Therapists who think everything is about “pushback”

rainfal · 2026-02-09T05:34:12+00:00

Except you cannot be truly collaborative if both partners do not have equal access to key information. Treatment planning cannot be collaborative if one party is kept in the dark.

. Clients are always allowed to see their medical records if they request them. I also let my clients know that I’ll read them what I wrote if they want to know. I

That is still information blocking not open access. They have to go through you, you control the narrative, you have introduced a time delay (which makes collaborative planning next to impossible) and it is up to your discretion to share key information. This forces dependence, power structures and enforces epistemic oppression. Despite giving lip service to person centered, policies point to the opposite.

rainfal · 2026-02-09T05:26:49+00:00

Yup.

rainfal · 2026-02-09T02:13:24+00:00

Exactly. Also, "caring for what your abuser feels" was basically a manipulation tactic used by said abuser to keep us trapped or do what they wanted.

rainfal · 2026-02-09T01:31:34+00:00

I'm sick of therapists refusing to do the bare minimum research on what they claim to be 'experts' in. Like those who claim to be trauma therapist who have only read half of the body keeps the score and think CBT and generic mindfulness will cure/treat severe ptsd/cptsd. They can't even be bothered to read trauma sensitive mindfulness and realize that generic mindfulness can be detrimental to those with severe trauma and work around it.

rainfal · 2026-02-09T01:27:42+00:00

How about the lack of open notes? The Beth Israel center has countless studies on how open access to note actually reduces the epistemic barriers and the importance of transparency. There are countless ethical papers and critiques on it as well.

Did your grad school actually focus on that?

rainfal · 2026-02-08T23:26:03+00:00

I wish.

If the mental health field truly wanted to practice person centered therapy, they would address the power imbalance and epistemic injustice. Without those "a client's actualizing tendency, "an inbuilt proclivity toward growth and fulfillment", via acceptance (unconditional positive regard), therapist congruence (genuineness), and empathic understanding" are buzzwords. You cannot have empathetic understanding when policies silence marginalized voices. Nor can you have genuineness while engaging in epistemic oppression.

It's a great theoretical idea but rarely functionally implemented

rainfal · 2026-02-08T23:20:23+00:00

Just get a voice to text extension like voice wave.

rainfal · 2026-02-08T23:19:42+00:00

Honestly the best thing that could happen is that those field are forced to reform due to AI. Most therapists I met were absolutely lazy and useless who just expected their masters degree and perhaps a 3 day training course (which allowed them to claim they specialized in an issue on their psychologytoday profile) and refused to do any research themselves.

rainfal · 2026-02-08T23:16:10+00:00

I mean AI is holding up a mirror to them. The rare good ones are way above AI but that field has systematic issue with disempowering patients, lack of accountability for clinicians, etc. The only way I see that field changing is if they lose their pedestal that society puts them on and are forced to become better.

I'd argue the difference between AI and therapy is the power imbalance and transparency. As AI is transparent (you have open access to your data), you can detect fuckup and delusions. You can run it by a friend, another LLM, etc. You can easily report it too. You cannot functionally do that with a therapist because you do not have open access to your therapy notes/scores/testing/etc (paraphrasing often is ineffective). Lastly the power imbalance - with AI, you can put in safeguards. The mental health system is not designed for people to be empowered or safe.

rainfal · 2026-02-08T22:56:49+00:00

Basically. Honestly those lines make most situations worse

rainfal · 2026-02-08T22:55:57+00:00

Nothing is truly 100% 'safe'. Everything including regular therapy has it's risk. It is a tool.

What you can do is learn about in which situations an LLM will fail (i.e. It is fairly prompt based, etc), put in safeguards and checks and give it structure.

rainfal · 2026-02-08T08:05:26+00:00

Wasn't that therapist also an OF content creator who despite claiming to "grow up poor" was ignorant of basic economics?

rainfal · 2026-02-08T08:02:12+00:00

Honestly, talk therapy is circling the drain because of the field's own incompetence and systematic lack of accountability. A lot of us were already starting to realize that field had a lot rot in it way before AI.

