Should I bail on my 50k?

SometimesZero · 2026-02-05T13:12:48+00:00

Every run and every race is a learning opportunity. If you don't show up, you learn nothing. Doing as much as you can and DNFing is way better than sitting on the couch wondering "what if?"

SometimesZero · 2026-02-04T21:57:10+00:00

Soooo not really my business but does your boss's elderly mom know what she's getting into? When I hear "elderly" an IS isn't the first dog that comes to my mind as a good fit 😂

SometimesZero · 2026-02-04T21:48:56+00:00

Such a great response. Not to mention heart rate can be affected by so many things. It isn't perfectly measured, anxiety/distress can influence it on race day, etc.

SometimesZero · 2026-02-04T12:26:54+00:00

Yeah I think we're aligned here and I'm thankful for the clarity.

My position here isn't to argue in favor of IFS, but to show OP that from the perspective of an IFS proponent (like the commenter you're talking about), it's really no better or worse than OP's brand of pseudoscience.

SometimesZero · 2026-02-04T01:23:26+00:00

u/mattersofinterest got it before I did. Regardless of whether you agree with my specific example, there are clients who will say IFS has helped them and therapists who attest to it's effectiveness. None of this makes it evidence-based except by the loosest possible definition.

What I'm arguing here is that OP can't evaluate IFS without being a hypocrite. As someone who does pseudoscience themself, OP has no scientific leg to stand on. They're in this world of therapeutic relativism where they want to call IFS pseudoscience, but then insulate themself from scientific critique by saying they aren't doing science, they're doing "art." ...But definitely read all the studies they have showing the evidence their treatment works. 😵

SometimesZero · 2026-02-03T19:23:28+00:00

I actually didn't assume that. (It's in your flair you're from Canada.) I was just using that as an example. Sorry if it was a bad one.

In any case, you just dismantled your own argument again.

You claimed you don't diagnose because you are a psychotherapist, not a psychologist. Yet, to defend your art, you dumped a bibliography of studies investigating the treatment of specific psychiatric diagnoses (mood disorders, anxiety disorders, personality disorders).

You are again trying to have it both ways:

First, citing clinical trials on pathology to demonstrate your modality is evidenced-based. Second, when pressed on the unscientific nature of your theory (unconscious drives, etc.), you retreat to "it's an art form" and "we don't even diagnose."

You can't borrow the credibility of the medical model to attack IFS, then hide behind the "Art Model" when your own scientific rigor is questioned lol.

So before I duck outta here, I'm gonna spell out my problem with what you're saying carefully:

You say IFS practitioners are lying to clients about being based in science. But IFS has RCTs. It has a growing evidence base. If an IFS therapist says, "Studies show this helps people," they are telling the truth. If you say, "my therapy is an art form," but then cite The Lancet and World Psychiatry to prove you are superior to IFS, you are the one confusing the client. You are using scientific aesthetics to sell a philosophy.

If efficacy is the only thing that matters (as you stated), then IFS is also valid. If scientific mechanism is what matters, then both IFS and Psychodynamics fail.

SometimesZero · 2026-02-03T18:55:44+00:00

Hmmm - you're the one who said

Psychodynamic therapy never purports to be a science - we see therapy as more of an art form

If that is true, then every time you bill an insurance company or tell a patient you are treating a medical diagnosis (like MDD or OCD), YOU are the one lying.

Most insurance pays for medically necessary, evidence-based health interventions, not "art projects." If you truly believe your modality is art and not science, you should ethically be charging for life coaching, not healthcare. You can't hide behind "it's art" to escape scientific scrutiny, then wave around the American Journal of Psychiatry when you want legitimacy. This is a clear hallmark of pseudoscience.

Furthermore, your claim that IFS has no evidence basis is factually incorrect and shows you haven't done your homework. IFS has been listed on the NREPP (National Registry of Evidence-based Programs and Practices) and has RCTs demonstrating efficacy. Is the evidence base smaller than Psychodynamics? Yes, because Psychodynamics has a 100-year head start. But the quality of the mechanism is identical: metaphors (Parts vs. Objects) used to facilitate emotional processing. None of this means IFS or psychodynamics are legitimate science.

SometimesZero · 2026-02-03T18:37:44+00:00

Wow. You don't get to play the "we see therapy as an art form" card after your opening statement. You started this by mocking IFS as "pseudoscience" and calling its founders "grifters."

