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PaperclipPerfector  4mo ago (text post)   25981 thread views

Culture War Roundup for the week of January 8, 2024

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The issue of modern divorce was discussed here last week in the context of yet another round of wider discussion about the Sexual Revolution. (It's pretty much becoming tiresome at this point, but anyway.) Everyone who bothered to chime in seemed to agree with the notion that divorce is usually a net negative for the wife, both romantically and economically. It appeared to me that there's mostly a consensus about that here.

Fair enough. However, I've seen online data indicating that a) roughly 40% of all marriages end in divorce b) roughly 80% of divorces are initiated by the wives c) in cases where the wife is college-educated, that figure is 90%. In other words, in cases of marriages that fail, modern women are more likely than not to voluntarily put themselves in a disadvantageous life situation.

So...what gives? Are modern women just that impulsive when feeling unhappy in a marriage? Or misled? Do they have illusions about singlehood?

Relationship therapist Esther Perel has a famous line that "The victim of the affair isn't necessarily the victim of the marriage." In the same way, the person that initiates the divorce isn't necessarily the person that ended the marriage. For a variety of reasons, I speculate that is more likely for men to "quiet quit" on a marriage, in a way that is less possible/likely for a woman. The woman might be the one who files the divorce papers, but in a lot of cases the man checked out a long time ago and has been, sometimes willfully sometimes passive-aggressively, baiting her into filing.

Rarely are divorces truly "out of nowhere," more normally divorce filings formalize the death of a marriage that has already broken down completely. Long processes of fights, counseling (secular or religious), compromises, deals, fights, betrayals, and failures precede the actual legal process. The actual filing often reflects a situation where there is no marriage going.

A man will stop doing anything around the house when he checks out of his marriage. Men typically do fewer chores around the house to start with, and have a greater tolerance for mess/disorder/eating trash. Absent any care for his wife's feelings, most men will have no real interest in doing laundry, doing the dishes, cleaning the bathrooms. Often this extends to kids: he's not scheduling doctors appointments, buying them clothes, keeping track of their schooling.

In my own marriage (which is great and nowhere near divorce), my wife and I have a regular fight about chores that goes something like: she thinks I don't do enough chores around the house, I think that I would totally do them if she would stop doing them first. She's home more than I am for a variety of work reasons, and she has a lower tolerance for seeing dishes in the sink, for seeing a full laundry bin, etc. I'm at work later, left to my own devices I will happily spend a few hours doing all that, but I won't reflexively do it when I get home from work, while she will sit there during the day working and see the dishes and they will bug her and she'll do them.

Because I'm out of the house more for work, as is typical for men, I could also just do another common thing men do and just...stop coming home after work. I'd be perfectly happy eating three dollar egg sandwiches from the local store, spending my time out drinking with friends, showing up back at ten or eleven at night and going to sleep before leaving in the morning.

Keep in mind that men typically control more of the finances. Both in terms of assets and income, and servicing debts and taxes. I would have vastly more ability to mess with marital assets than my wife would: I make more money, I know where the assets are, I would know how to move them around.

This is before we get into things like Exit Affairs, when an extramarital relationship is just a tripwire to make her file, or physical abuse.

So the dynamic is often that a man stops doing anything around the house, stops substantively being a husband, and then a wife files. So the decision these women are making when filing isn't "Happily Married Woman vs. Divorced Woman" it's "Abandoned, but legally married woman with no legal tools to control her spouse's use of marital assets, still expecting divorce vs. Divorced woman, with legal tools to control spouse's disposal of marital assets."

The woman might be the one who files the divorce papers, but in a lot of cases the man checked out a long time ago and has been, sometimes willfully sometimes passive-aggressively, baiting her into filing.

This is going to be very hard to quantify because I'd wager it's always a slow spiral that eventually takes such a sharp downturn that one party finally pulls the chute. Who pulled away first? What was the first defection? I don't think you can draw a strong conclusion as to who pulled away from whom, especially from the outside.

Is it the man 'checking out' of marriage for entirely internal reasons, or is it partially a response to the wife being less sexually available, or putting less effort into housework (esp. if housework is shared,), or has the wife become openly and constantly critical of him even if not directly abusive?

