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


Ulisse Mini
@MiniUlisse
after my 
@jhanatech
 retreat I was like "I'm never going to be depressed again!" then proceeded to get depressed again because I was no longer meditating 8hrs/day isolated from everything in my life, lol
2:42 PM · May 10, 2025
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For example, many people experience ego deaths that can last days or sometimes months. But as it turns out, having a sense of self can serve important functions (try navigating a world that expects you to have opinions, goals, and boundaries when you genuinely feel you have none) and finding a better cognitive strategy without downsides is non-trivial. Because the “breakthrough” wasn’t integrated with the conflicts of everyday life, it fades. I call these instances “flaky breakthroughs.”

It’s well-known that flaky breakthroughs are common with psychedelics and meditation, but apparently it’s not well-known that flaky breakthroughs are pervasive in coaching and retreats. 

For example, it is common for someone to do some coaching, feel a “breakthrough”, think, “Wow, everything is going to be different from now on,” but feel and act no differently weeks or months later. 

Worse, some techniques can even cause bypassing. Such “false breakthroughs” can come with intense positive affect or “cathartic” crying without addressing the underlying issue. (More below.) 

Flaky breakthroughs can set people back for years or decades: If someone has a “breakthrough” that unexpectedly reverts, they can become jaded on progress itself. They can learn helplessness and give up on growing. The most depressed person you know has likely had this happen multiple times.


QC
@QiaochuYuan
yes, maybe 3-4 times now, various durations. the stories are too long to summarize but i think basically the mechanism was "aha! i've figured out all my problems and now i will never fail ever again" which felt good but was never robust and broke down the next time i failed
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Chris Lakin
@ChrisChipMonk
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Aug 29, 2024
Have you ever had Big psychological growth that lasts 1+ months and then basically reverts? Please share your story I'm trying to figure out how common this is
7:28 PM · Aug 29, 2024
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Flaky breakthroughs pervade inner work. Despite this, almost no one — coaches, therapists, retreats, bodyworkers, etc. — tracks whether their breakthroughs last.

Almost no practitioners track whether breakthroughs last. 

Earlier this year, I attempted to make a list of “10x Coaches” to refer people to. 20–30 coaches reached out as interested in working with me, and I asked each to share the best evidence that they had facilitated lasting growth for others.

But all anyone could show me were testimonials that basically read, “The session I just had was *really* nice. They had such a kind presence! I felt a big release at the end.” — And I’m glad to hear they’re nice, but immediate reviews do not distinguish lasting growth from flaky breakthroughs.

To show you just how bad it can be, one coach asked me how it was even possible to know if the client resolved their issue long-term:

Coaching @ Coach Mar 14 If the coach could fix the problem in one session then they simply helped the client to answer the “why am I doing this?” Question. The answer belongs to the client. As does the agentic follow through. Not sure how the coach would know about the 6m+ bit.
My response: You ask them.

As someone from a physics background where we measure whether interventions work, I was surprised by the lack of rigor.

Even among well-respected practitioners, checking for flaky breakthroughs isn’t standard practice. For example, Joe Hudson (Art of Accomplishment) posted a coaching video where he stated they’d discovered “how procrastination can completely dissolve.” When I asked if he’d followed up to verify this, he explained he doesn't track results.

Almost every practitioner I’ve seen doesn't track whether breakthroughs last. 

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

Can we fix this, guys?

What happens during flaky breakthroughs?

Here's my main model:

Let's say someone is struggling with procrastination. A practitioner helps them release a few blocks, and the client feels amazing — lots of insight, big emotional release, etc. But feeling good in the moment doesn't mean they'll actually stop procrastinating. They could have 100 more blocks creating their procrastination. You just don't know.

So when the client hits those remaining blocks in real life, they're blindsided. The “breakthrough” doesn't stick. And because they expected to be “fixed”, they become jaded on growth itself. They start believing their problems are unsolvable and give up entirely.

When a practitioner neglects to remind them, “by the way, more blocks are probably going to come up, this is probably just one of many,” they're failing to set proper expectations. If the client walks away with false confidence, this could be net negative for their long-term growth.

