How does a psychology/therapist relate?

I imagine for a patient to truly feel like the therapist is listening, the therapist needs to at least be able to feel, on some level, what the patient is feeling.

But there are certain mental states that simply cannot be described unless you have experienced it. An extreme version of this would be the psychotic state you’re in when you’re on psychedelics. There’s no normal human experience that can mimic this.
How does one then even become empathetic towards the patient? And if they can’t, why should the patient even bother confiding in the therapist?

They use that weird doohickey from Black Mirror

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great episode!

A (good) psychologist doesn’t necessarily need to empathize with you - they just need to help you understand why you feel the way you do. And then help you find ways to change it.

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So it’s more a cause and effect thing?

“You tell me you feel B, I have no idea what B is, but A probably causes it, so let’s change A.”

I think medicine in general is still in the stone age.

In simple cases, sure.

I think it gets more complicated (as you say) when you’re dealing with psychotic mental states. It’s very hard to convince a Bipolar I person that manic states are bad, for example.

it’s certainly stuck because our ability to describe our experiences is extremely limited

but how does a psychologist even know what a manic state feels like? Are they only observing its effect on other people and treating it from that perspective? Because unless the psychologst has experienced a manic state him/herself, how does s/he know if it’s a good or bad feeling or how to navigate around/deal with it

I would say it’s based on the cumulation of knowledge that we have on that particular affliction plus experience that the psychologist has with other subjects suffering the same symptoms.

Knowing how a manic state feels from the perspective of a manic person is certainly helpful in understanding why they feel a certain way - but I wouldn’t say it’s necessary to understand the patterns we see on the outside. If that makes sense.

But yeah a manic state feels GREAT to the person in it when they’re in it, but that doesn’t mean it’s not completely fucking up their lives.

I’ve never experienced a manic state. But I have done psychedelics and other drugs, and I know it’s kind of pointless describing the experiences to someone who has never done them.

I imagine the feeling is probably the same for people suffering from various mental illnesses.

For lack of a better term, I agree that people trying to explain their psychedelic experiences to those who haven’t had them - sound crazy.

There’s usually talk of divine experiences and things that probably didn’t happen in the not-just-in-their-head world.

Just like a physician can diagnose and treat myriad ailments they themselves have never had.

People don’t seek out the services of a psychologist/psychiatrist/counselor so that the PPC can emphasize with the person. They are having some sort of issue in their life that they need to resolve. The PPC doesn’t need to be able to emphasize to be able to make a diagnosis or assign a correct treatment.

Similarly, if I went to bat against the pitchers on my JV team they would strike me out almost every time. However, I have the ability, training, and knowledge to coach any of my players on how to improve their swing and maximize their at bats. Just because I am not able to have the same experience as them doesn’t mean I can’t help them.

but physical pains are more or less extrapolatable. some discomforts are indeed indescribable though, if you’ve never experienced them.
For example, it’s impossible to describe the pain of crushing your testicles to women, just like men cannot possibly comprehend what child birth feels like. But to the extent that we use relative pain measures, we can get there…somewhat.

But some psychotic experiences cannot even be described using other mental states, because they’re in a category of their own. There’s no extrapolatable experiences available.

I guess the issue is, if the psychologist cannot empathize with the patient, there’s no way for the patient to describe the experience to the psychologist, especially if there’s no comparable mental state.

There are lots of ways for the patient to describe what their issue is. Based upon the evidence provided, the psychologist makes a determination as to what is causing the issues. People might use phrases like “I felt like someone else was controlling my body”, “I hear this voice in my head that sounds like Grover telling me to punch people.”, “I can’t drag myself out of bed in the morning”, “I think the world would be a better place without me”, or “I have to have the radio on all the time so I can move to the music”. People will tell stories of behaviors they have like a bipolar person describing how they decided to take their motorcycle apart. They also observe behaviors in the office. A person with ADD will probably fidget a lot, be looking around the room, and start conversations about random things they see or hear.

If you are going to a therapist to validate that you did indeed see the Virgin Mary in your living room, that probably is not going to happen.

I would think that most psychologists need to avoid empathizing with a patient for the most part. Otherwise they would be experiencing the negative feelings of their patients all day.

I think that to imagine how a person is feeling is not the same as empathy. When i imagine a feeling, there is a distance between me and it that is not present with empathy. Also imagination in that case is an intellectual experience, while empathy is a visceral experience.

When you imagine a person’s mental state, you can use mental models, just like when you imagine anything else. You do not need to have directly experienced it. I’m sure it helps.

That’s the thing though, there may not be a comparable mental model.

When people describe a psychedelic experience, they almost always have to borrow another psychedelic experience (“DMT is like shrooms on steroids”), otherwise they sound completely crazy to someone who’s never done it.
I mean the most they can say is probably something like “I saw the meaning of life”, or “it felt like a lucid dream”, knowing full well the description doesn’t even come close to what they actually felt.