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Emil's argument is almost the opposite of the movie that every faux-intellectual overquotes. Idiocracy. Great job framing the contradictions in Kirkegaard's theory.

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Sep 7, 2023·edited Sep 7, 2023

At some level it seems like the fact that evolution designed us to enjoy non-procreative sex -- oral, manual, etc -- would count as "mental illness" in the Emil framework. After all, those members of the species with a strong preference for PIV would tend to have more conceptions.* So, enjoying blow jobs means you're mentally ill? Really? And that's not just us, it's also bonobos, and a range of other (at least) mammals and avians. This just seems like a very poor fit for any kind of common-sense interpretation of "mental illness".

* Except of course they must not have, or we'd all have that preference today. With both bonobos and humans, clearly most sexual encounters are _actually_ about maintaining happy feelings towards members of your social group and especially your pair-bonded mate, not about reproduction. It was evolutionarily adaptive for us _as a species_ to develop female appetite for sex outside of estrus, and relatively hidden estrus, and a general enjoyment of sex accompanied by bursts of oxytocin and other happy-chemicals that make us think positively about our fellow tribe members and work hard to resolve conflicts. What helps the group as a whole may not be what's best for the individual. (Which is basically the point of _The Selfish Gene_. Ants are also extraordinarily good at propagating their assorted species, even while the vast majority of individuals reproduce not at all.)

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He's so funny for thinking that "reproductive fitness" isn't a political problem. For some intuition, recall the old quote "everything is about sex, except for sex, which is about power". Or even more directly stated, power is sexy and politics is the discourse of power allocation. So, of course it's political.

As usual, I like Freud's definition best. He didn't have a concept of "mental illness", everything was instead about the symptom itself (i.e. what the patient presents with as a problem), and he classified various symptoms structurally by cause. The DSM's approach is like looking at someone with liver cancer and someone who's an alcoholic with a failing liver and saying "ah, both have liver disorder".

The problem is we're not allowed to talk about cause in psychiatry without it being neurological, because weird effects of subjectivity are inadmissible in falsifiable research that must be reproducible for any arbitrary observer, so we get this whole mess of Scott's Depression Inventory (SDI, ever heard of it?) that make it hard for people to get the right kind of help.

Anyway I'll get off my soapbox. A part of me is glad that Emil K is still hanging around, he's a fun dude to get drunk with.

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I think evaluating everything on the level of procreative fitness /at the level of an individual human/ is not useful. It feels rather arbitrary or at least reduces the human experience to something very 2D.

I’m also sure that there are plenty of adaptions that support procreation / continuation of a group that would look prima facie maladaptive taken through EK’s individual organism lens.

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I read the "benefitting your friends" dig not over your value judgement over pedophilia but over your value judgement about homosexuality. I think it's a fair assessment.

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An illness is a degradation of some natural function with an external etiology. Most of what political hacks want to classify as illness (transgenderism, homosexuality) is actually chimericism: people have a non standard but functional combination of different entirely natural traits. This isn't quite there in terms of definitions. Something like polydactalysm is also obviously not a disease but is not composed of normal human traits. But with homosexuality and transgenderism it is literally just a non standard assemblage of normal sex traits, including normal brain traits. The only weird thing is how high a dose of cross sex hormones trans people's innately gendered brains experience as a result of "natural" puberty.

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I enjoy points 4 and 7. They remind me of the old joke that if evolutionary psychologists took their beliefs seriously, they'd stop reducing their biological fitness by ranting about evopsych all the time.

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"Is an interest in philosophy (or science, or art, or any other worthy endeavor) that reaches the point where it consumes your life a mental illness?"

This reminds me a bit of of Hakuin's "Zen sickness".

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Great job avoiding an argument about definitions while arguing about definitions.

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Emil's concept of "mental illness" already has a name:

It's simply the christian (Catholic, dunno about others) concept of unnatural sexual sin but put in secular terms to appeal to a non-Christian audience.

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"(I wouldn’t describe this as “benefiting my friends” - I’m against children getting raped whether they’re my friends or not. I think this dig was unworthy of Emil, and ask that he correct it.)"

Are you also against adult men getting raped by other adult men? If so, why are you against pedophilia but not homosexuality?

"Evolutionary psychologists are pretty smart people and can probably coordinate on new terminology and move on, whereas normal people have brought the US to the brink of civil war over pronouns."

Sorry, but it was the "smart people" who invented the bizarre ritual of declaring your pronouns. It falls into the category of things so stupid that only an intellectual can believe them.

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It doesn't seem to me that Emil thinks that you believe that mental illnesses are just preferences. He responded to you, but also Caplan(mostly Caplan really).

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The two of you might meet in the middle, at "mental states that reduce life expectancy"?

ADHD and alcoholism do. I guess maybe anxiety and chronic pain do too, at least via suicide. Pedophilia and other socially undesirable ones surely do, via the risk of punishment. Being Plato or a monk doesn't.

In modern humans, we have raised baseline life expectancy so much that losing some years doesn't usually mean losing some of the fertile ones. That has to impact evolutionary reasoning about modern humans so fundamentally that I for one can't calculate the full breadth of it right now.

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I take exception to defining anything as mental illness _today_ based on whether if it would have caused problems in the Environment of Evolutionary Adaptedness. There is no such thing as an EEA; evolution never ceases, and each time there's a change in environment, evolutionary pressures change.

If this is in fact what Emil is proposing, then he doesn't understand evolution, and he's most likely yet another Paleofantasist (TM).

If Emil truly believes that the height of human accomplishment consists entirely of spreading one's genes, well, I wonder how he expects writing the article you referenced to contribute to that goal. Usually when someone makes this sort of claim, it turns out to be a pseudo-scientific wrapping for a demand that everyone live according to the imagined mores of some imagined past... generally one where the person making the demand imagines that he'd personally receive automatic deference and status. Any creatures more successful than humans at this kind of fitness are ignored. (And there are plenty of them.)

It's certainly interesting to look at the actual implications of his stated definition. (ADHD good? drunkenness good? credulous religiosity also good, provided the religion opposes contraception...) Of course that's short term; I'm not clear that pursuing a strategy of quantity rather than quality in one's offspring is in fact effective for humans in even the medium term (3-4 generations); has anyone researched this?)

Bottom line - if you are accurately describing this author's position, I don't think much of him.

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Of course, the most obvious example of all is non-reproductive heterosexuality. If homosexuality is a mental disorder because it impedes reproductive fitness, then by the same logic, heterosexuals who use contraceptives and/or engage in manual, oral, or anal sex are likewise mentally ill. Kirkegaard is free to bite that bullet if he wants, but at that point, upwards of half the adult population would be considered mentally ill. That seems like a pretty useless way to define mental illness.

I'm also not even fully convinced that homosexuality is a disorder from a strictly evolutionary perspective. Obviously it prevents the individual from passing on their genes, but it may have benefits for group selection. I've heard that the math doesn't add up for the Gay Uncle Theory, but I've yet to hear this math explained in sufficient detail for me to consider it debunked. And the Gay Uncle Theory isn't the only way that homosexuality might be evolutionarily beneficial on a group level, it's just the simplest and most well-known explanation.

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Definitions are made for discriminating thing in ways that serve a purpose of an agent with some intention- that's true in mathematics, in computer science, and in here. I'll say bluntly what is between the lines, but I guess Scott can't write lest he is accused of not being charitable in interpreting the other opinions. Scott's definition is about solving the practical problem of "who needs help". And so are all the million ones that are less precise, but nearly everyone uses, and are adjacent in definition-space to Scott's. These include those of SJW and fundamentalist Christians - they may do weird things in the specifics, but at least they are genuinely caring about the same practical question.

What you have to ask when someone pushes so hard for definitions that defy the usual sense and are openly useless to the problem at hand is: what do they get out of it? The charitable interpretation is: because accepting a fuzzy and politically charged definition makes them so uncomfortable and anxious that they need to spend large amounts of effort trying to battle society even if it makes us all worse off. (Not relevant to the point, but I think this sounds a bit like (Emil)-mental-illness.)

But the less charitable -and more parsimonious- one is that a lot of this debating could be simplified, at least on Caplan's side, by revealing his preference of morality in a simple "I don't care about the problem of helping people".

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Here's a simple test: What traits do you want your children to have?

Schizophrenia? No, that's a massive malfunction.

Sickle cell anemia? No, that's a massive malfunction, although they seem to be making progress on a genetic engineering treatment.

Pedophilia? No, that's pretty bad.

Congenital deafness: No.

Homosexuality? They can grow up to lead happy, productive lives. But, still, homosexuality reduces your chances of grandchildren ... so ... yeah, that's another malfunction, not as bad the ones above, but still a malfunction you don't wish upon your children.

Homosexuality is a malfunction of a _basic_ part of life, so what else could it be other than a malfunction?

