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But any improvement I made was incremental at best.
A pretty girl laughs a little too long at a man’s joke; is she trying to flirt with him, or just friendly?And then I had lunch with my friend, and she was like “It’s so stressful when all of your patients identify you with their parents and break down crying, isn’t it?Don’t you wish you could just go one day without that happening?For every autistic person, there are a dozen who are just sort of nerdy. We naturally think of some people as more trusting than others, but maybe that isn’t the best frame.“Trusting” implies that we all receive the same information, and just choose how much risk we’re willing to tolerate. A recent theme here has been the ways that our sense-data is underdetermined. A few years ago I had lunch with another psychiatrist-in-training and realized we had totally different experiences with psychotherapy. As per the textbooks, there should be a climactic moment where the patient identifies me with their father, then screams at me that I ruined their childhood, then breaks down crying and realizes that she loved her father all along, then ??? ” or “Maybe you feel like screaming at me right now? So I figured the textbooks were misleading, or that this was some kind of super-advanced technique, or that this was among the approximately 100% of things that Freud just pulled out of his ass.
We were both in the same training program, studying under the same teachers. In particular, all her patients had dramatic emotional meltdowns, and all my patients gave calm and considered analyses of their problems, as if they were lecturing on a particularly boring episode from 19th-century Norwegian history. I wish I could get my patients to have dramatic emotional meltdowns. I tried, I even dropped some hints, like “Maybe this reminds you of your father?
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With me, they tended to give calm and considered analyses of their problems, as if they were lecturing on a particularly boring episode from 19th-century Norwegian history.
Everyone assumed that meant I was good at dealing with difficult cases, and must have read a bunch of books about how to defuse crises. Then a few days ago I stumbled across the Reddit thread Has Anyone Here Ever Been To An LW/SSC Meetup Or Otherwise Met A Rationalist IRL? I’ve always believed psychodynamic therapies are mostly ineffective, and cognitive-behavioral therapies very effective, because all my patients seem to defy the psychodynamic mode of having having weird but emotionally dramatic reactions to things in their past, but conform effortlessly to the cognitive-behavioral mode of being able to understand and rationally discuss their problems.
” And later, my supervisor was reviewing one of my therapy sessions, and I was surprised to hear him comment that I “seemed uncomfortable with dramatic expressions of emotion”.