I feel like, in literally all cases, whenever I felt like I made a breakthrough it was pretty sticky. At least if I still endorsed the breakthrough literally one day later when I double checked. But usually the next day double check passes too. Including breakthroughs made while high. In this regard I think I am just unusual. 

Notably I have never actually thought a breakthrough would solve all my problems or cause me to never be sad again. Im not that optimistic. But the breakthroughs lead to substantial improvements for me personally. 

I agree with this. From the perspective of the coach, I don't really understand it. Even if you ignore the fact, that it would be good to actually know what works, writing an email to a client a year afterwards asking: "We had our coaching a year ago, and I'm curious about whether the effects lasted?" is useful purely from a marketing perspective. If the person answers "Yes", the coach just reminded them that the coach successfully helped them with a problem that they have in the past which makes it more likely that they will come back as a client and book another coaching session or recommend the coach to other people. 

The flakiness of breakthroughs is one of the reasons that in Zen we're so insistent on consistent practice as part of a sangha with a teacher. It's one thing to have some kind of experience while meditating, like on a retreat. It's another to integrate that experience into daily life, and that's done over months, not minutes, and a skilled teacher can get you back on track when you waver, so long as you don't waver in your commitment to keep showing up and doing the work.

Thanks for writing this - it introduces a concept I hadn't considered before.

However, I do find myself disagreeing on many of the specific arguments:

"Has someone you know ever had a 'breakthrough' from coaching, meditation, or psychedelics — only to later have it fade"

I think this misses that those "fading" breakthroughs are actually the core mechanisms of growth. The way I see it, people who are struggling are stuck in a maze. Through coaching/meditation/psychedelics, they glimpse a path out, but when they're back in the maze with a muddy floor, they might not fully remember. My claim is that through integration, they learn which mental knobs to switch to get out. And changing their environments will make the mud / maze disappear.

"after my @jhanatech retreat I was like 'I'm never going to be depressed again!' then proceeded to get depressed again..."

I don't think the jhanatech example is great here. During their retreats (I've done one), they explicitly insist you integrate jhanas, by doing normal things like cooking, walking, talking to close friends. And they go to extreme lengths to make sure you continue practicing after. I do know multiple people who have continued integrating those jhanic states post-retreat, or at least the core of the lessons they learned after.

"For example, many people experience ego deaths that can last days or sometimes months."

My experience talking to meditation/psychedelics folks is that ego death becomes increasingly accessible after the first time, and the diminished ego often stays permanently even if the full feeling doesn't.

"If someone has a 'breakthrough' that unexpectedly reverts, they can become jaded on progress itself..."

I agree non-integrated breakthroughs can lead to hopelessness. However, this "most depressed person you know" basically has many puzzle pieces missing and an unfavorable environment. What needs to happen is finding the pieces, integrating them, while transforming their environment.

"The simplest, most common way this happens is via cliche inspirational statements: [...] 'Just let go of all resistance,'"

"Let go of resistance" points at something quite universal. The fact that not-processing things makes them stronger. I don't think this one loses its effect like you mention.

"Flaky breakthroughs are common. Long-term feedback loops matter!"

Note: I do agree with your main thesis, which I'd paraphrase as: "we need to ensure long-term positive outcomes, not just short-term improvements, and unfortunately coaches don't really track that."

I'm in agreement with a lot of this. I more or less agree with your model of the problem as well as your solution of stress testing combined with setting expectations that there might be more work to do.

I'll expand on where I diverge a bit.

How do they know whether they’re facilitating lasting growth or flaky breakthroughs?

Even if there are a hundred more blocks you've achieved one percent. You say the same thing from a "glass is half empty" perspective, but I think the glass is half one percent full perspective is the more useful one here. It may be only one percent, but you don't actually lose that progress or end up worse off so long as you recognize it for what it is. You figured something out. You just didn't figure everything out, yet.

It's like climbing a mountain when you can't see the top. For some questions you need to know how much mountain there is left, but if you're committed to climbing it and want to make sure you're doing it efficiently, it's enough to track your local altitude gain -- and make sure you're approaching the upper bound set by available power/m*g.

I still think follow up data is good (And I did follow up a few months later with the person I helped in my chronic pain post. The improvement lasted), but I think it's going too far to suggest that without long term data you can't know if you're helping people grow.

So partly I diverge in thinking that this data taking isn't fully necessary, but I also diverge a bit in thinking that it's not fully sufficient either. It's like testing whether your cholesterol lowering drug still works 3 months down the line... but not measuring all cause mortality. And good luck measuring the equivalent of that and getting good data (as I say this, I'm reminded of an NLP "Core Transformation" study that did try to measure "global well-being" 8 weeks after a single session, and got positive results).

I'll give an example of how this can be hard to track. Once upon a time I tried to help an online friend with her fear of needles. There may have been some marginal improvement, but I mostly just considered it to be a failure -- which was surprising, since it seemed to have gone well enough that I would have expected it to help. So what data are you going to take in a case like this? "Hey, it's been three months. Did our lack of progress hold up, or can I take credit for a flakey lack-of-breakthrough?"?

About three months later, an online friend visited and we didn't sit down to "solve psychological problems" at all. I showed her around, took her to a rock in the ocean to jump off, just fun stuff. Then, shortly after this visit she had to get blood drawn and wasn't afraid.

