this post was submitted on 10 Jan 2026
17 points (90.5% liked)
Public Health
1699 readers
81 users here now
For issues concerning:
- Public Health
- Global Health
- Health Systems & Policy
- Environmental Health
- Epidemiology
- etc.
🩺 This community has a broader scope so please feel free to discuss. When it may not be clear, leave a comment talking about why something is important.
Related Communities
- Medical Community Hub
- Medicine
- Medicine Canada
- Premed
- Premed Canada
- Public Health (📍)
See the pinned post in the Medical Community Hub for links and descriptions. link (!medicine@lemmy.world)
Rules
Given the inherent intersection that these topics have with politics, we encourage thoughtful discussions while also adhering to the mander.xyz instance guidelines.
Try to focus on the scientific aspects and refrain from making overly partisan or inflammatory content
Our aim is to foster a respectful environment where we can delve into the scientific foundations of these topics. Thank you!
founded 2 years ago
MODERATORS
you are viewing a single comment's thread
view the rest of the comments
view the rest of the comments
Is therapy any better than a placebo?
Is a therapy session better for men than watching a YouTube video about mental health? taking a walk? Reading a book? Bingeing a TV series? Chronically masturbating?
Somehow, I doubt it.
Saying stuff like that is self protection cope so you rationalize staying away. None of those are even remotely close replacement to therapy. I was resistant for a long time to therapy, but actually going has dramatically improved my life in ways that consuming media never could.
I've heard similar arguments from other people, with the only functional difference being the replacement of the word "therapy" with the word "church".
I accept that therapy has benefited you. I accept that church has benefited others.
My own experiences with therapy do not match yours. Much like my interaction with religion, I found multiple experiences with therapy to be denigrating and exploitative. Despite external criticism and accusations of "toxicity", I feel my viewpoints on therapy are as valid as anyone else's.
Well, you're entitled to your own view. I don't know you or your history so I'm not going to harp on you. It was obvious from the jump you have therapy trauma and I'm deeply sorry for that. I've had bad experiences as a teen with therapy, but looking back I can see I was part of the problem. So now I just see these types of arguments as justification to keep living in a miserable dysfunctional way.
However I will say comparison between organized religion and a medical science is sort of silly. I get what you're going for, different strokes for different folks. But therapist are trained medical professionals backed by research and countless studies, not "sky wizard said I alone know best".
I'll leave you alone, I just had to say something. Bless and GL. ♥️
Go, find out. Can't be worse than being in the post.
Peer pressure is not an adequate replacement for scientific study.
Last thing I want to do is pressure you. Therapy is a safe space, you can talk or not talk as you wish.
You are proving my point brilliantly though. Men are so resistant to therapy despite it being shown to work. Here's an article with links to a study.
Here's an excerpt:
But no, we (men) convinvince ourselves it won't work and: the post. Worse when shown scientific studies we demand, we'll reject it to keep our toxic world view intact. Talking works don't let anyone convince you that "real men don't talk about their problems" it makes your life worse, it makes society worse.
I feel that anything I post contradicting the "outcomes comparable to those of women", is trying to "keep our toxic world view intact."
I feel that any criticism I have about the validity of therapy is dismissed as a "toxic worldview".
I feel that there is a distinct difference between "talking" and "therapy".
I feel that you're demonstrating the parent comment's point:
With regards to your comment:
I feel that this is not a valid comparison. Yes, therapy works better than booze and suicide. You know what else works better than booze and suicide? Joining a cult. Scientology. Weed. Pretty much anything works better than booze and suicide, including therapy. I feel that the "alternatives" you provided are disingenuous.
I feel that the primary destabilizing factor in my mental well being is economic, and I feel that any benefit I might achieve from therapy is vastly outweighed by the bill for that therapy.
I feel I'm being told "Therapy is the way, the truth, and the light. No one comes to mental health but through therapy". And I feel that this sort of worldview is far more toxic than anything I might have in my head.
Respectfully
Scientific study was provided. A target was set. A target was met, twice to show it wasn't a fluke. You may now move the target if you wish. You may now reconsider if that target was a valid one anyway. I really don't want to pressure you into anything.
I'm just trying to set the seeds: therapy works, I've shown you it works. Society tells men that we shouldn't talk about our feelings, that pressure results in the above post.