Some practitioners even make this worse by asserting “That’s it.” after the client has felt a single “breakthrough.” For example, imagine how this man will feel if he encounters a totally different procrastination block the next time he sits down to work.

In cases like these, the “breakthrough” was not complete. Maybe it was only 1%. You can’t know until you check later. 

Without long-term feedback, practitioners can mistakenly think they're helping — wow look they just had a breakthrough!” — but just be short-term reward hacking.

This can be especially harmful when techniques bypass the underlying issues rather than address them. For instance, it is possible for a practitioner or retreat to temporarily zap someone (someone who is cognitively insecure) into feeling like their problem never mattered in the first place. The simplest, most common way this happens is via cliche inspirational statements: “You are already perfect,” “Just let go of all resistance,” “Return to the present,” “Just love yourself more.” Statements like these can help in very specific circumstances with long-term integration, but usually they lose their effect (though they may make newcomers cry a few times).

It’s similar to how someone can take psychedelics and temporarily relax one of the tense beliefs they use to interact with the world. But just because someone gets zapped into ~no ego for a short period of time doesn’t mean they can safely replace the use for an ego in all contexts permanently. (Not to say it’s impossible, but it requires integration.) As psychedelic researchers have found, a ”feeling of profound understanding” doesn't guarantee accuracy — insights can feel undeniably true while being completely false.

In general, bypassing seems most prevalent when practitioners come from a frame that assumes a client’s symptoms are simply suboptimal. Never mind that suffering often has a complex and locally optimal purpose. Never mind that social anxiety is usually protecting from outcomes perceived to be worse. The most problematic approaches suggest you tear down Chesterton's Fence while calling it “healing.”

Reduce flaky breakthroughs with accountability

I don't blame practitioners — I blame the system they’re in. Their incentive structure rewards short-term feel-good moments more than lasting change. 

If you’re a practitioner interested in reducing flaky breakthroughs, suggestions can be found here.

Flaky breakthroughs don’t mean rapid growth is impossible

Some people will read the post above and conclude that growth must always be a slow process, and that all claims of rapid resolution of lifelong issues are deceit. I think this is wrong. Much of my work has been about how to help people grow from as few hours of instruction as possible with long-term verification.

Conclusion

Flaky breakthroughs are common. Long-term feedback loops matter! I’m looking forward to how good practitioners will get once they start tracking long-term outcomes. 

Thanks to Brian Toomey for suggesting I write this.

@ChrisChipMonk

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When I first encountered the breakthrough people in the Bay I thought that surely they must be aware that 90 percent of breakthroughs are flaky, don't last and the last 10 percent gives at most moderate benefits [or harms....]. Surely any educated person past the age of twenty knew that coaches were the scammers, grifters that spiritual gurus almost without a fault turn out to be sexual predators, that most studies that claim strong benefits from interventions are p-hacked garbage thrust on the trusting public by a swarm of self-interested wilfully high-on-their-own-supply neuroscientists slash drugs addicts, that well-done long-term scientific studies pretty conclusively show that lifestyle interventions rarely work etc etc?

Entering the rat/ea sphere I met many very smart people who were completely taken in I was quite mystified by their behaviour and seeming earnestness. I had many speculations about this phenomenon: was it a social signalling thing? A cultural difference between California and my home? Did it bring people social benefits in terms of friends and romantic prospects? Was the coaches thing a way to signal wealth, or maybe an euphemism for a therapist? Was the spiritual guru shtick a way to pick up chicks? just a type-of-guy like the jock, nerd, or the moody artist that a certain type of girl is into? Was the whole thing an act, mostly for fun, a passing fad, a folly of youth they would harmlessly grow out of? Were the crazy diets, hacky lifestyle interventions just a fun way to pass the time, the equivalent of brewing craft beer or knitting circles in another place? Was I just too cynical, too european, too upper class to appreciate something beautiful, creative,  American, innovative I couldn't quite fit into my preconceived notions? Was I simply being judgemental because I lacked the brain structures for woo vibing?

