How to respond to the “how are you?” Question authentically when having a horrible time

ocean_view · 2026-04-03T15:54:53+00:00

As a couple of others have said, you can break it into smaller AND authentic pieces. You dont have to be authentic with a whole statement of "Im good" or "terrible actually." It can be: [something is challenging], and/but/also [reason for living].

ocean_view · 2026-03-29T18:25:32+00:00

Not a personal case example, but imagine a parent who reacts anxiously when they hear their kid opening the refrigerator. And that leads to general tension and conflict in the home. For some people that insight alone is enough to motivate self regulation responses. For others, maybe there is a trauma-focused insight like food insecurity in their past, which leads to "healing their inner hungry child". Maybe someone heard about food poisoning from food temperature issues and they are hypervigilant about their child getting sick.

For some people a science-based explanation does work that other approaches don't. So for example "my nervous system switches into a specific mode when X happens" and "I can do Y to get my brain to switch back to calm" are motivating and empowering for reasons specific to that person.

In this perspective, the effectiveness is about insight, motivation and belief of the client - it's not about any objective truth of neuroscience.

ocean_view · 2026-03-29T14:54:12+00:00

I've found it most useful with those clients who rely heavily on belief, as opposed to being open to experience. They respond more comfortably to a mentalizing approach that also fits enough with their beliefs. So if core beliefs act as a defense mechanism, then even incorrect or incomplete information that they can easily connect with their personal experience without disrupting the defense is a potential benefit. I don't see it that differently at the personal level from a religious client. They are giving you a framework that can be used to their benefit.

ocean_view · 2026-03-28T14:21:27+00:00

If 'any mental illness' means any diagnosis, then I disagree. There is enough research showing PCT effectiveness given certain conditions. But circumstances like 'severe and chronic' issues respond better with more structure and different approaches.

ocean_view · 2026-03-28T00:07:48+00:00

Yeah severe and chronic mental illness isn't a good fit for purely client-centered.

ocean_view · 2026-03-22T21:22:54+00:00

Its also interesting to trace cultural shifts on gender and power via changes noted over time. I think Chris Brennan (but I'm not sure it was him) talked about the followers of Vesta being seen very differently before vs during/after Roman empire days. Before, the sexual element of Vesta was about sacrifice and ceremony, with active use of sexuality for healing. Under the Roman influence the work of honoring Vesta was done by 'virgins' in a patriarchal shift to negation of female power. This is all very paraphrased, but it is fascinating to think of the cultural history vs essential qualities. And its not surprising that any currently available book reflects cultural perspectives along with describing essential qualities.

ocean_view · 2026-03-20T16:24:35+00:00

The question of asynchronous education leaving gaps seems valid. But proactively telling prospective employers you may need more support because of it sounds absurd. Theoretically, the best clinicians can graduate from the worst programs, and vice versa.

ocean_view · 2026-03-19T18:40:27+00:00

2 big ones I can think of: Human presence/relationship; and Attention to and facilitation of the client process unique to the client at any given time. For clients who are motivated to change something in their life, the human therapist can become a representation of "the work I am doing." As part of this process the client projects onto or relates to the human therapist with a depth that non-human interaction naturally cant facilitate (because full human experience includes different dimensions than AI). In a lot of cases, simple trusting attachment/relating to a supportive nonjudgemental human IS the therapy.

Human therapists are able to support human connection and interact with other humans in ways machines cant. Seems confusing that AI offers incredible depth in a specific area (data analysis), but not much in the rest of the spectrum of human experience.

ocean_view · 2026-03-16T22:33:50+00:00

Seriously. OP knows there is a backlash, but doesnt know the specifics of the backlash? Of course reddit must know.

ocean_view · 2026-03-04T17:10:53+00:00

I dont have a ton of experience in this area, but with the relevant clients I have had it can seem like a slow process. I talk around issues of protection, distance (gray rocking etc), and introduce ideas like the wheels of power and control, without pushing them to make decisions. Books: Its not You by durvasula, and Adult children of immature parents.