Your response is natural considering the social pressures we are under. There is a name for this social pressure: toxic masculinity, it is well discussed. But, even ignoring all the feminist mumbo jumbo, we have the studies, we have the results. Therapy works to lessen the number of suicides, we know it does.
Look at the story we tell ourselves:
Yes, therapy is better than all those things.
The science says therapy is just as effective for men as women, we've known this for over 10 years. It's a catastrophy. We need to communicate to men there are real solutions for us beyond ending it all. I'm not saying therapy is a magic bullet, but for the most vulnerable of men, we cannot be dissmissing the very real affect therapy (and the skills they develop there) has on achieving positive outcomes.
Perhaps talking isn't the best marketing for therapy. Do we focus on the skills people develop in therapy? Is that more masculine? I don't really know, emotional self sufficiency? Cognitive self sufficiency? Resilience Training? There has to be a way.
Confirmation bias. Therapy works for the people who decide to keep using it. The people who realize it doesn't work for them stop using it, or don't start to begin with.
You need to listen to what men are communicating to you, rather than immediately dismissing their concerns as a "toxic worldview".
Attrition and self-selection are real issues.
Where I think this goes too far is treating attrition as if it invalidates the evidence entirely. Every behavioral and medical intervention has drop-off: antidepressants, physiotherapy, rehab, even exercise programs. That doesn’t make them placebos; it means they’re not universally effective.
Therapy “working” in the literature doesn’t mean everyone benefits. It means: people who engage with evidence-based modalities show measurable improvement compared to controls this holds for men at similar rates to women once access and engagement happen.
Listening to men also means being honest about tradeoffs: therapy won’t fix economic stress, it won’t work for everyone, it costs time and money. Those are as true for women as they are for men.
But telling men “it doesn’t work for people like you” goes beyond skepticism. It closes off an option that does reduce risk for a non-trivial number of men at their most vulnerable. How many men, given the option of an honest attempt at therapy and the skills learned there, wouldn't be a statistic in this post?
I have and specifically addressed it. It's tragic the story we tell ourselves: "therapy doesn't work for men" I was told... Yes it does, here's the study that says it does. "Therapy is a placebo, as effective as sitting at home and masturbating" I was told. No, here's the study that says it isn't. I addressed where these feelings come from: the pressure society imparts on men.
What would convince you? Not science, you have that already, it didn't work. What could change your mind?
Science says I don't get to present my anecdotal evidence. I don't get to discuss how it has failed me, personally, in the multitude of times I have experienced it. The explanation for that could be that I have failed; the explanation could be that therapy has failed.
Refreshing my position:
The answer to the question you posed of me is "falsifiability". An understanding of how therapy can fail, rather than a blanket assertion that it can do nothing but succeed. Therapy is presented as infallible; that if it doesn't work, fault and blame lies primarily or entirely with the patient and their "toxic worldview".
That's not mental health. That's religion. Therapy seems to work for the same reason that religion works. And it seems to fail for the same reasons that religion fails.
The conversation that we should be having isn't how patients can succeed at therapy. It's how therapy can better serve the patient. And for that, we need to ignore the successes, and look at the people it has failed.
It does, it is represented in the data. Not everyone experienced a positive outcome. Just more people experienced a positive outcome than in the control group. Negative outcomes are represented. Target set. Target met.
1st article, 1st paragraph:
"Can help" not "will help". "Reduce" not "eliminate".
The language is specifically fallible Target set. Target met.
I feel you are clouded by your personal bias. Valid though your bias is. To feel like you put in the work and got nothing out of it must be harrowing. I'm sorry. That sounds patronising/condescending, it isn't meant to be.
I went through some trauma therapy for a traffic accident, the exercises were stupid but I was bed ridden so I did them anyway, the difference was measurable. I have an annecdote and bias too.
That's what the study did. It put a bunch of men through therapy and measured the results Vs a control group. Had the therapy group had no better results, then the hypothesis would be proven false. Target set. Target met.
Respectfully, I am looking at the people the system failed. It's the post. The conversation should be how do we get more vulnerable men through therapy (because we know it works the same way we know any treatment works: controlled falisfiable studies). Specifically, because we are currently doing nothing, and the language men use around this treatment that we know works) is actively harmful to men.