It was the same friend, so that hypothetical 3 month checkup would have actually been positive. I'm not sure whether that work we had done earlier was a necessary precondition or whether the visit alone would have been sufficient, but either 1) it was a necessary precondition, and the right interpretation of that hypothetical 3 month follow up really is "Yeah, your explicit intervention resolved my fear issue with a 3 month delay", or else 2) the intervention that did it had nothing to do with needles whatsoever. So again, what kind of data are you going to take? "Any seemingly unrelated improvements in your life in the last three months that I can take credit for?"?

If you tunnel vision on concrete goals it gets easier to take data, but you end up missing any value that's not captured in your explicit metric. From my experience, I think this less legible value swamps the legible value, which is... inconvenient for clean analyses. To give an example, one friend has explicitly given me credit for "a large part of [her] current happiness", and another seems to be on the same path for the same reasons. In neither case did I sit down with them and say "Let's solve this unhappiness thing", and I would not have been able to get these results if I did. They both know I'm available to help them with "psychological issues" whenever they want and that I'm generally successful with that, but the concrete goals of those are much more limited and the sum of a few things like "Help me get my daughter to take her eye drops"/"help me stop overthinking jiu jitsu" pale in comparison.

The main thing I did that actually mattered was tease and talk shit, criticize, and comfort as needed. This is illegible to the point of looking like "just normal friend stuff" -- and it is -- but it was also guided by psychological principles aimed at the big picture. The jump rock experience wasn't just fun, it was intentionally a reference experience for how to handle novel and scary situations with a person you know you can trust (that's why it was fun).

The result that was life changing is that it allowed them to form relationships with their husband/fiancé that are really good, and which they would not have been able to even begin before my collection of illegible "interventions". I can think of a third case where I intervened directly and successfully got a couple back together, now happily married four children later -- but that one has the opposite problem because without a control group I have no idea if I can actually take credit. It's really quite likely that they'd have figured out that breaking up was stupid on their own, if I hadn't intervened to shake some sense into them.

So with the equivalent of "all cause mortality" I think I understand the default trajectory enough to make pretty good guesses in a couple cases, but that's relying a lot on my understanding (and their understanding) of the trajectories they were on rather than hard data. Who tf knows in the other case. And without really big samples, one death does a lot to change how the "all cause mortality" looks -- so better have a damn good reason to believe we're not trading more legible benefits for less legible but larger risks.

So yes, I agree. Take the data. Check in down the line, and all that.

At the same time, know that the data you're not taking might contain the bulk of the story, and that if you're aiming at what you can easily measure you might be missing high leverage points for what really matters.
 

I personally keep a log of breakthroughs, along with the narrative that lead me to it. I read through it occasionally to see what didnt stick and try again.

That's really disappointing and surprising that so few practitioners seem to check back and validate if the breakthroughs hold.

It also seems like a tremendous lost opportunity because even if a breakthrough lasts or isn't flaky, there's no reason to believe it has maximized returns - checking in with former clients and reviewing could mean there is further optimization, further juice to be squeezed out even if at first the technique that caused the breakthrough was effective.

This also begs the question in my mind what differentiates a breakthrough from a "insight", or even from a illusory moment of bliss that is mistaken for a meaningful breakthrough. In terms of insight: I'm thinking about insightful and potentially useful broad statements about the causes or patterns of a client's negative behavior "You tie too much self-worth to hours worked, and not output produced" but doesn't prescribe a list of techniques or a method for rewiring or changing that behavior. The observation may be true and could probably guide how to produce a remedy method, but it is not the method itself. Yet, for a client, hearing that they may have this profound sense of unblockage coming from the revelation, and an elation even that may be mistaken for breaking through.

Edit: I just realized I forgot to say - I thoroughly enjoyed reading this post.

This is a great point. Making the "breakthrough" from that poster's meditation retreat last is less about maintaining a single realization and paradigm shift, and more about distilling the 8+ hours of daily meditation into a single 5-30 minute daily practice that still confers the majority of the benefits. Instead, as you point out, people end up chasing the feeling of finding a revelation over actual progress. 

Before enlightenment, chop wood, carry water.

After enlightenment, chop wood, carry water

Expectation setting does indeed seem very important here. I had a few flaky breakthroughs in the past but I tend to see them in a mostly positive light - and that's probably because I never expected them to just stick and change me permanently. Even as they have faded, I can look back and inhabit that state of mind again to some degree. Knowing that I can (and temporarily did) have certain feelings or convictions sometimes help me have a richer perspective nowadays.

If we’re talking therapists, call me cynical but curing people as opposed to just reducing/managing their problems is bad for business. (As Big Pharma has also noted.)

Which is not to say therapists don’t try to help, or wouldn’t be pleased to produce a breakthrough so major and permanent that the patient didn’t need them any more, but there’s not such a big incentive for them to do that, and I suspect most of the profession doesn’t particularly aim to achieve it.

Also compounded by the fact that no doubt it’s difficult to achieve, and would be somewhat hit or miss even if therapists had figured out what methods are actually effective.

But medicine attempts to do that, by tracking outcomes and crunching the numbers, so therapy should too (more than it already does anyway).