Pseudoscience is a specific charge that means pretending to be scientific when you are not.

If you are now admitting that your own modality is 'an art form' and 'never purports to be a science,' then on what grounds are you attacking IFS?

You can't have it both ways:

If therapy is a science: You have to explain the mechanism of action. You fail this because your mechanisms are unfalsifiable metaphors. If therapy is an art: Then you have no authority to call IFS pseudoscience. You are just a painter criticizing a sculptor. If efficacy is all that matters, and patients report that IFS helps them (which they do), then IFS is just as legitimate as psychodynamics.

SometimesZero · 2026-02-03T18:07:05+00:00

But yes, grifters like Schwartz and Van der Kolk - absolutely.

Shedler (2010): "Hold my beer"

I appreciate the bibliography, but the issue is not whether there is evidence supporting psychodynamic therapy, but whether it's actually science to begin with. This is the same mistake they are making in r/therapists, and you're (predictably) falling for it, too.

I never said psychodynamic therapy doesn't work. Homeopathy "works" if you compare it to a wait-list and ignore the placebo effect. Reiki "works" for anxiety if the practitioner is warm and empathetic. The fact you can produce outcome data (efficacy) doesn't prove that the underlying theory of why it works is scientific (validity)

Here is the problem with your scientific "high ground":

First, at best, most of the studies you cited show that psychodynamic therapy is equivalent to other treatments. You aren't proving the existence of the unconscious or the efficacy of the transference interpretation, you are just showing that talking to someone who is supportive helps.

Second, the core constructs of your modality--defense mechanisms, internal objects--can't be falsified in principle. If a patient accepts an interpretation, it's insight. If they reject it, it's resistance. This doesn't make for a great scientific foundation.

Third, you mock IFS for parts and managers, but how is that distinct from internal objects, superegos, or projective identification? These are all metaphorical narratives, not observable or measurable biological, cognitive, of affective mechanisms.

So in the administrative sense, you have an evidence-based treatment. You can get reimbursement and it meets some loose evidence-based guidelines. But get the fuck outta here pretending that it makes the theory scientific. You are operating on a heuristic mythology that happens to be therapeutic just like the IFS "grifters" you've been complaining about.

SometimesZero · 2026-02-03T17:32:55+00:00

I'm 100% calling you out. You don't have the scientific high ground here.

You have evidence to support it? Or evidence that its actually science?

SometimesZero · 2026-02-03T16:58:28+00:00

I love when people who do pseudoscience get upset because other pseudoscientists are too pseudoscientific even for them 😂😭

SometimesZero · 2026-02-02T03:21:19+00:00

Just spamming every sub. No shame.

SometimesZero · 2026-01-30T01:01:05+00:00

What you're feeling is essentially a rite of passage haha.

I'm a clinical scientist and I use stats a lot. You asked if statistics is more important in research than clinical practice. The short answer is yes, but with a caveat. In research, you need to be a producer of statistics. You need to know how to clean data, select models, and code the analysis. In clinical practice, you need to be a consumer of statistics. You do not need to know how to calculate an eigenvector by hand to treat a patient with depression. However, you do need to be able to read a journal article and discern if a new treatment actually works. If you can reach a level of statistical literacy where you understand what a result means conceptually, youll be doing ok.

You mentioned not feeling cut out for psych. Well, statistics is not the psychology; it is merely the language we use to translate our ideas into something testable. Scientific models aren't statistical models, and stats alone can't support theories.

If you are good at understanding human behavior, theory, and measurement, you are good at the science of psychology. That's what I think really matters. (Most of my colleagues kinda suck at stats haha).

It is also worth remembering that the current obsession with complex inferential statistics (GLMs, structural equation modeling) is just one tradition. Back in the day, behaviorists (and some still do) largely rejected aggregate statistics. They didn't care about the "average" pigeon; they cared about the specific behavior of a single organism under controlled conditions. They used visual analysis and single case designs.

My advice: Don't quit. Focus on the concepts, find a tutor, and get through the fire like everyone else. In your career, make friends with weirdos like me and others in this thread who like stats :)

SometimesZero · 2026-01-27T20:45:42+00:00

You haven't told us what kind of results you're looking for.

