Congratulations! I'm very glad to hear that you have come through the cancer, and also glad to hear that your depression has been healed!
When last you wrote, you worried (as I recall) that your drive to write poetry and some other pursuits might have been caused by your tumor. I wonder if you have any new thoughts on this?
Yes! The tumor pushed me, I think, to a passionate philosophy that I might end up calling "personal physicalism"; at the end of Recursive Reflections I teased, and in the 7SSermons I 've only begun to express, this ontology. It continues to seem to make sense to me; I have many more elaborations of it yet to be spell out and see whether I can make it all make sense in prose. https://x.com/7SecularSermons/status/2094022179675410510
This is wildly joyful, hilarious, and - well, just an all-round delight. I don't think I have ever read any account of cancer, surgery, or serious illness like it. The little poem was the best! Wishing you many happy years to come!
After looking it up, I see that getting bitten by a vampire is not sufficient to turn one into a vampire. (My vampire knowledge is poor and I only chose it because: https://en.wikipedia.org/wiki/Transformative_Experience)
I meant having gone through the transformation that turns one into the vampire. I specifically wanted to say that it keeps you from dying.
This is fascinating! I feel like the mere awareness that this is possible could be helpful for anxiety.
Electing to have an amygdalectomy for mental health seems a little spooky, given that it’s not reversible. Did you gather an almost universally positive impression from the literature? What are the odds of dissatisfaction, or serious complications? If it’s safe enough, it sounds compelling, removing fear from my life would be a major upgrade (perhaps meditation is the best path, though).
It’s wonderful to hear that you’ve seen improvement after the surgery! And what a strange blessing that came with it.
the neurosurgeons told me it was CSF leaking from the cranial cavity, indicating a common post-neurosurgery complication called “postoperative hydrocephalus.”
Isn’t hydrocephalus excess buildup of CSF in the ventricles, not CSF leakage out of the cranial cavity?
In principle yes, but the amount of fluid was so large that if it had been CSF, the outflow would have had to be large enough to further expand the hole. In their reasoning, which I suspect but don't know for sure was biased, that only ever happens with hydrocephalus.
I'm glad you're doing well! This is an incredible post and I enjoyed reading it.
When I was reading the recent lobotomy book review, I was thinking about posting some corrections that "actually, psychosurgeries are still performed, notably amygdalectomies for aggression..." but never did. Glad to see this.
Is ACX Grants now going to fund someone's research project in which they track amygdalectomies (and possibly create amygdalectomies) to create research papers about the potential benefits?
When I ask Claude about amygdalectomy it warns of "emotional flatness, weird appetites, and blunted everything", describing an absence of the brain's ability to assign significance and citing Klüver-Bucy. Given that, I wonder if your experience is typical or anomalous among amygdalectomy patients, and if anomalous, whether further research could make it less so?
My reaction on reading this account was that it's probably anomalous, because I have to suspect that if this were a typical outcome, that would be relatively well-known in neuroscience circles. I'm far from an expert, but I'd also heard that amygdalectomy tends to result in emotional flatness, so I suspect there's a wider evidence base to support that outcome. And frankly, the author's treatments involved so much messing around with his brain anatomy that it seems extremely difficult to investigate the results of performing similar procedures on other people systematically, even if it could be done ethically, because other elements apart from just the removal of the amygdala might have been significant to achieving these particular results.
This was my thought as well. For example, memory plays a big role in suffering as well. Off the top of my head, one example is that people have a better view on a negative experience if it ends "well" or "better" than when it started, even if they experienced the negative thing for longer. But even beyond that, if you feel a pang of fear but your memory system doesn't remember it viscerally in the next moment, it is much less likely to reify. He also lost parts of the brain related to memory. So jumping on the amygdala as *the* cause does not seem warranted
If this is "emotional flatness" then Ibuprofen gives you "body sensation flatness".😁 My appetite is fine and I can still cry tears of joy, so "blunted everything" is just flat out false.
> In my hospital stay, I pestered the surgeons about why they were not handing out amygdalectomies as freely as appendectomies. None of them had a valid rationale; instead they awkwardly mumbled about the infamy of lobotomies half a century ago.
Chesterton's Fence comes to mind here. If Amygdalas are bad to have, why did we all evolve to have them?
Yes, tigers are no longer easy to come by, but what about wars? Germany hasn't been in one for 80 years, but it's not like Europe has entered an eternal peace era somehow.
I think wars are a very relevant example for discussion - the mental (and so also "brain-hardware") attributes that are helpful to survive and function well in a war zone (even as a civilian) and the adaptations from that experience often tend to be counterproductive in the peaceful society afterwards; sometimes extremely counterproductive, with severe PTSD, suicides and external violence.
So while it is clear that amygdala has a purpose, it may well be that after major mass traumatic events, such as large scale wars, we would have many, many patients which would really benefit from a reduced amygdala function - even if that amygdala function helped them survive up to this point.
Right here in my hometown of Leipzig, war is back actually, with recent well-publicized drone attacks at the airport that investigators have publicly announced did have direct backing from the Kremlin.
This was also my thought through a lot of the article.
Viking berserkers were gobbling on psychoactive mixtures, and Nazis were routinely drugging their own soldiers when sending them to fight armies that were often more numerous. Looks like amygdalic suppression was the common theme.
Had the Nazis somehow perfected amygdalectomy, I guess we'd be all speaking German.
That's naturalism fallacy though. Evolution didn't select for the same things we care about as modern humans.
I think a similar but distinct rationale is something like 'humans are complex systems that work surprisingly well; any random walk away from their current formulation is more likely to lead to loss of function than improvement.'
And you're just repeating the hypernormalicy fallacy. "Evolution didn't select for..."
One person saved from a car crash -- or saving their child from being sat on by a car? Both of these are adrenal responses that are pro-social and pro-life in our current system.
Not to mention war. If you can't feel fear, as a politician, you're more likely to choose risky behaviors. That's why we don't still have Amazons -- they didn't send the political class to go fight, so they ran around like rabid weasels, hyperaggro.
>One person saved from a car crash -- or saving their child from being sat on by a car? Both of these are adrenal responses that are pro-social and pro-life in our current system.
This is a completely different argument, though.
'This is probably good for us because we evolved it' is not the same logic as 'This thing we evolved for a different reason has a clear benefit in a different situation today, which I will argue for on its own merits'.
You arguments making fine arguments against amygdalectomy, they just have absolutely nothing to do with Chesterton's Fence.
Adrenal strength, to use the Rolemaster term, has clear benefits in Hunter Gatherer society and also in current society.
Fight or flight, the generic response, can also save lives if channeled well -- and I think that's a generic thing useful in most societies.
It is inarguable that we are in a far different society at the present moment than Hunter Gatherer society, however, I feel that's a very fragile thing.
I think the more relevant question is "Why hasn't this outcome been reported by many other patients"? The internet is telling me that right amygdala removal is sometimes associated with reduced anxiety, but not always, and very rarely to the extent reported here. Böttger had an unusually complex sequence of things happen to his brain in a short period of time, and given the evidence from other patients, I wouldn't assume that amydala removal alone typically eliminates fear and suffering.
Given that it apparently affects being motivated by potential negative consequences, I would not be surprised if removing the amygdala from a population made them more likely to cause or get into trouble, on average. People who are highly conscientious might be fine, someone who is already impulsive or emotionally reactive might not do so well.
Did you have some of your friends read over the "Personality change" section to confirm that it feels like an accurate summary to them, and doesn't leave out anything important?
Absolutely fascinating. As someone who seems almost congenitally incapable of using negative motivation (possibly because of a bundle of "ADHD like" traits -- future doesn't exist) but who also suffers from hypervygilance and visceral anxiety that are a bit PTSD adjacent without quite being PTSD as a result of a traumatic experience 8 years ago (I was broadly low anxiety person before) the idea seems very appealing, tho I can't imagine anyone agreeing to do it here. I do wonder if it'd not make me ridiculously reckless tho (I was fairly reckless pre trauma, the "falls over and laughs" model applied to me, no near-miss fear).
The particularly interesting part is lower pain sensitivity which ABSOLUTELY makes sense considering how much pain is centrally modulated and arguably constructed, and almost explicitly related to pain as threat signalling, and how for example chronic pain strategies (I have OA) focus on managing those responses. I wonder if amygdaloctomy would work as means to relive some chronic pain too.
I know precisely zilch about neuroscience. Would it be possible to countenace developing a trivially reversible, non-invasive 'chemical amygdalectomy' in the same sense that 'chemical castration' is such a thing already in existence?
Back when I was in grad school there was a lot of buzz around transcranial magnetic stimulation, basically a sort of targeted emp that would 'scramble' a specific brain area for a short period.
Not sure where that field has gone in the last few decades, but I definitely wondered whether it would work for this as I was reading.
The effects of TMS are quite transient and effect sizes for it's use as therapy for eg depression/anxiety are very limited. The amygdala would of course be the first target to think of, however, TMS primarily targets surface areas of the brain (targeting something deeper would inevitably stimulate the layers above).
There's been a lot of research on therapeutic use of TMS, but I (neuroscientist myself) remain sceptical of it's efficacy and effect sizes over classical therapies. Similar to neurofeedback there's a lot of techno-optimism in the field that isn't warranted by the meager study results.
The field is still alive if you’re asking. This fall, my friend is beginning a neuroscience master’s under the mentorship of a professor who is doing research in it.
Reading about his experiences, it honestly sounded very similar to what it was like being on SSRIs for me. Becoming kinda autistic, happy all the time, sometimes saying things that frighten others but you can't really perceive that, etc. Honestly sounds exactly like my experiences with SSRIs.
can you share details of this? (dosing? how fast this effect appeared? days? weeks?, how long it lasted? months?, withdrawal schedule?, daily pharmacokinetics? compared to other SSRIs? compared to MDMA? any residual depression/anhedonia? motivation?) many thanks!
... that's somehow even more interesting. (And it's usual for SSRIs to be hit and miss in a group of people, but ... I would expect that it's due to genetics, but then I read "twin", so ... woah!)
Years, but I don’t think it was just the SSRIs that caused it. It was more of a personality shift, or some sort of enlightenment, I’m not sure. It is very strange, I genuinely don’t know what happened. I’m just saying this because it might be useful information for some people. But I think the SSRIs may have had a major role to play.
Chemical castrations are not reversible, famously. If they were, they would not be useful. I don’t think they can be used as an analogy for a hypothetical chemical amgydalectomy.
First off, congratulations on surviving the tumour, the chemotherapy, and all the surgeries!
Secondly, "In my hospital stay, I pestered the surgeons about why they were not handing out amygdalectomies as freely as appendectomies."
Consider you are now making this request post-amygdalectomy. Your judgement regarding risk etc. has been affected. You are like someone asking "but why don't you dangle the patients out the window? it's fun!" after having your "argh I could fall this is risky this is bad I don't want to do it" sense removed.
Regarding your last paragraph: Very valid point. I realized that this is a problem I have faced many times on a less spectacular level. For example, I have a herniated disc in my lower back. I struggled for (a few short) years with regular pain, reduced mobility and reduced "choice of activities", despite trying a few recommended things. Only when I found proper weightlifting did it completely change my life to be even stronger than I was before.
This too was such a fundamental shift in inner experience, that when I try to recommend this course of action for others with similar problems to mine, I can feel that there is a big river between us. No matter my enthusiasm, I can barely break through the veil of that person's perception; and since I don't have brain damage I can very clearly remember what it feels like to be in their shoes. It is simply unimaginable from their perspective.
If you're able to elaborate on this I'd be curious to hear more. I've known forever that weight lifting and being more athletic would be good for me, but yes to be honest it's always been a vague boring kind of obligation like how I ought to eat more kale or whatever. What is your Phenomenology of Getting Swole?
My practical method was to say "Claude make me a workout plan app" then negotiate with it around specific exercises I like/ hate doing or didn't have the equipment for at the gym until we got a good plan.
As a general note I life and my (similarly aged) brothers don't, we've noticed I have considerably fewer aging pain related complaints than they do.
Adding the tag that the best workout is the one you actually do, so it's mostly about finding what's least boring to you (lifts while listening to music? Group HIIT? Long runs by the river? Some esoteric mix? This is the part that varies wildly by person).
I’m not the OP and have only a moment to comment, whereas I’d like to go on at length. But I had chronic pain in my scapula and ribs for years which was debilitating. Weightlifting solved it. But not only is the pain gone, the feeling of what it’s like to be me is completely different. Pain or a sense that your body is vulnerable affect your mentality so much. I had become timid, risk-averse, downtrodden. But being strong and physically capable made me confident, calm, and enterprising. And it just feels great on a physical level, moment to moment. I even get sick less often and less severely. Everything about the body starts to work better, and that in turn makes the mind and the state of experience better too.
I am happy to elaborate. The most important principle is: Find something that's fun for you. Easier said than done, though.
But this might get you on a journey to try stuff out. One thing you might observe is: Once you start moving your body for real, you will have a lot of mental effects. You simultaneously become more awake, and you become more tired and sleep better at the end of the day. After sports, you might feel calm or energetic, other problems in your life seem smaller or easier to handle. Solutions present themselves to your mind, a productive business in your head that brings ideas for the next day.