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Here's a simple test: What traits do you want your children to have?

Schizophrenia? No, that's a massive malfunction.

Sickle cell anemia? No, that's a massive malfunction, although they seem to be making progress on a genetic engineering treatment.

Pedophilia? No, that's pretty bad.

Congenital deafness: No.

Homosexuality? They can grow up to lead happy, productive lives. But, still, homosexuality reduces your chances of grandchildren ... so ... yeah, that's another malfunction, not as bad the ones above, but still a malfunction you don't wish upon your children.

Homosexuality is a malfunction of a _basic_ part of life, so what else could it be other than a malfunction?

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It's a fun reply to be sure. Actually, I was saying Caplan is the one saying there are only preferences, not you. Rather, you prefer to say that whether we should call something a mental illness is a mix of political (state funding for people some people think should be given such money) and scientific reasons. I am disagreeing with that, and saying it should only be a matter of science, even if we can't come up with an airtight or maybe even good definition for now (as you showed here with your 7 examples). My post was mainly aimed at Caplan's view (hence the title which is based on Caplan's claim).

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The case of autism was conspicuous by its absence in this piece - perhaps "is autism a mental disorder?" is a topic too radioactive even for you?

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The biggest problem to me seems to be “relative to what?” Are all animals mentally ill? If not then we are introducing arbitrariness. If I limit myself to my species, then there are also people out there smarter than me and more conscientious than me, therefore I am not mentally optimal. If that is the case, then am I mentally ill? If not more arbitrariness... and so on. Not to mention that plenty of “improving fitness” will be what is called political. Certain beliefs will help you get laid.

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Presumably people who don't want to have children would have fewer children. Is not wanting to have children a mental disorder?

If you're looking for evolutionary fitness or somesuch, number of grandchildren might be a better measure.

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Seems to me that you could just add “reproduce and raise healthy functional offspring” to that guy’s definition and you avoid most of the criticisms you’re making.

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I think Randolph Nesse's concept of a fitness cliff is relevant here. He argues that for contiually distributed traits subject to fitness trade-offs, the resulting fitness function doesn't have to be normally distributed, but can be slanted. This will result in a point of trait fixation in a population that is not at it's maximal point of fitness, since at one end a catastrophic result for some will occur.

This is proposed to explain why certain mental disorders are fixed in the population. I find it very elegant. We have strong evidence that most psychopathological traits are distributed continually throughout society.

So, looking at it from the gene's eye view, mental disorder is not, in fact, disadvantageous. It can be part of a trait fixating it's underling genetic frequency in an optimal manner. Of course, there are other conceptions, and it surely won't be the whole story. But still, it serves as a reminder that what is being selected for it's evolutionary fitness is not individuals, but gene frequency.

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Sep 7, 2023·edited Sep 7, 2023

Emil Kirkegaard gets to the conclusion he does because he is is concluding that the competition that matters is at the individual level. But the whole point of evolutionary adaptive explanations is that the traits you are considering have a genetic origin. So, somewhere in there are a set of genes and if you happen to have these series of mutations, poof, you end up gay. And here what matters is whether these genes will prosper in ancestral human populations.

Consider a much simpler case, the genetic inheritance which is responsible for sickle cell disease. Sickle cell disease is caused by a mutation in the hemoglobin-Beta gene found on chromosome 11. So, simple. It is just one gene. And it is recessive, like having blue eyes. You need to inherit the trait from both of your parents if you are to have the disease. Thus every human being has the genetic makeup of one of these 4 states: {NN, NS, SN, SS} where the first letter is your paternal inheritance, the second your maternal inheritance, N is a normal gene and S is a sickle cell gene. NN are normals. They cannot pass the disease to their children. NS and SN are carriers. They do not have the disease but carry the trait and can pass it along to their children. SS have the disease. Were they to reproduce, they would give the trait to every one of their children, but that is not an issue, because until the event of extremely modern medicine, all the SS children died before their sixth birthday.

If Emil Kirkegaard's limited definition of evolutionary fitness was correct, then the sickle cell gene should be bred out of human populations. The SS people are already dead before reproductive age, and the NS and SN people have a 25% immediate failure rate in their children -- and it's actually worse than that. The SS aren't stillborn, which means their parents either committed infanticide or spent years supporting these ill children before their eventual demise. All of this is evolutionary waste.

You would expect that this mutation would fall out of the population and be extremely rare, and if you look at populations where malaria is rare, you would be correct. But in places where malaria is endemic, the mutation thrives, and indeed becomes dominant in the population. Turns out that being SN or NS give you protection from malaria. You are not only less likely to contract it, but also it is less severe when you do. Some researchers in Kenya claim that it gives you a 60% reduction in childhood mortality 'from other causes' before age 6.

This tells us two things. First, malaria -- and anything else you are protected from if you are NS or SN -- is really, really, bad from an evolutionary point of view. If NS and SN parents are able to outbreed NN parents, despite throwing away 25% of their offspring and having another 25% who are genetically NN, thus no different from the NN's offspring -- then carrying the sickle cell trait must be of tremendous advantage to still come out ahead. And second -- evolution is terribly wasteful. All those SS deaths -- you could imagine an alternative world where those embryos conceived as SS would perish early in pregnancy. There are recessive traits where this does seem to happen, called 'homozygous lethals'. Not happening here.

So, back to the inheritability of gayness. The 'wastefulness' of having gay people who do not reproduce around in your prehistoric band doesn't matter. They have _got_ to be less wasteful than the children with sickle cell disease. As long as the genes that produce gayness confer some sort of benefit then it doesn't matter if every so often it also produces somebody that doesn't breed, as long as the benefit is substantial. And it could quite possibly be the _not breeding_ that is the benefit. If mom and pop struggle to raise 2,4 children to reproductive age for the next generation but mom, pop, and pop's brother who doesn't have children can comfortably raise 6 of them, then the genes in pop and pop's brother will prosper. It may also be that not having hungry young mouths to feed and take care of frees up the time needed to invent pottery and philosophy both.

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I feel like mental disorder (Emil) kinda encompasses mental disorder (Scott). If you can't function socially, that will likely reduce your reproductive fitness

Mental disorder (Scott) seems like a special case of mental disorder (Emil)

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I think Jerome Wakefield solved the how-to-define-a-disorder problem in 1992 with his «harmful dysfunction» analysis. A disorder has to be harmful to the individual or other people (value statement) AND an evolutionary dysfunction (fitness reducing). Both you and Emil alludes to it, but do not mention it explicitly. Here is the paper: https://www.psy.miami.edu/_assets/pdf/rpo-articles/wakefield-1992.pdf

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That was so much fun! And mostly right. Just one thing, nay, two: 1. Pederasty (man does boys): Socially tolerated (Plato, Afghanistan) and socially enforced in several tribes of Papua-Guinea: https://en.wikipedia.org/wiki/Simbari_people#Gender_roles_and_sexuality "Pre-pubescent boys are required to perform fellatio on older males and swallow the semen because it is believed that without this 'male milk' they will fail to mature properly. Upon reaching adulthood, men marry and engage in heterosexual behavior, initially requiring their (under-age) brides to fellate them and later perform penis-in-vagina sexual intercourse. Homosexual behavior past this point is rare." Now, for the Simbari people this seems neither mental-disorder-(Emil) nor mental-disorder-(Scott). Me, I feel different.

2. Maybe some deviant acts in our society we best call: 'crimes' - and some others just 'pervert'? (Some say: certain people seem to have certain sets of preferences that make them more or less prone to commit certain crimes.)

If one can adjust one's actual behaviour to societal/social pressure (as nearly everyone nearly always can and does), then considering applying societal/social pressure seems rather straightforward in dealing with unwanted behavior - not excluding therapeutical approaches, when efficient. "You can do better than fool around!" וְלֹ֖֣א תִּֿנְאָֽ֑ף׃ . Or more East of Eden: sin lies in wait at the door: its urge is for you, yet you can rule over it. "Timshel" תימשל

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I don't understand why this battle is being fought over paraphilias, nor over evolutionary fitness. I am getting that Englishman-in-New-York vibe of having wandered in to a culture war I don't understand. Evolutionary fitness is about heritability, and I don't see why it gets a look-in here, given the very small hereditable component in schizophrenia, depression etc. We don't analyse cancer or for that matter broken legs in these terms, despite both of them being clearly negative for survival prospects.

The paraphilias don't fit for several reasons. They don't seem to disable sufferers in other areas of their lives (see high-functioning pillars of society with 12,749 extreme images on their laptop) which doesn't go with intuitive understandings of illness, they don't seem to be routinely incompatible with reproduction (see married fathers of four with 12,749 extreme images on their laptop). They are in fact an evolutionary tool. Consider peahens: there was presumably a time when peafowl of either sex were drab brown things, and a peahen who imprinted on an abstract painting with a lot of eyes in it would be a raging fetishist, no question. Fast forward a bit and having that fetish is crucial to her reproductive fitness: and it is just a fetish, it's not in itself about better food gathering qualities or camouflage from predators.