The sad thing is that ultimately I concluded that no - it seems many or most of them were- are!- honestly and earnestly deluded. As the years passed a steady trickle of post-mortems came in. People who are after many years of fruitless questing slowly and begrudgingly admitted that the whole thing was misguided, some still in the overeager tones of having achieved a great insight. And that it is - a great insight. A hard-earned and slow-learned insight but a great insight nonetheless. Happiness is not achieved by one weird trick - the psychological equivalent of the silicon valley unicorn. They are gained by luck of genes and circumstance, a bit of solid work, a cultivation of a carefree attitude and solid group of friends, an honesty with oneself and ones limitations, an acceptance of the way things are. 

It is uncouth and unbecoming for me to gloat ' I told you so' because the truth is I did not. I bit my tongue. I made an sly remark here, an ironic allusion there. I thought we were all in on the game surely but in the end what I should have done was speak frankly and earnestly: this path is misguided, not just the specific New Thing you are trying - the entire philosophy can be yeeted. Don't trust these grand claims that people about completely changing their lives. Distrust and verify. Check in a year later. Ask their mother how they are really doing. Ask: who benefits? Is this objectively surprising claim a conveniently high-status thing to say? etc and many more

 There is no end of samsara in this life. The human RL loop won't allow it. 

Reply4211

When I first encountered the breakthrough people in the Bay I thought that surely they must be aware that 90 percent of breakthroughs are flaky, don't last and the last 10 percent gives at most moderate benefits [or harms....].

90 percent of breakthroughs being flaky sounds plausible - I myself have definitely had my fair share of them - but the bit about the last 10 percent sounds too pessimistic to me. 

For example, between 2017 and now I feel like I've gone from having really bad self-esteem and basically assuming that I'm a bad person who ~everyone dislikes by default (and feeling that this is terrible if they do), to generally liking myself and assuming that most people do so as well + usually not caring that much if they don't. 

While a big chunk of that came from gradual progress and e.g. finding a better community, I do also feel that were some major breakthroughs such as this one that were major discontinuities and also helped enable later progress. (The other breakthrough moments feel a little too private to share.) In that if I hadn't had those breakthroughs, I suspect I wouldn't have been able to find a community in the same way, as I'd have been too afraid of people's judgment to feel fully at home in one. So even much of the gradual progress was dependent on the breakthroughs.

Also part of the reason why I got into coaching myself was that I'd previously applied some techniques to helping my friends and they told me (later, when I happened to mention to them I was considering this) that they'd found my help valuable and encouraged me to go into it. And then e.g. one client emailed me unprompted almost exactly one year later to express gratitude for the benefit they'd gotten from just a few sessions. When I asked them if I could use their message as a testimonial, they provided the following that they said was okay to share:

I attended a few IFS sessions with Kaj towards the end of 2022.

I don't say this lightly, but the sessions with Kaj had a transformative impact on my life. Before these sessions, I was grappling with significant work and personal-related challenges. Despite trying various methods, and seeing various professionals, I hadn't seen much improvement in this time.

However, after just a few sessions (<5) with Kaj, I overcame substantial internal barriers. This not only enabled me to be more productive again on the work I cared about but also to be kinder to myself. My subjective experience was not one of constant cycling in mental pain. I could finally apply many of the lessons I had previously learned from therapists but had been unable to implement.

I remember being surprised at how real the transformation felt. I can say now, almost a year later, that it was also not transient, but has lasted this whole time.

As a result, I successfully completed some major professional milestones. On the personal front, my life has also seen positive changes that bring me immense joy.

I owe this success to the support from Kaj and IFS. I had been sceptical of 'discrete step' changes after so many years of pain with little progress, but I can now say I am convinced it is possible to have significant and enduring large shifts in how you approach yourself, your life and your pursuits.

("Some major professional milestones" and "personal positive changes" sound vague but the person shared more details privately and the things they mentioned were very concrete and significant.)

Getting this big of a lasting benefit in just a few sessions is certainly not a typical or median result but from my previous experience with these kinds of methods, I didn't find it particularly surprising either.

it seems many or most of them were- are!- honestly and earnestly deluded.

I agree with this

Check in a year later. 

I do this

 There is no end of samsara in this life. The human RL loop won't allow it. 

I think this is jumping to conclusions

I share the sense that "flaky breakthroughs" are common, but also... I mean, it clearly is possible for people to learn and improve, right? Including by learning things about themselves which lastingly affect their behavior.

