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riparianx comments on Can we talk about mental illness? - Less Wrong
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Coming from a reductionist "mind is brain" viewpoint, therapy actually does help. This is pretty well documented in the fact that 73% of patients who go through it say it helped in the long run. (statistic from my psych 101 textbook) Talking to a therapist may not increase your serotonin levels, but it does help teach you new mental "patterns" and ways to cope with the results. Saying the brain doesn't follow patterns is, well, wrong. The more you have a thought, the more the thought comes to you. If a chemical imbalance puts you in a mood that leaves you susceptible to a kind of thought, then you'll have that thought and start a negative pattern. So even then, if the chemical imbalance is fixed, you can still be stuck with the results. Therapy helps you build more positive patterns and maybe even let the old ones fade.
You have to admit, this is weak tea. What would you think of a pharmacological study that relied on the fact that 73% of patients "say it helped." We don't need no stinkin' effect size or control! As I'm sure you're aware, there is a great deal of controversy about the effectiveness of talking therapies, and it is even controversial whether such therapy really does anything more than "just talking."
Now look, I too am in the reductionist "mind = brain" camp, and I too think therapy can be effective in principle. I am actually very sceptical of the idea that mental problems such as depression, anxiety and OCD result from a generalised "hardware" problem (such as faulty neuroendocrine function). Yet just by mentioning the (very widely held) notion that these problems do have such a basis, I'm apparently espousing dualism. It's very strange.
Who exactly said that?
The issue isn't that you mentioned the notion that the problem might be due to faulty neuroendocrine function but that you assume that talking can't do anything about that.
If you limit talk therapy to the goal of changing the mind and ignore hardware than you lose effectiveness.
Granted it's impossible to get good feedback to do targeted interventions on the biochemical level but the body is still vitally important.
But even given SSRI isn't targeted intervention on the biochemical level. According to a recent article:
SSRI might also work by reducing inflammation. They also hit targets outside the brain. Depression correlates with inflammatory cytokines. There are efforts underway to focus on diagnosing depression with blood tests and if those tests come the prime measuring stick the official definition of depression might even include inflamation.