So are people trying to motte and bailey their way to an R D Laing position, where the motte is schizophrenia and the bailey is being gay? I think the sort of schizophrenic who is instructed by God to murder complete strangers, or their parents, is a more useful type case.

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Nitpick re: the ephebophilia example: assuming the men have already had children, 3 would probably be more likely to help them have children of their own so eventually he might end up with more grandchildren than 1 and 2

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By Emil's definition, being shy is a mental illness

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Reminds me also of that (possibly apocryphal?) thing where modern chickens are *hyper* aggressive and can really hurt one another badly, in part because early breeding programs selected the most prolific hens in each coop. Turns out the way to be the most prolific hen in a coop was to bully all the others violently and break the others' eggs; but once you have a coop of all bullies, however, it's not nearly as effective. So we made a species of jerk chickens that didn't notably outperform the alternative.

In hindsight, of course, they should have picked the highest-laying *coops*, not the highest-laying *individual hens*. When you've got a species with complex social interactions and specialized roles, it's really dangerous to assess fitness only on the basis of individual childbearing numbers! Which is to say, I don't think that mental-disorder-(Emil) even resolves the ambiguity that Emil probably wants it to, because human reproductive fitness itself depends on the social dynamics of what other people around you are doing. Anchoring mental illness in evolutionary biology doesn't even excise the cultural relativism!

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What I find so puzzling about these debates is why it seems that sophisticated individuals like Caplain or this new individual can nevertheless seem to become super convinced there is something like the 'true' meaning of a term and that it can be somehow divined just by thinking about the distinctions they care about. And why do they always seem to assume that these new meanings carry along the usual morally associations? And once they realize they aren't using the terms like others are why don't they just introduce some nuetral term and stipulatively define it to make their argument.

I understand that they might believe that they have a more elegant choice of terminology but surely they don't believe that words always just mean whatever it takes to give the most elegant account and even if they did believe that why would they think those words retain their usual moral associations?

Like why do they never just say: I think terms like preference and mental illness are too vague/inelegant so I propose we use spreference and smental illness instead with these new meanings and then explain why they think this new means of description supports their moral views?

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I think a better framing of mental illness would include a notion of 'mental distress'. For various speculative ruminations on this topic, see my following blog post: https://www.awanderingmind.blog/posts/2022-02-02-on-being-mentally-unwell-part-2.html

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I think a lot of people are mistaken about the lack of reproductive fitness for homosexuals throughout history - yes, perhaps it lessens it a bit, but for the overwhelming part of history, loving your wife was a secondary consideration at best and most everyone was expected to marry and have a family regardless of their sexual preferences.

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I think this article is excellent on its own, but an important point that is only hinted at here and there is that Emil's definition presumes adaptation to a particular environment. This environment is obviously not modernity, but it is obviously not the savannah either since basically no modern humans are adapted to living on the savannah. So where is it? The answer is it's nowhere because human evolution has been ongoing, indeed accelerating, for 100,000 with each new adaptation causing a change in environment which introduces new evolutionary pressures.

However, you are simply and obviously wrong that homosexuality "seems basically okay for everyone involved". First of all there's AIDS, duh and that should be case closed. But even if there wasn't AIDS, gay (not lesbian) people mostly lead really squalid lives. Yes you doubtless know some gay people who seem pretty fine, you also almost certainly know some manic depressives who seem just fine too.

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>1: ADHD

One does wonder to what degree this is a made-up category for moderns unable to sit sufficiently still in a boring classroom.

>3: Ephebophilia

As phrased ("only"), 1 and 3 exclude almost all of fertile females. 2 is the least disordered of the three, per Emil's disorder definitions.

>5: Chronic Pain, Panic Attacks, Or, If You Insist, Nightmares

>I think Emil has to bite the bullet that conditions which make people miserable and ruin their lives aren’t mental disorders as long as they don’t affect functioning.

If they don't affect functioning, they sound inconsequentially mild. Being "miserable" and having a "ruined life" sounds incompatible with unaffected functioning.

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On alcohol & fecundity: Mormons are supposedly teetotalers, and seem to have lots of children. As are Seventh Day Adventists. I'm not sure if Orthodox Jews are teetotalers or not, but they, too, tend to have many children.

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Umm.. .."mental-disorder-(Emil)" would classify feminism as a mental illness. Not sure if he realizes that, or wants to go there.

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Is it possible that there is an aspect of "non-overlapping magisteria" here when trying to characterize certain behaviors strictly through the lens of their apparently dysgenic consequences?

I.e., a man who is monogamous may have fewer children than a promiscuous one, but that doesn't imply that man 1 suffers from some disorder. Perhaps some behaviors should be assessed through the lens of improvements to social harmonization rather than the absolute magnitude of offspring produced by that strategy?

The social consequences of these behaviors (unrestrained promiscuity is clearly frowned upon for its social destructiveness!) have implications for the future reproductive fitness of men via their social standing - or even their very survival, as sexual jealousy is a leading cause of various forms of violence.

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There's actually good reasons to think that a certain amount of pedophilic attraction would have been adaptive for men in ancestral societies. It seems irrational and maladaptive for men to be attracted to little girls in modern societies where we have high ages of consent and marriage is only practised between adults. But in the hunter-gatherer societies we evolved in which they practice child marriage the adaptive value of pedophilic attraction would be that it would motivate men to secure child brides.

I've noticed that most arguments about the adaptive value of attraction to particular age groups naively focus on the female's current fertility and whether having sex with them would lead to reproduction at that age. Humans don't run around having one-night-stands with eachother but instead form long-term bonds so what really needs to be considered is the TOTAL amount of offspring a man can potentially get from a female.

An 8yo girl has all of her fertile years ahead of her can give a man many more offspring than a 30yo who is approaching the end of her fertility (about 40 in HG societies). So imagine we have two men. The first man is attracted most to 8yo girls: "Oh, the're so cute and pretty! I want to hold one and keep her for myself!". The second man is attracted most to 30yo women. The first man would be more likely to secure an 8yo wife while the second man would be more likely to secure a 30yo wife, whether by seducing them, making deals with their dads, or by kidnapping them from other tribes. Since the 8yo has many more fertile years ahead of her than the 30yo the first man would leave behind more descendants than the second man.

The logic really isn't complicated. A certain amount amount of pedophilic attraction would have been adaptive in ancestral hunter-gatherer societies and so must have become normal in men. But it's such a taboo topic at the moment our society isn't ready to accept this. If we lived in a tribe in the Amazon where men marry girls when they're 8yo and start having intercourse with them when they're 12 (I'm not making this up) people would be much more accepting of the claim that pedophilic attraction can have adaptive value.

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"Emil proposes an alternate definition: a mental disorder is a mental trait which lowers reproductive fitness."

I don't think this can be a useful definition. Evolution has many uses for genetic diversity. A trait which lowers your chance to reproduce in one environment may enhance your chance in a different environment, or it may enhance the chance of your group reproducing.

Some traits may have survival value for the individual, but we still might want to consider them mental disorders: psychopathy, for example

A man who volunteers for a dangerous mission to explore outer space may be lowering his chances of reproducing, but we don't want to call that a mental disorder.

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Emil seems to consider a rather wide range of mental illnesses:

https://www.smbc-comics.com/?id=2636

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Problem with the term illness is it comes with a lot of baguage: Social stigma, or the opposite: societal help in term of treatment reimbursement or other monetary/non monetary benefits, protection against discrimination and getting fired. Also, in some cases, removal of full adult autonomy (forced treatments or internment) and/or partial removal of judiciary responsability.

Defining something as an illness has more to do with those "side effects" than any logical consideration, or actual treatments.

Maladaptive may be better: socially maladapted and reproductively maladapted are clearly different but relatively easy to understand things.

My own definition is quite pragmatic but neither very useful nor without problematic cases: an illness is a condition that make someone suffer (pain or unhappiness) for which a treatment exists or could theoretically exists, the treatment being anything (that at least alleviate the problem(s) and would be voluntarily taken by the ill person.

This is not foolproof: with this definition, poverty is an illness ;-p.

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I would *hate* this concept of "genetic maladaptation" - at least as defined in these terms.

I'm looking at this from the perspective of developmental systems theory lately, the idea of which is that (contra the popular view and people like Richard Dawkins) it isn't just the genes that replicate themselves. Genes can't, in fact, replicate themselves in the absence of a whole complex interacting web of developmental resources that includes the cytoplasm of the reproductive cell, the environmental conditions that allow for reproduction and so on (which for humans includes a very complex cultural context). What reproduces itself, then, isn't the gene, or the individual, but the entire developmental system, which includes much of culture.