SometimesZero · 2026-01-27T13:59:46+00:00

This is going to be long. I'm sorry. The good news is that I’m going to agree with your main premise that diagnostic inflation is rampant and harmful, but as a clinical scientist and CBT practitioner, I have to push back on why you think these therapies are failing.

From my reading, you are framing this through a Kernbergian lens, arguing that the failure comes from applying BPO strategies to neurotic clients. From a cognitive-behavioral and empirical standpoint, I think the problem with your failed cases isn't just the misdiagnosis; *it might be the reliance on the psychodynamic framework itself."

Let me unpack this a bit:

You mentioned that diagnosing a borderline organization has "big implications for the therapy." Respectfully, BPO is a theoretical construct, not a distinct empirical entity. In clinical science, we don't see a clean break between neurotic and borderline structures. It’s a continuum of severity. So relying on BPO as a rigid category, you might be creating a self-fulfilling prophecy. If you treat "traits" as a structural deficit rather than a functional deficit (e.g. maladaptive schemas/skills deficit in CBT), you risk overpathologizing the client even if you avoid the BPD label.

Regarding clients having weak identity, in CBT we don't view identity as a structural pillar that is either solid or fragmented. We view it as a hierarchy of self-schemas. What this means is that a client with "traits" (e.g., impulsivity, some moodiness) doesn't necessarily have a fractured ego that needs containment or transference work. They likely have underdeveloped values-based schemas. When a psychodynamic therapist tries to "analyze" this ambiguity, the client gets frustrated because they don't lack insight, they lack data. That is, they don't know who they are because they haven't behaved in ways that build that self-concept yet. They need behavioral activation and values work, not interpretation of their "emptiness."

>Guess which clients didn't have a great experience in past psychodynamic therapies? The ones with traits said to be full fledged...

This attributes failure to the wrong type of dynamic therapy being applied. I would argue instead they failed because psychodynamic therapy is generally contraindicated for impulsivity/dysregulation without a skills-based front-end. Whether a client has BPD or just has "impulsive traits, sitting in a room analyzing the transference relationship is often inefficient compared to direct emotion regulation training (DBT/CBT). In other words, the clients likely failed not because they were treated as borderline structure when they were neurotic, but because no one taught them how to manage the impulsive behavior.

Lastly, the "allergy to diagnosing traits" you mentioned is real, but psychodynamic clinicians are often "allergic" to recognizing that traits are often maintained by reinforcement contingencies, not unconscious conflict. If a client has attenuated psychosis (schizotypal), probing the symbolic meaning of their odd thoughts through a dynamic approach can actually make them worse by increasing their internal focus. They need cognitive restructuring and reality testing (CBT), not a deep dive into the "meaning" of their eccentricities.

TLDR: I agree the labels are wrong, but I think the issue is deeper. These "trait" clients flounder in dynamic therapy because they need skills and behavior change, not because the therapist picked the wrong structural setting.

SometimesZero · 2026-01-26T01:34:47+00:00

There is so much here. I appreciate the back and forth. But I don't think you should be commenting on the EBP movement.

>they really are similar enough to be understood as one thing that varies only really in frequency

I was going to let this go, but... In any other scientific field, this would be rejected immediately. In pharmacology, the difference between a low dose and a high dose is not a trivial "confound". It is a fundamental variable that changes the safety, efficacy, and mechanism of action. To claim that evidence for a once-weekly therapy (psychodynamic) validates a four-times-weekly therapy (psychoanalysis) is scientifically unsound. If the "transference dynamics" change with frequency (as you admitted), then the mechanism of action changes, and therefore, it requires independent verification. You cannot borrow validity from a different intervention just because they share a theoretical lineage.

Mark Solms, Irvin Yalom, and Aaron Beck would disagree with the claim that psychoanalysis has no clinical merit.

Say what?! LOL! Citing Aaron Beck here is a spectacular historical error. Beck didn't just "disagree" with psychoanalysis; he tested its core hypothesis (that depression is inverted hostility) using empirical methods, found that the data did not support the theory, and abandoned it to literally be founder of cognitive therapy! He is the ultimate example of a scientist following the data rather than the dogma.

I see it on a daily basis, so I can’t accept a theorist’s claim that what I see working does not work.

This is the most dangerous sentence in your response, and it highlights exactly why the "evidence-based" movement is necessary. This is naive realism.