Once you have made those activities a habit, you tend to remember how you feel afterwards. When you feel low/stressed/"bad", you remember you can just go to the gym/mountain/whatever and feel great afterwards. Not "just feel great", but have an actual bodily and mental relief, and new motivation and strength to tackle whatever stressed you. This might include putting things in their place ("it's just a job", "i got worked up too much"), but also just courage to act ("just ask for x").
Lifting is actually just a supporting side activity. My main sports is cycling, specifically mountainbiking. I need plenty of muscles there too, and it is a massive motivator to go to the gym on rainy days and dark evenings when I can't or don't want to cycle. So, find a reason and then do it for the results (faster, stronger, easier, more mobile, or whatever your goal is), not for the looks. The latter is rather "cringe", though very human. Of course, I appreciate the improvement in looks too (my partner approves).
Some clarifications: I'm not "jacked" and I don't think that needs to be the goal for anyone. The biggest muscles should be in your legs anyways where they are not very conspicuous. And I'm not talking only about the gym here: Physics kind of dictates that we need bigger legs than arms. Getting jacked is often even a massive blocker for other activities: Mobility is reduced, weight is gained (even if it's muscles, it will make you slower). I like the all-rounder mindset; have good running pace, be able to lift shit (look, I'm a nice guy, but even I find it a bit "cringe" when healthy men can't lift their own suitcase into the overhead bin without being wobbly or visibly struggling).
If you want an introduction to functional weight lifting, do the famous 5x5. Start as low as possible, proceed as slow as possible, be meticulous about correcting your posture constantly (this is the most important thing about lifting, the weights are a distraction really). Show patience and consistency for *one year* and you will be positively surprised, even if you stop lifting afterwards.
I agree with all of this. Stiltwalking is that fun way to exercise for me, and when 5x5 was boring I went (via 7x7) to just Dancing with my 15kg handlebar and topical AI generated music. That is such fun that I find myself happily doing it every morning.
I started strength training primarily out of curiosity, but then realized one thing. Imagine: you’re 70. You’re already pretty weak, and then SARS-3 forces you into bed for several months. When you beat the virus, will you have enough strength to lift yourself out of the bed? What kind of life will you have if you get that frail?
I decided to get myself to somewhat-overkill levels of strength so that scenario would at worst reduce me to “untrained middle-aged man” level.
In daily life, endurance, mobility and getting rid of excess weight perhaps matter more than raw strength (just look up the video of how Mike Israetel runs), but obviously it’s best to achieve all of that.
As for what exactly to do, just follow Starting Strength. The program is as simple as it gets, four barbell exercises, three sets of five, three days a week. Another commenter suggested 5x5, which is very similar but, as the name suggests, calls for five sets. I think the outcomes should be pretty much the same so the shorter program is preferable.
Have you written about this in detail anywhere? I had surgery on a herniated disc last year and am still struggling with daily pain. I'd love to hear what exercises you find most helpful.
There is a longer comment on this thread, but I will partly repeat here for your benefit specifically. Given the caveat that I do not know your exact circumstances, obviously, here is my experience.
The single most effective exercise is traditional barbell squats, as part of the traditional 5x5 program. Substituting with any kind of guided machine did not work for me (very little return for the time spent). The magic in an actual barbell is that it makes all of your body's muscles work, even the small ones that balance your feet, legs, back, hips and shoulders. So it also works out *all* of the tiny muscles surrounding the vertebrae.
The trick is to start with as low as possible weight = empty bar (20kg standard, or even lighter bars if necessary!) and meticulously correct your posture. Get the posture and movements *right* before adding weights, and continuously check your posture to get the full and correct range of motion.
Go up in weight methodically slowly, add 2,5kg only even if you feel like you could easily add more. Going up too fast messes up your posture. And with a herniated disc that will give you bad nerve pain that creates pain, messes up your entire week or worse. You know that kind of pain. Doing it that way also trains your brain to avoid going to the gym, as it is the source of pain.
Don't feel embarrassed about filming yourself at the gym, to review your posture. If you are not a great self-learner or don't trust your own judgement, get an expert. But a real one, not a random gym trainer (most of them "suck" in that they are simply not precise and strict enough to actually get you in a perfect position).
Don't wear running shoes or any other shoes that are padded and have a height difference between heel and toes. I wear socks at the gym, but there is also "lifter shoes" that are basically ballerinas for men.
Why? You are lifting weights, duh. Padded shoes will just deform and mess with your posture, mess with your knees, make you wobbly and overall do nothing to help you. At the gym, I give this advice unsolicited to people lifting serious weights, and almost all of them have specifically thanked me afterwards.
The shoe thing might also be a tip for you in general. Walking is arguably just as important for me to relieve my back as is lifting weights. I have become an avid walker ever since. Shoes with less or no padding under the foot, as well as no height difference between front and back are so much better. Yes they feel less comfortable to start with, but first you adapt to it long-term, and they generally feel much better and comfortable the longe you walk. Maximally counter-intuitive, but proven over hundreds of kilometers. My go-to shoes are Vivobarefoots and some "skate style" inspired sneakers for cycling, like Five-Ten Freeriders or any of the dozens of copies (these shoes have very little sole padding and no raised heels, so surprisingly similar to Vivobarefoots while offering more protection through a harder upper shell).
Commenting just add my own bit of testimony. I also had a herniated disc and later started weightlifting/resistance training. Luckily, my back pain resolved relatively easily after a few months of PT and being careful, but I still had reduced mobility after recovery. Resistance training resolved this, and to quote commenter "David", "changed what it feels like to be me" for the better. It's like training renegotiates the relationship between the mind and the body. It's kind of like, instead of being trapped in a cramped corner of my body, my "self" now more fully inhabits the whole thing, and acts more freely in the world. For me, training delivers a marked boost to overall well-being with no downsides except for time & money costs, and slightly more tiredness/sleep hunger in the evening on workout days. Specific benefits include improved mood, mental sharpness, distress tolerance, general confidence and sense of personal efficacy, physical strength (obviously), flexibility & posture, increased enjoyment of food, reduced anxiety, and less random pains of any kind.
For anyone reading this who is interested in getting started, I highly recommend finding a good personal trainer to work with. You need external feedback to learn how to do the exercises properly, and to push your limits the right amount without fear of doing damage. Once you know what you're doing, you can continue on your own without the trainer.
I fully agree with all the effects section, very well said.
Regarding personal trainer, I think it's an individual decision to be made. Some people, like me, have a very good feeling for their own body (maybe because of other sports before) and a self-learner mindset (which probably applies to most people lurking here). I'd say try it out and see if you can do without a personal trainer - it worked for me, but it doesn't have to for you!
Just mentioning this because personal trainers can be expensive or not very good (and the latter is the worst outcome).
Funny, I had almost the exact opposite impression. I thought it was like listening to a robot who was on MDMA. "I unexpectedly felt wonderful. After I ran an internal diagnostic I was able to confirm that I did, in fact, feel wonderful. Here is my analysis of what joy feels like."
I find it funny because it's almost exactly what I'm like when I'm on stimulants. I dunno if it's just a coincidence but I'm mostly German by ethnicity.
Any sexual side effects? I'd always understood that the system governing physiological arousal for fear/disgust/fight-or-flight/etc also governed sexual arousal to some degree (shaking bridge effect etc), but maybe the literature has moved on since I learned that in undergrad.
If you're willing to share, interested if you previously had any pain/fear/disgust/humiliation/dominance/etc based kinks (ie anything that might be recruiting amygdala activation to heighten salience and engagement), and if there's been a change.
I appreciated this if nothing else for the walkthrough of the *kind of thing that is possible* with contemporary technology, which is somehow a) continuously wondrous to me even though b) I try actively to apprise myself of these kinds of developments.
What a great post. You are awesome!! Not just making fun poems and writing, but doing happiness research and improve outcomes from chemotherapy. I'm in awe.
Medical technology is always surprising, because most people don't have any experience of it unless they require treatment. It is the reason why I find going to hospital such a thrill.
I would like you to know that your review of On the Marble Cliffs is one of my favorite things I have ever read. I keep it bookmarked, and return to it from time to time.
Wishing you many years of healthy, happy life.
PS Scott, run more stuff from this guy anytime :-)
The thought occurred to me that the part of your brain that used to be able to go AAAAAAAAAAAAAAAAA is still there, but it's trapped and only able to express itself via alliteration...
Thank you! 💖 Chemotherapy suspended my libido until I found the taurine fix, but I did not see any other change the few times that I had sex or experienced limerence since.
No my Atheism is about as Enthusiastic as before. https://sevensecularsermons.org/ I had the good fortune of meeting a formidable Catholic hospital counsellor and have since attended several Sunday services in the hospital chapel, but I only ever felt the same condescending appreciation for liturgy as a folklorist art form, as before.
I very heavily use Google Calendar and alarms to cut my days into chunks of usually 1 to 3 hours. Often I will additionally set up a timer to count down the remaining minutes in the current chunk, e.g. minutes till the next job videocall or doctor's appointment or time to pick the kids up from school. Beyond the current day, I have lots of notes and Google Tasks as well as a huge paper calendar with lots of room for written notes prominently placed on the corridor wall, and a couple of Google Docs where I track and plan medium- and long-term projects like this guest post. My days are as regular and routine/practiced as I can make them while shared custody forces important differences between days my kids are with me and days where they aren't.
When I go out without company with a functioning hippocampus, I have only two options: continual attention on Google Maps or most likely get lost and run late, even in my hometown where I have lived for 22 years.
Wow, I'm really happy for you! Thanks for sharing, this was great.
I'm sure I'm not the only one thinking about the different dimensions in which Buddhist enlightenment might compare to this. There seem to be a least a few parallels.
The Yogic and Buddhist traditions do offer usable vocabulary for euphoric altered experience, but I have long preferred scientific understanding https://sevensecularsermons.org/why-atheists-need-ecstasy/ and where secular science of sentience is not developed enough yet, I take that to be a task, not an excuse to fall back on venerable but prescientific attempts at modeling the relationship of experience and reality.
Hmm, or perhaps gained it? Wondering, because I'm very into the horror genre, but it usually doesn't trigger disgust or fear reactions in me (although jumpscares do provoke the latter, and I don't like them, and actively avoid horror that uses jumpscares). I really don't think I would be into it if it did. I'd call the reaction I tend to feel more 'thrill', it's generally very pleasant.
Yeah I would like horror if I didn't find it so scary. Jump scares get me the worst, but I also really don't like the constant anxiety they can induce. The tension is just too much. Some gore doesn't bother me, but other kinds do and I'm not sure what the difference is.
Excellent guess. The very horror-heavy conclusion of "A Practical Guide to Evil" held an appeal when I still had the cancer and depression, that now on the re-read has vanished, while many other aspects of that bombastic book continue to fascinate me.
Is there any independent corroboration of any hard details in Bottger's story? Sorry Daniel, but your corpus is setting off my confabulator warning lights.
I know Scott isn't acting as a traditional editor here, so I'm curious if fact-checking was part of the process.
I haven't seen his medical records or anything, but I can independently vouch for the following:
- Daniel studied neuroscience and has published many papers in the field. See https://sites.google.com/site/danielboettger/ . He also used to email me from an email address associated with a Leipzig medical university.
- He's corresponded with me about his cancer treatment progress by email ~10 times over the past two years, with the progression and dates mirroring the story he tells in this post. He's also tweeted about the progress of his treatment over the same period.
- All of his medical claims check out as far as I can tell. Claude says the image on this post correctly corresponds to a brain that's undergone the operation he says it's undergone. I can't prove it's not from a stock radiology site, but it looks like a crappy picture someone took of a scan on their phone, rather than the fancy digital scan you would get from a stock website.
- Before I edited this piece for length, there were even more gory details about his care, all of which check out as far as I can tell. Although I suppose that a neuroscientist ought to be able to get the neurological details right, his descriptions of life as a long-term patient in a hospital also rang true to me.
- After his 2024 surgery, he tweeted a picture of his scar, and although the face isn't visible, the head looks like him from his other videos. See https://x.com/7SecularSermons/status/1828429760365482108, warning for scary scar picture.
- He's been in the rationalist community for about fifteen years, has been well-liked during that time, and nobody has had any complaint about him. He says he goes to European rationalist meetups regularly. Maybe one of our German meetup attendees can verify that he has a wound in his head; maybe they can even ask to touch it, Doubting Thomas style!
I agree it's very surprising that a neuroscientist with a special interest in human happiness/flourishing and a preexisting connection to a blog whose audience would be interested, would be the one to have this very rare surgery. I still think it's probably a real coincidence.
Thank you for the thorough response. I certainly find this a fascinating essay. Perhaps that's the true source of my suspicions - paranoia about believing something because it fits in so well with my preexisting ideas.
I'd pour a heaping pile of salt on this too. Not that it "didn't happen" but simply because you've got an N of one. And this isn't the only guy who's ever done this. Perhaps the most well spoken, perhaps the happiest... but those should ring bells too, considering "brain surgery often causes IQ damage."
Cream rises to the top, and you should suspect you're looking at the 1 in 1000 guy.
Thank you Scott! I think "nobody has had any complaint about him" is an exaggeration though. There are multiple European rationalists who know me well enough to have told me to my face that I've been acting strange since the surgery. I owe them for the observations concerning personality change that are an important part of this post.
No need to apologize; I know my story is exceptionally unlikely and consider myself something like the luckiest guy on the planet.