And, for those that do not respond to therapy (any therapy), what can we do for them? Not all patients respond to all treatments for any given condition, this is a known phenomena. Just as some patients drop out of studies is a known phenomena
Gotcha. Therapy works. The problem is the men. Makes perfect sense. Thanks for listening, have a nice day.
I am genuinely sorry it didn't work for you.
I am genuinely sorry your expectations for what therapy could do for you were not managed successfully.
I am genuinely sorry you have been made to feel as if it was your fault you didn't respond to the treatment. Very few treatments are 100% effective
That doesn't mean it doesn't work for everyone.
It doesn't mean vulnerable men should be denied the opportunity to do something that we know has a higher chance (not guaranteed) of success than doing nothing.
It doesn't mean we shouldn't do the thing that we know would have saved many (not all) of the lives represented by the corpses in the post.
It also doesn't mean that, for those therapy fails, we shouldn't try something else.
You were very clear. Therapy didn't fail these men. These men failed therapy. I understand perfectly.
That's explicitly not what I said. I'm not sure I can say anything to mollify you. I am sorry you were failed by the system and by me.
No, no, no. You don't get to go there now. You've spent all this time explaining to me that "the system" works. You've shown all the scientific data supporting it. That's now an absolute fact. The system clearly works, so if I experience any failure, that has to be all on me.
You could scroll up. You've posted any number of scientific studies showing that therapy works. Scroll up far enough, and you'll find a graph that says it doesn't.
You could shift your focus away from "the system's" successes and shift instead toward its failures.
It's much easier to fix something that we know to be broken. Stop fighting people when you're told how badly it sucks, and keep the focus on what it needs to change.
You could completely remove the word "toxic" from your vocabulary: 100% of the time, it is used accusatorily against the very people that "the system" has failed.
I want to be very clear about something, because I think it got lost. I am not saying therapy failing you makes you wrong, broken, or culpable. Nor have I ever said that, please quote me. You havent provided a source for anything yet, I demand one now. Or stop with this pitiful attempt to portray me as something I am not.
I am saying that generalizing from personal failure to “therapy doesn’t work for men” causes harm at a population level even though that conclusion feels emotionally justified.
We know men under utilise mental health services. We know mental health services help men on aggregate. I am sorry it didn't help you personally.
Those two things can be true at the same time.
A treatment can be fallible, imperfect, and even damaging for some people and still be worth recommending when it reduces risk for many others.
My frustration is not with men who were failed by therapy. It’s with the narrative leap from “this didn’t help me” to “this shouldn’t be encouraged,” because we know where that road ends for a lot of men. The graph.
I feel you misrepresented so much in this discussion. The language around therapy is infalible, it wasn't. You wanted scientific studies until you got them, having got them you didn't read them. You thought therapy is treated as unfalsifiable, it isn't. Was it you that suggested therapy is as effective as placebo when it isn't. It might not have been, I don't read usernames. I feel like you have gone out of your way to not read anything you don't like, and interpret everything in the least charitable light you could.
Here you misrepresent so much of what I say it isn't worth it to go line by line but to remind you you've consistently done it before, tell you you're doing it egregiously now and leave it at that. Provide a quote.
I am
You're arguing against a strawman. That narrative leap isn't being made.
Of course. BUT, (and this is the part you keep missing) when you have concrete evidence in front of you that it is ineffective/damaging (The Graph), the focus needs to shift toward ameliorating that harm. Stop shoving the failing status quo down throats. Stop blaming patients. Admit failure, admit fault, and focus on fixing the system.
Recognize that there is a group of people for whom the current system doesn't work. Stop telling that group to utilize the current system. Give them a system that does actually work for them.
That's not what the graph shows. Death by suicide is reported at a higher rate for men in all countries. That's what the graph shows.
It doesn't show therapy being a placebo. It doesn't show "concrete evidence" of anthing you have assserted. You haven't shown anything at all. You have provided no evidence to support that therapy less positive outcomes than the control group. You cannot make that claim. Of course I'm missing it, you havent done anything..
Here's what the data does show: Men experience positive outcomes similar to women when using mental health services.
But why are men's suicide rate so much higher? Because men utilise mental health services at a much lower rate. Perfectly explained by the graph.
