about what others though, and fitting it, and getting along, to people who have been encouraged to think their own needs should be centred.

Now, I do believe that your wellbeing should be central to your own life. Because you cant help anyone if you dont look after yourself. But at the moment it seems to have gone to the extremes and people seem to have the attitude that nothing in their life should be challenging, difficult or distressing. Some self reflection is a good thing. But too much is incredibly damaging. The YouTube about the woman who was talking to AI about her psychiatrist illustrates this perfectly.

https://www.swlondon-healthiertogether.nhs.uk/resources/information-on-local-healthcare-services/mental-health-support-team-mhst-schools

hiowhealthcare.nhs.uk/our-services/a-z-list-of-services/mental-health-support-team-schools-portsmouth

https://camhsdorset.org/about-camhs/mental-health-support-teams-mhsts

It’s clearly evolving.

Would love to know what potential harms are involved with any of that. What might the harms be?

And again what do you suggest schools and families do- nothing?

@GagMeWithASpoon You'd be surprised what those with enough disposable income come to therapy for. The same as parents sending children to therapy for very trivial reasons. A good therapist will signpost onto a more suitable service.

What do you mean no data was used? Data was clearly used in the papers they are reviewing, that’s how reviews work? They use secondary data, not primary data. This is the same as meta-analyses.

Yes, but potential harm is still very significant. I wouldn’t want my child exposed to any potential harm. I also wouldn’t be happy if my child was given hypnotherapy, which also carries potential harm, just because the waiting list for CAMHS is too long.

All mental health services are evolving, it’s called service development.

As far as I can see, none of the MHSTs focus on providing psycho education classes to children. On the official document, the three objects are

1. to deliver evidence-based interventions for early support for mental health issues (which is individual therapy).
2. to support the senior mental health lead in schools and colleges
3. to give timely advice to school staff and liaise with external agencies (CAMHs, social work etc)

In other words, to provide individual therapy and work systemically with the student. There is no mention in the guidance about implementing CBT (or any other therapeutic) psychoed classes in school, which is likely because the evidence shows there is potential harm.

Why would I be defensive, why would I need to consider anything else and how about linking to some evidence for your claims.

He's unique to me, his circumstances aren't. 🤔 he won't be featuring in any medical journals.

You love to think that your opinion is the only valuable opinion because you're defensive about your families diagnosis and won't consider anything else.

Your son does not speak for everybody.

You missed out -“Given that negative effect sizes in this literature are typically small, we are cautious about describing negative effects as evidence of definitive harm, and instead refer to them as potential harm”

And the fact that no data was used and the MHST are evolving.

Again what do you suggest schools and families do instead whilst navigating a broken and non existant system?