I would sincerely believe that if two people spent 10 years or more together, the ultimate destruction of the relationship is due to the two parties each reciprocating in small wounds which go untended and thus slowly kill the coupling rather than one side unilaterally having changed feelings out of the blue.

What I would guess is that the man is the one who more often wants to fix it rather than throwing it out and buying a new one, vs. a woman seeing no reason to repair what is damaged when it's easy enough to find a replacement.

I would also guess that the woman puts more effort into fixing the marriage in the first round or two of counseling then concludes it can’t be fixed because her husband won’t put in the effort.

Assuming counseling is highly effective. I’ve never seen someone start therapy graduate from therapy. I have seen people with illness stop going to see the specialist once cured.

I think therapy is a racket.

I plan to become a psychiatrist, and I think therapy is overrated, at least when considering the vocal segment of the Overly Online who think everyone should be in therapy.

But it is possible to overhype something that is good for some people, some of the time, and the research I've read shows that therapy is pretty effective for many mental disorders, often being considered the first line intervention, such as for depression, anxiety, and so on.

And there are many different types of therapy, from the bullshit Freudian and Lacanian kind to the much better validated CBT. The thing is, even the shittiest forms of therapy that exist, such as the former two examples that are built off pure pseudoscience, work empirically, being better than placebo (or at least no therapy at all), though CBT is usually better. I wager much of the benefit in any of them is purely from the simulation of a helpful, non-judgemental "friend" who'll let you vent to your hearts content and won't tattle on the pain of their friend-card being retracted, and while you could substitute that for an actual friend, apparently those are getting harder to come by and have scheduling conflicts.

Besides, most reputable therapists (especially the ones who aren't into the Freudian crap) at least pay lip-service to the notion that their clients should always be temporary, and that they should be directed elsewhere if several sessions show no benefit. And if the client is showing up to sessions after they're satisfied it's not working, then I lay the blame for their stupidity on them. If they still want to go, well apparently they're getting their money's worth somehow. People go for haircuts and manicures even when the damn keratin just keeps growing back, and barbers aren't a scam.

Care to share those studies? How many of them are longitudinal?

I originally read that on the Wikipedia page, and when I tried to hunt down the citations, linkrot has eaten the Google Books excerpt that was supposedly cited, at least the one supposedly claiming that metanalysis showed they were all equivalent. However, after some hunting, I did find that claim in a different, well cited meta analysis down below.

https://en.wikipedia.org/wiki/Psychotherapy

Large-scale international reviews of scientific studies have concluded that psychotherapy is effective for numerous conditions.[8][22]

One line of research consistently finds that supposedly different forms of psychotherapy show similar effectiveness. According to The Handbook of Counseling Psychology: "Meta-analyses of psychotherapy studies have consistently demonstrated that there are no substantial differences in outcomes among treatments". The handbook states that there is "little evidence to suggest that any one psychological therapy consistently outperforms any other for any specific psychological disorders. This is sometimes called the Dodo bird verdict after a scene/section in Alice in Wonderland where every competitor in a race was called a winner and is given prizes".[151]

Further analyses seek to identify the factors that the psychotherapies have in common that seem to account for this, known as common factors theory; for example the quality of the therapeutic relationship, interpretation of problem, and the confrontation of painful emotions.[152][153][page needed][154][155]

Outcome studies have been critiqued for being too removed from real-world practice in that they use carefully selected therapists who have been extensively trained and monitored, and patients who may be non-representative of typical patients by virtue of strict inclusionary/exclusionary criteria. Such concerns impact the replication of research results and the ability to generalize from them to practicing therapists.[153][156]

However, specific therapies have been tested for use with specific disorders,[157] and regulatory organizations in both the UK and US make recommendations for different conditions.[158][159][160]

The Helsinki Psychotherapy Study was one of several large long-term clinical trials of psychotherapies that have taken place. Anxious and depressed patients in two short-term therapies (solution-focused and brief psychodynamic) improved faster, but five years long-term psychotherapy and psychoanalysis gave greater benefits. Several patient and therapist factors appear to predict suitability for different psychotherapies.[161]

Meta-analyses have established that cognitive behavioural therapy (CBT) and psychodynamic psychotherapy are equally effective in treating depression.[162]

The bolded section is the one I can't easily verify, at least not when it's 9 am and I've been up all night studying.