Why do men utilise mental health services at a much lower rate? Perhaps other men erroneously say it doesn't work for men. Perhaps other men erroneously say its no better than staying at home and jerking off. Perhaps men are under a social pressure to not seek help.
I've said all this before though. There's nothing new above just rehashing things you've ignored many times before.
Liar. I haven't, please provide a quote of me directly blaming a patient that isnt. If you don't I'll ask you stop lying about me. I'll provide 1 of me directly doing the exact opposite.
That was easy.
I have, repeatedly. Please stop lying about this too. If you don't, I'll ask you stop lying about me. I'll provide a quote of me doing the exact opposite.
That didn't take long to find.
But here's a new one for you. Just because there are some people allergic to some drugs that doesn't mean we stop using them. We just don't use them for that patient. This is the strongest case you can make, this drug a is actively harmful for patient a. We still give drug a to patient b. That also doesn’t mean that, for those that therapy fails, we shouldn’t try something else. just give patient a drug b. Drug a still "works".
You didn't say that therapy didn't help you? You didn't say that therapy was as effective as sitting at home and masturbating? Hmm maybe that was another guy.
This you?
And this? This you?
Is this you?
it shows therapy failing to prevent harm. It shows a systemic failure that you refuse to accept.
The very first words you gave us in this thread:
You didn't say we need to make therapy comfortable for men. You said we need to make men comfortable with therapy. You described the problem as being on the side of the patient, rather than on the side of the system. You continued:
Didn't bother to discover any of their concerns. Didn't bother to determine the validity of those concerns. Didn't validate their feelings on the subject; just dismissed them entirely. You collapsed every concern of men about therapy into "toxic masculinity". Your very first thought on the topic was to blame the patient.
That victim-blaming attitude upset me considerably, and is the specific reason why I decided to engage with you. The attitude you presented in your very first words of your very first comment is my answer to a question you will ask later in the conversation:
Stop dismissing their concerns. Stop alienating them. Start listening. Start fixing the system so that it adequately addresses their concerns. Stop blaming their "toxic masculinity", start validating their concerns.
No, actually, I did not. I invite you to read the comment again. You provided "booze" and "suicide", and argued that therapy was better than these harmful alternatives.
In response, I asked whether therapy was better than neutral alternatives. Obviously, it's better than direct harm. I asked whether it was better than a placebo. I asked whether therapy was better than chronic masturbation, among several other neutral, non-harmful alternatives.
It doesn't, it shows men in all countries reportedly committing suicide at a higher rate. You inferred that from nothing. Why are women's numbers so much lower? They don't succeed in therapy more. They do attend more. If therapy is such a systemic failure where's the systemic faliure? Where's the massive number of women committing suicide. Surely you believe more women commit suicide? (More women attend therapy, therapy is a failure) We have a split on gender lines that outcome of therapy (we know are qual) do not explain. With sources please. It isn't outcome, it's income.
Any evidence therapy is particularly uncomfortable for men? There is evidence, that when men attend therapy, theres little difference in result between men and women. You have inferred that therapy, in itself, is uncomfotable for men from nothing.
There is also evidence that men do not attend therapy at the same rate as women. Hence: we need to get men comfortable with therapy. I go on to justify why I think men are uncomfortable with therapy hence:
What do you think toxic masculinity is? It's all of that. It's the pressures that society places on men in that result in toxic outcomes. We agree men committing suicide at a ludicrously high rate is a toxic outcome? Their concerns? I am a man, they're my concerns. Men are concerned with going to therapy. We need to get them comfortable with the idea. Because therapy works, we don't attend as much as we should, and vulnerable men die because of it.
None of that is victim blaming. Smashing gender norms will get men comfortable with therapy. No blaming the individual man necessary.
I'm satisfied you're lie is a spurious link. My counter examples are direct.
You did ask that. But we've known for over a decade that it is better. JAQing off whether therapy is better than Jacking off is suggesting therapy is as effective as a placebo. We know it isn't. If you weren't JAQing off, having just learned you are over a decade behind why didn't you transition to learning mode. Who finds out they're a decade behind, and continues to argue a position they just learned is a decade out of date.