We regularly have ACX meetups at my place, next one is on October 6th. You can come and browse or even photograph my patient files if you want. It's over 100 pages of rigorous documentation in small print, since this hospital is German after all. 😎
Neurological problems with frontal lobe behavior begat frontal lobectomies. Many years hence, neurostimulation techniques (for example transcranial magnetic stimulation (TMS)) are now showing promise in targeted ways to "kickstart" healthier neurology in those localized areas without physically touching them.
Now, I read this article as saying: neurological problems with amygdala behavior might beget amygdalectomies. Does the analogy conclude then: although TMS - itself - will struggle to provide effective neurostimulation to such a deep brain center because it's a "shallower" technique in nature, might other neurostim (invasive or noninvasive, DBS, FUS, etc.) will provide the controlled improvement in localized neurology sought?
Yes! Non-invasively we can only do the crucial EEG source localization to ascertain better than fMRI can whether an amygdala is acting up; to therapeutically influence it we need to get closer than non-invasive methods can. "Brain pacemaker" branded implant rather than ablative surgery MIGHT work comparably well. The difference is that they haven't been performed successfully nearly as often, so our prior has to be they are much more risky.
Regarding surgery options for Amygdala. There’s also high intensity ultrasound where sound instead of radiation is focused on a target so that only that target in the brain is destroyed. Currently this is in use mostly for tremor patients in destroyed the thalamus.
I think there is going to be a large cultural hurdle in performing irreversible treatments for a psychiatric disorder alone. Even though psychiatric disorders can be just as, if not more crippling than neurologic disorders.
Fascinating paper. It sounds like the ablation of the right amygdala was performed to treat the epilepsy, and these two patients happened to also have PTSD, and it turned out that their PTSD symptoms were significantly improved.
"In my hospital stay, I pestered the surgeons about why they were not handing out amygdalectomies as freely as appendectomies. None of them had a valid rationale; instead they awkwardly mumbled about the infamy of lobotomies half a century ago."
I was just recalling the recent review of lobotomies posted when before Daniel mentioned it. But it's not really a contradiction; it is surprising that a careful and informed procedure has different effects than rooting around roughly in a delicate organ?
Still, I'd certainly turn down the offer barring the cancerous incentive.
I'm suggesting that the procedure this writer, Daniel, suggests sounds kind of nuts after hearing about the recent history of lobotomies, but we know more about brain function now and this surgery is more precise, so maybe it's less crazy of an idea, for those who need it. Maybe.
Yes. There are now improved prefrontal neurosurgeries, exactly like there is now gastric weightloss surgery that is much superior to the horrific jejunoileal bypasses of the middle 20th century.
But more importantly, the prefrontal cortex is a different thing than the amygdala. To oversimplify both into a pseudo-monolithic "brain" serves for everyday conversation, but doesn't when we want to understand neurosurgery.
The Neolithic people performed trepanation, not lobotomy. During a trepanation, the brain should not be disturbed, it should involve the skull only. It basically means "making a hole in the skull".
Lobotomy starts with a trepanation, but then involves invasion of the brain proper.
Interesting! Without any further research on literature, I am curious why would the ability to appreciate and mitigate risks remain unaffected. Could it be that having Amygdala for long enough in your life has been important in forming the correct processing pathway towards risk and fear? Therefore, should keep it at least until an individual is developed enough to understand and process risk? Although where to draw the line for developed enough is likely very subjective and debatable
It feels like a cruel cosmic joke for a neuroscientist to get brain cancer. But it sounds like it's gone as well as it could so far. On the topic of brain cancer leading to a paradoxical increase in perceived wellbeing - this reminds me of an excellent (fictional) story on the same topic:
Never heard of that story, will check it out, thank you.
I don't think the joke is particularly cruel!😁
Before the craniotomy when they had the big pre-surgery talk with me and asked my opinion for their big judgment call how much to cut, explained the dilemma of conflicting priorities not to do too much collateral damage but also having to cut out as much tumor as possible (so its exponential growth would continue from the smallest possible remainder) my neuroscience background did play a causative role, because I got to say that I wanted them to be very conservative about that main artery and the bundle of motor neurons (without which I would now be hemiplegic) but I would happily sacrifice that amygdala they're getting more certainly rid of the cancer. So it's not ENTIRELY coincidental... but still coincidental enough for me to consider myself the luckiest guy on the planet.
I'm not done, but I wanted to say that this was glorious:
> Any and all anxiety apparently absent, an attentive and able anesthetist allowed abnormal admission absent anxiolytic amnesiac: an active, authoritative acknowledgement that nobody who experiences fear normally could pull that off!
What a read! I’m so glad to hear how things turned out with your illness. You truly are an extraordinary person, spectacularly resilient, and such a beautiful writer. And I love the idea of you walking with your stilts
Have you read Greg Egan’s “Reasons to Be Cheerful”? It explores a similar theme but in the other direction : the protagonist's brain tumor causes constant euphoria, until its removal saves his life but destroys his capacity for pleasure.
"Hippocampal damage also seems to be why in introspection I perceive what my brain does not as a single integrated cognition"
That's fascinating to know. Can you expand a little? How does a unitary and a dis-unitary mental state of mind differ exactly?
Could the fact that the hippocampus and the amygdala are located next to one another help explain why people with autistic symptoms often also experience attention deficit disorder?
I'm happy for you, but I deeply care about my capability to empathize with the pain and suffering of others, so I would probably not find an amygdalectomy a good thing.
Now I’m imagining a world where this is normalized and pushed in certain careers the way weight loss drugs are in careers that value thinness - if empathy or fear are seen as detrimental to job performance, it could make the world much worse to be able to medically suppress them!
I find that this future is likely unavoidable. The first thing I think about when people talk about suppressing certain drives and emotions is fear-free soldiers who are constitutionally unable to question authority.
But as they say, you can't have the good without the bad. I can only hope these transitions are net positive for humankind.
I’m not convinced it’s an unavoidable future. The next big thing was supposed to be everyone taking GLP-1s to cure all sorts of metabolic diseases - turns out they’re prohibitively expensive and have all sorts of unpleasant side effects. I anticipate there would be even worse complications and expenses associated with elective brain surgery.
If there were something that could let you sympathize with the pain and suffering of others but not empathize with it, would you still have the same reaction? I know everybody defines these differently, but at least for me empathize = feel bad about viscerally, sympathize = think is bad and want to do things to fix.
Given your definitions: I think that some level of feeling bad viscerally, of sufficient mirror neuron firing, is required to actually be able to comfort people. Wanting to "fix" things too much can be actually detrimental when dealing with humans. Sometimes they just need support to fix it themselves. And I understand this frustrates certain kinds of personalities that tend to be very common in rationalist spaces.
That said, if someone felt so bad for others that this actually was detrimental to their own well-being I'd support them doing something like this.
So I'm currently experiencing something LIKE this, aided by ketamine therapy. I'm absolutely not afraid it's making me a worse friend or partner, but then again I wouldn't be afraid of that, since I have no social fear. But the argument I can make is that I'm much more loving and tolerant of others. I might be even more able to empathize, since I no longer get defensive and that can be such an obstacle to empathy. (Maybe I got a bit defensive with my husband today, but it didn't FEEL the same).
This experience revealed to me how often in the past I've been angry at someone else due to some deep primal fear that their behavior was harming me in some way. Even the basic complaint that someone's "not being respectful"--it's based on the FEAR of becoming "disrespected," whatever that means, that your social status will be lowered and your self esteem and mental health will fail and you'll be THRUST FROM HUMAN COMMUNITY AND DIE IN THE COLD.
Because I don't have that fear anymore, I feel much better able to accept people as they are, tolerate the ways they're different from me, and continue to interact with them even during behaviors that would have set me off before. I also feel much more attuned to the GOODNESS of others. I'm more grateful for them and more aware of my love for them.
I'm happy for you, but I wonder if this is really comparable. Do you feel like you have a diminished ability to understand the emotions of others compared to your baseline?
Congrats on the accidental wireheading! I’m a little bit jealous of the effects, though it doesn’t seem quite worth it as a purposeful intervention given the risk to life and neurology.
> I perceive what my brain does not as a single integrated cognition, but as a creatively chaotic cranial company culture of cohabiting, collaborating cortical circumstances
I’d be very curious to hear more about this; are you saying that you feel like multiple sub-agents? What are the similarities/differences between what you’re experiencing and what people with DID report?
I have a very severe anxiety disorder, and I have genuinely thought before "why can't they just remove my amygdala? Wouldn't that fix the problem if the problem is too much fear induced by my brain circuitry being wired wrong?" Well, apparently they can if you have brain cancer, and the results sound great! I join you in praying that this may one day become an elective procedure for those of us without brain tumors.
Have you tried any hallucigens? I have no idea how typical it is (there's certainly some science investigating a link, but I've only skimmed it, and I don't know if it holds up), but a single LSD trip completely excised my anxiety. It's been completely gone for four years now.
I just remembered Zoraya ter Beek, a Dutch woman whose intractable depression and desire for euthanasia received extensive international coverage in spring 2024 (died May 22 of that year, age 29).
Voluntary amygdala zapping seems like an easy "Why not?" for a country that has decided to practice euthanasia. I'm curious if anyone has seriously suggested it as an alternative to suicide.
> It's hard to push the ethics point too hard when the alternative is ‘or death’
For a consequentialist, maybe. (Still need to consider second-order effects.)
For a deontologist, death is natural therefore good, "playing God" is bad. Bioethicists have no problem with thousands of people dying every day, but may object against the mad science.
But yeah, a country with legal euthanasia probably keeps their bioethicists in check.
Great read. I'd like to pedantically quibble with your choice of analogy here:
"Modern amygdalectomy is as different from lobotomy as your smartphone is different from an electrical telegraph!"
I don't think this actually communicates the idea you're trying to communicate. You're not just talking about an obsolete practice; you're trying to assuage people's fears of something terrifying. Maybe something like:
"Modern amygdalectomy is as different from lobotomy as today's surgery is different from medieval bloodletting!"
The idea that now you're missing your amygdala, you've decided you're fine without it reminds me of this part of Hitchhiker's Guide to the Galaxy:
> “Yes, an electronic brain,” said Frankie, “a simple one would suffice.”
> “A simple one!” wailed Arthur.
> “Yeah,” said Zaphod with a sudden evil grin, “you’d just have to program it to say What? and I don’t understand and Where’s the tea? Who’d know the difference?”
> “What?” cried Arthur, backing away still farther.
> “See what I mean?” said Zaphod, and howled with pain because of something that Trillian did at that moment.
> “I’d notice the difference,” said Arthur.
> “No, you wouldn’t,” said Frankie mouse, “you’d be programmed not to.”
My concern would be that, in biologically removing fear, there would be implications for the development of character. Isn't courage defined as "feeling the fear and doing it anyway"? In cases of pathology that would be different, but for a relatively normal person, removing the fear center would have all sorts of unintended consequences. How much could we alter the brain and still retain our humanity?
I think courage is only a virtue because we experience fear. Without fear, you could just do stuff without the need for courage, which voids the need for it. Character development need only occur when there’s something that needs to be improved or overcome, not just for the sake of it.
I must admit I am deeply scandalized by this post and all its implications. There are very many useful purposes for fear. Fear is a part of our humanity, and part of our survival mechanism. When people start wanting to alter the brain in order to create a fantasy utopia, which we all know from science fiction never works, we are playing God. Playing God never ends well for humanity. Look at AI. AI WILL win! AI has NO FEAR. People commit atrocities regularly as it is-- not just psychopaths, megalomaniacs or sociopaths. Imagine what worse atrocities they would commit if "ordinary" people could not have any concern for consequences of any kind. You can keep your brave new world; I don't want it. Science could never design the human brain or create anything close to it. Why should we tinker with something that we cannot even fully comprehend? Targeted, controlled experiments for medical purposes is one thing, when there is pathology. But a normal brain needs no improvement. Character is difficult enough to build with all our faculties intact. Without our programmed instinctual life-- you'd have robotic sociopaths, not human beings. Maybe those ones can serve the AI Masters.
P.s. as for character development I beg to differ-- it is a constant undertaking throughout the entirety of a lifespan. Unless you think maybe people are born "good".
You might find reading about Jo Cameron interesting. She was born with a very similar situation, not feeling pain or negative emotion. By all accounts she is a great mother and community member, an all-round lovely and productive person despite her lack of misery. https://www.astralcodexten.com/p/profile-the-far-out-initiative
With all due respect, obviously I can't comment upon her personality or character. But reading the description of her was rather chilling. I don't see how someone suffering a great deal subjectively from mental illness could continue in a relationship where the other person is constitutionally incapable of even imagining the other's pain. I don't think I could stay in such a relationship.
Please consider this statement: what we call joy, happiness, or peace is a result of RIGHT ACTION. The "feeling" of joy, happiness, peace, etc. ISN'T THE GOAL-- RIGHT ACTION IS. Her goodness is because of her right action. Her peace is because of her right action. Not because she has a brain abnormality which keeps her from feeling physical pain. Does she not grieve? Did she not grieve the loss of her husband??!! Are you suggesting we should not grieve? Avoidance of pain is not the goal of life. Avoidance of pain is the avoidance of one's own humanity.
Sounds fun, but hard to do legally in Germany. Maybe this histrionic declaration of war on Death can at least rule out fear of embarrassment? https://youtu.be/SqZPglIeSWg
A fascinating read, and nice to hear that you’re doing well!