In that context, the question of whether a particular individual is reproductively successful is irrelevant; what matters is a much broader system. So, to take an imaginary example, it might be the case that homosexuality contributes to the community in which others who aren't the direct offspring of homosexuals are raised by being extra adults who are able to provide resources and care or whatever, and in that way would contribute to an overall developmental system. That's just a made up just-so story; the point is that it *could* be the case, and to understand whether the trait of homosexuality is "maladaptive" for the developmental system we'd have to know whether it is the case or not. Another example would be a teacher who doesn't have children but contributes to the overall developmental system of very many children by educating them.

I'm reminded of a very post-Darwinian line from Nietzsche, where he says something to the effect of "no matter what your characteristics are, they are all part of the nature of the species, and thus all part of the output of a phenomenally successful evolutionary lineage." (He says it a lot more eloquently...) In terms of adaptive fitness, it might even be the case that society benefits in some opaque way from sociopathy or depression or whatever, and if those conditions were removed from the social environment the developmental system would be less reproductively successful. The point isn't that sociopathy and depression are "fine" or shouldn't be treated; the point is that we can't even form a coherent concept of "genetic maladaptation" if we're myopically focused on the individual's success or lack thereof of passing on their own personal genes at the expense of looking at the broader developmental system.

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There are some things you point out e.g. schizophrenics where you say it's not maladaptive because they have more children.

But the real adaptive strategy is to have more *grandchildren*. If your kids die before reproducing, then they might as well not exist as far as your genes are concerned.

I think a number of those conditions cause more children through carelessness. But if they don't grow up (because of carelessness) then do they actually increase fitness? We aren't salmon after all.

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Would those guys who cheat by putting more of their sperm into sperm banks (whether by owning the sperm bank or by signing up for more donations than they're supposed to) be the height of mental health?

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"I’ve pointed out a useful category (mental conditions which are bad for people and society)."

I'd count that as two useful categories.

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Sep 7, 2023·edited Sep 7, 2023

A lot of confusion can be avoided by introducing (1) a selected effects account of function and (2) distinguishing dysfunction from cases of fitness-reducing evolutionary mismatch. (And also just looking at the philosophy of biology that's been discussing this for several decades and arguably made a lot more headway: https://www.journals.uchicago.edu/doi/full/10.1093/bjps/axw021#_i11 )

Emil is groping towards (1) without recognising the relevance of (2). Scott’s counterexamples are somewhat less persuasive once Emil has this in hand, but he can still get to his conclusion when it comes to thinking about ‘disorder’.

A selected effects account of function says that the function of a trait is the effect for which that trait has been selected (importantly, not what caused that trait to develop in the first place, but what causes that trait to be maintained in the population, so we don’t need to go all the way back to the savannah. Additionally, Caucasians losing their skin pigmentation was clearly a more recent selection pressure producing a particular phenotype). Insofar as a phenotype is failing to produce the effect for which it was selected, it is dysfunctional. Osteoarthritis is dysfunctional because joints were not selected to stiffen and cause pain.

Importantly, putting someone in an environment for which their phenotype was not selected will often make them worse off, but does not mean they are dysfunctional: there is simply a fitness-reducing mismatch between the environment they evolved for and the environment they are in. (Compare: someone who has lactose intolerance because their ancestors never needed to develop lactose digestion and who lives in a city where only dairy is available will do terribly, but they are not dysfunctional. Someone whose ancestors did evolve this, but who cannot digest lactose, is dysfunctional).

Here’s what this gets us:

ADHD: We need to remember that a range of phenotypes can evolve and all be selected for (e.g. the range of heights), so there can be a range of attentional capacities, and many people think ADHD is just people at the lower end of the attentional bell curve. Insofar as people with ADHD do poorly today compared to ‘the savannah’, it’s because it’s a case of mismatch without thereby being dysfunctional. If people with ADHD are doing better fitness-wise today than the average person, then this doesn’t show the average person is dysfunctional because their level of attention is still doing exactly what it was selected for.

Alcoholism: A tendency to become addicted to alcohol needs to have been selected by some other pressure in order to have evolved at all (e.g. ‘liking GABA’), and whatever that trait is wouldn’t decrease fitness on the savannah given there’s no alcohol, and so that trait isn’t a dysfunction. Since Chinese people have developed anti-alcoholism adaptations, this seems like evidence that alcoholism was fitness lowering in the recent ancestral environment, undermining the relevance of the observation that people who like alcohol have more kids today. Once someone without anti-alcohol adaptations gets put into an environment with alcohol, ‘liking GABA too much’ becomes fitness reducing due to mismatch. Insofar as some groups have weaker anti-alcohol adaptations, they are in the middle of a transition, developing new traits in response to the changed environment.

Attraction: If men evolved to be attracted to women of child-bearing age, someone who is only attracted to women who are not of child-bearing age (either too young or too old), would be dysfunctional.

Chronic pain: Pain evolved to signal damage. Insofar as our nervous system is sending messages of pain when there is no damage, then there is dysfunction present.

Nightmares: nightmares probably aren’t a dysfunction given their prevalence. Nightmare disorder, however, plausibly is given it’s not what was selected for.

Things get a lot more complicated once we introduce culture and cultural learning, as we have learned to do all kinds of things that we weren’t selected to (use mobile phones, flick lightswitches, attend college). So I’m not sure about things like ‘pursuing philosophy’ or ‘violating taboos’ but I think we need to keep the reference class on traits which were selected for. Pursuing philosophy is arguably a form of seeking prestige/status, or excessive curiosity. Seeking status in general is a trait that we evolved as social beings. Seeking so much status that you no longer have children is plausibly dysfunctional, like continually eating so much your stomach gets distended?

Ok, that's dysfunction, but what happens when we start thinking about ‘disorder’?

Suppose a selected effects account of function gives us all we need for our scientific investigations. Accepting this while still asking about ‘disorder’ means tacitly accepting that extra-scientific considerations are going to be relevant to guiding usage of this term, and so values are on the table, meaning some of Scott’s other points come back into play.

Many negative mismatches are managed by making our environment much more like the ancestral one (e.g. avoiding dairy, avoiding direct UV light) but when this is infeasible, we arguably envelop those mismatches into our folk understanding of dysfunction (as in, can't 'function' normally in our society). When it’s a dysfunction or mismatch that directly impedes quality of life in ways we care about, perhaps that's when we call it a disorder (hence why same sex attraction isn’t disordered).

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"when the most demanding cognitive task around was hunting giraffes."

This is an excellent example of "things I don't understand are easy."

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Emil's definition is not widely shared in his chosen field. Randy Nesse is the best known "evolutionary psychiatrist." Reproductive outcomes are just one possible concern. Other explanations for disease (all disease, not just mental illness) include:

- Mismatch: our bodies are unprepared to cope with modern environments

- Infection: pathogens evolve faster than we do

- Constraints: there are some things that natural selection just can’t do

- Trade-Offs: every trait has advantages and disadvantages

- Reproduction: natural selection maximizes gene replication, not health or happiness

- Defensive responses: Adaptive reactions are often unpleasant

Review of Nesse's book:

https://open.substack.com/pub/affectivemedicine/p/good-reasons-for-bad-feelings?r=1jkibi&utm_campaign=post&utm_medium=web

Martin Brune also wrote a fairly accessible book, his Textbook of Evolutionary Psychiatry.

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The problem with Kirkegaard's account isn't merely limited to weird edge cases etc. rather its a problem with virtually all WIERD societies, given their low fertility rates etc. The point about drawing a line being hard is something I have brought up many times previously, along with various considerations as to the EEA when assessing current, past and future humans. The important point relating to Szasz/Caplan etc. is that none of the various reasonable taxonomies that have been proposed say relating to moral goodness/evolutionary adaptiveness/widely held legal and social norms etc. actually describe what the DSM 5 is, rather a Szaszian account of different interest groups with different values, positive beliefs and moral beliefs all (reluctantly) compromising to create some weird amalgamation that is the current taxonomy. This is important as lay people and even some experts and such take it for granted that the current taxonomy actually consistently carves nature at its joints and such, with only a handful of people active behind the scenes seeing how the DSM is actually compilled, say Richard Green or Blanchard and Cantor vs Rind etc. I should add that a pretty good reason to be interested in the Evolutionary psychiatry account of things is that it almost certainly has the best chances of working out various diseases' etiology.

