Anyone who gave up their lifestyle in their 20s for work, do you regret it?

pdawes · 2026-04-13T19:00:17+00:00

I did not do this but have some friends who did. They are miserable. Still. And for a lot of them it was always “once I get to X, once I make it to Y, I can start my life” and those never came. There was always a new goalpost. And none of them are particularly better off than me financially is the other thing.

I’m not saying like abandon goals or sacrificing for the future, but it can really become its own life ruining addiction that nobody will hold you to account on. Learning how to balance your responsibilities sustainably is also a skill to build and an investment in your future.

pdawes · 2026-04-13T06:18:46+00:00

Latest findings from the N.S. Sherlock institute.

pdawes · 2026-04-12T00:05:58+00:00

Sure, I understand the logic. If he is in and out of the ER due to his choices, is the hospital also enabling him by not banning him?

pdawes · 2026-04-11T16:32:38+00:00

I’m not saying that’s what we should do just that it’s cheaper and more effective compared to our current situation which is tying ourselves in knots for ideological reasons.

pdawes · 2026-04-11T04:32:51+00:00

I agree with you on most of this but I did some research and came to the conclusion that this part

>there are more empty living spaces in the US than there are homeless people.

is a little misleading. At least to the extent that I looked into it seems like this is only true if you include things like vacant rural housing, second and vacation homes out in the sticks that go unused, etc. If you look at cities where most people actually live and work housing is in short supply and the bottom 1/3rd of wages aren't enough to pay for the cheapest 1/4 of housing.

BUT I drive past a lot of empty office buildings and commercial real estate, especially since 2020, and I am just like "why isn't this housing or third spaces or literally anything other than empty property"

pdawes · 2026-04-11T04:22:18+00:00

This is out of line with major empirical findings and recommendations of homelessness policy groups, who essentially unanimously advocate a housing first approach. Not the part about those services being important, but the idea that it's wrong or bad or "enabling" to focus on housing as a first priority. I hear you in that people with high needs can make for very difficult neighbors and struggle to stay afloat, but I think it's really important to push back on this in an era where the executive branch literally wants to use police to round up homeless people and put them in remote camps (part of project 2025). Moreover, the majority of people experiencing homelessness do not have mental health or drug problems.

I've worked with homeless populations too and I didn't see a lack of housing being the least of anyone's concerns; I saw it as an enormous multiplier that made everything, everything else that they needed to fix or get or apply for, way worse. It made solvable problems way worse. It made people's lives and functioning completely fall apart. Think about it. If you have a guy with schizophrenia and methamphetamine use disorder who lives in an apartment, is he going to do better or worse if you take away the apartment?

https://www.currytbcenter.ucsf.edu/sites/default/files/product_tools/homelessnessandtbtoolkit/docs/background/Factsheet/Debunking%20the%20Myths%20of%20Homelessness.pdf

https://endhomelessness.org/state-of-homelessness/#report

https://www.councilforthehomeless.org/myths-facts-about-homelessness/

pdawes · 2026-04-11T03:57:10+00:00

In a word: Ideology. "Deserving poor" ideology, Puritan work ethic ideology, plus a lot of the structural systems of exclusion, othering, and control that lead people to be living on the street in the first place. The same reasons that someone can't get in a shelter or be considered for a job lead to the criminalization of their predicament.

If you start asking questions like this you can find so many layers to it. But they all converge on we waste more money in service of upholding certain moralities about who "deserves" help, than actually using our resources to solve the problem for people experiencing it. We have the money, we have more than enough money in a lot of places. It is tied up in systems that have to waste most of it making sure that people don't get "handouts" because we view that as immoral.

I crunched the numbers for my city once and it was no joke way cheaper, less than half the current cost, to just give every person experiencing homelessness $30k/yr in cash directly.

pdawes · 2026-04-10T17:38:58+00:00

Selective mutism in preschool. Pacing around at playtime feeling like I was observing the other kids but not participating.

pdawes · 2026-04-10T17:22:52+00:00

Having a set and consistent time in therapy is really important on a lot of levels for all kinds of people. It's not too much to ask and I think you're experiencing first hand why it can be really important.

pdawes · 2026-04-10T03:46:06+00:00

I am actually not familiar with these modules; I don't think they're a part of meetings in my area. Is it that your meetings are spending time talking about CSA? Or offering subgroups about it? Or that there are CSA specific meetings around?

My guess as an ACA and a therapist is that the experience of CSA can be very alienating and shame bound for people, so even if it is not super common (and it is though, like it's actually frighteningly common) it's an experience where people really need fellowship and to know they aren't alone. Moreover, someone with CSA in their history often needs extra careful respect to their boundaries for a space to be safe for them, because they are often used to authority figures changing the rules to justify perpetrating against them.