In R. Scott Bakker’s technothriller Neuropath, there is (minor spoiler warning) a secret government program that involves performing “amygdala deactivation” along with other interventions (IIRC) to create titular neuropaths that are intended to be used as ruthlessly efficient superspies. However, it turns out that neuropaths (somewhat predictably given the genre and author) often go rogue and end up as sociopathic serial sexual predators / murderers. Towards the end of the novel, there is a memorable rant by one rogue neuropath along the lines of (paraphrasing from memory): “Before the surgery, I was so worried and afraid of everything; what people think and what I’m allowed to do. But now I realize that anything goes!”
After reading this essay, I was quite surprised to learn that amygdalectotomy seems to reduce aggressivity instead (at least in those with pathological levels of aggression in the first place). The portrayal in the book can of course be chalked up to artistic license (and perhaps the other interventions done to neuropaths), but it somehow fit my prior intuitive beliefs about the social importance of some negative emotions; if we excise fear (of, among other things, violating social norms), shame etc., would this not affect the inner enforcement of morality? I'd be happy to be proven wrong on this.
To me, there is increasing evidence that we've overcorrected from the problems of the mid-20th century science to having the opposite problems. Scott has already covered the move from crude race science to complete denial of structured genetic differences between ancestry groups that plagues current genetics more than enough. Related are the new developments in archeogenetics, which also has repeatedly shown now that history has also struggled with replacing the old stereotypes of savage early cultures with instead an idealized image of societies spreading purely by "trade" and "cultural exchange", which was complicated with a genetic profile that show a complete replacement (or the similarly common Y-haplogroup replacement).
One article that has stuck with me, since it completely inverted a lot of assumptions of mine, was from a gay man in his fourties or so. Sadly, I can't find it directly anymore.
In short, he was gay but otherwise wanted a "completely normal" (his words, not mine) relationship with biological kids (since he understood enough about genetics to know how much it matters). The second was already definitionally impossible (at the moment at least), the closest possible was if the kids are his with a selected woman; But again, what he wanted was kids with the person whom he chose to spend his life with. Even if that person is fine with the arrangement, he found it rather lacking.
And an almost bigger problem was the first condition, finding another gay man who wanted a dedicated relationship with no sleeping around. And not only did most guys he dated turn out to sleep around even after telling him they don't, even his gay friends told him to stop being such a curmudgeon, it's just sex, why does he care?
And this further extended to the entire lifestyle. At the end, he was jealous of straight people, and he actually tried to look into conversion therapies. But of course, not only are they illegal, insofar as you can find anyone in those spaces, it's all ideological dilettantes. There simply is no serious research on the topics. In the end, he preferred celibacy, if I remember correctly.
And we should also think about the cultural implications here. Functionally, he is repeatedly told from everyone around him that his personal wishes for a normal family with biological kids is invalid and inherently questionable, that he has to change and adapt. But when it comes to modern lifestyle choices like extreme promiscuity, those are totally valid and questioning them in any way is hurt- and hateful.
To be clear, I'm not advocating in favour of conversion therapies, and the way they were used in the past was abhorrent. But if an adult man with clearly functioning mental faculties wishes to change a part of him he does not like, why does he get a blanket no if that part is somewhat inconvenient for the current Zeitgeist? It would be rather interesting, and maybe even helpful for a few people, if we investigated more into how homosexuality arises and how malleable it is to intervention, as long as it is done with the full consent of an adult individual.
Conversion therapy doesn’t actually work. It’s like going to therapy to get yourself to stop liking the taste of ice cream.
The reason it’s not legal is because the common outcome is suicide, self harm, or tragically inauthentic “straight men” who get into hyper religious communities where they marry a woman who is going to spend the rest of her life being disappointed and he will spend the rest of his life hating himself.
Sexual orientation is not innate and there are ways to open up your range of desires, but becoming *unattracted* to something you are already desiring is nigh impossible bar extreme traumatization with wide ranging effects on how you’re able to connect with others. A form of sex therapy based on letting you acknowledge the edge cases where you do feel glimmers of desire for things usually outside off your norm and helping you orient to that through fantasizing is possible. I moved myself two points closer to the middle of the Kinsey scale that way. But I don’t think straight society (straight men, especially) would accept that being mainstreamed because it requires acknowledging that their heterosexuality is an imposed construct of Girardian mechanisms of memetic desire.
It is wonderful to hear this update and see that you've come through.
It would be very interesting to see how suppressing amygdala activity, maybe using some advanced form of transcranial magnetic stimulation, would affect people.
I wonder what is the connection, if any, between the amygdala and the default mode network, said to be active in cases where patients complain of anxiety (e. g. in Miller, Psychedelic Medicine at the End of Life, ch. 4).
Often when designing treatment plans for stereotactic radiosurgery, we need to make tradeoffs about which parts of healthy tissue will receive higher doses of radiation to spare the more critical areas. This makes me wonder if we should allow a higher dose to the amygala to help further reduce dose to other parts of the brain.
Of course, but what I'm wondering is whether the typical amygdalectony patient reports an experience comparable to yours, if you know? And if people's experiences are mostly like yours, why are there so many reports of emotional blunting and "Küver-Bucy" and all sorts of other adverse effects?
I think I was on 20mg vyvanse, 10mg Lexapro, 2mg guanfacine, later moved from 5 to 10 to 20 mg of Adderall a day. Unfortunately can’t really give much more info. I am not sure it was entirely pharmacological. I wish I knew what caused it so I could reproduce it, it felt great. I know it persisted even when I would not take any amphetamines. Honestly im not sure. But it came to me in a span of 2 weeks, and lasted until either something broke psychologically, or because I quit Lexapro. It’s hard to explain because I don’t know much about what caused it, too many variables. Honestly I think it was pretty stable, I just lost it because I broke psychologically after realizing that the adderall was turning me into a tweaker. I should try Lexapro again even though I’m not depressed, because it was genuinely the best period of my life - genuinely almost incapable of negative emotions.
> I meditated deep into myself, and despite my best efforts could not find anymore the old abyss of depression! And I could not find any traces of fright, terror or panic either!
This sounds amazing, I got tingles reading this. I'm very happy for you! Would love to read an update in a couple of years.
THIS IS THE MOST INTERESTING THING I'VE READ ALL YEAR.
I'm having a similar (maybe less extreme) experience aided by ketamine therapy. I've noticed my social fear is practically GONE. I still have all the positives of socializing--I'm interested in people, want to be close to them, am happy when they like me, and want to express myself so they see who I am. I'm just non concerned when these things DON'T happen. I still feel upset if I hurt someone, or if they hurt me, but those feelings lack the secondary layer of second-guessing and shame. I've also shed a family of fears related to productivity, thoughts like "should I be working right now" and "why am I so scared to do this?" aren't plaguing me anymore. I ABSOLUTELY love it. I feel more connected and attentive to my life and everyone in it. I'm really happy that you're getting to have this experience and thank you for sharing!!
I wonder how you can tell whether you’re primarily motivated by negative or positive emotions? I experience quite a lot of negative affect (stress, shame etc) and I’m also quite low conscientiousness (read: lazy). I wonder if an amygdalectomy would make me more productive (because I’m no longer being held back by fear/ wasting so much mental energy on negativity) or less productive (because the only scrap of motivation I had turned out to have come from negative emotions).
Very late to the party, but I've come across a nice quote which reminded me of this.
"All things considered, being shot is not as bad as I thought it might be, as long as you can keep the fear from your mind. But I guess you could say that about most anything in life. Its not so bad as long as you can keep the fear from your mind." (Special Agent Dale Cooper, Twin Peaks)
This is a fascinating read! Thank you for sharing this experience so vividly. It seems almost a blessing in disguise to have lost the capacity for fear and negative affect, otherwise it would have been unimaginable to go through all the surgeries and mishaps. I am so glad it all led to positive / cancer-free outcomes for you!
Evaluating branching game trees under emotional pressure exposes the limits of human calculation. Even with deterministic rules, human intuition relies on pattern recognition rather than raw search. Detailed why simple rules produce immense difficulty here:
One might be able to research this with TMS (transcranial magnetic stimulation) or focused ultrasound to temporarily disable the amygdala. This would change the ethical picture considerably. Unlike surgery, the effects would be reversible, so participants could take part without risking permanent harm, and informed consent would be far more straightforward. That could open the door to studying what the amygdala actually contributes to mood, fear, and decision-making in healthy people.
Focuses ultrasound is still experimental though and the Amygdala is really deep in the brain.
Small note: surely that heart shaped hole isn't the size of a fist. A children's fist maybe.
Love this. Unironically I'd very very strongly consider a radiosurgical amygdalectomy if it ever became elective. And I'm 90% sure I'd pull the trigger after a couple years of favorable outcomes.
Congratulations! I'm very glad to hear that you have come through the cancer, and also glad to hear that your depression has been healed!
When last you wrote, you worried (as I recall) that your drive to write poetry and some other pursuits might have been caused by your tumor. I wonder if you have any new thoughts on this?
Half-jokingly: The poetry does go well with the secondary autism.
It makes me wonder if Pumuckl has an amygdala missing, too...
Yes! The tumor pushed me, I think, to a passionate philosophy that I might end up calling "personal physicalism"; at the end of Recursive Reflections I teased, and in the 7SSermons I 've only begun to express, this ontology. It continues to seem to make sense to me; I have many more elaborations of it yet to be spell out and see whether I can make it all make sense in prose. https://x.com/7SecularSermons/status/2094022179675410510
This is wildly joyful, hilarious, and - well, just an all-round delight. I don't think I have ever read any account of cancer, surgery, or serious illness like it. The little poem was the best! Wishing you many happy years to come!
If being bitten by a vampire actually *kept* you alive. The alternative to losing his amygdala is decidedly worse than what happened.
After looking it up, I see that getting bitten by a vampire is not sufficient to turn one into a vampire. (My vampire knowledge is poor and I only chose it because: https://en.wikipedia.org/wiki/Transformative_Experience)
I meant having gone through the transformation that turns one into the vampire. I specifically wanted to say that it keeps you from dying.
Maybe I'll just delete my comment.
In long term, being bitten by a vampire actually keeps you alive. (Unless you get involved in some stupid fight.) http://luminous.elcenia.com/
Yes, I fully agree. I laughed multiple times while reading. I think Daniel's condition is clearly transmitted through his writing.
Oh, maybe we should all just get an amygdalectomy preventatively. I can't deny a pang of envy :)
Personally, I wish mine worked a little better. I think my performance at martial arts would improve with a little jolt of energy at the right moment.
This is fascinating! I feel like the mere awareness that this is possible could be helpful for anxiety.
Electing to have an amygdalectomy for mental health seems a little spooky, given that it’s not reversible. Did you gather an almost universally positive impression from the literature? What are the odds of dissatisfaction, or serious complications? If it’s safe enough, it sounds compelling, removing fear from my life would be a major upgrade (perhaps meditation is the best path, though).
It’s wonderful to hear that you’ve seen improvement after the surgery! And what a strange blessing that came with it.
“Did you gather an almost universally positive impression from the literature? What are the odds of dissatisfaction, or serious complications?”
Would he even be capable of getting a negative impression from the literature anymore?
Fascinating.
But I am going to be nitpicky and ask about this
the neurosurgeons told me it was CSF leaking from the cranial cavity, indicating a common post-neurosurgery complication called “postoperative hydrocephalus.”
Isn’t hydrocephalus excess buildup of CSF in the ventricles, not CSF leakage out of the cranial cavity?
Leakage is a sign of hydrocephalus.
How so? Any hole in the membranes around the CSF can leak whether one has hydrocephalus or not.
In principle yes, but the amount of fluid was so large that if it had been CSF, the outflow would have had to be large enough to further expand the hole. In their reasoning, which I suspect but don't know for sure was biased, that only ever happens with hydrocephalus.
I'm glad you're doing well! This is an incredible post and I enjoyed reading it.
When I was reading the recent lobotomy book review, I was thinking about posting some corrections that "actually, psychosurgeries are still performed, notably amygdalectomies for aggression..." but never did. Glad to see this.
I know that's not at all what this post is about, but your poem has a very Christian Morgenstern-ish vibe.
What a lovely compliment, thank you very much. I have loved Christian Morgenstern's poems since my dad recited them to me from a very young age.
Bro was diagnosed with major affective disorder.
It’s more analogous to persistent depressive disorder aka dysthymia aka dysthymic disorder, so maybe it should be euthymic disorder?
Is ACX Grants now going to fund someone's research project in which they track amygdalectomies (and possibly create amygdalectomies) to create research papers about the potential benefits?
Or will it fund a secret, we'll remove your amygdala charity/start up?
When I ask Claude about amygdalectomy it warns of "emotional flatness, weird appetites, and blunted everything", describing an absence of the brain's ability to assign significance and citing Klüver-Bucy. Given that, I wonder if your experience is typical or anomalous among amygdalectomy patients, and if anomalous, whether further research could make it less so?
My reaction on reading this account was that it's probably anomalous, because I have to suspect that if this were a typical outcome, that would be relatively well-known in neuroscience circles. I'm far from an expert, but I'd also heard that amygdalectomy tends to result in emotional flatness, so I suspect there's a wider evidence base to support that outcome. And frankly, the author's treatments involved so much messing around with his brain anatomy that it seems extremely difficult to investigate the results of performing similar procedures on other people systematically, even if it could be done ethically, because other elements apart from just the removal of the amygdala might have been significant to achieving these particular results.