On a related note it's important to note that heterosexual pedophilia and nepiophilia actually seem extremely rare, with the most plausible explanation behind offending being sadism/power dynamics/opportunistic rape or extreme emotional congruence with children/some sort of intellectual disability, this is supported not only by various quantitative data such as that from phallometry (despite all its problems this is a consistent finding) and various qualitative data looking at various cases of physical and virtual offending. Interestingly Scott seems to roughly imply although not explicitly say that ephebophilia (his example borders hebephilia) is adaptive, which has some interesting implications for modern prevalence etc. unfortunately Cantor doesn't share his hebe data (0.0sd cutpoint specificity values would be nice as a start) and since Blanchard 2008 they explicitly don't use epheb stimulus, their are lots of other problems such as the fact that most research has used controls selected for teleiophilia whether it be SOAs or volunteers etc. and researchers seem disinterested in actually establishing prevalence estimates instead needlessly focusing on validating the test against ideal groups and such. If Scott is right its sort of interesting that very few evolutionary psychologists and such have touched on this topic, maybe Lassek and Gaulin recently (although they make quite a lot of mistakes) and maybe if you caught someone like Trivers off guard he might mention a couple things, and there is that Robin Hanson post from a while back, but for the most part evo psychologists just heard some stuff about Montagu or Symons and anovulatory cycles etc. then leave it at that.

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Scott, I agree that your definition makes sense and is useful, but it's got an important consequence that I don't think you've addressed: psychologists should not be allowed to make determinations about whether something is a mental disorder since having expertise about the working of the brain does not give you any special authority to determine whether something is moral or good for society. Mental disorders should be defined by religious leaders, ethical philosophers, or whoever has moral authority in our culture, and then given to psychologists to treat. Allowing psychologists to decide whether something is included in the DSM is a category error just like asking an expert in the material properties of concrete where we should build the next bridge.

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I don't know if sexual attraction to children is something that would be a mental illness by Scott metrics, either.

(But note a MAJOR difference between "sexual attraction" and "rape" - rape is unacceptable regardless of the age of the victim, so child-raping pedophiles seem not really different from adult-raping non-pedophiles, by this criteria. And just in case this needs to be said, *any* sex with a child is rape.)

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Sep 7, 2023·edited Sep 7, 2023

I feel like both Emil and Scott are using a narrow definition of fitness that's not in line with modern evolutionary theory. For example, in the discussion of chronic pain, we see how narrow Scott's definition of "evolutionary fitness" is: "hunt, gather, or have sex". This is far too narrow a definition to be taken as a serious connection to modern evolutionary theory. What does it mean to have a disorder that "ruins their lives", but you're still passably functional? Does it interfere with your ability to maintain long-term relationships? Does it impede your ability to plan for the future? Do you spend a lot of time trying to get rid of your chronic nightmares, or make you less willing to take small risks that might lead to big payoffs later? This is important in a hunter-gatherer society that will need to track the movement of herds, trends in the weather, etc. Long-term survival is a lot more complicated than "find a willing mate as often as possible".

Let's go through some of the others to get a fuller picture:

ADHD - As I said above, having more kids is NOT synonymous with fitness. Scott waves a hand briefly in the direction of "it's more complicated than that", but not in a way most modern evolutionary theorists would recognize.

Alcoholism - Again, problems arise with "it's more complicated". Plus, I'd suggest religious teetotalers are more likely to have lots more children (i.e. Mormons, Adventists, etc.).

Ephebophile - there are good evolutionary reasons for society to prefer mating of younger men (who can take care of their offspring) over older men. A society where fitness is optimized for "every man wants to always mate with girls the moment they go through puberty" would not be positively selected for. Meanwhile, a society where older men pair up with women near their age (especially on the savanna) is going to ensure the wisdom of the elderly is preserved, while not sacrificing the fitness of the youth. Experience his hard-won, and shouldn't be thrown away, but it needs to pass down to the next generation, not take the next generation's place. Thus, you need to keep elderly people alive (preferably by pairing them up) without preventing younger generations from having and raising their own children. Therefore, the most fit scenario is absolutely #3.

Plato - If you have people in your society who contribute to societal fitness but don't directly reproduce you'll out compete a society that does. The extreme of this is the human body, where a tiny fraction of cells are actual gametes, but without the majority of OTHER cells functioning properly the gametes are useless.

Severity - An asexual person who never procreates, but who enables six other people to do so and expands the community's resources to support that population increase is a net gain for the community. Genes that select for asexuality will persist to the extent they expand resources greater than their prevalence in the community (again, cf multicellular organisms vs. gametes). Meanwhile, a schizophrenic who is unable to take care of themselves and has a schizophrenic child unable to take care of themselves is a net LOSS for the community, consuming resources but unable to produce them or to create resource-producing offspring.

(That's the extreme/pretend case where schizophrenia is 100% genetically dominant - see my concluding paragraph for why I think it's a problem to specifically identify something as truly 'unfit'.)

Emil the contrarian - it's important that a community be able to survive tail events, because circumstances change. This is especially true in an evolutionary environment where every species is constantly shifting strategies to get ahead of every other species. While continuity along the current strategy is important, it's also important for a community to continuously be experimenting with new potential strategies for fitness. Even if it costs you 2% of your population (or more!) experimenting on non-fit strategies, it's worth it to devote this resource to 'R&D' of the next fitness strategy for your community to embrace. Otherwise, you're stuck in the same fitness strategy. That strategy will work ... until it doesn't and you're wiped out - probably in favor of a community that is able to drive social adaptation through 'random mutation' by contrarians. Maybe doomsday preppers are mostly idiots who waste their lives. But if 0.0001% of the time you get a tail-end risk that wipes out 99.9% of the population, it's the preppers who'll survive. Until then (maybe for the next 300 years?) they just look like useless idiots.

Once we expand our view from "eat, sleep, procreate" to the more complicated view of long-term evolutionary fitness of a community, most of Scott's objections don't seem to fit the discussion at all. However, if we're asking about community fitness, this makes it more difficult for us to identify something as 'disordered', because society is complicated and it can be difficult to tell when a condition is truly "unfit" versus being a Chesterton fence nobody quite understands what to do with.

I think the biggest objection to Emil's definition is that it's EXACTLY the thing that drove the eugenics movement a hundred years ago to begin sterilization programs and ... other things. It's probably a road we shouldn't go down under any circumstances.

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> I weakly predict that alcoholics have the most [children] (they have lots of chances for drunken flings without contraception)

But maybe that is more than offset by the negative effects of the childrens' likely haphazard upbringing and possible outright neglect by alcoholic parents.

Also (on a related topic) it seems odd that the Chinese were the first to brew alcohol and yet a good proportion of Asian people, far more than a typical westerner, are intolerant of it due to the rs671 (ALDH2*2) allele on chromosome 12, which results in a less functional acetaldehyde dehydrogenase enzyme (says he, cribbing from https://en.wikipedia.org/wiki/Alcohol_flush_reaction )

It would be natural to assume they were more tolerant of alcohol, not less, since those who were not would have been at a reproductive disadvantage over time, just as western adults are generally more tolerant of lactose, as their ancestors have presumably been consuming dairy products for longer than those of the Chinese.

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>This definition would cover depression, where people might be too depressed to hunt or gather or woo mates. It would cover pedophilia, where people have sex with children (and not adults) and so can’t reproduce. But it would also cover homosexuality, which also lowers people’s chances of having children.

I don't even think you can say this with confidence.

For depression, how sure are we that it never helps you conserve your resources by 'hibernating' and lowering your energy output in low-resource periods when running around failing at hunting all day will kill you? Or keeps you home from wars and blood fueds and so forth that would see you dead pretty often?

For pedophilia, how sure are we that snapping up the best spouse when they are too young for anyone else to be interested, and grooming them to be devoted to you for life, is actually a bad evolutionary strategy (even if it's morally detestible)?

For homosexuality, are we admitting all the stuff about inclusive fitness (resources to nieces and nephews, sexy son hypothesis, etc)? And in traditional cultures, how sure are we that gay people aren't being herded into marriage anyway, do they actually have less children in traditional cultures? Does being gay strengthen your bonds with other men and get you more resources and protections (think bonobos), does being a lesbian help you resist getting pregnant outside wedlock and lead to fewer children with higher rates of survival?

In the evolutionary environment, do schizophrenics have fewer children, or are they treated as shamans and visionaries and given many wives?

Etc.

And that's assuming that we're judging fitness based on some imagined evolutionary environment that we have no way to actually measure or confidently predict. If we make it relative to a given modern culture, then not only does that mean what is and isn't a mental disorder is different in every culture in the world and over time within every culture, but it probably means that things like intelligence and impulse control are mental disorders because they anti-correlate with birth rates in modern societies.

Emil's definition has the property of *sounding* simple and objective, but I'm pretty sure it's actually quite incoherent and would rely on lots of subjective and arbitrary handwaving to implement. I don't think it actually describes a compact or useful concept.

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If someone has a really great hammer - like Thor's Hammer they're always going to be looking for ways to use it(like 'if I swing it around fast enough can I fly?'). If one has a trait society values it can get overused as a tool to understand (or mis-) stuff. Analytical thinking.