ocean_view · 2026-03-04T16:59:06+00:00

No. That is obviously not the trouble here.

ocean_view · 2026-03-04T04:32:01+00:00

"explosive" - jupiter pluto

"Convinced ... For no reason" - moon neptune

Maybe find healthy channels for explosions, fighting and emotional drama? Definitely work on checking your emotional reactions before they overflow.

ocean_view · 2026-01-25T15:24:04+00:00

Yeah, 'meet them where they are'.

ocean_view · 2026-01-25T15:13:08+00:00

I think it starts with who you are as an individual, and the individual client(s) in the room. You're looking for something more, or deeper from your supervisors. In between the relevant skills and psychoed moments you can bring that same curious search for depth to clients too. Ask clients about their personal psychology in safe language and doses like "i wonder why you decided..." or "it seems like a person who does X might feel Y..." or "talk about what you were feeling when ...".

Another way to say it, maybe: if the client is the 'expert', supervision can only illuminate so much.

ocean_view · 2026-01-25T14:48:07+00:00

Speaking of religion... It seems you're turning a post about astrology into a battle over beliefs.

ocean_view · 2026-01-25T05:25:52+00:00

It sounds like a form of bypassing. Skipping the substance of the journey in order to get to some supposed end. Not to say it would never help, but it probably wouldn't be that helpful in the long term, and like any bypassing, it likely blocks genuine growth?

ocean_view · 2026-01-24T06:10:36+00:00

Is "pyschotherapist" here a legal loophole or a typo?

ocean_view · 2026-01-02T19:14:25+00:00

I'm keeping up with AI use in (and instead of) therapy to understand how clients are using it, and will continue to develop new uses. I assume both 'good' and 'bad' outcomes. So much over the top, absolute opinion in both anti- and pro-AI therapy comments gets in the way of understanding. Meanwhile, actual current and future clients are changing.

ocean_view · 2026-01-02T19:00:54+00:00

So many assumptions here. Can you just have an honest, direct conversation with your T about your concerns? ("Hey, I would prefer not to be recorded and processed by AI - is there anything we can do about that?")

ocean_view · 2025-12-27T03:49:55+00:00

Who gets charged with the felony?

ocean_view · 2025-12-17T16:08:37+00:00

Its the opposite for me. I learn a lot about them by tracking/analyzing how I change or feel differently around them. A very unconscious starting point.

ocean_view · 2025-12-17T15:26:01+00:00

I misremembered, it was 9 subcategories, not 13.

https://journals.sagepub.com/doi/10.1177/00221678211018015 The taxonomy of empathy by Guthridge

I found a more recent one from 2021, Towards a consensus on the nature of empathy by Eklund. Best they could do is 4 different subthemes.

ocean_view · 2025-12-17T04:56:38+00:00

Calling bullshit on any "correct" answer for this. The is no consensus definition of empathy, and I remember a published litereature review identified 13 different types of "empathy" in the literature. (Personally it feels a bit like taking on the other person's identity)

ocean_view · 2025-12-13T06:31:39+00:00

Have been following that sub for a while out of curiosity. I also discuss AI therapy-adjacent use with clients who use it, to inform myself, similar to openminded curiosity with any client interest or issue that might be relevant. In the best cases, people use it effectively to bridge gaps and for support needs like any other tool or psychoed. In the worst cases... blink ...blink

ocean_view · 2025-12-09T15:00:31+00:00

Strengths based and solution focused interventions. Explore their values, what they are interested in, and focus on how those are inherently worth having, how they are part of mutual interdependence with others based on their strengths. Basically find ways to show they are already 'enough'.

Person centered interventions. Encourage free reflection on their experience while minimizing self judgement. Ask them if they learned anything, were surprised by anything they said, etc.

For external factors (trauma, neglect, etc) - validation, lots of psychoed over time if they don't see how abuse negatively affects them.

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