This was my thought as well. For example, memory plays a big role in suffering as well. Off the top of my head, one example is that people have a better view on a negative experience if it ends "well" or "better" than when it started, even if they experienced the negative thing for longer. But even beyond that, if you feel a pang of fear but your memory system doesn't remember it viscerally in the next moment, it is much less likely to reify. He also lost parts of the brain related to memory. So jumping on the amygdala as *the* cause does not seem warranted
If this is "emotional flatness" then Ibuprofen gives you "body sensation flatness".😁 My appetite is fine and I can still cry tears of joy, so "blunted everything" is just flat out false.
> In my hospital stay, I pestered the surgeons about why they were not handing out amygdalectomies as freely as appendectomies. None of them had a valid rationale; instead they awkwardly mumbled about the infamy of lobotomies half a century ago.
Chesterton's Fence comes to mind here. If Amygdalas are bad to have, why did we all evolve to have them?
Yes, tigers are no longer easy to come by, but what about wars? Germany hasn't been in one for 80 years, but it's not like Europe has entered an eternal peace era somehow.
I think wars are a very relevant example for discussion - the mental (and so also "brain-hardware") attributes that are helpful to survive and function well in a war zone (even as a civilian) and the adaptations from that experience often tend to be counterproductive in the peaceful society afterwards; sometimes extremely counterproductive, with severe PTSD, suicides and external violence.
So while it is clear that amygdala has a purpose, it may well be that after major mass traumatic events, such as large scale wars, we would have many, many patients which would really benefit from a reduced amygdala function - even if that amygdala function helped them survive up to this point.
I've wondered about cures for PTSD or any kind.
I think people would argue that PTDS puts some limits on war, though I'm not convinced it's worth it.
Right here in my hometown of Leipzig, war is back actually, with recent well-publicized drone attacks at the airport that investigators have publicly announced did have direct backing from the Kremlin.
Yes. It's still far from the war that is happening in Ukraine, but that's my point -- we shouldn't assume that we're safe.
Yes. The very neurosurgery ward I was in has treated Ukrainian patients with war injuries.
This was also my thought through a lot of the article.
Viking berserkers were gobbling on psychoactive mixtures, and Nazis were routinely drugging their own soldiers when sending them to fight armies that were often more numerous. Looks like amygdalic suppression was the common theme.
Had the Nazis somehow perfected amygdalectomy, I guess we'd be all speaking German.
You've got an interesting point, but mine is actually the opposite -- that a quick fight-or-flight response might be valuable in a warzone.
Valuable for the individual in question - of course.
Just as not being on psychoactive substances / drugs, would have been valuable.
I was speaking of the army leadership.
That's naturalism fallacy though. Evolution didn't select for the same things we care about as modern humans.
I think a similar but distinct rationale is something like 'humans are complex systems that work surprisingly well; any random walk away from their current formulation is more likely to lead to loss of function than improvement.'
And you're just repeating the hypernormalicy fallacy. "Evolution didn't select for..."
One person saved from a car crash -- or saving their child from being sat on by a car? Both of these are adrenal responses that are pro-social and pro-life in our current system.
Not to mention war. If you can't feel fear, as a politician, you're more likely to choose risky behaviors. That's why we don't still have Amazons -- they didn't send the political class to go fight, so they ran around like rabid weasels, hyperaggro.
>One person saved from a car crash -- or saving their child from being sat on by a car? Both of these are adrenal responses that are pro-social and pro-life in our current system.
This is a completely different argument, though.
'This is probably good for us because we evolved it' is not the same logic as 'This thing we evolved for a different reason has a clear benefit in a different situation today, which I will argue for on its own merits'.
You arguments making fine arguments against amygdalectomy, they just have absolutely nothing to do with Chesterton's Fence.
Adrenal strength, to use the Rolemaster term, has clear benefits in Hunter Gatherer society and also in current society.
Fight or flight, the generic response, can also save lives if channeled well -- and I think that's a generic thing useful in most societies.
It is inarguable that we are in a far different society at the present moment than Hunter Gatherer society, however, I feel that's a very fragile thing.
If H cups are bad for posture then why did humans evolve to have bigger-than-necessary breasts?
Because reproductive success can elbow comfort out of the way, call it a nerd, and keep swaggering down the genetic street.
I think the more relevant question is "Why hasn't this outcome been reported by many other patients"? The internet is telling me that right amygdala removal is sometimes associated with reduced anxiety, but not always, and very rarely to the extent reported here. Böttger had an unusually complex sequence of things happen to his brain in a short period of time, and given the evidence from other patients, I wouldn't assume that amydala removal alone typically eliminates fear and suffering.
Given that it apparently affects being motivated by potential negative consequences, I would not be surprised if removing the amygdala from a population made them more likely to cause or get into trouble, on average. People who are highly conscientious might be fine, someone who is already impulsive or emotionally reactive might not do so well.
Amygdalas are not bad per se. Amygdala hyperactivity is.
Just like the vermicular appendix is not bad per se, but appendicitis is.
Did you have some of your friends read over the "Personality change" section to confirm that it feels like an accurate summary to them, and doesn't leave out anything important?
Two of them, yes. I imagine the others have read it by now, but have not yet commented.
Wonderful read. Thank you!!
Absolutely fascinating. As someone who seems almost congenitally incapable of using negative motivation (possibly because of a bundle of "ADHD like" traits -- future doesn't exist) but who also suffers from hypervygilance and visceral anxiety that are a bit PTSD adjacent without quite being PTSD as a result of a traumatic experience 8 years ago (I was broadly low anxiety person before) the idea seems very appealing, tho I can't imagine anyone agreeing to do it here. I do wonder if it'd not make me ridiculously reckless tho (I was fairly reckless pre trauma, the "falls over and laughs" model applied to me, no near-miss fear).
The particularly interesting part is lower pain sensitivity which ABSOLUTELY makes sense considering how much pain is centrally modulated and arguably constructed, and almost explicitly related to pain as threat signalling, and how for example chronic pain strategies (I have OA) focus on managing those responses. I wonder if amygdaloctomy would work as means to relive some chronic pain too.
I know precisely zilch about neuroscience. Would it be possible to countenace developing a trivially reversible, non-invasive 'chemical amygdalectomy' in the same sense that 'chemical castration' is such a thing already in existence?
Back when I was in grad school there was a lot of buzz around transcranial magnetic stimulation, basically a sort of targeted emp that would 'scramble' a specific brain area for a short period.
Not sure where that field has gone in the last few decades, but I definitely wondered whether it would work for this as I was reading.
The effects of TMS are quite transient and effect sizes for it's use as therapy for eg depression/anxiety are very limited. The amygdala would of course be the first target to think of, however, TMS primarily targets surface areas of the brain (targeting something deeper would inevitably stimulate the layers above).
There's been a lot of research on therapeutic use of TMS, but I (neuroscientist myself) remain sceptical of it's efficacy and effect sizes over classical therapies. Similar to neurofeedback there's a lot of techno-optimism in the field that isn't warranted by the meager study results.
I've wondered whether repeated TMS could train people to chose to enter into the state without it.
Whilst I have wondered whether a portable TMS device that one could wear might provide longer lasting benefits.
The field is still alive if you’re asking. This fall, my friend is beginning a neuroscience master’s under the mentorship of a professor who is doing research in it.
Reading about his experiences, it honestly sounded very similar to what it was like being on SSRIs for me. Becoming kinda autistic, happy all the time, sometimes saying things that frighten others but you can't really perceive that, etc. Honestly sounds exactly like my experiences with SSRIs.
can you share details of this? (dosing? how fast this effect appeared? days? weeks?, how long it lasted? months?, withdrawal schedule?, daily pharmacokinetics? compared to other SSRIs? compared to MDMA? any residual depression/anhedonia? motivation?) many thanks!
But I’m not sure if it was entirely pharmacological because my twin brother was on a similar med schedule and didn’t experience anything like this
... that's somehow even more interesting. (And it's usual for SSRIs to be hit and miss in a group of people, but ... I would expect that it's due to genetics, but then I read "twin", so ... woah!)
Thanks for replying!
This is far from a typical response to SSRIs. How long did these effects last?
Years, but I don’t think it was just the SSRIs that caused it. It was more of a personality shift, or some sort of enlightenment, I’m not sure. It is very strange, I genuinely don’t know what happened. I’m just saying this because it might be useful information for some people. But I think the SSRIs may have had a major role to play.
Chemical castrations are not reversible, famously. If they were, they would not be useful. I don’t think they can be used as an analogy for a hypothetical chemical amgydalectomy.
> Chemical castration lasts as long as you continue to take the drugs. Once you stop taking them, hormone production returns to normal.
> The effects are generally reversible. But if you’ve been taking the medications for a long time, some side effects may continue.
https://www.healthline.com/health/chemically-castrating#duration
> Fourth, unlike surgical castration, the effects of anti-libido medication are reversible after discontinuation.
https://pmc.ncbi.nlm.nih.gov/articles/PMC3565125/
You would want to look at Intranasal Oxytocin, Propranolol and maybe Buspirone.
My prejudice is that any effective sedative will be habit-forming enough to make the reversibility nontrivial.
Sorry for the late reply, but a Buddhist teacher called Shinzen Young was working with reseachers on this a while ago, not sure what became of it. https://tricycle.org/article/brain-stimulation-meditation/
First off, congratulations on surviving the tumour, the chemotherapy, and all the surgeries!
Secondly, "In my hospital stay, I pestered the surgeons about why they were not handing out amygdalectomies as freely as appendectomies."
Consider you are now making this request post-amygdalectomy. Your judgement regarding risk etc. has been affected. You are like someone asking "but why don't you dangle the patients out the window? it's fun!" after having your "argh I could fall this is risky this is bad I don't want to do it" sense removed.
Regarding your last paragraph: Very valid point. I realized that this is a problem I have faced many times on a less spectacular level. For example, I have a herniated disc in my lower back. I struggled for (a few short) years with regular pain, reduced mobility and reduced "choice of activities", despite trying a few recommended things. Only when I found proper weightlifting did it completely change my life to be even stronger than I was before.
This too was such a fundamental shift in inner experience, that when I try to recommend this course of action for others with similar problems to mine, I can feel that there is a big river between us. No matter my enthusiasm, I can barely break through the veil of that person's perception; and since I don't have brain damage I can very clearly remember what it feels like to be in their shoes. It is simply unimaginable from their perspective.
Daniel's experience might be similar to this.
Makes you wonder what else is out there, where we stand on that other far side still, unable to see what is possible.
If you're able to elaborate on this I'd be curious to hear more. I've known forever that weight lifting and being more athletic would be good for me, but yes to be honest it's always been a vague boring kind of obligation like how I ought to eat more kale or whatever. What is your Phenomenology of Getting Swole?
My practical method was to say "Claude make me a workout plan app" then negotiate with it around specific exercises I like/ hate doing or didn't have the equipment for at the gym until we got a good plan.
As a general note I life and my (similarly aged) brothers don't, we've noticed I have considerably fewer aging pain related complaints than they do.
Adding the tag that the best workout is the one you actually do, so it's mostly about finding what's least boring to you (lifts while listening to music? Group HIIT? Long runs by the river? Some esoteric mix? This is the part that varies wildly by person).
https://www.reddit.com/r/swoleacceptance/ this is one route, if you're open to a new religion (/s)
I’m not the OP and have only a moment to comment, whereas I’d like to go on at length. But I had chronic pain in my scapula and ribs for years which was debilitating. Weightlifting solved it. But not only is the pain gone, the feeling of what it’s like to be me is completely different. Pain or a sense that your body is vulnerable affect your mentality so much. I had become timid, risk-averse, downtrodden. But being strong and physically capable made me confident, calm, and enterprising. And it just feels great on a physical level, moment to moment. I even get sick less often and less severely. Everything about the body starts to work better, and that in turn makes the mind and the state of experience better too.
Yes, that's exactly my experience too. "Mens fervida in corpore lacertoso."
I am happy to elaborate. The most important principle is: Find something that's fun for you. Easier said than done, though.
But this might get you on a journey to try stuff out. One thing you might observe is: Once you start moving your body for real, you will have a lot of mental effects. You simultaneously become more awake, and you become more tired and sleep better at the end of the day. After sports, you might feel calm or energetic, other problems in your life seem smaller or easier to handle. Solutions present themselves to your mind, a productive business in your head that brings ideas for the next day.
Once you have made those activities a habit, you tend to remember how you feel afterwards. When you feel low/stressed/"bad", you remember you can just go to the gym/mountain/whatever and feel great afterwards. Not "just feel great", but have an actual bodily and mental relief, and new motivation and strength to tackle whatever stressed you. This might include putting things in their place ("it's just a job", "i got worked up too much"), but also just courage to act ("just ask for x").
Lifting is actually just a supporting side activity. My main sports is cycling, specifically mountainbiking. I need plenty of muscles there too, and it is a massive motivator to go to the gym on rainy days and dark evenings when I can't or don't want to cycle. So, find a reason and then do it for the results (faster, stronger, easier, more mobile, or whatever your goal is), not for the looks. The latter is rather "cringe", though very human. Of course, I appreciate the improvement in looks too (my partner approves).