I believe that defining "mental illness" like morals/ethics is about balancing(e.g. doctrine of the mean, middle path). Balancing the primitive reproductive instinct with the higher intellect's concern for society as a whole. The latter being far more subjective. From a smattering of reading it seems the West's smartest have been on a analytical thinking bender for a few hundred years which resulted in DSM recommending treating 'this' illness with 'this' pill(1). I think that mental illness is often caused by cultural characteristics and must be treated within a given environment(2). I read that an American treatment for Bulimia was used by American doctors in Singapore where there was a more mild form present and it made the condition worse there(3). That's not to say that some conditions aren't generally occurring and generally treatable(e.g. depression).

Lastly, I'd say that as as all civilizations age, morality loosens which creates tears in the social fabric(Khaldun, 1377, etc). Consider Freud's idea that all "sociable feelings of affection" not appropriately sexual are "aim-inhibited"(1921). A bit over-stated, imo, but it fits that these inhibitions would start to break down as the social fabric condition worsens(communities fragment, people become divided, lonely and so other alt. compensations are sought).

Please know that I'm not saying that there is never a time some people aren't attracted to the same sex but in a healthy society there would be fewer that felt the need to act on it and one would hope exceptions would be made for those that felt compelled to live that lifestyle.

[I can fill in the footnotes if anyone is interested]

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Evolutionary fitness is about more than the number of kids you have. If you have 100 kids and you can’t feed any of them, that’s bad for your genes. It’s probably better to think in terms of how many great grandchildren you will have. It’s not clear that things like ADHD and alcoholism would result in you having more great grandchildren. Especially in a world without government-provided welfare.

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mental illness: a pattern of behavior that annoys enough people enough that they would do something about it

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Sep 7, 2023·edited Sep 7, 2023

1) "benefits [...] friends" would seem to obviously refer to Scott being friends with LGBTQ+ folks but not with pedophiles.

2) ADHD isn't a mental disorder

3) Chronic pain clearly reduces fitness.

4) Nightmares also clearly have health and social impacts (being less rested and looking visibly shaken in the morning -- not something you can hide from your tribe) that reduce fitness.

5) The idea that it's good and a human right to be president when you''re patently less invested in the nation, properly speaking ('nation' and 'prenatal' have a common root -- a gay man without children will have nonstandard biases about the future and why wouldn't this make a difference to how he governs?) seems nonobvious.

6) Someone who can't get it up except for 14 y/os is going to have only one child per spouse -- even if his dream comes true and he gets that 14 y/o, she's going to look downright matronly by 16 after her first child. Obviously reduces fitness.

7) Alcoholism isn't itself a mental disorder, though likely most alcholics also have underlying mental disorders that contribute.

8) Emil isn't exhibiting a trait called 'contrarianism', he's saying what seems true to him, a trait known as 'honesty' and which is overall valued-enough by society that it seems strong selected-for evolutionarily.

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An interesting question to me is whether some of these mental illnesses existed in primitive humans at all. Primitive tribes that still exist today don't appear to have homosexuality, sexual fetishism, or gender identity disorder, nor even the ability to conceive of such things. Maybe primitive humans also didn't have persistent anxiety attacks or nightmare disorders? Just as you point out that alcoholism is only possible after the invention of alcohol, and we lacked time to develop defenses against it, maybe some of those other conditions can only exist after certain cultural technologies are brought into existence, creating psychological hazards against which we had evolved no defenses.

In light of our having evolved almost entirely in kinship groups of fewer than 100 people, I wouldn't be surprised if nearly every abnormal behavior pattern we observe today is recent in origin and caused by current social obligations and conditions being radically unlike those we evolved to survive in. (Of course that makes evo-psych functionally useless at predicting modern behavior and maladies, as many have already concluded for their own reasons.) Or alternatively, that there's some underlying malady that manifests itself differently now than it did on the African Savannah, and which we view as different because we're getting hung up on specifics, e.g. people who today are schizophrenic would instead have had a strong delusion that their penis was stolen by a witch, or a compulsion to move towards the sun at all times of the day, or something totally alien and inconceivable to us.

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> I wouldn't describe this as "benefiting my friends"

I...would? I...I thought that everything you've written on this topic, including this very post, was loudly and explicitly in favor of defining mental illness in a way to benefit your friends? I'm confused as to why you object to that characterization.

> 1: ADHD

You explicitly do not believe that ADHD is a for-real not-for-pretend thing that really exists in the real world.

> Psychiatric guidelines are very clear on this point: only give Adderall to people who “genuinely” “have” “ADHD”.

>

> But “ability to concentrate” is a normally distributed trait, like IQ. We draw a line at some point on the far left of the bell curve and tell the people on the far side that they’ve “got” “the disease” of “ADHD”. This isn’t just me saying this. It’s the neurostructural literature, the the genetics literature, a bunch of other studies, and the the Consensus Conference On ADHD. This doesn’t mean ADHD is “just laziness” or “isn’t biological” – of course it’s biological! Height is biological! But that doesn’t mean the world is divided into two natural categories of “healthy people” and “people who have Height Deficiency Syndrome“. Attention is the same way. Some people really do have poor concentration, they suffer a lot from it, and it’s not their fault. They just don’t form a discrete population.

https://slatestarcodex.com/2017/12/28/adderall-risks-much-more-than-you-wanted-to-know/

The pre-Columbian inhabitants of the Americas, as distinct from the pre-Columbian inhabitants of Asia and Europe and Africa, form a natural category in the real world. The people who "have" "ADHD" do not. Do you disagree with this summary of your position?

As I understand it, you do believe that *some* "mental disorders" are things that really for-real not-for-pretend exist in the real world, but that that is *irrelevant* to whether they are included in mental-disorder-(Scott). Even when some particular "mental disorder" does happen to point to a genuine geographic feature of the territory, that's not your stated justification for including it in mental-disorder-(Scott). Right?

That is to say, you do not believe that mental-disorder-(Scott) is a thing that really for-real not-for-pretend exists in the real world. (Right?) But because of the particular quirks of government dysfunctions, your friends with ADHD won't get funding for Adderall unless we pretend that it is. That would make your friends sad, because they want Adderall in order to do the things that are important to them. Therefore you endorse treating mental-disorder-(Scott) as if it is real, even though you do not believe it is, because at this point in time that is the strategy that will yield the results you want from the government. If later your government has different dysfunctions, then you will endorse a different definition of "mental disorder" with the same purpose of your friends getting funding for Adderall. I...which part of this summary do you object to? You describe this as a "dig", but, I mean, I sort of thought this was what you've been shouting from the rooftops.

It sounds like maybe it's just the "friends" part you object to? But, I mean. That seems obvious? Suppose Adolf Hitler "has" "ADHD", that is, Adolf Hitler is less capable of focus and long-term planning than the historical Hitler was. This Adolf Hitler would like to construct an elaborate multi-year plan to take over the German government and exterminate the Jews, but he keeps getting distracted and not following through. This makes him sad. Do you want mental-disorder-(Scott) to get Adderall for him, or not? Presumably not. You've loudly and explicitly and repeatedly endorsed the idea of defining "mental disorder" in order to get the results you want, not in order to accurately point to any particular geographic feature of the territory. (Again, do you disagree with that summary? If so, which part?) The results you want include helping your friends self-modify and do not include helping your enemies self-modify.

I suppose you could insist that mental-disorder-(Scott) includes ADHD when the things you would do with Adderall are good and does not include ADHD when the things you would do with Adderall are bad. But then you're just baking your friends and enemies into mental-disorder-(Scott).

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Scott makes a good point that both are valid categories, but I think what he misses is that disorder-(Scott) is a more recent, politically-driven definition than disorder-(Emil), and worse, like many political efforts, attempts to co-opt and subvert existing definitions. if there were an entirely different term for disorder-(Scott) then we wouldn't be having this conversation, but we are having it because there is a political effort to eliminate the older, more scientific definition.

This manifests in the trans argument, too. What trans people claim to experience is not what science has meant or what the billions of people Scott appeals to here mean when they say man, woman, he, she, etc. Those terms have a precise scientific meaning that aligns nearly perfectly with the vernacular meanings, even if the vernacular meaning is fuzzy and reliant on subjective judgment. Almost no one, until very recently, used those terms to refer to an imperceptible mental state, nor are they denying the existence of such by using them in the traditional context - it's just that it's not relevant, nor what people are talking about. The insistence on subverting existing words exists precisely because inventing new words that specifically refer to mental states, ze/zir, etc - don't in any way enforce their use, because that was never what anyone was talking about anyway.

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Would it be accurate to say that, if someone were given a large harem and a buffet, doing *anything other* than eating, sleeping, and having procreative sex forever (and maybe a few other health-preserving things) would be a mental illness under this definition?

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The other big issue with Emil's proposal is that behavioral evolutionary strategies ussually reach multipolar equilibriums rather than being dominated by a single strategy.

Such as:

If your entire tribe is strictly monogamous (by instinctual evolutionary fiat rather than cultural norms), then the first person to want polyamorous relationships may be able to snag several confused wives and have a huge advantage.