Personally, I've had many such updates which have had lasting effects—e.g., noticing when reading the Sequences that I'd been accidentally conflating "trying as hard as I can" with "appearing to others to be trying as hard as one might reasonably be expected to" in some cases, and trying thereafter to correct for that.

I do think it's worth tracking the flaky breakthrough issue—which seems to me most common with breakthroughs primarily about emotional processing, or the experience of quite-new-feeling sorts of mental state, or something like that?—but it also seems worth tracking that people can in fact sometimes improve!

Couldn’t have said it better! 

What could current examples be where very smart people are deluded? Jhanas? 

This is honestly exactly what I first thought of, in particular Jhourney which I first learned of via Kuhan's post strongly recommending one of their remote meditation retreats. That said there's a bit of evidence contra my suspicion in this retrospective survey (coauthored by Jhourney and Nadia Asparouhova).

[-]pjeby220

I've been a bit confused by this post, but it's probably because I've never really done such short-term work with people; mostly I work with people on things that require one or more years of sustained effort across dozens of individual "breakthroughs" to reshape their life or personality the way they want (though of course they are getting incremental improvements all along the way).

So the idea of asking somebody a year after they're done seems weird to me, as why would the year after their last year be different than the year after their first? (And when I do hear from people a year or more later, it's nearly always to refer a friend or to work on something that's come up in the context of a new job, project, business, etc., usually with little relation to past work.)

Still, when someone gets excited about a breakthrough, I usually caution them that we won't know for a couple months whether it sticks (IME most fallbacks happen within 6-8 weeks). OTOH, when someone is skeptical about a breakthrough that's only a slight change to their automatic feeling response, I usually remind them that progress is progress, and that less dramatic changes are less likely to revert.

IOW, assuming a slight regression to the mean + cautious optimism is the best frame. (Two steps up and one step back is a meme for a reason!)

Also, in my experience, the "real" (i.e. most sticky) breakthroughs feel more like grief and regrets and loss than they do "exciting new breakthrough". The feeling is more like, "oh f*** I could have been doing things differently all this time, I didn't need to do XYZ or avoid ABC, crap!" (Or sometimes, it's just realizing how messed up some of the things that happened to you actually are.)

I think these types of changes stick better because the feelings are more reflective of "shift in values / perspective / actually seeing things in a new light" than "excitement about an idea in the present moment." This applies to me too, because I tend to get very excited when I spot where some of my behavior or feelings are coming from, and then forget to do the painful part that results in the actual perspective shift!

In such cases the problem comes "back" (not that it ever really left) within days, rather than weeks. Luckily I don't usually make that mistake with clients, as I have notes that keep me on track so I don't forget to pop the stack in session (and because any excitement is an obvious reminder we're probably not finished). But when i do stuff on myself I'm often just walking or standing around with no tracking of any sort.

tl;dr: being excited about a change is overall a bad sign for its longevity. The most positive signs are surprise (or sudden inspiration to actualy do something), grief/loss/sadness, or relief/release. (Not necessarily in that order)

afterthought: one of the reasons insight breakthroughs are more likely to fail is that more often than not, they represent an intellectual understanding that must be realized in action in order to benefit from, but most of the people i work with are working with me precisely because "intentions into actions" is the thing they have problems with. It's like, now you have even more ideas you have difficulty implementing, great. ;-) So it sticks for as long as they can maintain enthusiasm (2-3 weeks) then forget about it for another few weeks before something reminds them of the problem again (around 6-8 weeks).

But you can also have genuine breakthroughs (automatic feeling/behavior shifts, not intellectual ones) that revert around that time, but in that case it's usually a reinforcement/equilibrium of forces/"ecology" issue. For example, I once had a client who had made many improvements to his workflow to reduce stress... only to abandon those changes after a couple months. Turns out his family believed that if you're not stressed, you must not be doing anything very important/high status. So his new stress-reducing -- aka status-lowering -- workflow changes always felt subliminally wrong and uncomfortable until he shrugged them off again.

