Welcome to The Nonlinear Library, where we use Text-to-Speech software to convert the best writing from the Rationalist and EA communities into audio. This is: The mental health challenges that come with trying to have a big impact (Hannah Boettcher on the 80k After Hours Podcast), published by 80000 Hours on July 20, 2023 on The Effective Altruism Forum.
We just published an interview: Hannah Boettcher on the mental health challenges that come with trying to have a big impact. You can click through for the audio, a full transcript, and related links. Below are the episode summary and some key excerpts.
Episode summary
We're in a universe where tradeoffs exist, we have finite resources, we have multiple things we care about, and we have incomplete information. So we have to make guesses and take risks - and that hurts. So I think self-compassion and acceptance come in here, like, "Damn, I so am wishing this were not the case, and by golly, it looks like it still is."
And then I think that it's a matter of recognising that we aren't going to score 100% on any unitary definition of "rightness." And then recognise that, "Well, I could just look at that and stall out forever, or I could make some moves." And probably making moves is preferable to stalling out.
Hannah Boettcher
In this episode of 80k After Hours, Luisa Rodriguez and Hannah Boettcher discuss 4 different kinds of therapy, and how to use them in practice - focusing specifically on people trying to have a big impact.
They cover:
The effectiveness of therapy, and tips for finding a therapist
Moral demandingness
Internal family systems-style therapy
Motivation and burnout
Exposure therapy
Grappling with world problems and x-risk
Perfectionism and imposter syndrome
And the risk of over-intellectualising
Who this episode is for:
High-impact focused people who struggle with moral demandingness, perfectionism, or imposter syndrome
People who feel anxious thinking about the end of the world
80,000 Hours Podcast hosts with the initials LR
Who this episode isn't for:
People who aren't focused on having a big impact
People who don't struggle with any mental health issues
Founders of Scientology with the initials LRH
Get this episode by subscribing to our podcast on the world's most pressing problems and how to solve them: type '80,000 Hours' into your podcasting app. Or read the transcript below.
Producer: Keiran HarrisAudio Engineering Lead: Ben CordellTechnical editing: Dominic ArmstrongContent editing: Katy Moore, Luisa Rodriguez, and Keiran HarrisTranscriptions: Katy Moore
"Gershwin - Rhapsody in Blue, original 1924 version" by Jason Weinberger is licensed under creative commons
Highlights
What makes therapy more or less effective?
Hannah Boettcher: So broadly speaking, we have known for a long time, and it's not controversial, that psychotherapy is efficacious and effective - so under control settings and less controlled settings. And in meta-analytic evidence, the effect size of psychotherapy is approximately 0.8 in comparison to no treatment - and that's conventionally considered a large effect size. Another way to say this would be that in comparison to not getting therapy, getting therapy explains 14%ish of the outcomes in randomised controlled trials. 14% might not sound great, depending on what your priors are, but this is actually really good for healthcare: it's on par with or better than effects of medications, both psychiatric and medically, and it's superior to plenty of medical interventions that are considered effective.
Luisa Rodriguez: What do we know about how effective different types of therapy are? Are those compared in studies?
Hannah Boettcher: Yes, these are definitely compared head to head. And something that's really interesting here is that specific treatment ingredients or therapeutic "modalities" are actually not strong predictors of better outcomes in psychotherapy.
Luisa Rodriguez: Right, this is a thing I've actually heard before, and it bas...