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this post was submitted on 11 Aug 2026
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Talk therapy is 1 ingredient in the mental healthcare burrito.
It's the tortilla.
People have existed long before therapy has. Do you think people 500 years just suffered in misery until someone invented therapy?
The problem with therapy, I find, is what you can teach people. You can teach people facts. You can't teach people what it is like to be someone else. If you have a therapist that can ONLY relate to you in terms of theory, you're going to have a bad time. So that depends on who you are and what problem you are bringing.
An easy example, that the field is just now grappling with, is existential depression. That is to say, a depression that doesn't come from distorted thinking but thinking TOO clearly. Unless a therapist has been through it themselves, they might try a bunch of tools to "fix" the depression, trying to convince you that you are having distorted thoughts, etc..
But to come back to my historical point: therapy will just take tools from existential philosophy and recycle them as "therapy", thereby continuing their monopoly. There are entire fields of therapy that have been entirely lifted from other philosophies. CBT is basically stoicism. ACT is basically Buddhism.
There are great therapists out there, but I think they are DESPITE the systems in place to train and certify them, not because of those systems.
As Daniel Mackler has said, "it is easier to become a good therapist, than to find one."
For the most part, yes. At least in this context. Granted, functions similar to those covered by therapy (teaching, guidance, healing, realignment) have been carried out human-to-human for probably millennia.
But the proportion of people that were helped before there were systems and science was likely much lower than today.
Therapists (especially good ones) aren't unable to relate to you beyond theory unless they have literally experienced circumstances similar to yours. Empathy + experience goes a long way. Compatibility is an important factor which is why you're encouraged to keep looking until you find someone that matches, but they don't need to share your philosophical views in order to be effective.
Well, if you went to them because the depression is making you suffer and you would like to get rid of it, they should try to help you deal with it. How that is best to be achieved is of course a dialog between you and your therapist, but even if the root cause is "thinking too clearly" there are ways to mitigate the depression.
Philosophy and psychotherapy are completely different subjects of study with mostly disjoint areas of applicability. Sure, one draws heavily from the other, but that's not exactly particular to psychology - philosophy is the mother of all science, after all.
There are areas of philosophy that are particularly rich in resources (e.g. ethics), but even if there are philosophical schools that tell you how to live, for most people they aren't concrete/practical enough to be applied (not to mention the time needed to sift through dozens of philosophies, and the risk of choosing one that is unhelpful; or worse, misunderstanding it).
Most people need help with this which is why we have a field that actually has the human psyche as its central subject of study.
Therapy works, it helps a great number of people, and for most of them philosophy is not a viable replacement.
Absolutely not. I don't know if you have qualms with specific institutions in a particular country - those might well be justified. But organizing and systematizing a discipline leads to increased quality of practitioners rather than the opposite. Without training, most therapists would be significantly worse, especially during the early years of their career. Without certification, you'd get many more people doing the job that are simply not qualified for it.
Therapy is hard and unfortunately many therapists are mediocre or worse. There are probably also many institutions that overall don't produce high quality professionals. But I think laying the blame on the education/certification system as a whole is misguided.
As I said, just now, "it is easier to become a good therapist if you study and get certified than if you don't".
Somebody from Canada replied in this thread about their experience with Indian families... my experience with people in my life is if there is a groundswell need among the population something will develop that at least claims to meet that need. Just look at "The Secret" a massively bestselling book premised on the idea that everything that happens to you--good or bad--is your fault. People want to believe it, someone will sell it.
I think we have therapy now and not in the past because society and the human spirit wasn´t as thoroughly broken as it is today. Before, people would live and die in the same village, have their funeral in the same church that baptized them, do the same job their entire lives, be married to the same person from a young age, have a defined role in various sectors of their society. Modernity is not like that, so we had to develop a "science" of wellness to deal with the new misery generated by the various crises of modernity. I doubt people suffered the way they do today with no response.
I find this is an interesting way of looking at things, and I think I really did sincerely share it. But if you want to look at a critical look from inside the profession, I´d recommend the book "The Heart and Soul of Change" which really goes into depth about the very many flaws of the research of therapy, starting with the bedrock argument (I think it's in this book) that therapy, for all the research that has been done, is no more effective today than it was 50 years ago.
There's a lot of little data points along the way, but I find that sometimes it's helpful to have a very clarifying fact. Like you can get into the weeds on AI is successful or not, but all anyone needs to do is show a general LLM business that is making a profit to establish the possibility that LLMs are the future. If no general LLM business is making a profit, or even on track to make a profit, then perhaps the entire project is flawed. Likewise, if therapeautic outcomes have not improved, then perhaps the "systems and science" of therapy are flawed.