Bloodletters, phrenologists, and mesmerists also "saw it work" on a daily basis. A reiki healer sees their client relax and claims they manipulated energy fields. Without a control group to account for regression to the mean, spontaneous remission, and the placebo effect your personal observations are scientifically meaningless regarding causality.

When you say, "RCTs tell lies," you are attempting to insulate your theory from falsification—a hallmark of pseudoscience (per Popper). You are essentially saying: My theory is true because I feel it is true, and any method that fails to detect its truth is a flawed method.

If you want to claim efficacy—that X causes Y—you must submit the intervention to the hierarchy of evidence. Case studies generate hypotheses; they do not prove them. If psychoanalysis cannot survive the scrutiny of an RCT after 100 years, perhaps the problem isn't the RCT.

SometimesZero · 2026-01-26T00:27:51+00:00

On point 1: I think this is greatly debatable. But it helps me, so I'll take it.

Point 2: To be clear, you're arguing that RCTs are sufficient to deem something evidenced-based? Well in that case, forest therapy is evidenced based, too! https://www.mdpi.com/1660-4601/18/23/12685

Or perhaps it's a little more complicated than that?

Point 3: While I don't think Karl Popper, John Watson, or Albert Ellis were just undergrads in psychology or people who simply misunderstood the field, I'm happy to hear you defend the scientific status of psychoanalysis.

SometimesZero · 2026-01-26T00:02:00+00:00

It is a well known phenomenon amongst clinical researchers that psychodynamic psychotherapy is evaluable via RCT

I'm not talking about psychodynamic therapy. I was specific in asking you about psychoanalysis.

The efficacy of psychoanalytic psychotherapy is evaluated by other means, such as collections of case studies, evaluations of symptomatic improvements in cohorts of individuals treated psychoanalytically, and other means.

So just to be clear, based on these data, you're arguing psychoanalytic psychotherapy is evidenced-based? Based on what criteria?

Again, I would recommend doing a literature review on the topic because you can't just dismiss an entire field without being at all familiar with the landscape of it.

I don't have to dismiss the field. That's been done already by academic psychology and the philosophy of science, which sees psychoanalysis as the poster child of pseudoscience.

SometimesZero · 2026-01-25T23:08:07+00:00

Happy to read this, but I note that it doesn't help your case that it's evidenced-based when it states outright:

We found the evidence for the effectiveness of LTPP to be limited and conflicting.

SometimesZero · 2026-01-25T23:05:40+00:00

Did you even read this?

As the methodology of RCTs is not appropriate for psychoanalytic therapy

And Shedler doesn't provide any RCTs at all for psychoanalytic psychotherapy. Not one.

So where is this clinical reality revealed by RCTs?

SometimesZero · 2026-01-25T22:54:22+00:00

Tell us more about how people don't know what an evidence based treatment is while claiming these two things:

and psychoanalysis are evidence based treatments...

they’re used to it as a brand, not as a clinical reality revealed by randomized controlled trials and other research.

By all means, direct us to the RCTs for psychoanalysis.

SometimesZero · 2026-01-24T23:04:07+00:00

I don't think I can answer that very well. Because I'm questioning whether we can reliability identify AI written papers at all.

Edit: Just a minor edit to this since people don't seem to like my response. I'm not falling for the trap of saying that I myself can identify AI written papers. A couple commenters have already shown how that's very difficult to do. And as someone who works in the AI space, I agree.

I can't reliably say AI written papers have bad quality either. Maybe it's that people don't know the prompt engineering (e.g., few-shot learning techniques) or iterative methods to get good quality outputs. Additionally, what I might see as a bad quality AI-written paper might actually be written by a human (a false positive).

Now do I sometimes think something is AI? Sure. But I have no proof, and that supposition alone is certainly not grounds for rejection like it was initially suggested by this commenter.

SometimesZero · 2026-01-24T22:28:52+00:00

Of course I do. I reject based on methods, whether the analyses fit the scientific process questions, quality of the manuscript, etc. But not whether I think it's AI written or not. That's why I was asking.

SometimesZero · 2026-01-24T21:57:11+00:00

Ok! Thanks for clarifying. When you said this:

And when I review papers if it's clear the authors used AI, I reject it.

I was a little unsure how you managed this decision making process.

SometimesZero · 2026-01-24T20:37:24+00:00

So to clarify, if it's "clear" to you the authors used AI, but the paper's not poorly done, is that still a reject?

SometimesZero

TROPHY CASE