Some clarifications: I'm not "jacked" and I don't think that needs to be the goal for anyone. The biggest muscles should be in your legs anyways where they are not very conspicuous. And I'm not talking only about the gym here: Physics kind of dictates that we need bigger legs than arms. Getting jacked is often even a massive blocker for other activities: Mobility is reduced, weight is gained (even if it's muscles, it will make you slower). I like the all-rounder mindset; have good running pace, be able to lift shit (look, I'm a nice guy, but even I find it a bit "cringe" when healthy men can't lift their own suitcase into the overhead bin without being wobbly or visibly struggling).
If you want an introduction to functional weight lifting, do the famous 5x5. Start as low as possible, proceed as slow as possible, be meticulous about correcting your posture constantly (this is the most important thing about lifting, the weights are a distraction really). Show patience and consistency for *one year* and you will be positively surprised, even if you stop lifting afterwards.
I agree with all of this. Stiltwalking is that fun way to exercise for me, and when 5x5 was boring I went (via 7x7) to just Dancing with my 15kg handlebar and topical AI generated music. That is such fun that I find myself happily doing it every morning.
I started strength training primarily out of curiosity, but then realized one thing. Imagine: you’re 70. You’re already pretty weak, and then SARS-3 forces you into bed for several months. When you beat the virus, will you have enough strength to lift yourself out of the bed? What kind of life will you have if you get that frail?
I decided to get myself to somewhat-overkill levels of strength so that scenario would at worst reduce me to “untrained middle-aged man” level.
In daily life, endurance, mobility and getting rid of excess weight perhaps matter more than raw strength (just look up the video of how Mike Israetel runs), but obviously it’s best to achieve all of that.
As for what exactly to do, just follow Starting Strength. The program is as simple as it gets, four barbell exercises, three sets of five, three days a week. Another commenter suggested 5x5, which is very similar but, as the name suggests, calls for five sets. I think the outcomes should be pretty much the same so the shorter program is preferable.
Have you written about this in detail anywhere? I had surgery on a herniated disc last year and am still struggling with daily pain. I'd love to hear what exercises you find most helpful.
There is a longer comment on this thread, but I will partly repeat here for your benefit specifically. Given the caveat that I do not know your exact circumstances, obviously, here is my experience.
The single most effective exercise is traditional barbell squats, as part of the traditional 5x5 program. Substituting with any kind of guided machine did not work for me (very little return for the time spent). The magic in an actual barbell is that it makes all of your body's muscles work, even the small ones that balance your feet, legs, back, hips and shoulders. So it also works out *all* of the tiny muscles surrounding the vertebrae.
The trick is to start with as low as possible weight = empty bar (20kg standard, or even lighter bars if necessary!) and meticulously correct your posture. Get the posture and movements *right* before adding weights, and continuously check your posture to get the full and correct range of motion.
Go up in weight methodically slowly, add 2,5kg only even if you feel like you could easily add more. Going up too fast messes up your posture. And with a herniated disc that will give you bad nerve pain that creates pain, messes up your entire week or worse. You know that kind of pain. Doing it that way also trains your brain to avoid going to the gym, as it is the source of pain.
Don't feel embarrassed about filming yourself at the gym, to review your posture. If you are not a great self-learner or don't trust your own judgement, get an expert. But a real one, not a random gym trainer (most of them "suck" in that they are simply not precise and strict enough to actually get you in a perfect position).
Don't wear running shoes or any other shoes that are padded and have a height difference between heel and toes. I wear socks at the gym, but there is also "lifter shoes" that are basically ballerinas for men.
Why? You are lifting weights, duh. Padded shoes will just deform and mess with your posture, mess with your knees, make you wobbly and overall do nothing to help you. At the gym, I give this advice unsolicited to people lifting serious weights, and almost all of them have specifically thanked me afterwards.
The shoe thing might also be a tip for you in general. Walking is arguably just as important for me to relieve my back as is lifting weights. I have become an avid walker ever since. Shoes with less or no padding under the foot, as well as no height difference between front and back are so much better. Yes they feel less comfortable to start with, but first you adapt to it long-term, and they generally feel much better and comfortable the longe you walk. Maximally counter-intuitive, but proven over hundreds of kilometers. My go-to shoes are Vivobarefoots and some "skate style" inspired sneakers for cycling, like Five-Ten Freeriders or any of the dozens of copies (these shoes have very little sole padding and no raised heels, so surprisingly similar to Vivobarefoots while offering more protection through a harder upper shell).
I took my forever to respond, but I just wanted to say thank you for your reply!
Commenting just add my own bit of testimony. I also had a herniated disc and later started weightlifting/resistance training. Luckily, my back pain resolved relatively easily after a few months of PT and being careful, but I still had reduced mobility after recovery. Resistance training resolved this, and to quote commenter "David", "changed what it feels like to be me" for the better. It's like training renegotiates the relationship between the mind and the body. It's kind of like, instead of being trapped in a cramped corner of my body, my "self" now more fully inhabits the whole thing, and acts more freely in the world. For me, training delivers a marked boost to overall well-being with no downsides except for time & money costs, and slightly more tiredness/sleep hunger in the evening on workout days. Specific benefits include improved mood, mental sharpness, distress tolerance, general confidence and sense of personal efficacy, physical strength (obviously), flexibility & posture, increased enjoyment of food, reduced anxiety, and less random pains of any kind.
For anyone reading this who is interested in getting started, I highly recommend finding a good personal trainer to work with. You need external feedback to learn how to do the exercises properly, and to push your limits the right amount without fear of doing damage. Once you know what you're doing, you can continue on your own without the trainer.
I fully agree with all the effects section, very well said.
Regarding personal trainer, I think it's an individual decision to be made. Some people, like me, have a very good feeling for their own body (maybe because of other sports before) and a self-learner mindset (which probably applies to most people lurking here). I'd say try it out and see if you can do without a personal trainer - it worked for me, but it doesn't have to for you!
Just mentioning this because personal trainers can be expensive or not very good (and the latter is the worst outcome).
Yes. I did eventually figure that out and was hoping this would be obvious from the post.
This is the least German essay that I have ever read.
Funny, I had almost the exact opposite impression. I thought it was like listening to a robot who was on MDMA. "I unexpectedly felt wonderful. After I ran an internal diagnostic I was able to confirm that I did, in fact, feel wonderful. Here is my analysis of what joy feels like."
I find it funny because it's almost exactly what I'm like when I'm on stimulants. I dunno if it's just a coincidence but I'm mostly German by ethnicity.
And yet still undeniably German
Any sexual side effects? I'd always understood that the system governing physiological arousal for fear/disgust/fight-or-flight/etc also governed sexual arousal to some degree (shaking bridge effect etc), but maybe the literature has moved on since I learned that in undergrad.
If you're willing to share, interested if you previously had any pain/fear/disgust/humiliation/dominance/etc based kinks (ie anything that might be recruiting amygdala activation to heighten salience and engagement), and if there's been a change.
I have noticed no change in this regard.
I appreciated this if nothing else for the walkthrough of the *kind of thing that is possible* with contemporary technology, which is somehow a) continuously wondrous to me even though b) I try actively to apprise myself of these kinds of developments.
What a great post. You are awesome!! Not just making fun poems and writing, but doing happiness research and improve outcomes from chemotherapy. I'm in awe.
Medical technology is always surprising, because most people don't have any experience of it unless they require treatment. It is the reason why I find going to hospital such a thrill.
Thank you for sharing this astonishing story!
I would like you to know that your review of On the Marble Cliffs is one of my favorite things I have ever read. I keep it bookmarked, and return to it from time to time.
Wishing you many years of healthy, happy life.
PS Scott, run more stuff from this guy anytime :-)
Did you know that fear starts in the brain?
A certain piece that I now lack
Thieving cancer sure is a pain
But please don't put it back!
The fluid's staying in my spine
And neighboring address
My vitals are all doing fine
(At least for me I guess)
So let's get this done, a quick cut and run
There's a blog post to write
There's a story to tell (with the occasional pun)
From the man who feels no fright!
Extraordinary and wonderful! Thanks for sharing.
The thought occurred to me that the part of your brain that used to be able to go AAAAAAAAAAAAAAAAA is still there, but it's trapped and only able to express itself via alliteration...
His remaining left amygdala wrote this XKCD. https://xkcd.com/2957/
What do you mean? I don't get the joke
The part of his brain that used to go AAAAAAAA verbally is now reduced to writing crosswords where the answers are…you know
I was trying to make that thought occur to you. I'm glad that seems to have worked.
What a wonderful post! My favourite on the site for years and years.
To ask a very personal question which I suppose you will not want to answer, has it had any effect on sexuality or sexual desire?
Thank you! 💖 Chemotherapy suspended my libido until I found the taurine fix, but I did not see any other change the few times that I had sex or experienced limerence since.
Failure to experience negative consequences subjectively doesn't imply the absence of those consequences objectively.
As a side note, I'm interested in the author's change in his experience of religious thoughts, feelings, and experiences (If any).
No my Atheism is about as Enthusiastic as before. https://sevensecularsermons.org/ I had the good fortune of meeting a formidable Catholic hospital counsellor and have since attended several Sunday services in the hospital chapel, but I only ever felt the same condescending appreciation for liturgy as a folklorist art form, as before.
Your harnesses for compensating for time blindness and memory challenges sound useful. Can you share more details and/or resources?
I very heavily use Google Calendar and alarms to cut my days into chunks of usually 1 to 3 hours. Often I will additionally set up a timer to count down the remaining minutes in the current chunk, e.g. minutes till the next job videocall or doctor's appointment or time to pick the kids up from school. Beyond the current day, I have lots of notes and Google Tasks as well as a huge paper calendar with lots of room for written notes prominently placed on the corridor wall, and a couple of Google Docs where I track and plan medium- and long-term projects like this guest post. My days are as regular and routine/practiced as I can make them while shared custody forces important differences between days my kids are with me and days where they aren't.
When I go out without company with a functioning hippocampus, I have only two options: continual attention on Google Maps or most likely get lost and run late, even in my hometown where I have lived for 22 years.
Wow, I'm really happy for you! Thanks for sharing, this was great.
I'm sure I'm not the only one thinking about the different dimensions in which Buddhist enlightenment might compare to this. There seem to be a least a few parallels.
Good luck! 🙏
The Yogic and Buddhist traditions do offer usable vocabulary for euphoric altered experience, but I have long preferred scientific understanding https://sevensecularsermons.org/why-atheists-need-ecstasy/ and where secular science of sentience is not developed enough yet, I take that to be a task, not an excuse to fall back on venerable but prescientific attempts at modeling the relationship of experience and reality.
I'm glad you're feeling good. Wishing you many more healthy and happy years.
Did you ever like horror fiction? I'm guessing that if so, you've lost interest.
Hmm, or perhaps gained it? Wondering, because I'm very into the horror genre, but it usually doesn't trigger disgust or fear reactions in me (although jumpscares do provoke the latter, and I don't like them, and actively avoid horror that uses jumpscares). I really don't think I would be into it if it did. I'd call the reaction I tend to feel more 'thrill', it's generally very pleasant.
Yeah I would like horror if I didn't find it so scary. Jump scares get me the worst, but I also really don't like the constant anxiety they can induce. The tension is just too much. Some gore doesn't bother me, but other kinds do and I'm not sure what the difference is.
Excellent guess. The very horror-heavy conclusion of "A Practical Guide to Evil" held an appeal when I still had the cancer and depression, that now on the re-read has vanished, while many other aspects of that bombastic book continue to fascinate me.
Is there any independent corroboration of any hard details in Bottger's story? Sorry Daniel, but your corpus is setting off my confabulator warning lights.
I know Scott isn't acting as a traditional editor here, so I'm curious if fact-checking was part of the process.
Always with the negative waves, Yozzarian22
https://m.youtube.com/watch?v=Xyh-JpWdGmQ&ra=m
I haven't seen his medical records or anything, but I can independently vouch for the following:
- Daniel studied neuroscience and has published many papers in the field. See https://sites.google.com/site/danielboettger/ . He also used to email me from an email address associated with a Leipzig medical university.
- He's corresponded with me about his cancer treatment progress by email ~10 times over the past two years, with the progression and dates mirroring the story he tells in this post. He's also tweeted about the progress of his treatment over the same period.
- All of his medical claims check out as far as I can tell. Claude says the image on this post correctly corresponds to a brain that's undergone the operation he says it's undergone. I can't prove it's not from a stock radiology site, but it looks like a crappy picture someone took of a scan on their phone, rather than the fancy digital scan you would get from a stock website.
- Before I edited this piece for length, there were even more gory details about his care, all of which check out as far as I can tell. Although I suppose that a neuroscientist ought to be able to get the neurological details right, his descriptions of life as a long-term patient in a hospital also rang true to me.
- After his 2024 surgery, he tweeted a picture of his scar, and although the face isn't visible, the head looks like him from his other videos. See https://x.com/7SecularSermons/status/1828429760365482108, warning for scary scar picture.
- He's been in the rationalist community for about fifteen years, has been well-liked during that time, and nobody has had any complaint about him. He says he goes to European rationalist meetups regularly. Maybe one of our German meetup attendees can verify that he has a wound in his head; maybe they can even ask to touch it, Doubting Thomas style!
I agree it's very surprising that a neuroscientist with a special interest in human happiness/flourishing and a preexisting connection to a blog whose audience would be interested, would be the one to have this very rare surgery. I still think it's probably a real coincidence.