I don't dismiss their concerns. I show evidence to counter them. Is therapy effective for men? Yes, here's a link. Is it more effective than jacking off? Yes here's a link. I have to listen to their concerns to counter them. I've told you many times that I am trying to fix the system.
You don't understand toxic masculinity. A man doesn't have toxic masculinity, a man experiences pressure to perform in masculinity in ways that can lead to toxic outcomes. Like suicide. We call these pressures toxic masculinity "TM". With that clarified does that explain some things? You heard a term you didn't understand. You inferred some nonsense from nothing. You then gave me a hard time for your misunderstanding.
Link Excerpt:
See: graph
The reference to TM was purely to tell people that know why not to waste time talking to me about why. The "why" doesn't matter, it didn't help you at all to learn it. It's decades of feminist theory, 3 actually that's how far you are behind, and this is a Lemmy thread.
The "what" does matter, the "what" we need to do is get men into pathways that lead to positive outcomes. Therapy is one. Parallel to therapy, you are welcome to suggest another (you haven't). But do not suggest therapy is in anyway similar to a placebo, you're merely reinforcing the pressure men already have to not seek it.
Got it. Therapy works.
All these people killing themselves aren't indicative of any sort of problem with "the system". They're responsible for their own deaths, because they refuse to accept what you know to be true.
Makes perfect sense. Have a nice day.
Not what I said. It's just not "therapy" that is the "system" they're being failed by. Could you take your own advice and start listening please?
You are right, men are being failed by a system though. Read some of the sources. Read the wiki on TM, you'll find it. It's a distraction from this conversation though, and given your reaction to the term TM, I don't think it would be a productive discussion anyway.
Genuinely, please start listening. It's frustrating having to say things umpteen times. It's frustrating having you interpret my words in the least charitable way possible. Listen for a bit. Your ideas are very, very out of date. It's time to do some learning.
The system alienates men. 30+ years after realizing that, your first thought isn't "The system is the problem. How do we make the system more appealing to men?".
The very first thing you have to say about it is "The men are the problem. How do we make the men more appealing to the system?".
And I don't just mean you personally. That hostile attitude pervades the whole field. When confronted with complaints that this overt hostility is uncomfortable, off-putting, and alienating, double down. Force the patient to choose between submission or retreat, then act all surprised at the ones who never come back.
Please listen I'll just copy and paste some relevent points. I could have copy pasted the last comment too.
Any evidence therapy is particularly uncomfortable for men? There is evidence, that when men attend therapy, theres little difference in result between men and women. You have inferred that therapy, in itself, is uncomfotable for men from nothing.
It doesn’t, it shows men in all countries reportedly committing suicide at a higher rate. You inferred that from nothing. Why are women’s numbers so much lower? They don’t succeed in therapy more. They do attend more. If therapy is such a systemic failure where’s the systemic faliure? Where’s the massive number of women committing suicide. Surely you believe more women commit suicide? (More women attend therapy, therapy is a failure) We have a split on gender lines that outcome of therapy (we know are qual) do not explain. With sources please. It isn’t outcome, it’s income.
Not what I said. It’s just not “therapy” that is the “system” they’re being failed by.
You are right, men are being failed by a system though. Read some of the sources. Read the wiki on TM, you’ll find it. It’s a distraction from this conversation though, and given your reaction to the term TM, I don’t think it would be a productive discussion anyway. But the system men are being failed by has also been discussed for 30+ years.
Wrong question. The right question is "how are we failing women too?"
The systemic failure is what you were describing in your first two paragraphs in this thread.
Men don't attend therapy at the rates you think they should. Men are highly resistant to what you are offering.
Your proffered solution to that isn't to make your offering more palatable. Your solution is to blame them and tell them to suck it up.
The fact that men are actively choosing not to attend therapy at the rates you seem to think they should is prima facie evidence that therapy is particularly uncomfortable for men.
Instead of accepting, internalizing, and taking responsibility for that fact, the field outsources blame for it to men.
Me: "Little Jonny isn't eating his vegetables."
You: "Boys who eat their vegetables enjoy them about as much as girls who eat their vegetables".
Me: "Yeah, but little Johnny isn't eating his."
You: "What did I just tell you? Boys who eat their vegetables report they like them at similar rates as girls".
Me: "That's great, but we aren't talking about a boy who eats his vegetables. We're talking about a boy who chooses not to. He doesn't like vegetables."