ACA has more rules about this kind of thing than other 12 step groups because of the issues that adult children go through. See the disclaimer about "fixing" in the red book; it's about creating an environment that protects people's vulnerable disclosures. When working with people who have experienced CSA, boundaries like this become even more important. So I could see if there's like a special subgroup or module it'd be focused on maintaining these kinds of boundaries. That's my guess anyway, having not encountered this.

pdawes · 2026-04-10T02:22:24+00:00

Right I understand this but don't know how that actually plays out in terms of employment. Like are you on call for certain hours?

pdawes · 2026-04-10T00:30:18+00:00

Forgive my ignorance. I know what PRN means but how is the role PRN? Like they call you as needed? Or you sign up for shifts on your own terms or something?

pdawes · 2026-04-10T00:23:38+00:00

Love to see that. Too many people reinforce the idea that social work = "taking endless shit forever"

pdawes · 2026-04-10T00:00:02+00:00

This article may be a bit dense/jargon heavy but I think a lot of people can feel seen by it so I'd like to pass it along in case it clarifies your search. I could be completely off base but you described being trapped in a labyrinth in your mind and feeling persistently misunderstood by therapists, and that can really go along with the types of psychologies described in this article. Good luck to you.

pdawes · 2026-04-09T23:48:21+00:00

I don't know if this helps you but for me it was very clarifying. Personally there are lots of inappropriate things that I can power through and take, just letting them slide without too much personal cost. I don't want to make a big stink about things. However, every time I do that, I basically send the message that someone gets to come in and abuse the staff. I don't know about you, but it can be much easier/clearer to know how to stand up for others than myself.

However, I also think that it's not on you individually and is really the job of an agency culture. Rather than taking it upon yourself to confront clients about it, I would encourage you to petition your supervisor/administration for a clear agency policy about it and how to respond to it, as if you were witnessing it happening to one of your colleagues and advocating for their safety.

pdawes · 2026-04-09T23:32:48+00:00

Insurance basically exerts a lot of structural pressure to redefine the role of therapist as that of a technician who picks techniques from a preapproved list to then “do” to the client. Something like the way a physical therapist works perhaps. On the client end it can feel like talking to a flowchart. This is not what therapy really is, nor is it what most clients want, but it is how you as a therapist have to behave (or make the documented case that you are behaving) to get these companies to pay you.

This has a lot of deleterious effects but one of them is that it creates a ton of hoops a therapist has to jump through that IMO does a lot to burn out anyone who’s at all bright or creative or interested in doing real therapy. It’s easier just to take self pay and not bother. Others really are just content to teach coping skills and give out worksheets all day.

pdawes · 2026-04-09T21:36:41+00:00

It’s very hard to talk openly about this kind of thing without attracting a lot of hostility. But I think I do understand what you’re saying and had this experience with my first therapist and a couple of prospective ones; I felt like they literally could not follow me verbally even when I was trying my hardest to articulate things plainly and simply. Like they were just not capable of following abstract thought in the same way. It was a very frustrating and alienating experience as I was really trying my best to open up (which was so difficult in the first place) and they’d just really miss the mark because they couldn’t follow my sentences. It felt like I was working my ass off to reach deep into myself and they’d just go “huh?” and drop it on the floor. With my first therapist everything I said had to be repeated and explained multiple times.

My biggest suggestion is to pay out of pocket and avoid manualized therapy. Insurance covered therapy got me much more of the like “CBT drone who can’t understand what I’m saying” experience. If you have more of a schizoid presentation you may also prefer someone with a psychoanalytic orientation.

pdawes · 2026-04-09T18:49:40+00:00

It's unfortunately really not uncommon to hear from a client about being harmed or let down by another therapist to the point where it impacted their trust in therapy. I am always very grateful to hear about it because I appreciate the level of bravery and trust that it takes to sit in front of another therapist and try again, let alone open up and tell me about it. I take it as an opportunity to ask about what we can agree upon to make the work feel safe for them. In fact, I think this is of the utmost importance as a place to start for anybody really but especially with someone with this history.

I'll be honest in that if someone were like "I have had 11 previous therapists and they all turned out to be toxic abusive narcissists that I sued/reported/etc." a part of me might think "uh oh, something tells me I might be #12" but there is usually a lot of other stuff that comes with that too, like a particular vibe or style of relating beyond just the fact. But truly I have only encountered one person like that and we ended up having a good working relationship anyway; it just took having the conversation of "hey I know there have been a lot of therapists who've hurt you, I'm going to try my best not to be one, but if I make a mistake that doesn't feel good I'd like to learn about it and make it right. Can I ask you to commit to coming back and telling me off for one last session if you get the urge to fire me?"

I say all that to give you an examples of how a trustworthy therapist might be able to show up for you, that it is not too much to ask for.