Specifically regarding CBT, I found the following metanalysis-

https://pubmed.ncbi.nlm.nih.gov/23870719/

Results: A total of 115 studies met inclusion criteria. The mean effect size (ES) of 94 comparisons from 75 studies of CBT and control groups was Hedges g = 0.71 (95% CI 0.62 to 0.79), which corresponds with a number needed to treat of 2.6. However, this may be an overestimation of the true ES as we found strong indications for publication bias (ES after adjustment for bias was g = 0.53), and because the ES of higher-quality studies was significantly lower (g = 0.53) than for lower-quality studies (g = 0.90). The difference between high- and low-quality studies remained significant after adjustment for other study characteristics in a multivariate meta-regression analysis. We did not find any indication that CBT was more or less effective than other psychotherapies or pharmacotherapy. Combined treatment was significantly more effective than pharmacotherapy alone (g = 0.49).

Conclusions: There is no doubt that CBT is an effective treatment for adult depression, although the effects may have been overestimated until now. CBT is also the most studied psychotherapy for depression, and thus has the greatest weight of evidence. However, other treatments approach its overall efficacy.

And when speaking of CBT as applied to more psychiatric conditions:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3584580/

We identified 269 meta-analytic studies and reviewed of those a representative sample of 106 meta-analyses examining CBT for the following problems: substance use disorder, schizophrenia and other psychotic disorders, depression and dysthymia, bipolar disorder, anxiety disorders, somatoform disorders, eating disorders, insomnia, personality disorders, anger and aggression, criminal behaviors, general stress, distress due to general medical conditions, chronic pain and fatigue, distress related to pregnancy complications and female hormonal conditions. Additional meta-analytic reviews examined the efficacy of CBT for various problems in children and elderly adults. The strongest support exists for CBT of anxiety disorders, somatoform disorders, bulimia, anger control problems, and general stress. Eleven studies compared response rates between CBT and other treatments or control conditions. CBT showed higher response rates than the comparison conditions in 7 of these reviews and only one review reported that CBT had lower response rates than comparison treatments. In general, the evidence-base of CBT is very strong. However, additional research is needed to examine the efficacy of CBT for randomized-controlled studies. Moreover, except for children and elderly populations, no meta-analytic studies of CBT have been reported on specific subgroups, such as ethnic minorities and low income samples.

Addressing the specific claims of similar efficacy to the forms of therapy based on pseudoscientific principles:

CBT for depression was more effective than control conditions such as waiting list or no treatment, with a medium effect size (van Straten, Geraedts, Verdonck-de Leeuw, Andersson, & Cuijpers, 2010; Beltman, Oude Voshaar, & Speckens, 2010). However, studies that compared CBT to other active treatments, such as psychodynamic treatment, problem-solving therapy, and interpersonal psychotherapy, found mixed results. Specifically, meta-analyses found CBT to be equally effective in comparison to other psychological treatments (e.g., Beltman, Oude Voshaar, & Speckens, 2010; Cuijpers, Smit, Bohlmeijer, Hollon, & Andersson, 2010; Pfeiffer, Heisler, Piette, Rogers, & Valenstein, 2011). Other studies, however, found favorable results for CBT (e.g. Di Giulio, 2010; Jorm, Morgan, & Hetrick, 2008; Tolin, 2010). For example, Jorm and colleagues (2008) found CBT to be superior to relaxation techniques at post-treatment. Additionally, Tolin (2010) showed CBT to be superior to psychodynamic therapy at both post-treatment and at six months follow-up, although this occurred when depression and anxiety symptoms were examined together.

Compared to pharmacological approaches, CBT and medication treatments had similar effects on chronic depressive symptoms, with effect sizes in the medium-large range (Vos, Haby, Barendregt, Kruijshaar, Corry, & Andrews, 2004). Other studies indicated that pharmacotherapy could be a useful addition to CBT; specifically, combination therapy of CBT with pharmacotherapy was more effective in comparison to CBT alone (Chan, 2006).

Anyway, therapy seems to beat placebo, and works synergistically with drugs, even if you cynically notice that therapy based off nonsense does much the same thing as more considered approaches, but it's not in dispute that it works. At least I have the consolation of being able to throw drugs at people instead of just talking at them if/when I'm a licensed shrink, for all the quibbling about if SSRIs work, ain't nobody claiming their ADHD isn't being helped when they're zooted up on stimulants.

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