If your entire tribe is polyamorous, the first person to explain the idea of monogamy and credibly offer 100% certain paternity to the best man in town or 100% of their resources dedicated to just one person's kids to the best woman in town can probably monopolize the best available mate.

The equilibrium is some people being monogamous and some people being poly, in whatever ratio roughly equalizes their fitness. Importantly, this should be something approaching a non-exploitable equilibrium; no monogamous person should expect better outcomes if they flip to being poly, and vice -versa.

In terms of things like depression, adhd, being contrarian, etc etc etc., we may expect equilibriums like these to hold for many of these traits, such that it's not really meaningful to ask whether it is more fit to have them or not have them, because the answer depends on marginal difference based on the state of the local social equilibrium they appear in.

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Although I think gist of Scott's argument.is right on, It's similar, to another way to stipulate what counts as mental disorders - they are the class of conditions that are "harmful dysfunctions".

Some conditions are dysfunctions (evolutionarily maladaptive) but they are not harmful, at least for us today. There's no need to so anything about them - they should not count as mental disorders. Some conditions may not be dysfunctions evolutionarily (for example, antisocial personality may be a very adaptive parasitic strategy ), but they are harmful to society. Thys,, although we should minimize the harms antisocial people do, they are not technically mentally disordered. Only the conjunction of dysfunctional adaptation AND harmfulness (something that society decides) should count as mental disorder.

This idea was proposed a while back by psychologist/philosopher Jerome Wakefield. To avoid reinventing the wheel, his article would be good starting point to take things further. Heres the PDF:

https://www.psy.miami.edu/_assets/pdf/rpo-articles/wakefield-1992.pdf

From Euthymic Chickens: https://jnicanorozores.substack.com

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Here's my proposal for a semi-objective definition of "illness" (I just came up with it right now, maybe it's bad): Imagine an utopia constructed through something like Rawls' Veil of Ignorance scenario, where all unborn souls are perfect rationalists and committed contractualists. Before the creation of the world they set up a code of conduct which they remember and obey after being born. An illness would then be a condition of your body or mind that would require special accommodation. It's a fuzzy category - the more special accommodation it would require, the more of an illness it is.

* Queerness is very easy to accommodate (just agree to not persecute them), and therefore is not an illness.

* Paraplegia requires some accommodation (covering wheelchairs under universal healthcare, putting ramps everywhere) so it's an illness.

* Schizophrenia is a condition that none of the unborn souls would want even after coming to an agreement, so it's a pretty serious illness. They could however agree to put them schizophrenics on (extra) welfare and compose social rules about how to treat them properly.

* Urge to murder requires constant willpower on the part of its sufferer and constant vigilance on part of society, so it's as serious as it gets.

The purpose of this definition is to factor out the social and political factors in the common meaning of the term, so that it's limited to the domain of medical science. Since man's sole remaining enemy is nature, any bodily/mental condition that is still challenging to treat must have been caused by nature.

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Sep 7, 2023·edited Sep 7, 2023

I think this post gives pretty good evidence that there are phenomena that fall outside of the definition of “disorder-(Emil)” yet are addressed by the definition of “disorder-(Scott),” and that using disorder-(Scott) to categorize them gets people the help and treatment they need.

But there’s an unaddressed question of what to do with those illnesses that meet both definitions. One of the major conclusions from Kirkegaard’s piece is:
 “There is no need to inject politics into the scientific study of mental illnesses, in the same way we don't inject politics into the study of many other natural phenomena.”

If there are mental illnesses that meet both the disorder-(Scott) and the disorder-(Emil) definitions, yet using the (Scott) definition allows political interference that prevents finding the root cause of the illness,* then using disorder-(Emil) might be preferable.

For Scott, who is actively treating people with mental illnesses, it's probably super obvious why the good done by one definition outweighs the other. It might be less clear to those without experience in the field.

*I do not have any in mind. I only point it out as a possibility.

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Although the edge cases Scott brings up have reduced my conviction that the evo-psyc definition of mental disorder is the singular correct definition, I disagree with Scott about who should own the term. The reason both sides want the term “Mental Disorder” is that the current term communicates that the described concept is an official, quantified thing – and (often) therefore qualifying for insurance coverage and/or protected class status. However, only the Emil (and Cochran, from whom I first heard it) definition is quantifiable. While “Reduces reproductive fitness” is theoretically calculable given sufficient records over a sufficient timescale, “Bad for people and society” is simply a qualitative descriptor that will far too often simply be determined by the whims of whatever group is in power. Allowing the latter definition to use the Mental Disorder term therefore simply results in giving the those in power the ability to say, “It is scientifically determined that you are a disgusting bigot for disagreeing with me on what is good for people and society.”

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Sep 7, 2023·edited Sep 7, 2023

Perhaps the primary benefit of teleology is that it makes debates like this trivial.

Caplan is saying that mental illnesses are only preferences, Scott says they're social dysfunctions, Emil says they're evolutionary disfunctions, and all seem to miss the point due to a rejection of teleology. Emil tries to replace teleology with evolutionary fitness, Scott with flourishing in general, and Caplan doesn't try to replace it at all.

Surely the very idea of illness and disease comes from a teleological point of view? You can't say something is a defective member of a category if you don't believe the category exists. In the same way, you can't say a man whose dying of cancer has a disease unless you have some idea that he is not supposed to be like that. That there is such a thing as a human qua human, and that deviations from the form of humanity is a disorder. Someone whose eyes have been gouged out has something wrong with them because humans are supposed to have eyes. Similarly, humans who are caught in schizophrenic delusions have something wrong with them because humans are supposed to be rational animals. Not perfectly rational, but rational enough to recognize that they're not Napoleon or Jesus. Or to realize that it is very unlikely that the CIA can read your thoughts, or that there is no benefit to locking and unlocking the door 21 times every time you leave the house. Mental disorders are deviations from what the human mind is supposed to be, just as physical disorders are deviations from what how the human body is supposed to function.

Modern philosophies ditched teleology, and with it ditched all the "supposed to"'s. Yet without teleology, how can you really say that a madman has something wrong with them, and needs to be cured, or just has their own way of thinking that is different from yours but just as valid? You're forced to resort to justifications for calling it bad anyway, even though there isn't such a thing as a "right" way to be human. It's bad because it reduces reproductive fitness! It's bad because it causes social disfunction! These things are true, but don't capture the truth of it. Even if your schizophrenic delusions cause you no social or reproductive dysfunction (perhaps you live in a community that has decided delusional schizophrenics are sacred beings who should be taken care of and who you should have lots of children with) you still have something wrong with you because humans are not supposed to have schizophrenic delusions!

Certainly it is useful to have a concept of mental-disorder (Scott) and mental-disorder (Emil) to refer to specific aspects of mental dysfunction, but neither serve to adequate replace the idea of mental dysfunction itself.

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I would describe someone who stigmatizes a person classified as having a mental illness as suffering from bigotry, which while not a mental illness itself, exactly, comes pretty close. Perhaps the problem can best be solved not by abandoning the categorization scheme for another one, but by extending it further! Personally, I would rather stigmatize a bigot than a schitzophrenic.

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Sep 7, 2023·edited Sep 7, 2023

The attractive thing about Emil's approach to defining mental illness is that it's consistent -- there's a rule, a criterion, for defining mental illness. One feels as though if mental illness is a real thing, there *should* be a single clear criterion. Scott, on the other hand, has a mushier definition: bad for people and society. “Bad for” is just vaguer and more inclusive than “reduces evolutionary fitness,” and bad for people and society gives two possible arenas (individual & society) for “bad for” to happen to. So Scott’s criterion lacks that satisfying crispness, that put-your-finger-on-the-essence-of-it quality. However, Scott’s larger and looser criterion works much better than Emil’s. It is not possible to do to Scott’s criterion what Scott does to Emil’s — come up with a bunch of examples for which the criterion fades. And note that Scott also admits that “it’s somewhere between undesirable and impossible to have an apolitical taxonomy of mental disorders.”

It seems to me that the failure of Emil’s precise criterion here, and the success of Scott’s looser, and contaminated-by-politics-and-practicality criterion is a good example of how it does not work to categorize human variation human using simple, clear-cut rules. In grad school I was involved in developing scales for categorizing dream reports on various dimensions. One was presence/absence of aggression. The problem was that many dream reports had elements that defied categorization on that scale: There were dreams where someone said, “how’s the weather?” and the dreamer somehow knew that phrase was a death threat, and dreams where someone unsheathed a sword, and the dreamer knew that the entire purpose of the sword was to cut up a sheet of brownies. And even when I made extra categories to account for such aggressive nonaggression dreams there were still dreams that did not fit into either the old or the new categories.