Thank you for the thorough response. I certainly find this a fascinating essay. Perhaps that's the true source of my suspicions - paranoia about believing something because it fits in so well with my preexisting ideas.
I'd pour a heaping pile of salt on this too. Not that it "didn't happen" but simply because you've got an N of one. And this isn't the only guy who's ever done this. Perhaps the most well spoken, perhaps the happiest... but those should ring bells too, considering "brain surgery often causes IQ damage."
Cream rises to the top, and you should suspect you're looking at the 1 in 1000 guy.
I met him in Leipzig at a meetup and he had clearly had brain surgery.
Thank you Scott! I think "nobody has had any complaint about him" is an exaggeration though. There are multiple European rationalists who know me well enough to have told me to my face that I've been acting strange since the surgery. I owe them for the observations concerning personality change that are an important part of this post.
No need to apologize; I know my story is exceptionally unlikely and consider myself something like the luckiest guy on the planet.
We regularly have ACX meetups at my place, next one is on October 6th. You can come and browse or even photograph my patient files if you want. It's over 100 pages of rigorous documentation in small print, since this hospital is German after all. 😎
Fascinating.
Here's a coarse analogy/question:
Neurological problems with frontal lobe behavior begat frontal lobectomies. Many years hence, neurostimulation techniques (for example transcranial magnetic stimulation (TMS)) are now showing promise in targeted ways to "kickstart" healthier neurology in those localized areas without physically touching them.
Now, I read this article as saying: neurological problems with amygdala behavior might beget amygdalectomies. Does the analogy conclude then: although TMS - itself - will struggle to provide effective neurostimulation to such a deep brain center because it's a "shallower" technique in nature, might other neurostim (invasive or noninvasive, DBS, FUS, etc.) will provide the controlled improvement in localized neurology sought?
Yes! Non-invasively we can only do the crucial EEG source localization to ascertain better than fMRI can whether an amygdala is acting up; to therapeutically influence it we need to get closer than non-invasive methods can. "Brain pacemaker" branded implant rather than ablative surgery MIGHT work comparably well. The difference is that they haven't been performed successfully nearly as often, so our prior has to be they are much more risky.
I've got a friend who's brain-crazy and looking to get into neurosurgery. Figures this post would come out on his birthday.
Regarding surgery options for Amygdala. There’s also high intensity ultrasound where sound instead of radiation is focused on a target so that only that target in the brain is destroyed. Currently this is in use mostly for tremor patients in destroyed the thalamus.
https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/focused-ultrasound-for-essential-tremor
Slightly different, but amygdala laser ablation has been performed for severe PTSD plus epilepsy.
https://pmc.ncbi.nlm.nih.gov/articles/PMC10247517/
I think there is going to be a large cultural hurdle in performing irreversible treatments for a psychiatric disorder alone. Even though psychiatric disorders can be just as, if not more crippling than neurologic disorders.
Fascinating paper. It sounds like the ablation of the right amygdala was performed to treat the epilepsy, and these two patients happened to also have PTSD, and it turned out that their PTSD symptoms were significantly improved.
"In my hospital stay, I pestered the surgeons about why they were not handing out amygdalectomies as freely as appendectomies. None of them had a valid rationale; instead they awkwardly mumbled about the infamy of lobotomies half a century ago."
I was just recalling the recent review of lobotomies posted when before Daniel mentioned it. But it's not really a contradiction; it is surprising that a careful and informed procedure has different effects than rooting around roughly in a delicate organ?
Still, I'd certainly turn down the offer barring the cancerous incentive.
Are you suggesting that careful and informed procedures were a characteristic of the Neolithic period lobotomies? 80% survival rate, some places.
No.
No no no.
I'm suggesting that the procedure this writer, Daniel, suggests sounds kind of nuts after hearing about the recent history of lobotomies, but we know more about brain function now and this surgery is more precise, so maybe it's less crazy of an idea, for those who need it. Maybe.
Yes. There are now improved prefrontal neurosurgeries, exactly like there is now gastric weightloss surgery that is much superior to the horrific jejunoileal bypasses of the middle 20th century.
But more importantly, the prefrontal cortex is a different thing than the amygdala. To oversimplify both into a pseudo-monolithic "brain" serves for everyday conversation, but doesn't when we want to understand neurosurgery.
The Neolithic people performed trepanation, not lobotomy. During a trepanation, the brain should not be disturbed, it should involve the skull only. It basically means "making a hole in the skull".
Lobotomy starts with a trepanation, but then involves invasion of the brain proper.
An organ which many people find useful!
Congratulations! I am 100% pro-joy. I hope you experience for many years.
This is great.
Science question, though:
"high-powered photons at X-ray wavelength"
That's just X-rays, right?
Yes, and regarding the note about xrays versus gamma rays, I quote Wikipedia:
> There is no consensus for a definition distinguishing between X-rays and gamma rays.
(In general, gamma ray photons are higher frequency than xray photons. But, for historical reasons, the ranges have significant overlap.)
Correct. The difference is sharper in engineering and operational procedures than it is in fundamental physics.
Interesting! Without any further research on literature, I am curious why would the ability to appreciate and mitigate risks remain unaffected. Could it be that having Amygdala for long enough in your life has been important in forming the correct processing pathway towards risk and fear? Therefore, should keep it at least until an individual is developed enough to understand and process risk? Although where to draw the line for developed enough is likely very subjective and debatable
It feels like a cruel cosmic joke for a neuroscientist to get brain cancer. But it sounds like it's gone as well as it could so far. On the topic of brain cancer leading to a paradoxical increase in perceived wellbeing - this reminds me of an excellent (fictional) story on the same topic:
https://www.utilitarianism.com/greg-egan/Reasons-To-Be-Cheerful.pdf
I also thought about that short story while reading this post.
Ah, nuts, someone beat me to it. Great story. Thanks for linking it so others can enjoy it! :)
Jinx. I came here to say this. The four of us should form a group chat.
That's a great idea, I started one
Never heard of that story, will check it out, thank you.
I don't think the joke is particularly cruel!😁
Before the craniotomy when they had the big pre-surgery talk with me and asked my opinion for their big judgment call how much to cut, explained the dilemma of conflicting priorities not to do too much collateral damage but also having to cut out as much tumor as possible (so its exponential growth would continue from the smallest possible remainder) my neuroscience background did play a causative role, because I got to say that I wanted them to be very conservative about that main artery and the bundle of motor neurons (without which I would now be hemiplegic) but I would happily sacrifice that amygdala they're getting more certainly rid of the cancer. So it's not ENTIRELY coincidental... but still coincidental enough for me to consider myself the luckiest guy on the planet.
I was a little sad you didn't attempt an English rendering of your poem, so I've taken the liberty:-)
Of Midazolam I have no need.
I find no fear that I can see
since I watched my amygdala recede
thanks to a craniotomy
To what heights has my bispectral index aspired?
I bet it's still one hundred strong.
Propofol is still required
as is Sevofluran.
The gist is summarized in a footnote, but thanks for the poetic translation. Google Translate makes a hash of it.
Saw that, but it wasn't a "poem" so I felt the call 🙏
Beautifully rendered!
Thanks!
I'm not done, but I wanted to say that this was glorious:
> Any and all anxiety apparently absent, an attentive and able anesthetist allowed abnormal admission absent anxiolytic amnesiac: an active, authoritative acknowledgement that nobody who experiences fear normally could pull that off!
Brilliant. Please stay off of stilts! We need your thoughtful contributions.
What a read! I’m so glad to hear how things turned out with your illness. You truly are an extraordinary person, spectacularly resilient, and such a beautiful writer. And I love the idea of you walking with your stilts
Have you read Greg Egan’s “Reasons to Be Cheerful”? It explores a similar theme but in the other direction : the protagonist's brain tumor causes constant euphoria, until its removal saves his life but destroys his capacity for pleasure.
"Hippocampal damage also seems to be why in introspection I perceive what my brain does not as a single integrated cognition"
That's fascinating to know. Can you expand a little? How does a unitary and a dis-unitary mental state of mind differ exactly?
Could the fact that the hippocampus and the amygdala are located next to one another help explain why people with autistic symptoms often also experience attention deficit disorder?
I'm happy for you, but I deeply care about my capability to empathize with the pain and suffering of others, so I would probably not find an amygdalectomy a good thing.
Now I’m imagining a world where this is normalized and pushed in certain careers the way weight loss drugs are in careers that value thinness - if empathy or fear are seen as detrimental to job performance, it could make the world much worse to be able to medically suppress them!
I find that this future is likely unavoidable. The first thing I think about when people talk about suppressing certain drives and emotions is fear-free soldiers who are constitutionally unable to question authority.
But as they say, you can't have the good without the bad. I can only hope these transitions are net positive for humankind.
I’m not convinced it’s an unavoidable future. The next big thing was supposed to be everyone taking GLP-1s to cure all sorts of metabolic diseases - turns out they’re prohibitively expensive and have all sorts of unpleasant side effects. I anticipate there would be even worse complications and expenses associated with elective brain surgery.
If there were something that could let you sympathize with the pain and suffering of others but not empathize with it, would you still have the same reaction? I know everybody defines these differently, but at least for me empathize = feel bad about viscerally, sympathize = think is bad and want to do things to fix.
Given your definitions: I think that some level of feeling bad viscerally, of sufficient mirror neuron firing, is required to actually be able to comfort people. Wanting to "fix" things too much can be actually detrimental when dealing with humans. Sometimes they just need support to fix it themselves. And I understand this frustrates certain kinds of personalities that tend to be very common in rationalist spaces.
That said, if someone felt so bad for others that this actually was detrimental to their own well-being I'd support them doing something like this.
So I'm currently experiencing something LIKE this, aided by ketamine therapy. I'm absolutely not afraid it's making me a worse friend or partner, but then again I wouldn't be afraid of that, since I have no social fear. But the argument I can make is that I'm much more loving and tolerant of others. I might be even more able to empathize, since I no longer get defensive and that can be such an obstacle to empathy. (Maybe I got a bit defensive with my husband today, but it didn't FEEL the same).
This experience revealed to me how often in the past I've been angry at someone else due to some deep primal fear that their behavior was harming me in some way. Even the basic complaint that someone's "not being respectful"--it's based on the FEAR of becoming "disrespected," whatever that means, that your social status will be lowered and your self esteem and mental health will fail and you'll be THRUST FROM HUMAN COMMUNITY AND DIE IN THE COLD.
Because I don't have that fear anymore, I feel much better able to accept people as they are, tolerate the ways they're different from me, and continue to interact with them even during behaviors that would have set me off before. I also feel much more attuned to the GOODNESS of others. I'm more grateful for them and more aware of my love for them.
I'm happy for you, but I wonder if this is really comparable. Do you feel like you have a diminished ability to understand the emotions of others compared to your baseline?
Awesome alliteration about ameliorating an affliction and amazing aftereffects.
Congrats on the accidental wireheading! I’m a little bit jealous of the effects, though it doesn’t seem quite worth it as a purposeful intervention given the risk to life and neurology.
> I perceive what my brain does not as a single integrated cognition, but as a creatively chaotic cranial company culture of cohabiting, collaborating cortical circumstances
I’d be very curious to hear more about this; are you saying that you feel like multiple sub-agents? What are the similarities/differences between what you’re experiencing and what people with DID report?
I have a very severe anxiety disorder, and I have genuinely thought before "why can't they just remove my amygdala? Wouldn't that fix the problem if the problem is too much fear induced by my brain circuitry being wired wrong?" Well, apparently they can if you have brain cancer, and the results sound great! I join you in praying that this may one day become an elective procedure for those of us without brain tumors.
Have you tried any hallucigens? I have no idea how typical it is (there's certainly some science investigating a link, but I've only skimmed it, and I don't know if it holds up), but a single LSD trip completely excised my anxiety. It's been completely gone for four years now.
This is interesting. Can I ask what dose you took and whether it was in some kind of therapy setting?
Is the alliteration after the poem intentional? It's driving me crazy. It has to be, right?
Best thing I've read in ages, well written and good luck!
I just remembered Zoraya ter Beek, a Dutch woman whose intractable depression and desire for euthanasia received extensive international coverage in spring 2024 (died May 22 of that year, age 29).
Voluntary amygdala zapping seems like an easy "Why not?" for a country that has decided to practice euthanasia. I'm curious if anyone has seriously suggested it as an alternative to suicide.
If a country is willing to euthanise its subjects, it seems well within the Overton window to offer them radical brain surgery.
It's hard to push the ethics point too hard when the alternative is ‘or death’
One would hope!
> It's hard to push the ethics point too hard when the alternative is ‘or death’
For a consequentialist, maybe. (Still need to consider second-order effects.)
For a deontologist, death is natural therefore good, "playing God" is bad. Bioethicists have no problem with thousands of people dying every day, but may object against the mad science.
But yeah, a country with legal euthanasia probably keeps their bioethicists in check.
Great read. I'd like to pedantically quibble with your choice of analogy here:
"Modern amygdalectomy is as different from lobotomy as your smartphone is different from an electrical telegraph!"
I don't think this actually communicates the idea you're trying to communicate. You're not just talking about an obsolete practice; you're trying to assuage people's fears of something terrifying. Maybe something like:
"Modern amygdalectomy is as different from lobotomy as today's surgery is different from medieval bloodletting!"
IQ tests have a standard error of 4 points, so several tests would be helpful to see if your IQ really increased.