Other fun data points: there is no type or amount of training that demonstrably reliably improves client outcomes. There is no training any therapist can take that will make them demonstrably a better therapist. Instead we see a pretty reliable rise in outcomes for all therapists over time that plateaus after a short time (maybe 2 years), maybe goes up a bit, but then actually often starts to DECLINE after several years. (This does contradict what you're saying about training; I don´t know if you have a source for your claim?) (Also, please show me where passing a standardized exam improves client outcomes.)
After reading all of this and more, I came to the conclusion that therapy is effective for probably a multitude of reasons that are hard to predict, but that ultimately, the "systems and science" is largely there to entertain the therapists, give their brains something to do, and to give the profession a corpus of knowledge that can be taught, tested, and regularized so that is can be a respectable profession; as I pointed above, all this research has not increased in improved client outcomes, so what good is it?
I don´t know how you feel about Chinese Medicine, but I take a lot of inspiration from it that example. Basically the theory is that there is energy that flows throughout the body. It is total and absolute nonsense. Practitioners that supposedly work with this energy can't tell the difference between a body under a sheet and a heater under a sheet. There is no scientific validation of any of this energy. Has this prevented Chinese Medicine from amassing a MASSIVE library of books and learning and diagrams? Nope! It takes years to get a certification in Chinese medicine, even though the theory itself is based on bullshit. There is a TON to learn! But it's all based on total garbage, though it might contain some effective treatments.
I'm not saying that therapy is based on total garbage, I am saying that research has not led to better outcomes, and that we shouldn´t be dazzled by an enormous library into thinking we're making definite progress.
I think, fundamentally, therapy can NEVER be a science. Not that you can´t measure outcomes and inputs, etc., but there is such a WILD variation of how to even define a problem that therapy is ultimately an extremely subjective enterprise.
That said, I do think therapy can be helpful, but I honestly think the "systems and science" perspective actually makes therapists worse practitioners, encouraging people to lose contact with their client and consider them as an abstract puzzle to be solved instead of another human being to relate to. And, of course, it CAN also help a therapist gain insight into the issue which can also be shared with a client. I'm just saying everything about therapy is very messy and it's much more complex than just, "read this and you'll have better outcomes."
I mean, one of the dominant theories about why therapy works is the relationship between the therapist and the client, and if you ask around for "how to be a better therapist", you're more likely to find a set of skills you want to be monitoring when you're talking with people than a list of books you should be reading. Not that you shouldn´t be reading, of course, just that it might not have anywhere near as much impact as being keenly aware of how you are interacting with your client. That's why I think the "system and science" business has to be taken with a grain of salt and that ultimately maybe therapy is more about two people meeting each other than an educated professional applying a knowledge base to cure someone. But such a belief is extremely threatening to the professionalization of therapy, a professionalization which, not surprisingly, serves the people who can afford to go to school and who can be trained to excel in testing (btw, testing requirements for licensing have not been shown to improve client outcomes, but they have been very effective in keeping out minorities).
I legitimately think that this is a situation where you can follow the science into becoming an unbeliever, the same way studying the bible will make you an atheist. You don´t have to believe me, just follow the research closely. If you don't want to read the a whole book, ("Heart and Soul of Change"), then at least familiarize yourself with the parameters of the "Dodo Bird Theory" debate (https://en.wikipedia.org/wiki/Dodo_bird_verdict), and if you just want to listen to a podcast about it, Very Bad Therapy is two student therapists struggling with the research.
Sorry for the fire hose of information.
So what you're really saying is therapy IS great and vital and people have been getting therapy this whole time but just not calling it that
Your sophistry does not interest me.
It ain't sophistry, you are the one who claimed identity between the two things
I'm used to being pretty defensive on this topics, so... sorry.
What I'm pushing against is that therapy has any kind of unique monopoly on alleviating human suffering. That if you are suffering, the ONLY thing you can do is see a professional trained and certified and licensed therapist.
If you want to call reading, Boethius' Consolation of Philosophy, "therapy" I suppose that's valid; but so is riding a horse, or taking a walk in the woods, or petting your cat, or singing a song...
Yeah, I think in fairness most therapists would agree that many things are therapeutic outside of therapy. In fact many therapists do see themselves as a sort of emergency solution but not something you regularly need in the way you regularly need to brush your teeth. Pop-psychology randos online may act like therapy is nonnegotiable, but I fear that this then results in people attributing those claims to actual therapists and discrediting what is indeed a very valuable thing that (IMO) most people could benefit from. Unfortunately few people can read well enough to even get through the first chapter of any non-contemporary writing (even when its not philosophical), and therapists do also have a lot of scientific knowledge as well.
We must know different people. In my social circles, I know a bunch of people who would really benefit from therapy and think that climbing a mountain and reading Nietzsche is all they need. And honestly, that may be true, but they don't actually end up doing either of those things because they found them too difficult. Which brings me back to like "maybe first just talk to the person whose whole expertise is to help you with this".
Its a middle ground. Therapy is not a necessity or silver bullet, its also not useless or a scam. And in my experience the people who insist they don't need it are the ones who need it most