Anyway, I'm mighty curious about how these indicators and timeframes mesh (or don't) with others' experiences and practices. (And now that I've thought about detailed instances of specific personal and client cases, I'm realizing my 6-8 weeks is an outside limit, like 90-95th percentile? I think the median for things coming back is a lot lower, and my measurement might be skewed upward by how many weeks usually occur between sessions. IOW, probably half of everything that's going to come back does so within 3 weeks. So I say a couple months to be on the safe side, because the reinforce-extinguish patterns can take that long sometimes, even if it's not that often they actually do. (And partly because I now have tricks I use to try to identify them ahead of time.)

This makes a lot of sense if you work with all clients for a long time!

I mean, technically I have some clients who only stick around for a few months, but they're sorta not clients - they're the people who basically binge-watch my workshop recordings and figure stuff out for themselves, then say okthanxbye. There's not very many of them and they always seem really happy and seem to have only had one or two things they needed to figure out, and maybe only needed 1-2 calls with me to get clear on how to do something from the materials. I suppose it might be interesting to do a long-term followup with some of them, but I can only think of 2-3 people who ever did it that way.

Which are these workshop recordings you're talking about?

Which are these workshop recordings you're talking about?

The ones in my membership site. There's rather a lot of them.

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. 

A breakthrough is just the beginning of at least 3 months, and upwards of 18 months to solidify the thing IME. It's difficult for people to make commitments this big.

In Therevada there's a saying that 'insights are infinite' meaning that there is no end to nifty things you can notice about the mind, but most aren't of durable value.

while you're here - I'm curious if you think this will result in lasting growth or flaky breakthrough? I would've thought the latter from the top tweet, but

Each habit has its own reward structure. Those with smaller loops are much easier to inculcate. Thinking past the close (alternatively, ignoring semantic, or somatic, stop signs) could have enough reward that it could potentially stick.

It's difficult for people to make commitments this big.

Could you explain more what you're pointing to?

3 to 18 months of making something a priority.

Most coaches don't have a model like yours where they stop after a breakthrough. It's usually very clear when a client is keeping their breakthrough or not. I think for a client to have a breakthrough and a coach to not see what happens over at least the next months is the exception

I guess the exception to this is "experience based" things like retreats, ceremonies, workshops, etc, which compared to log term coaches ime tend to way over index on flaky breakthroughs

It’s been surprising for me that most coaches don’t see their role as helping people resolve specific issues. What do they see their role as?

It's the idea that a coach is someone that resolves one specific issue that's actually weird here, no offense intended. ;-) If all one does is address one specific issue, they fall more under the umbrella of either "consultants" or therapeutic "practitioners" (such as hypnotherapists, NLP practitioners and so on).

While coaches often practice some of these modalities or methods as part of coaching, it's not at all the same thing. (But of course a practitioner can still call themselves a coach, and there's probably been a lot more bleedover in recent years.)

But in the broadest sense, the idea of a coach is to provide you with an outside view combined with specialized knowledge or skills, to help you be more successful through advice and feedback (possibly including accountability), often combined with inspiration, encouragement, or some other parasocial relationship aspects (such as being an example to aspire to or look up to, someone whose approval you want to earn, etc.). This definition encompasses sports/athletic coaches, executive coaches, life coaches, health coaches, etc., which is the approximate historical evolution of the field I believe.

(Notice, btw, that nearly all of these names imply you keep the coach for as long as you want to do well in sports, be an executive, have a great life or good health, etc. That's the job!)

It's true nowadays that there are many coaches with narrower or more problem-oriented foci, like e.g. different health coaches may work on either specific goals vs. specific health problems. In general coaches who help with goals work with people longer than ones who help with problems, unless of course the problem is chronic or difficult to solve.

Things are made more complicated by the fact that you can pretty much do or call yourself whatever you want, assuming it works! I used to call myself a "mindhacking instructor" because I wanted to avoid certain aspects of the coach concept, and then basically realized at some point 1) nobody knows WTF a mindhacking instructor is, and 2) it was just ego on my part anyway. (While it's true I do more instruction than anything else, that's still part of coaching, so I was just being a semantic nitpicker not wanting to be in the same category as certain people calling themselves coaches or claiming to sell coaching.)