You: "He's just experiencing social toxicicity. If he tried them, he'd like them."
Me: "He has tried them. He doesn't like them. And he's getting pretty pissed off that you keep ignoring him when he tells you he doesn't like them."
You: "Nonsense. Boys who eat vegetables like them just as much as girls do. Science."
Me: "Yeah, but little Johnny isn't a boy who eats vegetables."
You: "Right. Because he's got some sort of toxic attitude against vegetables."
Me: "Or he just doesn't like what you're trying to shove down his throat."
You: "How many times do I have to tell you that boys who eat vegetables like them just as much as girls who eat vegetables?"
Me: "Whatever. Maybe we could try serving something that he might actually enjoy?"
You: "There's nothing wrong with the vegetables, just keep serving them. When we get rid of his toxic friends, he'll admit he actually likes his vegetables."
Me: "..."
You: "I do wonder why aren't boys eating vegetables as much as girls."
/Scene
Wrong, the right observation is "reality doesn't support my assertions.
When I said this you said I was victim blaming. They are, we agree. I said we need to get men into therapy and you got upset with me.
I've shown you a reason why men don't go into therapy, you took some imagined offence. Please God listen. It is well discussed why men do not go to therapy, you only just learned what TM meant yesterday. Now is not the time for your to provide assertions, without evidence, for a concept you just learned about yesterday.
That's called a lie. Do better.
You haven't done that. Vegetables work for the people they work for.
Vegitables are much better than sitting at home chronicaly masturbating as you JAQed off. We have a society that pressures boys not to eat vegitables. It was foolish of you to suggest. It was harmful of you to suggest when the aim is to get boys eating healthy. That's bad I would like to releave that pressure.
I like the healthy eating framing. We know healthy eating is just as benefital to little boys as to girls. We know little boys eat less healthy than little girls. We also know society puts pressure on little boys to not eat healthy.
It isn't society putting pressure on little boys to not eat healthy, there's just something anti-boy about eating healthy.
Do I have your position right?
Turns out Little Johnny doesn't actually hate vegetables. Turns out all you're serving is mushy green beans. Turns out he actually likes romaine lettuce and snow peas and carrots and spinach. But you've got it stuck in your head that mushy green beans are the only healthy option you can think to offer. Anyone turning up their nose at green beans is simply "unhealthy".
There's a bunch of therapy types such as:
Motivational Interviewing, Cognitive Behavioral Therapy, Trauma Therapy, Dialectical Behavioral Therapy, Psychiatry Sessions, and more
there isn't just mushy peas. He is being offered green beans, romain, fennel, all the things.
This statement is false. Incredibly false. Harmfully false.
But, society tells him little boys don't eat vegetables so he never trys Romain to find out he likes it.
Other men say that vegetables is as useful as staying at home masturbating. So he never trys Romain to find out he likes it.
Other men tell him all he will be offered is mushy green bean, so he doesn't even know Romain was an option. He doesn't try it to know he likes it.
I'm saying let's get little boys trying vegetables. Let's get vulnerable men, that would otherwise kills themselves, in therapy. Data shows it works.
Which is more conductive to little Johnny trying vegetables? Me saying we need to get little boys eating vegetables (how does he learn he likes romain without eating one, and vegetables are good for little boys (with provided link)? Or you suggesting it's as useful as a placebo (not true), and he'll only be offered mushy green beans (not true)? You want Johnny to discover Romain? Act like it.
I am curious. Which is the only therapy you believe I'm offering. Of all the therapies, which is the one? Why that one? With quotes please. I have mentioned one. But I didn't even imply it was the only one. You inferred I'm only offering one from nothing.
It's not men, its you specifically boo.
Men are not the problem in any of this conversation I've read thus far.
Something can not work for you. That's okay, it sucks and I'm sorry your experience was poor, truly, but it's okay you need other mediums to help your mental health, and I hope you have a support sysyem. But it seems you're saying because it didn't work for you, it doesn't work for men. That's not true.
Oh, I'm particularly special? I'm unique? My own concerns aren't shared?
Gotcha.
I'm guessing that only those men who find it helpful are the norm; the people for whom it doesn't work are each special snowflakes that can and should be ignored by the system.