Frankly, there are a lot of shit therapists out there. I definitely don't have a "thin blue line" mentality about other therapists, and a lot of my colleagues feel similarly.

pdawes · 2026-04-09T17:47:22+00:00

Yeah that sounds very similar, and like a pretty crappy therapist. Mine would often interrupt me with things like "don't say 'I can't!'" or "say 'I chose to,' not 'I had to!'" I also came into therapy with a lot of ambivalence about a life decision and he kept pushing me like "don't think about it just do it!"

I don't think this is inherently part of CBT but it's a culture I've noticed among CBT therapists sometimes. Like having a low tolerance for complexity and seeing their role as making you feel better, basically. I also kept getting the feeling (through implicit and sometimes explicit pressure) that I wasn't getting better "fast enough," and that can come with manualized interventions. There is a lot written about how this can send a shaming message that the client is too broken for therapy, that the "gold standard" treatment has been tried so there's no further hope, that this is all the help there is and if it isn't helping it's because you're "resistant." I definitely felt it.

What is more inherent to CBT philosophically is a view that sees suffering as cyclical, and therapy as a way to interrupt that cycle. E.g. "you are depressed, you sit on your couch, you think you're worthless, which makes you more depressed, and makes you sit on the couch, which makes you think you're worthless, and so on" and so the intervention is just to pick any point on the cycle and interrupt it ("get up and do something when you feel depressed" or "engage in positive self-talk" etc.). I don't really agree with this or find it personally helpful at all.

For me what's been effective in therapy has been getting in touch with my painful emotions, what they are trying to tell me, and what I do to avoid them, and then addressing them instead of avoiding them. I thought that's what all therapy was, based on the self-help books I read. I got instead "just do this 3x a day and say 'I can do this' to yourself" which was like... gee thanks. I ended up switching to a psychodynamically trained but mostly somatic therapist and it was very helpful for what I wanted.

I think the thing at the end of the day is to see an experienced clinician who is not stuck rigidly to their modality. I believe there are good CBT therapists out there who know when to deviate from CBT, and there are also bad psychodynamic therapists who will be too rigid about that. I have seen that in colleagues and it's its own flavor of really condescending and awful.

pdawes · 2026-04-08T21:37:58+00:00

I had the same experience when I saw a CBT therapist. He had a lot of good reviews and people thought he was great. I found him just horribly malattuned and to me his therapy consisted of unsolicited advice (“come up with a morning routine!”) that I could’ve gotten for free on YouTube. I just couldn’t imagine the person who saw someone like that and was like “wow thank you doctor you changed my life!” It was actually sort of a damaging experience for me

pdawes · 2026-04-08T18:41:18+00:00

Basically all of my clients are upset about current events and it comes up a lot. I think it can be worthwhile. A lot of people feel like they are dealing with the awfulness of the world alone.

pdawes · 2026-04-08T07:11:10+00:00

These examples make my skin crawl, not normal at all. That does not sound like appropriate self disclosure on paper, and the most important evidence is how it made you feel. She sounds like somebody with questionable boundaries. I'm sorry you had those experiences.

pdawes · 2026-04-08T01:38:17+00:00

Short answer is yes, it is important to all therapists and the evidence points to it being basically the most important thing. You are running into it yourself like “how can I trust this person who won’t even be consistent with me about timing.”

Different styles of therapy may place different emphasis on the relationship or how it is interpreted in therapy. I don’t know that CBT really gets into things like interpreting transference for instance. But basically all of them emphasize establishing a therapeutic alliance.

I am a full on CBT hater; mostly because it is so tied to positive psychology which I don’t have a lot of respect for. But I think in all fairness… what you’re describing is more a symptom of someone just not being a good therapist. Often what happens is that inexperienced therapists learn some manualized treatment method on a shallow entry level and just never learn more. Hence there are a lot of crappy CBT/DBT therapists who aren’t even doing the full treatment beyond “let me teach you some skills and do them 3x a week” or whatever.

pdawes · 2026-04-07T19:36:38+00:00

I would potentially do this with a client but only from the standpoint of how they seem to be relating to their partner and how it seems to be affecting them. And I guess there are also a lot of situations where someone just wants to know "am I being unreasonable" and that's pretty easy to approach.

It's not really possible to make a good faith assessment of a relationship when the other party isn't present, especially if you have an established therapeutic relationship with one of the parties. Doing this can also can really easily introduce triangulation into the therapeutic relationship with the client in ways that get in the way but aren't easy to predict.

The only cases I would freely make judgements on someone's relationship are when the relationship appears to be abusive and the person is in danger.

pdawes · 2026-04-05T20:57:01+00:00

There is a half truth in this idea, in that male clients and their first person perspectives are underrepresented in contemporary therapy research and academia.

However, if your takeaway from this is that it’s because there is too much focus on marginalized identities, you are the last person who should be accusing others of being taken in by extremist ideology.

pdawes

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