Anyway. It's certainly the case that there exist coaches who specialize in short term actions and one-offs, but in general I'd say if there's no relationship aspect to what you're doing, you're probably not a coach, but a consultant or practitioner of some kind, more akin to a hypnotherapist or a specialist in NLP, EFT, or some other change modality. Such people don't really have relationships with their clients, as they're more problem-solvers rather than people-helpers.

Yeah - that's maybe a better way to put it. Coaches are people-helpers who can also solve problems or practice some particular Art. Practitioners just practice their Art. I used to try to define myself in the latter category, then ultimately realized that a lot of what goes into long-term change and personal growth is actually social in an incredibly fundamental and inherent way.

For some kinds of change, for example, the experience of having "someone on my side in this" or "someone who believes I can do this" is absolutely critical, and a coach may literally be the only person in your life who can give that to you, especially with problems you're experiencing shame or feelings of inadequacy about. In that context, trying to cut the process as short as possible is about the worst possible thing one can do, if it implies that the person is not worth the effort (e.g. if their experience of life has been that nobody gives a crap about them, everybody leaves/gives up on them, etc.).

Ah okay. Also, given this, what would you call what I do? I sell secure attachment to everything, and try to have this happen after as few sessions as possible. Consultant? Practitioner? 

[-]pjeby*20

Eh, I wouldn't say you're necessarily not a coach, in the same way that an emu or ostrich isn't not a bird, it's just that I don't think your approach is a central example of the genre. Short-term coaches do exist, after all, just like flightless birds.

If you're asking from a marketing perspective, I wouldn't use consultant or practitioner, I'd either say "specialist" or "coach", i.e. secure attachment specialist or secure attachment coach. If you hardly ever work with anyone for very long or only work with people to solve a specific problem, I'd lean towards specialist. (Then again, I'm not sure I'd say "secure attachment" unless the people you work with already know that term and are looking for that. But I'm not the best person to ask marketing questions, anyway.)

oooh I hadn't considered specialist that's nice and neutral, thanks!

I think in general I tend to be helping them develop and thrive, be more integrated, and whole, have deeper spiritual insight, etc.  The specific issues are all part of this.

But I imagine different coaches view this differently.

While that might be true for many coaches, the field of hypnotherapy provides plenty of hypnotists who work very focused on a certain issue and assume there a point where the person is cured of their problem and the work stops. 

David Burns also comes to mind who claims to be able to cure depression in a single session but somehow doesn't follow up with people a year later to see whether they are still cured.

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. 

Oh wow this is an extremely good point. Why aren't coaches higher agency hahaha

edit: tweeted about it, thanks

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."

It actually turns out to be illegal for therapists to collect long-term testimonials, sad. 

Edit: Wait this is only for current clients. Past clients may be fine…?

It's worth looking into what they mean with testimonial. I think (and ChatGPT supports me on that), that it's mainly about collecting getting clients to write about their experience with the intention of then sharing that writing publically.

ChatGPT suggests:

Examples to clarify:

  • Not a testimonial:
    A therapist emails former clients asking, "Are your treatment outcomes still beneficial?" and later publishes anonymous statistics (e.g., 80% reported lasting results).
  • Likely a testimonial:
    A therapist emails former clients saying, "Can you share your experience with my therapy so I can post it on my website?"

This ban should not be a problem for a therapist or coach who wants to reach out to former clients to track results.

This morning I realized the guideline I was referring to is only for current clients, not past clients. There may other guidelines against soliciting testimonials from past clients but I'm not sure

Agree with your point on testimonials vs data collection, too

In fairness, it does make sense - much of therapy is built on the client divulging all of their most intimate secrets to the therapist, which then gives the therapist a lot of leverage and potential for extortion if they want to extract positive testimonials afterward. Making testimonials illegal ensures the clients never need to worry about that possibility, and can just safely share their intimate secrets.

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.
 

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.

Do you know any coach who does this? I will pay $100 for a link

Looking for a coach who:

  • collects long-term (6mo+) data on outcomes from all responsive clients
  • uses that data to improve long-term mental health outcomes and reduce “flaky breakthroughs”
  • I wasn't aware of — not Chris Lakin, Max Shen, maybe Sasha
  • is in this broad network
  • has online presence as a coach

"Collects long-term data" = following up with clients to check for lasting results at least 6 months after work has ended

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.

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