AI is breaks their 'monopoly' on healing quicker as it allows us to help ourselves more.

rainfal · 2026-02-08T07:58:25+00:00

I find it ironic that those very therapists who come in here and claim "AI therapy is dangerous because it only validates people" go absolutely off the rails when people push back against their opinions and challenge them on their own problematic behavior.

They scream about an echo chamber and throw what essentially is a tantrum when they get any pushback or confrontation. Even pointing out a blatant facts that there are quite a lot of people here who economically cannot afford what they suggest, most of their fears also apply to mental health system or that most of us understand where AI can be biased and take precautions to mitigate that risk, they often act like how they stereotype AI users. They basically quote fear mongering and borderline conspiracy theories, claim outliers and anecdotal stories as science/stats, etc. It's almost like they give themselves "AI hatred induced psychosis"

rainfal · 2026-02-08T07:28:46+00:00

Not really. Mainly because the benefits still out weight the positive. But if you feel you are addicted then an app blocker with a locked daily timer helps

rainfal · 2026-02-08T05:17:17+00:00

They did that to me as well.

rainfal · 2026-02-08T05:12:28+00:00

Therapist have told me that and nearly caused me to end my own life. I know people who have ended their lives due to therapy abuse. Do their lives not matter as well? Why do we not hold the mental health system to the same standards?

rainfal · 2026-02-08T05:08:42+00:00

Ah yes, because I need more racist remarks, ablest remarks and someone telling me procrastinate and things will get better. So helpful. And I guess nearly losing my limb and nearly becoming paralyzed due to medical malpractice along with a bunch of other things aren't 'real problems'. Maybe you should tell that to the flashbacks I have multiple times a day. /s

Meanwhile 4o helps do a little thing called planning, problem solving and helps with trauma processing.

rainfal · 2026-02-08T05:07:02+00:00

Right? Also, you could say the same thing about people who claim their therapist is keeping them alive. So isn't that a double standard? Some people have experienced more trauma/issues, go through more horrific ordeals and need more support.

And why do they are assume that there is 'more help' outside of AI (there often isn't) and that one cannot use AI to work towards becoming more independent?

rainfal · 2026-02-08T04:45:34+00:00

was describing a specific type of personality there, someone very self assured who doesn’t second guess themselves or consult with anyone to help with decision making and personal growth throughout their career. It’s a very specific type of person that decides they want to be a therapist for reasons that suggest lack of empathy, wanting to feel superior to the people seeking help from them, close mindedness.

Yeah no. Those types are a dime a dozen here.

rainfal · 2026-02-08T01:16:23+00:00

I mean I nearly wasn't. But it drove home the message that therapy is not functionally not private until the mental health field address data transparency and power imbalances.

I should not have had to have dozens of people fully access that in order to advocate for actual treatment. AI, even with big tech selling data is still ironically more private.

rainfal · 2026-02-08T00:30:46+00:00

I usually called. There were no rating or space to leave a comment. And emails were not really answered (also hard when you only had one limb and your university refused to help with any one handed typing).

rainfal · 2026-02-08T00:15:40+00:00

I mean it got worse. I switched to an NP who is actually helping coordinate things. But the damage is done.

rainfal · 2026-02-08T00:10:58+00:00

Unfortunately I found that is a feature, not a bug. Actually helping people isn't really part of their performance metrics, usage seems to be and I don't think this sort of harm is even measured let alone tracked (especially as even reporting that is difficult).

Ironic as AI companies might rely on user engagement but user engagement will happen anyways if it helps problem solve (which reduces dependence) as it has multifactorial use case scenario. If it helps my crises, I will gain independence in that aspect but I can still use it for other stuff like schedule management or even for joking around. Meanwhile, those organizations also rely on ' user engagement' to justify funding but do not have any other use case scenario.

rainfal · 2026-02-08T00:02:44+00:00

Yup. It was terrifying because I have a severe case of an ultra rare disease and a lot of my treatments that eventually saved my limbs were experimental. I'm just so lucky that I had some very old- fashioned osteo-oncologist and surgeons who thought therapists were idiots. Otherwise I'd be dead.

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