I am curious about possible cumulative effects. How much of the brain needs to be removed to get +20 IQ points?
The idea that now you're missing your amygdala, you've decided you're fine without it reminds me of this part of Hitchhiker's Guide to the Galaxy:
> “Yes, an electronic brain,” said Frankie, “a simple one would suffice.”
> “A simple one!” wailed Arthur.
> “Yeah,” said Zaphod with a sudden evil grin, “you’d just have to program it to say What? and I don’t understand and Where’s the tea? Who’d know the difference?”
> “What?” cried Arthur, backing away still farther.
> “See what I mean?” said Zaphod, and howled with pain because of something that Trillian did at that moment.
> “I’d notice the difference,” said Arthur.
> “No, you wouldn’t,” said Frankie mouse, “you’d be programmed not to.”
This has me thinking that maybe I have a hypoactive amygdala - I’m very hard to startle but also slow to respond to potential threats.
My concern would be that, in biologically removing fear, there would be implications for the development of character. Isn't courage defined as "feeling the fear and doing it anyway"? In cases of pathology that would be different, but for a relatively normal person, removing the fear center would have all sorts of unintended consequences. How much could we alter the brain and still retain our humanity?
I think courage is only a virtue because we experience fear. Without fear, you could just do stuff without the need for courage, which voids the need for it. Character development need only occur when there’s something that needs to be improved or overcome, not just for the sake of it.
I must admit I am deeply scandalized by this post and all its implications. There are very many useful purposes for fear. Fear is a part of our humanity, and part of our survival mechanism. When people start wanting to alter the brain in order to create a fantasy utopia, which we all know from science fiction never works, we are playing God. Playing God never ends well for humanity. Look at AI. AI WILL win! AI has NO FEAR. People commit atrocities regularly as it is-- not just psychopaths, megalomaniacs or sociopaths. Imagine what worse atrocities they would commit if "ordinary" people could not have any concern for consequences of any kind. You can keep your brave new world; I don't want it. Science could never design the human brain or create anything close to it. Why should we tinker with something that we cannot even fully comprehend? Targeted, controlled experiments for medical purposes is one thing, when there is pathology. But a normal brain needs no improvement. Character is difficult enough to build with all our faculties intact. Without our programmed instinctual life-- you'd have robotic sociopaths, not human beings. Maybe those ones can serve the AI Masters.
P.s. as for character development I beg to differ-- it is a constant undertaking throughout the entirety of a lifespan. Unless you think maybe people are born "good".
You might find reading about Jo Cameron interesting. She was born with a very similar situation, not feeling pain or negative emotion. By all accounts she is a great mother and community member, an all-round lovely and productive person despite her lack of misery. https://www.astralcodexten.com/p/profile-the-far-out-initiative
With all due respect, obviously I can't comment upon her personality or character. But reading the description of her was rather chilling. I don't see how someone suffering a great deal subjectively from mental illness could continue in a relationship where the other person is constitutionally incapable of even imagining the other's pain. I don't think I could stay in such a relationship.
Please consider this statement: what we call joy, happiness, or peace is a result of RIGHT ACTION. The "feeling" of joy, happiness, peace, etc. ISN'T THE GOAL-- RIGHT ACTION IS. Her goodness is because of her right action. Her peace is because of her right action. Not because she has a brain abnormality which keeps her from feeling physical pain. Does she not grieve? Did she not grieve the loss of her husband??!! Are you suggesting we should not grieve? Avoidance of pain is not the goal of life. Avoidance of pain is the avoidance of one's own humanity.
You should make a video of yourself handling some creepy spiders to show your fearlessness.
Sounds fun, but hard to do legally in Germany. Maybe this histrionic declaration of war on Death can at least rule out fear of embarrassment? https://youtu.be/SqZPglIeSWg
A fascinating read, and nice to hear that you’re doing well!
In R. Scott Bakker’s technothriller Neuropath, there is (minor spoiler warning) a secret government program that involves performing “amygdala deactivation” along with other interventions (IIRC) to create titular neuropaths that are intended to be used as ruthlessly efficient superspies. However, it turns out that neuropaths (somewhat predictably given the genre and author) often go rogue and end up as sociopathic serial sexual predators / murderers. Towards the end of the novel, there is a memorable rant by one rogue neuropath along the lines of (paraphrasing from memory): “Before the surgery, I was so worried and afraid of everything; what people think and what I’m allowed to do. But now I realize that anything goes!”
After reading this essay, I was quite surprised to learn that amygdalectotomy seems to reduce aggressivity instead (at least in those with pathological levels of aggression in the first place). The portrayal in the book can of course be chalked up to artistic license (and perhaps the other interventions done to neuropaths), but it somehow fit my prior intuitive beliefs about the social importance of some negative emotions; if we excise fear (of, among other things, violating social norms), shame etc., would this not affect the inner enforcement of morality? I'd be happy to be proven wrong on this.
To me, there is increasing evidence that we've overcorrected from the problems of the mid-20th century science to having the opposite problems. Scott has already covered the move from crude race science to complete denial of structured genetic differences between ancestry groups that plagues current genetics more than enough. Related are the new developments in archeogenetics, which also has repeatedly shown now that history has also struggled with replacing the old stereotypes of savage early cultures with instead an idealized image of societies spreading purely by "trade" and "cultural exchange", which was complicated with a genetic profile that show a complete replacement (or the similarly common Y-haplogroup replacement).
One article that has stuck with me, since it completely inverted a lot of assumptions of mine, was from a gay man in his fourties or so. Sadly, I can't find it directly anymore.
In short, he was gay but otherwise wanted a "completely normal" (his words, not mine) relationship with biological kids (since he understood enough about genetics to know how much it matters). The second was already definitionally impossible (at the moment at least), the closest possible was if the kids are his with a selected woman; But again, what he wanted was kids with the person whom he chose to spend his life with. Even if that person is fine with the arrangement, he found it rather lacking.
And an almost bigger problem was the first condition, finding another gay man who wanted a dedicated relationship with no sleeping around. And not only did most guys he dated turn out to sleep around even after telling him they don't, even his gay friends told him to stop being such a curmudgeon, it's just sex, why does he care?
And this further extended to the entire lifestyle. At the end, he was jealous of straight people, and he actually tried to look into conversion therapies. But of course, not only are they illegal, insofar as you can find anyone in those spaces, it's all ideological dilettantes. There simply is no serious research on the topics. In the end, he preferred celibacy, if I remember correctly.
And we should also think about the cultural implications here. Functionally, he is repeatedly told from everyone around him that his personal wishes for a normal family with biological kids is invalid and inherently questionable, that he has to change and adapt. But when it comes to modern lifestyle choices like extreme promiscuity, those are totally valid and questioning them in any way is hurt- and hateful.
To be clear, I'm not advocating in favour of conversion therapies, and the way they were used in the past was abhorrent. But if an adult man with clearly functioning mental faculties wishes to change a part of him he does not like, why does he get a blanket no if that part is somewhat inconvenient for the current Zeitgeist? It would be rather interesting, and maybe even helpful for a few people, if we investigated more into how homosexuality arises and how malleable it is to intervention, as long as it is done with the full consent of an adult individual.
Conversion therapy doesn’t actually work. It’s like going to therapy to get yourself to stop liking the taste of ice cream.
The reason it’s not legal is because the common outcome is suicide, self harm, or tragically inauthentic “straight men” who get into hyper religious communities where they marry a woman who is going to spend the rest of her life being disappointed and he will spend the rest of his life hating himself.
Sexual orientation is not innate and there are ways to open up your range of desires, but becoming *unattracted* to something you are already desiring is nigh impossible bar extreme traumatization with wide ranging effects on how you’re able to connect with others. A form of sex therapy based on letting you acknowledge the edge cases where you do feel glimmers of desire for things usually outside off your norm and helping you orient to that through fantasizing is possible. I moved myself two points closer to the middle of the Kinsey scale that way. But I don’t think straight society (straight men, especially) would accept that being mainstreamed because it requires acknowledging that their heterosexuality is an imposed construct of Girardian mechanisms of memetic desire.
It is wonderful to hear this update and see that you've come through.
It would be very interesting to see how suppressing amygdala activity, maybe using some advanced form of transcranial magnetic stimulation, would affect people.
I wonder what is the connection, if any, between the amygdala and the default mode network, said to be active in cases where patients complain of anxiety (e. g. in Miller, Psychedelic Medicine at the End of Life, ch. 4).
Often when designing treatment plans for stereotactic radiosurgery, we need to make tradeoffs about which parts of healthy tissue will receive higher doses of radiation to spare the more critical areas. This makes me wonder if we should allow a higher dose to the amygala to help further reduce dose to other parts of the brain.
Of course, but what I'm wondering is whether the typical amygdalectony patient reports an experience comparable to yours, if you know? And if people's experiences are mostly like yours, why are there so many reports of emotional blunting and "Küver-Bucy" and all sorts of other adverse effects?
I’m squeamish about things like brain surgery, but this was well worth it. Another strike against the evil bioethicists!
Oh lol Daniel, your verses are hilarious (in a good way)!
I think I was on 20mg vyvanse, 10mg Lexapro, 2mg guanfacine, later moved from 5 to 10 to 20 mg of Adderall a day. Unfortunately can’t really give much more info. I am not sure it was entirely pharmacological. I wish I knew what caused it so I could reproduce it, it felt great. I know it persisted even when I would not take any amphetamines. Honestly im not sure. But it came to me in a span of 2 weeks, and lasted until either something broke psychologically, or because I quit Lexapro. It’s hard to explain because I don’t know much about what caused it, too many variables. Honestly I think it was pretty stable, I just lost it because I broke psychologically after realizing that the adderall was turning me into a tweaker. I should try Lexapro again even though I’m not depressed, because it was genuinely the best period of my life - genuinely almost incapable of negative emotions.
holy shit they're psy-oping the aspies and now telling them to do a modern day lobotomy too can't make this shit up
Narrator: "she had, in fact, made this up."
Narrative noise is cheap. The scarce edge is deciding which claims still deserve capital when the story gets weird.
> I meditated deep into myself, and despite my best efforts could not find anymore the old abyss of depression! And I could not find any traces of fright, terror or panic either!
This sounds amazing, I got tingles reading this. I'm very happy for you! Would love to read an update in a couple of years.
THIS IS THE MOST INTERESTING THING I'VE READ ALL YEAR.
I'm having a similar (maybe less extreme) experience aided by ketamine therapy. I've noticed my social fear is practically GONE. I still have all the positives of socializing--I'm interested in people, want to be close to them, am happy when they like me, and want to express myself so they see who I am. I'm just non concerned when these things DON'T happen. I still feel upset if I hurt someone, or if they hurt me, but those feelings lack the secondary layer of second-guessing and shame. I've also shed a family of fears related to productivity, thoughts like "should I be working right now" and "why am I so scared to do this?" aren't plaguing me anymore. I ABSOLUTELY love it. I feel more connected and attentive to my life and everyone in it. I'm really happy that you're getting to have this experience and thank you for sharing!!
As a serious cPTSD sufferer very prone to those looping fears, I'd be up to getting an amygdalectomy, even with high risks and uncertain outcomes.
I wonder how you can tell whether you’re primarily motivated by negative or positive emotions? I experience quite a lot of negative affect (stress, shame etc) and I’m also quite low conscientiousness (read: lazy). I wonder if an amygdalectomy would make me more productive (because I’m no longer being held back by fear/ wasting so much mental energy on negativity) or less productive (because the only scrap of motivation I had turned out to have come from negative emotions).
<quote>but in my repeated experience, each random crazyman, rage addict or methhead who accosts me </quote>
your city sounds like a lovely place
Very late to the party, but I've come across a nice quote which reminded me of this.
"All things considered, being shot is not as bad as I thought it might be, as long as you can keep the fear from your mind. But I guess you could say that about most anything in life. Its not so bad as long as you can keep the fear from your mind." (Special Agent Dale Cooper, Twin Peaks)
This is a fascinating read! Thank you for sharing this experience so vividly. It seems almost a blessing in disguise to have lost the capacity for fear and negative affect, otherwise it would have been unimaginable to go through all the surgeries and mishaps. I am so glad it all led to positive / cancer-free outcomes for you!
Evaluating branching game trees under emotional pressure exposes the limits of human calculation. Even with deterministic rules, human intuition relies on pattern recognition rather than raw search. Detailed why simple rules produce immense difficulty here:
https://gzambrano.substack.com/p/chess-is-simple-why-is-it-so-hard
wowwa
One might be able to research this with TMS (transcranial magnetic stimulation) or focused ultrasound to temporarily disable the amygdala. This would change the ethical picture considerably. Unlike surgery, the effects would be reversible, so participants could take part without risking permanent harm, and informed consent would be far more straightforward. That could open the door to studying what the amygdala actually contributes to mood, fear, and decision-making in healthy people.
Focuses ultrasound is still experimental though and the Amygdala is really deep in the brain.
Small note: surely that heart shaped hole isn't the size of a fist. A children's fist maybe.
No, my IQ has not gone up!
That test now seems was fake.
Through Mensa's help, I've learned to stop
believing that mistake.
Great Scott, would you please mark as wrong
my optimistic claim
inside the post, up from among
this comment section frame?
Love this. Unironically I'd very very strongly consider a radiosurgical amygdalectomy if it ever became elective. And I'm 90% sure I'd pull the trigger after a couple years of favorable outcomes.