One reason I am pessimistic about AI alignment is that I am sure the same problem will surface regarding the AI being aligned with our species's best interests. I don’t think there is any guideline that will work. “Don’t harm people” — but doctors routinely cause pain, and surgeons cut people open. “Don’t harm people unless your goal in doing so is to improve their wellbeing over the long run” — but what about punishments meant to deter people from harming others? And besides these examples involving individuals, there are many situations where a group of people are involved, and somebody has to make decisions that will worsen things for some in order to help others. And then of course there's the stuff that involves taking into account how much power to do harm or good a person has, and giving the powerful ones special treatment and exceptions to the rules so as to maintain their goodwill, for the sake of humanity. And so on and so on.

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Sep 7, 2023·edited Sep 7, 2023

A clarification that I think would help bridge part of the gap between the two definitions of mental illness is the following: evolutionary fitness is based on group evolutionary fitness not individual evolutionary fitness. This is a common mistake. Small groups, composed of a mix of individuals with a particular mix of traits, that were more likely to survive and pass down their sets of genes, collectively, are more evolutionarily fit. The logic is easy to see - a group where one male impregnates every female will very quickly die off for a host of reasons. Other examples abound - groups where people are willing to die for each other would outperform groups where everyone is selfish. Human evolution did not optimize for individual procreation.

With this revised definition of evolutionary fitness, I think that an evo-fitness definition of mental illness makes more sense. Homosexuality, in limited doses, can possibly increase a groups evolutionary fitness through different channels, or at the very least not hurt it. More importantly, anti-social behavior fits nicely into this definition of mental illness-(Johan).

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If you want to have 'reproductive fitness' as a criterion, you really, really need to take into account 'selfish gene' arguments. It makes no sense to consider reproduction by the individual human being as the metric.

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I am not sure if alcoholism leads to more or to fewer children, but I think it is implausible that both 1) alcoholism leads to more children and 2) Chinese, being exposed to alcohol the longest, evolved to have adaptations against alcoholism. It is not impossible - may be alcoholism leads to more children but fewer grandchildren, but this is a bit far fetched and, in any case just reminds us that evolutionary fitness is determined by the rate of offspring multiplication, not the number of first generation offspring.

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Kierkegard falls in the naturalistic fallacy. If animals do it is good, otherwise is bad. For example, if a person decides to spend his or her life in a monastery living a life of celibacy, prayer and meditation, Kierkegard considers this as something bad because if doesnt lead to reproduction. But that is a total whim, why is having biological descendants necessarily good? For the most diverse reasons, there are plenty of people who dont want to (myself) and so what?

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Chronic pain is related to structural issues in your muscles and joints that cause inflammation, and rarely as simple as neurological wiring. Often it comes from sedentary behavior, the aftermath of a car accident, or a prolonged period of bad posture. Classifying it with the rest of these seems like a bad idea. Someone who deals with the dislocation of their rib who experiences chronic pain is not mentally ill. Their pain is not caused by funky neurology. The whole “pain is created by your thoughts” idea is a mental illness. It’s on par with the law of attraction stuff.

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Emil Kirkegaard only exists so people can say they won an argument against Kierkegaard and impress people who don't know how to spell.

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Here's an interesting statistic:

Prenatal testing has halved the number of babies born with Down syndrome in Europe, study finds

Date: December 18, 2020

Source: Massachusetts General Hospital

Summary: A new study finds that the growth of prenatal screening in Europe has reduced the number of babies being born per year with Down syndrome (DS) by an average of 54 percent.

There are noticeably fewer Down syndrome people around than when I was a kid around 1970, when many huge Catholic families had a Down child. You don't hear much about a Down Genocide because Down people don't write a lot of op-eds. But, if there hasn't been one, where'd they go?

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Sep 8, 2023·edited Sep 8, 2023

Re. "Also making a value judgment, I would call homosexuality an unusual but valid preference: it’s not my thing, but seems basically okay for everyone involved." -

Homosexuality is a case that makes the relativism of values clear. In evolutionary times, up until the 19th century, personal survival depended mostly on group survival, where "group" is the group level at which defense is organized; and group survival depended mostly on reproduction rates. Under those circumstances, /not reproducing/ was a sin, very harmful to the group. Almost every society on Earth before 1800 heavily emphasized that everyone should--in a moral sense--have children. Homosexuality was in some cases frowned on only if it stopped a person from reproducing; ancient Athens is an especially clear case, in which open homosexuality among men was fine IF both men also planned on fathering children. (There are exceptions such as Norse culture, which had a strategy of all-consuming hyper-masculinity. There were also cultures in which "homosexuality" was forbidden, but pederasty with boy slaves didn't count as homosexuality, as is seen in Islamic records of the doings and sayings of Mohammed's companions.)

And, let's be clear, those societies were CORRECT to shame people who chose not to reproduce. Such behavior was a serious threat to their group's survival. A 5% hit in reproductive rate is easily enough to exterminate a group.

In the 20th century, reproductive rate did not give much of a group survival benefit, if any, and so homosexuality without reproduction did no social harm; and so it was WRONG to shame people who chose not to reproduce. In fact, it now seems perhaps correct to discourage people who DO reproduce--and American society does that now, aggressively. Just ask any couple who has 8 or more kids, and they can tell you dozens of stories about people pressuring them not to have so many children. That never happened before the 20th century.

If you're shocked by the idea that it's sometimes correct to discourage homosexuality, ask yourself: Why aren't you shocked by the practice of discouraging large families? Isn't that exactly the sort of interfering in other people's sexuality as discouraging homosexuality? And if your answer begins with, "Because if everyone has large families," -- gotcha! You agree with me.

In developed nations, reproductive rate has fallen so much that it is now becoming an issue, particularly in Europe. Expect sympathy for homosexuals to drop in Italy starting about now. But the important thing is to notice that this is morally CORRECT, in Italy, today. It is right for a group to discourage behavior that threatens the survival of that group--but what behaviors do that, changes over time. We must not injure future generations by using the concept of "rights" to fix morality in stone when it comes to behaviors whose adaptive effects change over time.

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Sep 8, 2023·edited Sep 8, 2023

One thing missing from any definition of mental illness is conventiality. Laziness for example is harmful both evolutionarily and to one's well being but it's not a mental illness because it's 'normal'. Same goes for lots of psychological dispositions.

Of course this means there's an inherent problem with any formulation of mental illness in practical terms because it's ridiculous to have conventiality determine social policy. A better term for 'mental illness' would be something like 'negative mental anomaly'. Which would justify setting it aside for study as a composite but not justify a lot of the societal and policy attitudes we have.

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When Kierkegaard says that your definition "benefits your friends," he may just mean, "you likey [the current match-up between percieved and diagnosed illnesses]".

The better way to pit Scott versus Kierkegaard is to investigate whether or not Scott's definition of mental illness would satisfy him in a backtest. Would Scott, teleported to 1920, be happy with a definition of mental illness that was political? Or would he try to Caplanize or Kierkegaardize it by trying to come up with an "objective" definition?

That's my steelman anyway.

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Reproductive fitness isn’t just about the interests of the individual, it’s also about the interests of the group. The selfish gene has a hand in both pies at once. A small but steady minority population of homosexuals might serve a prosocial tribal purpose that enhances group viability or kin success, in some subtle way that we’re biased not to notice because we’re so focused on individualism.

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Arent most gay men raped in their adolescence?

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This fix (gender transition) is no fix at all if you think in term of homosexuality being an illness cause it prevent reproduction. Sperm/ovule donation could be such a fix, in theory but probably not in practice.

Anyway, things that are reproductive maladaptation are not necessarily bad, neither for individuals or for society (provided it does not force the whole population fertility below replacement level for too long). With 9 billion homo sapiens on earth, I would consider reproduction maladaptation as positive by default, only need to check for which traits it select (who are those who reproduce the most) and if it cause individual pain (physical or mental).

Social maladaptation is more complex: it may be a problem of the individual, or a problem with the current social acceptable window of behaviors.

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I would guess that a large percentage of gays would (at least in the early teen years) swallow a magic pills that would turn them hetero, if there was such a pill. I don't think this would work in reverse.

We know that sexual orientation is pretty much unchangeable, so the best alternative to the pill is to actually embrace your identity. Which is fine.

But it just kind of feels to me that homosexuality is not considered to be illness only because there can be no cure. Am I looking at this wrongly?

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“Chinese people seem to have some anti-alcoholism genetic adaptations, […] but still others - like the Inuit - clearly have none.”

Scott, what the heck. You link to the Wikipedia article on “Alcohol Flush Reaction” (aka “Asian Flush”) in that first sentence, which says right in the introduction:

“The condition may be also highly prevalent in some Southeast Asian and Inuit populations.”

I wasn’t able to track down the source of that claim in the citations, and that “may be prevalent” in that sentence makes it very ambiguous, but it doesn’t sound to me like this is quite that clear!

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